Contraceptive Utilization Research Articles

Reproductive Health Needs in Patients with Bleeding Disorders

Introduction: The U.S. Supreme Court's ruling to overturn Roe v. Wade may impact access to high quality reproductive healthcare for women across the United States. This includes women with bleeding disorders as well, potentially increasing the need for illegal abortions while increasing the risk of bleeding with higher rates of complications. This study aims to assess and establish the prevalence of surgical and medical abortions, including bleeding complications and utilization of emergency contraception in persons with bleeding disorders Methods: This is a retrospective cohort study conducted with deidentified data obtained from TriNetX Research Network, aggregating health records from 66 US Healthcare Organizations (>81 million patients) from 2007-2022.ICD10 codes were used to query the data. Cases were defined as females, between ages 10-45 years with Hemophilia A, Hemophilia B, Hemophilia A and B carriers, von Willebrand Disease (vWD); not in menopause. Controls were defined as females, between ages 10-45 years, who do not have Hemophilia A, Hemophilia B, vWD, not Hemophilia A and B carriers and not in menopause. The prevalence rates of any abortion, procedures for abortion, bleeding complications, medical termination with misoprostol/mifepristone, ectopic pregnancy, molar pregnancy, use of emergency contraception, use of oral contraceptive pills (OCP), intra-uterine devices (IUD), subcutaneous implants were calculated, and compared to controls. Results: We identified 19,733 cases and 23,923,130 controls. Among cases, 1941 (9.8%) patients had a documented abortion (induced/spontaneous/missed) and 76 cases (0.4%) had a medication induced abortion with misoprostol/mifepristone. Among cases, 489 patients (2.5%) had abortion listed as a procedure code. Ectopic pregnancy occurred in 354 cases (1.8%) and molar pregnancy occurred in 88 cases (0.4%). Emergency contraception with levonorgestrel 1.5mg (Plan B/ 0ther brands) was used by 73 cases (0.4%). 44 cases (0.2%) had delayed or excessive hemorrhage following induced abortion/incomplete spontaneous abortion/ectopic/molar Prevalence of use of hormonal contraception in patients with bleeding disorders include - combined OCP (9.6%), IUD (7.6%) and subcutaneous implant (0.4%). Prevalence rate of all of the above was significantly higher in patients with bleeding disorders when compared to controls (Table 1) Conclusions: Our study suggests persons with bleeding disorders have a significant need for high quality reproductive health care with emergency contraception and medical and surgical abortions being utilized at a higher rate than the general population. Though limited data, there was a trend towards increased rates of delayed or excessive hemorrhage following induced or spontaneous abortion or ectopic pregnancy in patients with bleeding disorders. Further analyses to look at all outcomes in bleeding disorder patients is ongoing from the database. A prospective registry to establish bleeding outcomes resulting from reproductive health-related procedures is urgently needed. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Risky Sexual Behaviour and Contraceptive Use Among Young Adults in Public Colleges of Education in Ogun State, Nigeria

Despite the benefits of contraception, young adults still engage in Risky Sexual Behaviour (RSB), which predisposes them to various sexual health-related challenges. Risky Sexual behaviour increases the prevalence of sexually transmitted infections, abortion, and unplanned pregnancy among others. This study examined risky sexual behaviour and contraceptive use among young adults in public Colleges of Education in Ogun State. One hundred and ninety-nine young adults from two colleges of education in Ogun State were included in this study utilizing the multi-stage sampling technique. This study used a control experimental design with a pretest and posttest. Two research questions were raised and answered. Three validated and reliable instruments were also used for data collection. These include Knowledge of Contraceptive Methods (KCMQ) (. Utilization of contraceptive methods (UCMQ) ( = 0.87) and Risky Sexual Behaviour (RSBQ) ( = 0.82). technique. Data collected were analyzed, using descriptive statistics of Mean and Standard Deviation to answer the research questions. The analyses of findings revealed a significant difference between the pre-knowledge of contraceptive methods and the post-knowledge of contraceptive methods. The participants' use of contraceptives before and after the treatment showed significant differences as well. Reproductive health education for young adults should be strengthened, and youth-friendly units should be established at the Nigeria Colleges of Education Health Center. For the inclusion of school-based contraceptive use education as curriculum innovation techniques, health educators should cooperate with the Ministry of Education. This is required to make them aware of the necessary abilities, information, and utilization of suitable contraceptive methods. Keywords: Contraceptive, Knowledge, Utilization, Young Adult DOI: 10.7176/JHMN/104-02 Publication date: November 30 th 2022

Gender relations and the utilization of contraceptives and antenatal care services in Kenya, Namibia and Nigeria.

