Contraceptive Utilization Research Articles

The Relationship between Perception and Self Efficacy of Long-Acting Reversible Contraceptive (LARC) Utilization in Women's Reproductive Ages

Introduction: LARC effectively prevents pregnancy; however, its use is still low. Self-efficacy and perception have an impact on the decision to use LARC. This study aimed to determine the relationship between perception and self-efficacy of LARC utilization in women of reproductive age. Methods: Cross-sectional study design. The population of women of reproductive age couples in the Bungah Health Center area. The research sample was 88 respondents selected by purposive sampling. The study's independent variable is the perceived benefits and perceived barriers, while the dependent variable was the self-efficacy in choosing LARC. The research instrument used a questionnaire. Statistical analysis using the Spearman's rho test with a <0,05 Results: There was a relationship between perceived benefits and selfefficacy in choosing LARC (p = 0.000) with r = 0.684. There is a relationship between the perceived barrier and self-efficacy in choosing LARC (p = 0.000) with a value of r = -0.407. Conculusion: The higher the perceived benefit, the higher self-efficacy in choosing LARC. However, if the perceived barriers are high, self-efficacy in choosing LARC will decrease. Further research needs to be done regarding other people's support factors for the choice of LARC.

A Systematic Review and Meta-Analysis on Post-Abortion Contraceptive Utilization and Associated Factors in Ethiopia.

BackgroundPost-abortion contraceptive utilization is the initiation and use of family planning methods at the time of management of abortion or before fertility returns. A significant discrepancy was reported regarding the prevalence and its associated factors of post-abortion contraceptive utilization in Ethiopia. So, this systematic review and meta-analysis aimed to estimate the pooled prevalence of post-abortion contraceptive utilization and its associated factors in Ethiopia.MethodsPreferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline was used. The databases such as PubMed, Google Scholar, Science Direct, Cochrane library, Scopus, CINAHL, Web of Science, and additional searches by using direct Google search, libraries, and preprint were searched. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used for critical appraisal.ResultsA total of 17 studies with 13,075 individuals were included. Of these, 14 studies with 5,719 individuals were used to estimate the prevalence. The pooled prevalence of post-abortion contraceptive utilization in Ethiopia was 63.64% (95% CI: 57.75–69.53). The subgroup analysis reported the highest prevalence of post-abortion contraceptive utilization in a study conducted in Addis Ababa (77.40%), a study published in 2015–2021 (66.15%), and among studies with a sample size >400 (66.84%). The pooled odds ratio (OR) of post-abortion contraceptive utilization for the mothers who had post-abortion family planning counseling was 4.15 (95% CI = 1.30, 13.2), and history of family planning utilization was 4.28 (95% CI = 2.66, 6.89).ConclusionsThe pooled prevalence of utilization of post-abortion contraceptives in this meta-analysis remains low. Post-abortion family planning counseling and the history of the utilization of modern family planning methods were significantly associated with the practice of post-abortion contraceptives. The Ministry of Health should encourage post-abortion family planning utilization, making more efforts on post-abortion contraceptive counseling. Health facilities should work hard to strengthen the family planning counseling service, especially focusing on those who had no previous family planning utilization.

Determinants of modern contraceptive utilization among married women in sub-Saharan Africa: multilevel analysis using recent demographic and health survey