The impacts of gender relations (GR) on reproductive health in sub-Saharan Africa (SSA) have received little attention. Virtually non-existent are studies that take cognizance of the socio-cultural diversity of SSA countries in assessing the impacts. Using Demographic and Health Survey data from Namibia, Kenya and Nigeria, this study investigated whether feminine gender relations (FGR) predict higher uptake of contraceptives and antenatal care services (ANC) in SSA. Results from univariate, bivariate and multivariate analyses showed that Namibia had the highest prevalence of FGR (20.0%) and contraceptive use (57.8%) while Nigeria had the lowest FGR (5.7%) but highest ANC utilization (42.1%). At the unadjusted levels, FGR predicted higher contraceptive use in Namibia and Nigeria but became insignificant when sociodemographic confounders were controlled for. Masculine gender relations (MGR) however predicted increased contraceptive and ANC utilization in the three countries at the unadjusted levels and contraceptive use in Kenya and Nigeria when adjusted. That MGR predicted higher odds of using contraceptives in a largely gender egalitarian Kenya and patriarchal Nigeria while FGR was insignificant even in the largely feministic Namibia, suggests that promoting equality in GR, rather than emphasizing female autonomy, possesses greater capacity for improving reproductive health outcomes in SSA.

Uptake of modern and traditional contraceptive methods in Nigeria: Lessons from a nationwide initiative on programming for results (2015-2018).

In general, family planning uptake promotes healthy living among couples and their children, in addition to aiding national development. This study was a secondary analysis of data collected from two nationally representative data - 2015 and 2018 National Nutrition and Health Surveys (NNHS) - aimed at measuring the uptake of modern and traditional contraceptive methods among women of reproductive age in Nigeria. The data were analysed by presenting differentials in prevalence of modern and traditional contraceptives between 2015 and 2018. The results showed that during the periods modern contraceptive uptake in Nigeria ranged between 10% and 17%. By contrast, the prevalence of the traditional methods was 8.3% and 10.0%. Within four years (2015-2018), the average national modern contraceptive uptake among women increased by 7%, while the traditional contraceptive uptake reduced by 2%. The uptake of both modern and traditional contraceptive methods varied by ages group of women, geo-political regions, and State of residence. We conclude that the uptake of modern contraception is below expectation in all regions in Nigeria. The uptake is worse in the northern regions as compared to the southern regions. Government needs to invest more to increase access to and utilization of modern contraceptive methods.

Magnitude and its associated factors of teenage pregnancy among antenatal care attendees in Bahir Dar city administration health institutions, northwest, Ethiopia

BackgroundWorldwide teenage pregnancies develop many devastating complications, both the mother and the neonate like developing anemia, nutritional deficiency, pregnancy induced hypertension, preterm baby, inadequate weight gains and obstructed labor, fistula and sepsis. Reproductive health concerns of adolescents the main emphasis area which increasing international attention in recent years. Therefore, we intended to assess the magnitude and its associated factors of teenage pregnancy in Bahir Dar city administration health institutions, northwest, Ethiopia, 2017.MethodsA health institution based a cross-sectional study was conducted among pregnant mothers from February 20-March 27, 2017 in Bahir Dar city administration. Five hundred forty-nine participants were selected by face to face interview and medical card review by using systematic random sampling technique every four intervals for each health institution. Bivariate and multivariate data analysis was performed using Statistical Package for the Social Sciences (SPSS) Windows version 21 and level of significance of association was determined at P- value < 0.05.ResultThe study identified 12.2%with (95%CI (9.5, 14.9)) of pregnant women were teenagers. Multivariable logistic regression analysis showed that: [(AOR (95% CI)) rural residency 3.21(1.234, 9.345), age at first marriage < 18 years 9(7.823, 17.571) and not using contraception prior to this pregnancy 5.22(3.243, 11.675)] were significantly associated with teenage pregnancy.ConclusionThe magnitude of teenage pregnancy was comparable to the 2016 Ethiopian demographic health survey finding. Rural residency, age at first marriage and not using of contraception prior to the current pregnant were significantly associated with teenage pregnancy. As per the findings, awareness creation to the rural population, advocating utilization of contraception, avoid early marriage and put the mindset the effect of teenage pregnancy for those are needed.