BackgroundFamily planning is a low-cost, high-impact public health and development strategy to improve child and maternal health. However, there is a lack of evidence on modern contraceptive use and determinants in sub-Saharan Africa. Hence, this study aimed at determining the pooled prevalence and determinants of modern contraceptive utilization among married women of sub-Saharan Africa.MethodsThirty-six sub-Saharan African countries' demographic and health survey (DHS) data were used for pooled analysis. A total weighted sample of 322,525 married women was included. Cross tabulations and summary statistics were done using STATA version 14 software. The pooled prevalence of modern contraceptive utilization with a 95% Confidence Interval (CI) was reported. Multilevel regression analysis was used to identify the determinants of modern contraceptive use among married women. Four models were fitted to select the best-fitted model using the Likelihood Ratio (LLR) and Deviance test. Finally, the model with the highest LLR and the smallest deviance was selected as the best-fitted model.ResultsThe pooled estimate of modern contraception use in sub–Saharan African countries was 18.36% [95% CI: 18.24, 18.48], with highest in Lesotho (59.79%) and the lowest in Chad (5.04%). The odds of modern contraception utilization were high among women living in East Africa [AOR = 1.47 (1.40, 1.54)], urban areas [AOR = 1.18 (1.14, 1.24)], and women with primary [AOR = 1.49 (1.44, 1.55)] and secondary and above educational level [AOR = 1.66 (1.58, 1.74)]. Moreover, husbands with primary educational level [AOR = 1.38 (1.33, 1.42)], middle [AOR = 1.17, (1.14, 1.21)], rich wealth status [AOR = 1.29 (1.25, 1.34)], media exposure [AOR = 1.25 (1.22, 1.29)], and postnatal care (PNC) utilization [AOR = 1.25 (1.22, 1.29)] had higher odds of modern contraceptive utilization compared with their counter parts. Furthermore, deliver at health facility [AOR = 1.74 (1.69, 1.79)] and birth order 2–4 [AOR = 1.36 (1.31, 1.41)] had higher odds of modern contraceptive utilization. On the other hand, women living in Central [AOR = 0.23 (0.22, 0.24)], Western regions [AOR = 0.46 (0.40, 0.54)], women who decided with husband [AOR = 0.90 (0.87, 0.93)], and decisions by husband alone [AOR = 0.73 (0.71, 0.75)] decreased the odds of modern contraceptive utilization.ConclusionThe uptake of modern contraception in sub-Saharan Africa is low. Modern contraceptive utilization is affected by different factors. More attention needs to be given to rural residents, illiterate women, and communities with low wealth status.

Unmet need for contraception and associated factors among women with cardiovascular disease having follow-up at Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia: a cross-sectional study

BackgroundUnmet need for contraception refers to the proportion of women who want to postpone or stop childbearing but are not using a contraceptive method. Addressing unmet need is especially important for women with medical conditions such as cardiovascular disease (CVD). Preventing unintended pregnancy is crucial to improve pregnancy outcomes and minimize complications of CVD during pregnancy. However, unmet need for contraceptives continues to undermine the potential benefits of contraceptive use. This research aimed to determine the rate of unmet need for contraceptives and associated factors among women with cardiovascular disease having follow-up at Saint Paul’s Hospital Millennium Medical College (SPHMMC), Addis Ababa, Ethiopia.MethodsA facility-based cross-sectional study was conducted from February 1 to May 31/2020. A total of 284 reproductive age women with cardiovascular disease having follow-up at the cardiac clinic of SPHMMC were enrolled consecutively until the desired sample size was reached. Data was collected through an exit interview using a structured and pretested questionnaire. Descriptive, bivariate, and multivariable methods were used to analyze the level of unmet need and its associated factors.ResultsThe overall unmet need for contraception was 36.0% (95% CI: 30.4–41.5). The majority of the respondents lack counseling on contraception use. The most common reasons for non-use of a contraceptive method were fear of drug side effects and drug interaction. Unmet need for contraception was found to be more likely among those who have not been counseled on contraceptive utilization (AOR 6.7, CI 1.8–24.7) and those who lack partner support on contraception use (AOR = 6.2, CI: 1.91–19.8). Unmet need was also found to be more likely among women who have never used contraception before (AOR = 3.2, CI 1.12–8.92).ConclusionUnmet need for contraception was high in this high-risk population group. The cardiac follow-up clinic should implement client-centered counseling by a multidisciplinary team to address the needs of women and prevent consequences of unintended pregnancy. Furthermore, there is a need to initiate interventions that encourage communication between couples and increase male partner involvement through a renewed focus on couples counseling.

Patterns and Determinants of Postpartum Long Acting Reversible Contraception Utilization and Sterilization Utilization in Michigan [A33