Health decision-making capacity and modern contraceptive utilization among sexually active women: Evidence from the 2014–2015 Chad Demographic and Health Survey

BackgroundGlobally, there has been an increase in the percentage of women in their reproductive ages who need modern contraceptives for family planning. However, in Chad, use of modern contraceptive is still low (with prevalence of 7.7%) and this may be attributable to the annual increase in growth rate by 3.5%. Social, cultural, and religious norms have been identified to influence the decision-making abilities of women in sub-Saharan Africa concerning the use of modern contraceptives. The main aim of the study is to assess the association between the health decision-making capacities of women in Chad and the use of modern contraceptives.MethodsThe 2014–2015 Chad Demographic and Health Survey data involving women aged 15–49 were used for this study. A total of 4,113 women who were in sexual union with information on decision making, contraceptive use and other sociodemographic factors like age, education level, employment status, place of residence, wealth index, marital status, age at first sex, and parity were included in the study. Descriptive analysis and logistic regression were performed using STATA version 13.ResultsThe prevalence of modern contraceptive use was 5.7%. Women who take health decisions with someone are more likely to use modern contraceptives than those who do not (aOR = 2.71; 95% CI = 1.41, 5.21). Education, ability to refuse sex and employment status were found to be associated with the use of modern contraceptives. Whereas those who reside in rural settings are less likely to use modern contraceptives, those who have at least primary education are more likely to use modern contraceptives. Neither age, marital status, nor first age at sex was found to be associated with the use of modern contraceptives.ConclusionEducation of Chad women in reproductive age on the importance of the use of contraceptives will go a long way to foster the use of these. This is because the study has shown that when women make decisions with others, they are more likely to opt for the use of modern contraceptives and so a well-informed society will most likely have increased prevalence of modern contraceptive use.Plain language summaryThe use of modern contraceptives remains a pragmatic and cost-effective public health intervention for reducing maternal mortality, averting unintended pregnancy and controlling of rapid population growth, especially in developing countries. Although there has been an increase in the utilization of modern contraceptives globally, it is still low in Chad with a prevalence rate of 7.7%. This study assessed the association between the health decision-making capacities of women in Chad and the use of modern contraceptives. We used data from the 2014 − 2015 Chad Demographic and Health Survey. Our study involved 4,113 women who were in sexual union and with complete data on all variables of interest. We found the prevalence of modern contraceptive utilization at 5.7%. Level of education of women, women who can refuse sex and employment status were found to be significantly associated with the use of modern contraceptives. Whereas those who reside in rural settings are less likely to use modern contraceptives, those who have at least primary education are more likely to use modern contraceptives. Our study contributes to the efforts being made to increase the utilisation of modern contraceptives. There is a need to step up contraceptive education and improve adherence among Chad women in their reproductive years. In the development of interventions aiming at promoting contraceptive use, significant others such as partners and persons who make health decisions with or on behalf of women must be targeted as well.

Long acting reversible contraceptive utilization and its associated factors among modern contraceptive users in high fertility sub-Saharan Africa countries: a multi-level analysis of recent demographic and health surveys

BackgroundLong-acting reversible contraceptives (LARC) have been hailed as one of the safest and most effective methods of contraception. However, the use of LARC is low in the world, including Sub Saharan Africa; therefore, the aim of this study was to assess LARC utilization and associated factors among modern contraceptive users in high fertility SSA countries.MethodsData for this study was obtained from the most recent Demographic and Health Surveys. A total weighted sample of 14,828 reproductive age women was included. A multilevel mixed-effect binary logistic regression model was fitted to identify the significant associated factors of long acting reversible contraception utilization. Finally, the Adjusted Odds Ratio (AOR) with 95% confidence interval was used to declare as statistical significance.ResultsOverall prevalence of LARC utilization was observed to be 20.1% (19.45, 20.74). The factors significantly associated with the utilization were women’s age ≥ 35 years (AOR = 1.42; 95% CI: 1.19,1.68), having media exposure (AOR = 1.13; 95% CI: 1.05, 1.28), number of alive children: 1–2 (AOR = 2.35; 95% CI: 1.38, 4.01), 3–4 (AOR = 2.98; 95% CI: 1.74, 5.10), ge 5 (AOR = 2.82; 95% CI:1.63, 4.86), have no history of abortion (AOR = 1.33; 95% CI: 1.17,1.51) and who have no big problem with distance to the health facility (AOR = 1.29; 95% CI: 1.16, 1.43).ConclusionThe use of long acting reversible contraception in this study was relatively low. To improve the utilization of long acting reversible contraceptives governments, policymakers, and stakeholders should implement health promotion strategies through media and improve accessibilities of health facilities.

Rural–urban disparities in birth interval among women of reproductive age in Nigeria

Nigeria like most developing nations still faced with a higher rate of short birth interval (SBI), and its associated consequences, such as adverse maternal and child health outcomes. This study aimed to determine the distribution and factors associated with SBI in rural and urban Nigeria. The data for this study were extracted from the 2018 Nigeria Demographic and Health Survey (2018 NDHS). Statistical analyses were descriptive analysis and binary logistic model. The proportions of SBI in rural and urban Nigeria were 20.7% and 20.3% respectively. Women’s age, geopolitical region, education level, and the number of children ever born were significantly associated with SBI in rural and urban Nigeria. Maternal Wealth index and antenatal care visits were only significant in rural while working status was only significant in urban Nigeria after controlling for other factors. Higher odds of SBI for middle class women than poor women (AOR = 1.19, 95% CI = 1.06–1.35), and increase in ANC visits reduces the odds of having SBI: 4–7 visits (AOR = 0.87, 95% CI = 0.77–0.98) and > 7visits (AOR = 0.83, 95% CI = 0.69–0.99). There were slight disparities in the prevalence of short birth intervals in rural and urban areas. Wealth index and ANC visits were only significant in rural Nigeria. Public health awareness campaigns should be strengthened to drive the importance of birth spacing techniques such as the utilization of modern contraceptives and breastfeeding in all the geo-political regions and across all age strata. Women particularly those residing in the rural areas should be encouraged to advance their education to at least a secondary level and enlightened on the importance of ANC.

Long-acting reversible contraceptives utilization and its determinants among married Yemeni women of childbearing age who no longer want children.

Some contraceptive methods, such as long-acting and permanent methods, are more effective than others in preventing conception and are key predictors of fertility in a community. This study aimed to determine which factors were linked to married women of childbearing age who no longer desired children using long-acting reversible contraceptives (LARCs) in Yemen. We used a population-based secondary dataset from Yemen’s National Health and Demographic Survey (YNHDS), conducted in 2013. The study analyzed a weighted sample of 5149 currently married women aged 15 to 49 years who had no plans to have children. Logistic regression analyses were used to investigate the parameters linked to the present use of LARCs. The final model’s specifications were evaluated using a goodness-of-fit test. An alpha threshold of 5% was used to determine statistical significance. Of the total sample, 45.3% (95% CI: 43.3–47.4) were using contraception. LARCs were used by 21.8% (95% CI: 19.6–24.1) of current contraceptive users, with the majority (63.8%) opting for short-acting reversible contraceptives (SARCs). In the adjusted analysis, maternal education, husbands’ fertility intention, place of residence, governorate, and wealth groups were all linked to the usage of LARCs. According to the findings, women whose spouses sought more children, for example, were more likely to use LARCs than those who shared their partners’ fertility intentions (AOR = 1.44; 95% CI: 1.07–1.94; P = .015). In this study, married women of reproductive age who had no intention of having children infrequently used contraception and long-acting methods. Improving women’s education and socioeconomic status could contribute to increasing their use of LARCs.

Contraception utilization in the developing world and the role of women autonomy

Modern contraceptive methods are considered an effective way to achieve family planning. It is also an efficient way to improve the overall health of both mothers and their children. This is achieved by helping women plan their pregnancies and reduce the number of unwanted pregnancies and through having a spacing gap between born children. It is also an essential mean to reduce the country’s fertility rate and thus help in its economic growth. The scientific evidence supports that the risks from using modern contraception methods are much less compared to the risks of pregnancy and delivery especially if they are high risk and unplanned. However, the utilization of these modern family planning methods is unsatisfactorily slow particularly among women in countries of the developing world. Although provision of family planning services and allowing an easy access should be encouraged, more attention should be directed towards the role of women’s autonomy in their likelihood to utilize these services.

Evaluating the MyPath web-based reproductive decision support tool in VA primary care: Protocol for a pragmatic cluster randomized trial