INTRODUCTION: We aimed to evaluate patterns and determinants of utilization of postpartum long acting reversible contraception (LARC) and sterilization to guide future quality improvement interventions. METHODS: This institutional review board (IRB)-approved retrospective cohort analysis used administrative claims data from a statewide collaborative quality initiative to identify childbirth episodes from 1/2016-12/2019. Outcomes included LARC utilization and sterilization utilization by 60 days postpartum. Multivariable logistic regression using hospital fixed effects evaluated associations between outcomes and patient characteristics, including neighborhood social vulnerability index (a composite measure of socioeconomic status, household composition, minority status, and housing/transportation). RESULTS: The cohort included 140,380 delivery episodes among 130,174 women (44% publicly insured). By 60 days postpartum, adjusted hospital-specific rates of LARC utilization ranged from 0.5% to 20.4%; sterilization utilization ranged from 0.0% to 13.2%. In multivariable models, women living in neighborhoods with the highest quintile of socioeconomic vulnerability and racial/ethnic vulnerability were more likely to use LARC, as were those with younger age, chronic conditions, public insurance, and birth year later in the study period. Sterilization utilization was less likely among women in neighborhoods with highest socioeconomic and racial/ethnic vulnerability and more likely among women in neighborhoods with highest housing/transportation vulnerability, and those with older age, chronic conditions, public insurance, and later birth years. CONCLUSION: Wide variation in postpartum contraceptive use calls for quality improvement efforts in Michigan. Observed associations with social vulnerability identify the pressing need to understand how potential community factors (e.g., transportation, housing, racism) shape postpartum contraceptive decision-making and utilization.

Family Planning Methods Utilization in Women of Reproductive Age Group: Evidence from Regionally Representative Data from Karachi, Pakistan

Background: To assess the status of knowledge and practices about family planning utilization and its influencing factors among women of reproductive age group in Karachi, Pakistan. The study design was analytical cross-sectional study. The Place and Duration of Study was Combined Military Hospital, Malir Cantt from January to March 2021. Methods: Data was collected from 426 participants visiting outpatient department of a tertiary care hospital, using structured questionnaire. Nonprobability, convenient sampling technique was used to select study participants. Data was analyzed in Statistical Package of Social Sciences, version 23. Results: Family planning knowledge and practicing contraceptive methods utilization among women of reproductive age group was 73.94% and 55.16% respectively. Effectiveness of contraceptive methods was acknowledged by 57.27%. Family planning utilization practices were statistically associated with educational status, marriage duration, number of children, knowledge, availability, suitability and effectiveness of FP methods and husband support. Family planning centers and hospitals were the most common (41%) sources of information and desire to conceive was found to be the leading cause (54.2%) to attain family planning services. Conclusion: Overall the study revealed satisfactory knowledge about family planning with relatively low practices or utilization of contraceptive methods. Researches using qualitative approach are recommended to gain deep insight of women’s internal feeling regarding family planning. Besides, reasons for non-utilization of family planning services need to be explored further.

Sexual behaviour and contraceptive uptake among female adolescents (15-19 years): A cross-sectional study in Sagnarigu Municipality, Ghana

There are reports of low utilization of contraception among adolescent females in developing countries. However, research on sexual behaviour and contraceptive uptake among female adolescents is scare in the Sagnarigu Municipality although the Municipality has a very high youthful population. The objective of the study was to assess the sexual behaviour and contraceptive uptake among adolescent females in Sagnarigu Municipality, Northern Region, Ghana. A cross-sectional study was adopted where 165 adolescent females (15-19 years) were randomly selected. The main tools for data collection were semi-structured questionnaires. For the data analysis, proportions of response variables were generated using statistical product and service solutions, version 24.0. The study revealed that among those who reported having sex in the past 12 months before the survey, over two-thirds of the participants have used at least one method of contraception. The results also showed that injectable was the leading form of contraception among both past and current users of contraceptive methods. Additionally, most of the respondents obtained their contraceptive methods from health facilities. We also established that avoidance of pregnancies was the main reason for using contraception. However, cultural beliefs, religion, fear of side effects were the reasons for non-use of contraceptives. The study further revealed that early initiation of sex among the participants was common. Nevertheless, some of the participants did not use contraceptives during sexual intercourse. The study recommended effective education on the types and uses of contraceptives among adolescents in the municipality.

Knowledge and Utilization of Contraceptive Methods among Secondary School Female Adolescents in Rwamagana District, Rwanda

BackgroundAdolescent pregnancy is a global health concern. Many adolescent deaths occur due to early marriage and pregnancy. This study assessed knowledge and utilization of contraception among secondary school female adolescents at selected secondary schools in Rwamagana district.MethodsCross-sectional design using a self-administered questionnaire was conducted on 117 participants selected by simple random. Analysis used descriptive and inferential statistics at 95% confidence interval, employing SPSS Version 23. Dependent variable was the use of contraceptive and independent variables were socio-demographics and knowledge variables. Bivariate analysis assessed the association between independent and dependent variables. Multivariate analysis assessed the strength of association between dependent and independent variables by computing Odds Ratio. Results are presented in tables and figures. ResultsThe majority (88%) had heard of contraception, though knowledge about contraception was inadequate (61.54%). Level of contraceptive use was low (17%). The significant independent predictors of contraceptive use were the level of education, having heard of contraception, knowledge of source of contraception, and knowledge of specific contraception methods. ConclusionHearing about contraception, was not proportionately associated with knowledge or practicing contraception among the sexually active female adolescents. There is a need to enhance sex education, youth-friendly health services, and research.
 Rwanda J Med Health Sci 2022;5(1):71-84

Contraceptive Utilization and Unmet Need for Contraception Among Women Undergoing Treatment for Tuberculosis in Addis Ababa, Ethiopia: a Cross-Sectional Study.