BackgroundCounseling to identify and support individuals' desires for family formation is a key component of preventive health care that is often absent in primary care visits. This study evaluates a novel, web-based, person-centered intervention to increase the frequency and quality of communication about reproductive goals and healthcare needs in Veterans Health Administration (VA) primary care. MethodsWe describe a hybrid type 1 effectiveness-implementation cluster randomized controlled trial in seven VA healthcare systems testing a web-based reproductive health decision support tool (MyPath). VA primary care providers are enrolled and randomized to intervention or usual care arms. Veterans scheduled to see intervention-arm providers receive a text message inviting them to use MyPath ahead of their appointment; Veterans scheduled to see control-arm providers receive usual care. Target enrollment is 36 providers and 456 Veterans. Outcomes are assessed by Veteran self-report after the visit and at 3- and 6-months follow-up. The primary outcome is occurrence of reproductive health discussions involving shared decision making; secondary outcomes include measures of communication, knowledge, decision conflict, contraceptive utilization, and receipt of services related to prepregnancy health. Data on implementation barriers, facilitators and cost are collected. ResultsThe trial is ongoing with no results to report. We have enrolled 36 primary care providers across 7 VA healthcare systems and recruitment of Veterans is ongoing. ConclusionsResults will inform efforts to increase the quality and person-centeredness of reproductive healthcare delivery in primary care and to operationalize and scale up use of digital decision support tools in clinical settings.Trial Registration:http://ClinicalTrials.gov Identifier: NCT04584294Trial Status: Recruiting.

Retraction: Prevalence and determinants of modern contraceptive utilization among women in the reproductive age group in Edaga-hamus Town, Eastern zone, Tigray region, Ethiopia, June 2017.

Retraction: Prevalence and determinants of modern contraceptive utilization among women in the reproductive age group in Edaga-hamus Town, Eastern zone, Tigray region, Ethiopia, June 2017.

Association between exposure to family planning messages on different mass media channels and the utilization of modern contraceptives among young women in Sierra Leone: insights from the 2019 Sierra Leone Demographic Health Survey

BackgroundAccess to sexual and reproductive health information enables young women to make appropriate decisions. We examined the association between exposure to family panning messages on different mass media and the use of modern contraceptives among young women in Sierra Leone.MethodsThis was a secondary analysis of the 2019 Sierra Leone Demographic and Health Survey data of young women aged 15–24 years. Multistage stratified sampling was used to select study participants in the survey. We used multivariable logistic regression to determine the association between exposure to family panning messages on different types mass media channels and utilization of modern contraceptives. All our analyses were done using SPSS version 25.ResultsOut of 6055 young women, 1506 (24.9%, 95% CI 24.0–26.2) were utilizing a modern contraceptive method with the prevalence higher among urban women (26.5%) compared to rural women (23.1%). Less than half (45.6%) had been exposed to family planning messages on mass media (radio 28.6%, television 10.6%, mobile phones 4.2% and newspapers or magazines 2.2%). Young women who had exposure to family planning messages on radio (AOR: 1.26, 95% CI 1.06–1.50) and mobile phones (AOR: 1.84, 95% CI 1.25–2.69) had higher odds of using modern contraceptives compared to their counterparts without the same exposure. Furthermore, having access to internet (AOR: 1.45, 95% CI 1.19–1.78), working (AOR: 1.49, 95% CI 1.27–1.74), being older (20–24 years) (AOR: 1.75, 95% CI 1.46–2.10), being married (AOR: 0.33, 95% CI 0.26–0.42), having visited a health facility within the last 12 months (AOR: 1.34, 95% CI 1.10–1.63), having secondary (AOR: 2.83, 95% CI 2.20–3.64) and tertiary levels of education (AOR: 3.35, 95% CI 1.83–6.13), higher parity (having above one child) AOR: 1.57, 95% CI 1.19–2.08) and residing in the southern (AOR: 2.11, 95% CI 1.61–2.79), northwestern (AOR: 1.87, 95% CI 1.39–2.52), northern (AOR: 2.11, 95% CI 1.59–2.82) and eastern (AOR: 1.68, 95% CI 1.27–2.22) regions of residence were associated with higher odds of modern contraceptives utilization.ConclusionIn Sierra Leon, only one in four young women were using modern contraception and more than half of them had not had any exposure to family planning messages on the different types of mass media channels. Behavior change communicators can prioritize family planning messages using radio, mobile phones and the internet. In order to publicize and encourage young women to adopt healthy behaviours and increase uptake of modern contraceptive.

Intention to shift from short-acting to long-acting methods of contraceptives and its associated factors in Gondar city, northwest Ethiopia: Using the theory of planned behavior.

BackgroundDespite its effectiveness, the intention, and utilization of long-acting contraceptive methods are very low in many developing countries, and the use of long-acting contraceptive methods has not kept pace with that of short-acting methods such as oral contraceptives and injectables. Therefore, this study aimed to assess the intention of using long-acting contraceptive methods and associated factors among women currently using short-acting contraceptive methods.MethodsInstitution-based cross-sectional study was conducted from March 19 to April 19, 2017. The study included 515 short-acting contraceptive users found in Gondar city who were selected from the study population using a systematic random sampling technique. A structured pre-tested questionnaire based on the theory of planned behavior was used to collect data. Both descriptive and analytical statistical procedures were used. Simple and multiple linear regression analyses were carried out. SPSS version 20 was used for the analysis of the data. Multiple linear regression was carried out to see the association between intention and sociodemographic variables, past contraception experience, attitude, subjective norm, and perceived behavioral control, and with 95% CI and a p-value of <0.05 was used to detect statistical significance.ResultsThe magnitude of intention to use long-acting contraceptive methods was 39.8%. Intention to use long-acting contraceptive methods was higher for women whose husbands were farmers when compared to women whose husbands were government employees (β =0.49, 95% CI: 0.41, 0.72). Number of children wanted (β = −0.19, 95% CI: −0.28, −0.1), attitude (β = 0.34, CI: 0.23, 0.46), subjective norm (β = 19, 95% CI: 0.12, 0.27) and perceived behavioral control (β = 0.18, 95% CI: 0.06, 0.3) were factors significantly associated with intention to use long-acting contraceptive methods.ConclusionsIntention to use long-acting contraceptive methods was low. Interventions that focus on women's attitudes toward long-acting contraceptive methods and support groups, peer education, social mobilization, and persuasive communication could promote the intention to use long-acting contraceptive methods.

Utilisation of modern contraceptives by sexually active adolescent girls in Rwanda: a nationwide cross-sectional study

BackgroundModern contraceptive use has been shown to influence population growth, protect women’s health and rights, as well as prevent sexually transmitted infections (STIs) for barrier contraceptive methods such as condoms. The present study aimed at assessing the level of utilization and factors associated with modern contraceptive use among sexually active adolescent girls in Rwanda.MethodsWe used secondary data from the Rwanda Demographic and Health Survey (RDHS) 2020 data of 539 sexually active adolescent girls (aged 15 to 19 years). Multistage stratified sampling was used to select study participants. We conducted multivariable logistic regression to assess the association between various socio-demographics and modern contraceptive use using SPSS version 25. Modern contraception included the use of products or medical procedures that interfere with reproduction from acts of sexual intercourse.ResultsOf the 539 sexually active girls, only 94 (17.4%, 95% CI: 13.8–20.1) were using modern contraceptives. Implants (69.1%) and male condoms (12.8%) were the most used options. Modern contraceptive use was positively associated with older age (AOR = 10.28, 95% CI: 1.34–78.70), higher educational level (AOR = 6.98, 95% CI: 1.08–45.07), history of having a sexually transmitted infection (AOR = 8.27, 95% CI: 2.54–26.99), working status (AOR = 1.72, 95% CI: 1.03–2.88) and being from a female-headed household (AOR = 1.96, 95% CI: 1.12–3.43). However, not being in a union (AOR = 0.18, 95% CI: 0.10–0.35) and region (AOR = 0.28, 95% CI: 0.10–0.80) had negative associations.ConclusionsTo promote utilisation of modern contraceptives, family planning campaigns need to place more emphasis on the younger, unmarried adolescents, as well as those with lower educational levels. Consideration of household and regional dynamics is also highlighted.

Prevalence of long-acting reversible contraceptive methods utilization and associated factors among counseled mothers in immediate postpartum period at Jimma University medical center, Ethiopia

BackgroundPostpartum family planning is defined as the prevention of unintended pregnancy and closely spaced pregnancies through the first twelve months following childbirth. The immediate postpartum period is particularly favorable time to provide long-acting reversible contraception methods; and postpartum provision is safe and effective. Despite the advantages of long acting reversible contraception methods, they may be infrequently used in Ethiopia.ObjectiveThis study assessed the prevalence and associated factors of long-acting reversible contraceptive methods utilization among counseled mothers in immediate postpartum period.MethodsA cross-sectional study was conducted on 393 women who gave birth at Jimma University Medical Centre from 12 November 2016 to 21 January 2017, Ethiopia. Data were collected by face-to-face interview using pre-tested structured questionnaire and by record reviewing using data compiling form; and analyzed using SPSS version 20. Logistic regression was used to identify associated factors for long acting contraceptive methods use. P-value less than 0.05 at 95% confidence level was taken as significance level.ResultsPrevalence of reversible long acting contraceptive methods utilization among immediate postpartum mothers was 53.2% (209/393) and more than three-fourths (78.0%) of participants used implanon. The most common reported reason for not using reversible long acting contraceptive methods was preference of other contraceptive methods like short acting contraceptives (25.5%). Having more than four alive kids (AOR 2.6, 95% CI: 1.15,5.95), high monthly income (≥1000 ETB) (AOR 2.4, 95% CI: 1.08,7.20), planning to delay next pregnancy by more than 2 years (AOR 4.0, 95% CI: 1.60,9.28), mothers with no fertility desire (AOR 2.0, 95% CI: 1.12,3.15), prior use of reversible long acting contraceptive methods (AOR 3.0, 95% CI: 1.30,7.20) and receiving counseling during antenatal care follow-up and before delivery (AOR 2.0, 95% CI: 1.01, 4.73) were associated with immediate postpartum reversible long acting contraceptive methods use.Conclusion and recommendationsAlthough the prevalence of reversible long acting contraceptive methods utilization in immediate postpartum was high, counseling mothers during ANC follow-up and before delivery can further increase its utilization. Therefore, the need for providing counseling during ANC follow up and before delivery to increase utilization of immediate postpartum reversible long acting contraceptive methods use is emphasized.