IntroductionPregnancy can pose a risk to women on tuberculosis (TB) treatment with a threat to the wellbeing of the mother and fetus. Physiological and stress-related effects result when pregnancy occurs during TB illness and while on treatment. Hence, this study aimed to assess contraceptive utilization, unmet need among women on TB treatment, and integration of family planning (FP) services with TB clinics in Addis Ababa, Ethiopia.MethodsA facility-based cross-sectional study was conducted using an interviewer-administered questionnaire. A total of 316 women aged 18–49 who were on TB treatment were enrolled. Contraceptive utilization rate, unmet need, and integration of FP and TB services were determined. Logistic regression models were conducted to identify factors associated with contraceptive utilization.ResultsAmong women on TB treatment 49 (41.9%) were using contraceptives. Out of contraceptive users, 10 (34.5%) used contraceptives to limit and 18 (62.1%) used to space. Only parity had a significant association with contraceptive utilization. Women who had 1–3 children were less likely to use contraception than those who had ≥4 children. Among women who were married or sexually active, 12 (18.9%) had an unmet need. Of the study participants, 144 (45.6%) had been informed about FP services at the TB clinics.ConclusionThe contraceptive utilization rate in the current study (41.9%) is slightly higher than the national prevalence (36.2%) yet it is still low. Furthermore, the unmet need (18.9%) was lower than the national report for the general population (22%). Educating women about the risk of getting pregnant while visiting the health facility for TB medication will help to improve their chances of better recovery and avoid medication side effects on the fetus. TB guidelines can consider providing FP counseling when initiating treatment to provide women with the power of information to make deliberate decisions.

Exploring the effects of programmatic intervention on family planning health literacy and contraceptive utilization in eastern Uganda.

Uganda Village Project (UVP) implemented the Healthy Village Initiative (HVI) and conducted household surveys to assess the effects of the initiative. This data adds to the limited body of knowledge regarding the efficacy of community health interventions for reproductive health in rural east Africa. As part of the HVI, UVP surveys rural Ugandan households before and after a 3-year programmatic intervention to assess changes in family planning health literacy, and contraception utilization. Results showed that there was an increase in contraceptive utilization, an increase in family planning health literacy, and a decrease in unmet need for contraception. Community-based outreaches led by community members and health workers can contribute to improving access to contraception, utilization of contraception, and health literacy surrounding contraception.

Factors Influencing the Utilization of Contraceptives among Adolescents in the Tamale Metropolis, Ghana

Background: Adolescents’ sexual and reproductive health is supreme to healthy living, and because the health of adolescents is important, it has compelled most countries across the globe to put up appropriate measures to meet their needs.
 Aims: The main aim of the study was to assess the factors influencing the utilization of contraceptives among adolescents in the Tamale Metropolis, Ghana.
 Methods: This study employed a community-based cross-sectional design. The study recruited 374 adolescents using the multi-stage sampling technique. Data were analyzed using SPSS version 25. A p-value < 0.05 was considered statistically significant.
 Results: The majority (92.8%) of the adolescents have heard about contraceptives. Half of the respondents had sex before, with only 29.4% reported to have used contraceptives in the past. Only 30.7% of the respondents felt the service providers were friendly to them, the majority (60.2%) of the study participants felt that the health practitioners did not respect their privacy during their visit. Over half (51.1%) of the respondents were unsatisfied with the location where contraceptive services are rendered. The majority (82.9%) of the study participants cannot discuss contraceptives issues freely with their parents. The study established a significant association between usage of contraceptives and age (P<0.001), level of education (P<0.001), and marital status (P<0.001).
 Conclusion: The majority of respondents were sexually active, although contraception use was low in comparison to the teens' high awareness level. Factors such as poor attitudes of health practitioners, poor accessibility and availability of contraceptives, and lack of parental concern have to be addressed by key stakeholders’ engagement to holistically address adolescents’ sexual and reproductive health concerns in the metropolis.

Utilisation of Emergency Contraception among Final Year University Female Students

Introduction: Unwanted pregnancy and unsafe abortion have become serious public health concerns around the world, particularly among female students in both developed and developing countries. The general objective of this study was to investigate the utilization of emergency contraception among final-year female students of a public university in Ghana.
 Methods: A stratified random sample was used to enroll 199 female university students for descriptive cross-sectional research. SPSS version 25 was used to analyze the data. To compare categorical variables, Chi-square analysis was employed, and a p-value of 0.05 was considered statistically significant.
 Results: Majority (88.4%) of the respondents demonstrated sufficient knowledge, and 84.4% had a favorable attitude towards emergency contraceptives (ECs). On the indications for EC; after unprotected sex (65.3%), after a missed period (22.6%), when one is raped (83.4%), unwanted pregnancy (75.9%), and rupture of condoms (88.9%) were identified. The majority (59.3%) of students have used EC, with most of the students (43.7%) using Postinor-2. The overall attitude towards EC and Residence (X2=7.5; p=0.023), Religion (X2=6.2; p=0.042), and marital status (X2=17.1, p=0.001) were statistically significant. There was a significant association between the use of EC and Residence (X2=10.9; p=0.004) and marital status (X2=8.6; p=0.035). 
 Conclusion: The findings of this study indicated that students had a high level of knowledge and favourable attitude towards EC, with a significant number of the respondents likely to utilize it in the future. This may aid in the treatment of female students' sexual and reproductive health issues and prevent dropping out of school as a result of unwanted pregnancy. Also, there is the need to engage opinion leaders to address their concerns to allow for the effective utilization of emergency contraceptives.

Extended post-partum modern contraceptive utilization and associated factors among women in Arba Minch town, Southern Ethiopia.

IntroductionPost-partum family planning is a novel strategy to reduce maternal and neonatal mortality by preventing unwanted pregnancy and unsafe abortion. However, little was done on community-based design to assess modern contraceptive use during an extended postpartum period in southern Ethiopia. Therefore, this study aimed to assess modern contraceptive use during extended postpartum period and factors associated among women who gave birth in the previous twelve months in southern Ethiopia.MethodsA community-based cross-sectional study was conducted among 416 women in Arba Minch town. A systematic random sampling technique was employed to select the enrolled women. Data were collected using a structured and pretested questionnaire. The data were entered into Epi-Data version 4.6 then exported to statically package of social science (SPSS) version 25 for data analysis.ResultAmong enrolled postpartum women, 64.7% were used modern contraceptives for the last 12 months. Women were more likely to use a modern contraceptive during the extended period of postpartum if they resumed sexual intercourse (AOR:7.4 [4.08, 13.23]), received post-partum family planning counseling (AOR: 3.2 [1.95, 5.28]), and if they resumed menses (AOR: 5.3 [3.12, 9.15]) than the counterpart. Being young age women (AOR: 3.2 [1.05, 9.82]) compared to age above 35 years and married (AOR:3.2 [1.17–10.28]) compared to currently unmarried were significantly associated factors for modern contraceptive use during the extended period of postpartum.ConclusionThe level of modern contraceptive utilization during the extended postpartum period was satisfactory. Therefore, in light of this finding, there is a need to improve the strengthening and scale-up antenatal and postnatal counseling of contraceptive use during the extended postpartum period, advice on preceding the return of menses, and give better attention for older age and unmarried women education on family planning.

95. Addressing the Missed Opportunities for Contraceptive Utilization Among Adolescence to Prevent the Unintended Pregnancy Among Adolescence Through Quality Improvement in Chancho District

Improving adolescent and youth sexual and reproductive health (AYSRH) is important in preventing unintended pregnancies, sexually transmitted infections, and unsafe abortion. Despite improvement in AYSRH highest adolescent pregnancy rate and the lowest rate of contraceptive use in sub-Saharan Africa including Ethiopia. Ethiopian Demographic Health Survey (EDHS) 2016 show that, modern contraceptive use among adolescents 15-19 and youth 20-24 age years is 31.8% and 38.5 % respectively. Chancho health center maternity unit and Quality improvement team conducted base line assessment of six months and identified gaps service provision modalities by untrained providers, low contraceptive use among adolescents and youths which is 47%.