Prevalence, trend and determinants of adolescent childbearing in Burundi: a multilevel analysis of the 1987 to 2016–17 Burundi Demographic and Health Surveys data

BackgroundVery little is known about factors influencing adolescent childbearing despite an upward trend in adolescent childbearing prevalence in Burundi, and its perceived implications on the rapid population growth and ill-health of young mothers and their babies. To adress this gap, this study aimed to examine the prevalence, trends and determinants of adolescent childbearing in Burundi.MethodsSecondary analyses of the 1987, 2010 and 2016–17 Burundi Demographic and Health Surveys (BDHS) data were conducted using STATA. Weighted samples of 731 (1987 BDHS), 2359 (2010 BDHS) and 3859 (2016-17BDHS) adolescent girls aged 15–19 years old were used for descriptive and trend analyses. Both bivariable and multivariable two-level logistic regression analyses were performed to identify the main factors associated with adolescent childbearing using only the 2016–17 BDHS data.ResultsThe prevalence of adolescent childbearing increased from 5.9% in 1987 to 8.3% in 2016/17. Factors such as adolescent girls aged 18–19 years old (aOR =5.85, 95% CI: 3.54–9.65, p < 0.001), adolescent illiteracy (aOR = 4.18, 95% CI: 1.88–9.30, p < 0.001), living in poor communities (aOR = 2.19, 95% CI: 1.03–4.64, p = 0.042), early marriage (aOR = 9.28, 95% CI: 3.11–27.65, p < 0.001), lack of knowledge of any contraceptive methods (aOR = 5.33, 95% CI: 1.48–19.16, p = 0.010), and non-use of modern contraceptive methods (aOR = 24.48, 95% CI: 9.80–61.14), p < 0.001) were associated with higher odds of adolescent childbearing. While factors such as living in the richest household index (aOR = 0.52, 95% IC: 0.45–0.87, p = 0.00), living in West region (aOR = 0.26, 95%CI: 0.08–0.86, p = 0.027) or in South region (aOR = 0.31, 95% CI: 0.10–0.96, p = 0.041) were associated with lower odds of adolescent childbearing.ConclusionOur study found an upward trend in adolescent childbearing prevalence and there were significant variations in the odds of adolescent childbearing by some individual and community-level factors. School-and community-based intervention programs aimed at promoting girls’ education, improving socioeconomic status, knowledge and utilization of contraceptives and prevention of early marriage among adolescent girls is crucial to reduce adolescent childbearing in Burundi.

Exposure to mass media family planning messages and associated factors among youth men in Ethiopia

BackgroundFamily planning programs usually focus information and messaging on women and girls. However, they may not be the primary decision-makers about their own contraceptive choice and utilization. Hence, this study aimed to assess youth men's exposure to family planning messages and associated factors in Ethiopia. MethodThe study used data for analysis from the 2016 Ethiopian demographic and health survey data set. A total of 7,639 youth men have been included in this analysis. Statistical package for social science version 20 has been used for data analysis. We have used multivariable logistic regression analysis to identify the association of independent variables with the outcome variable. Adjusted odds ratio with 95 % confidence interval was used to declare significant statistical association. ResultThe mean age of participants was 19.02 years with a standard deviation of ±2.83. The proportion of youths who have exposure to family planning messages was 34.7 % (33.7%, 35.7%). Owning mobile phone (AOR = 1.49, 95% CI: 1.12–1.97, using internet (AOR = 1.90, 95% CI: 1.33–2.73), knowing where to obtain family planning (AOR = 4.28, 95% CI:3.08–5.95), educational status of primary (AOR = 1.98, 95% CI:1.36–2.86) secondary (AOR = 3.01,95% CI:1.94–4.67) and higher (AOR = 6.01,95% CI:3.24–11.16) were the factors associated with the outcome variable. Also, the odds of exposure of youths who agree contraception is women's business was lower (AOR = 0.55, 95% CI: 0.35–0.85). ConclusionOnly one-third of youths have exposure to family planning messages. Educational status, owning a mobile phone, knowing where to obtain family planning methods, use of the internet, and considering family planning as a women's business were the factors that have an association with the outcome variable. So it is important to improve the education level of youths, to inform youths about different outlets through which family planning messages will be transmitted, and avert youth's misconception towards contraception.