Association between health system factors and utilization of modern contraceptives in Namutumba District, Uganda

Association between health system factors and utilization of modern contraceptives in Namutumba District, Uganda

Obstacles of Contraceptive Utilization Methods among Women during COVID-19 Outbreaks

Obstacles of Contraceptive Utilization Methods among Women during COVID-19 Outbreaks

Narrow distance inter-pregnancies increase the incidence of Post-Partum hemorrhage

Background and Aims. Maternal Mortality Rate (MMR) is the parameters of women's health status in community. The single most common cause of maternal mortality is obstetric haemorrhage, generally occurring postpartum. Most postpartum haemorrhage cases are caused by uterus atony, myometrium tonus loss, placenta retention, and clotting disorders. Short pregnancy intervals can cause threefolds of anaemia than normal pregnancy intervals. Pregnant women who suffer from anaemia has the possibility experiencing a postpartum bleeding caused by atonia uteri. This research aims to acknowledge the effect of narrow distance interpregnancy on a postpartum haemorrhage.
 Methods. This study uses an observational analytic study with a cross"‘sectional design. The data used is secondary data of pregnant women based on medical record to calculate the distance of interpregnancy with the incidence of postpartum bleeding during childbirth at Budhi Asih General Hospital of East Jakarta. The inclusion criteria are women who underwent childbirth during 2017"‘2018, multiparity, and postpartum women between 20"‘35 years old. The exclusion criteria are women with a history of postpartum haemorrhages caused by placental retention, tear of the reproductive tract or blood coagulation), gemelli parturition, macrosomia, assisted childbirth, grande multiparity, induction childbirth, and dystocia.
 Results. The number of samples used in this study amounted to 111 people. Postpartum haemorrhage are significantly associated with short interpregnancy intervals (p=0,000).
 Conclusion. Narrower pregnancy interval will leads to postpartum haemorrhage. To prevent this, it is important to consider contraception utilization, to improve iron consumption for pregnant women, and to provide decent antenatal care.

Determinants of contraceptive decision making among married women in Sub-Saharan Africa from the recent Demographic and Health Survey data

BackgroundDifferent evidence suggested that couples often disagree about the desirability of pregnancy and the use of contraceptives. Increased women's decision-making on contraceptives is identified as a key solution that can change the prevailing fertility and contraceptive utilization pattern in SSA. Therefore, this study aimed to determine determinants of contraceptive decision-making among married women in Sub-Saharan Africa.MethodsThe data source of this study was the standard demographic and health survey datasets of 33 Sub-Saharan Africa countries. Reproductive age group women aged (15–49 years) currently married who are not pregnant and are current users of contraceptive preceding three years the survey was included from the individual record (IR file) file between 2010 and 2018. Since the outcome variable is composed of polychotomous categorical having multiple-choice, the Multinomial logistic regression (MNLR) model was applied.ResultsA total of 76,516 married women were included in this study. Maternal age 20–35 and 36–49 years were more likely to had decision making on contraceptive use in both women-only and joint (women and husband/partner category (referance = husband/partner) (RRR = 1.2; 95% CI = 1.05–1.41, RRR = 1.18; 1.04–1.33 and RRR = 1.38; 95% CI = 1.17–1.61, RRR = 1.27; 1.11–1.47)] respectively. Married women with higher education were more likely to decide by women-only category on contraceptive use (referance = husband/partner) (RRR = 1.26; 95% CI = 1.06–1.49). Women only decision-making to use contraceptives relative to the husband/partner only decreases by a factor of 0.86 (95% CI = 0.80–0.93) among rural than urban residences. Women only or joint decision making to use contraceptives was 1.25 and 1.35 times more likely relative to husband/partner decision making respectively among women who had work than that of had no work. The relative risk of women's decision to use family planning relative to husband increased among couples who had a marital duration of ≥ 10 years (RRR = 1.14; 95% CI = 1.06–1.22). But it has no significant effect on joint decision making. Respondents found in the richest wealth index category increase the relative risk of joint decision-making relative to husband/partner (RRR = 1.33; 95% CI = 1.20–1.47) compared to the poorest category.ConclusionsDecision-making to use contraceptives among married women varies greatly by socio-demographic characteristics. The finding of this study showed that women's age, women educational status, residence, duration of the marriage, family economy, and country income were significantly associated with contraceptive decision-making. Therefore to promote ideal family planning decision making, there is a need to formulate policies and design programs that target women's socio-demographic characteristics and modern contraceptive interventions should be promoted by considering empowering women on decision making.