Determinants of adolescents’ contraceptive uptake in Ethiopia: a systematic review of literature

IntroductionVarious studies have identified different factors that affect adolescent contraceptive uptake in different parts of Ethiopia. However, varying results were reported across primary studies and those results need to be systematically collated to inform policies. Therefore, this systematic review aimed to synthesize the findings of those primary studies to obtain more robust and representative evidence about adolescent contraceptive uptake in Ethiopia.MethodsFive databases (MEDLINE via PubMed, Google Scholar, Scopus, Science Direct and CINAHL) were searched for papers published from January 2000 up to June 2021 in English. We limited our search to start on January 2000 as the health of adolescents have been given more attention after this period and to avoid time-lapsed biases. Seven studies were included in this systematic review. We used the Newcastle-Ottawa Scale and the Mixed Methods Appraisal Tool for quality assessment of the selected studies.ResultsDeterminants of adolescent contraceptive utilization were focused on four levels: individual, socio-cultural, healthcare service and knowledge related factors. Individual-related factors that influence adolescents’ contraceptive uptake include; being in the age group of 10–15 years, not currently enrolled in school and being from low-income families, while socio-cultural factors include: lack of discussion with family members, arranged marriage, pressure from a partner, harmful traditional practices, discussion with peer groups and sexual partners. Healthcare service-related factors include; lack of information about contraceptives during health facility visits, lack of privacy during service provision and inconvenient service hours at health facilities, and not visiting health facilities, whereas, knowledge related factors include; having knowledge of contraceptive methods and being heard about contraceptives from media. Also, the proportion of adolescent contraceptive uptake ranged from 12 to 79%.ConclusionsIn this systematic, individual, socio-cultural, health-care-related, and knowledge-related characteristics have all been identified as influencing adolescents’ contraceptive uptake in Ethiopia. Hence, integrated interventions aimed at overcoming barriers to adolescent contraceptive uptake would be beneficial to improving adolescent contraceptive utilization in Ethiopia.

Survival patterns of neonates born to adolescent mothers and the effect of pregnancy intentions and marital status on newborn survival in Kenya, Uganda, and Tanzania, 2014–2016

ABSTRACT Background Adolescent pregnancy and associated neonatal mortality are major global health challenges. In low-income settings where 90% of the 21 million global adolescent pregnancies occur, half are unintended and a fifth experience unsafe abortion. In Kenya, Uganda, and Tanzania, the survival patterns of neonates born to adolescents are unclear. Objectives To assess survival patterns among neonates born to adolescents and the effect of pregnancy intentions and marital status on survival in Kenya, Uganda, and Tanzania. Methods Cross-sectional data from demographic and health surveys in Kenya, Uganda, and Tanzania 2014–2016 were used. Kaplan-Meier estimates investigated patterns of neonatal survival among adolescent mothers, aged 15–19 years, compared to mothers aged 20–29 years. Cox proportional hazards regression determined the hazard ratios (HR) for the predictors of neonatal survival. Results About 50% of adolescent pregnancies were unintended and neonatal death rate was twice as high than older mothers (26.6 versus 12.0 deaths/1000 live births). The median survival time was two days for adolescent-born babies and four days among older mothers. The hazard of death for all adolescent-born neonates was about twofold that of 20–29 years-old-mothers, HR 1.80 (95% CI 1.22–2.63). Among married adolescents with unintended newborn pregnancies, the HR was 4-folds higher than corresponding older mothers, HR 4.08 (95% CI 1.62–10.31). Among married, primiparous adolescents with unintended pregnancies, the HR was six times higher than corresponding older mothers. Conclusion Our findings reveal how unintended pregnancies and deaths of neonates born to adolescents contribute substantially to preventable neonatal deaths in East Africa. Full implementation of existing adolescent health policies and utilization of contraceptives should be ensured. Partnership with youths and novel efforts that address sociocultural norms to reduce adolescent pregnancies or marriage should be supported. Regulations requiring adolescents’ obstetric care conducted by only skilled personnel should be introduced and implemented.