Practice and determinants of emergency contraceptive utilization among women seeking termination of pregnancy in Northwest Ethiopia-A mixed quantitative and qualitative study.

BackgroundEmergency contraceptives are used within 72 hours after unprotected sexual intercourse to prevent unwanted pregnancy. Although emergency contraceptives are widely available in Ethiopia, termination of pregnancy remains a public health problem indicating low uptake of emergency contraceptives after unprotected sexual intercourse. This study aimed to assess utilization and determinants of emergency contraceptives among women seeking termination of pregnancy in Northwest Ethiopia.MethodsAn institutional-based cross-sectional study was carried out, supplemented by phenomenologically approached in-depth interviews. Systematic random sampling was used to select study participants. A structured questionnaire and an in-depth interview guide were used to collect data. Data were entered by EPI-info and analyzed through SPSS version 23 to conduct logistic regressions. Thematic analysis was used to conduct qualitative interpretation.ResultsAlmost one-fifth (78; 19.2%) of the study participants used emergency contraceptives to prevent their index pregnancy. Women who had secondary education (aOR 3.28; 95% CI 1.59, 6.79) and women who had no living children (aOR 4.52; 95% CI 1.40, 14.57) had a positive significant association with emergency contraceptive utilization. On the other hand, women who did not discuss contraceptives with their sexual partner (aOR 0.49; 95% CI 0.27–0.91) and women without a history of abortion (aOR 0.45; 95% CI 0.24–0.97) had a negative significant association with emergency contraceptive utilization.Conclusion and recommendationThere is relatively low utilization of emergency contraception among pregnancy terminating women. Reproductive health programs should encourage women discussion with their partners about emergency contraceptives to decrease occurrence of unwanted pregnancy and termination of pregnancy.

Modern Contraceptive Utilization and Associated Factors Among Married Women in Liberia: Evidence from the 2019 Liberia Demographic and Health Survey.

BackgroundContraceptive methods help individuals control the number, interval, and timing of pregnancies and prevent unwanted pregnancies.ObjectiveThis study aimed to assess the prevalence of modern contraceptive utilization and associated factors among married reproductive-age women in Liberia.MethodsThis study was based on a large community-based cross-sectional survey, conducted from October 16, 2019, to February 12, 2020, in Liberia. The survey employed a multistage cluster sampling technique to recruit study participants. Binary logistic regression was used to identify associated factors of contraceptive utilization. A p-value of <0.05 and a 95% confidence interval were used to declare statistical significance.ResultsThe overall modern contraceptive utilization among reproductive-age women in Liberia was 23.87% (95% CI: 27.3, 29.9). Women with the age group of 20 and 24 years [AOR = 2.08 (95% CI:1.37, 3.14)], 25–29 years [AOR = 1.73 (95% CI: 1.13, 2.65)], 45–49 years [AOR = 0.46, 95% CI: 0.27, 0.76], being Muslim [AOR = 0.52, 95% CI: 0.399, 0.67], residing in South Eastern Regions (B) [AOR = 1.40, 95% CI: 1.11, 1.79], south central [AOR=0.48 95% CI:0.37, 0.61] and North Central region [AOR = 0.48, 95% CI: 0.37, 0.61], being employed [AOR = 1.26, 95% CI:1.06, 1.51], having 1–2 child/children [AOR = 2.81, 95% CI:1.80, 4.39] 3–4 children [AOR = 3.87, 95% CI:3.87, 6.24] and 5 and above [AOR = 7.06, 95% CI: 4.27, 11.69], completed primary [AOR = 1.52, 95% CI: 1.22, 1.88] and higher education [AOR = 1.72, 95% CI: 1.01, 2.94], having educated husband [AOR = 1.35, 95% CI: 1.12, 1.63], being from richer households [AOR = 1.41, 95% CI:1.09, 1.82], and had declared infecund [AOR = 0.13, 95% CI: 0.046, 0.36] were independently associated with modern contraceptive utilization among married women in Liberia.ConclusionThe prevalence of modern contraceptive utilization among reproductive-age women in Liberia was low. Contraceptive utilization was affected by partners’ education and participants’ socio-demographic and obstetric attributes. Thus, public health interventions are urgently required to enhance use of contraceptives among this group of population.