Contraceptive Utilization Research Articles

Impact of exposure to mass media on utilization modern contraceptive among adolescent married women in Ethiopia: evidence from Ethiopia demographic health survey 2016

<p class="abstract"><strong>Background:</strong> More than one billion of world population was adolescent age group. Adolescents are high risk of unwanted pregnancy related to pregnancy is preventable. This complication can be prevented by use of family planning method. One of the challenges to use family planning was lack of information about contraceptive. This study was investigated mass media impact on use of modern contraceptive among adolescent in Ethiopia, 2016 E. C.</p><p class="abstract"><strong>Methods:</strong> This study conducted based on EDHS (Ethiopia demographic health survey) 2016 data which was cross-sectional study design. Sample size for this study was 588 adolescent married women that completed interview in EDHS 2016. Mass media impact on modern contraceptive use were analyzed using propensity score matching. Recursive biprobit probit model was used to determine factor associated with mass media exposure on modern contraceptive utilization.</p><p class="abstract"><strong>Results:</strong> In Ethiopia about 31.8% of adolescent married women currently used modern contraceptive. Expose to family planning message had 16.8%, 13.2%, 17% and 21.9% point higher modern contraceptive use than unexposed to mass media message. In this study significant factor affected modern contraceptive use included residence, wealth index, radio message, exposed to TV message, magazine message and exposure to mass media message family planning.</p><p class="abstract"><strong>Conclusions:</strong> This study shows magnitude of contraceptive utilization was low and it might be due to lack of information about family planning. Therefore, policy maker and concerned body should consider dissemination family of planning information by mass media.</p>

Postpartum Family Planning Use and Its Determinants among Women of the Reproductive Age Group in Low-Income Countries of Sub-Saharan Africa: A Systematic Review and Meta-Analysis.

Background Postpartum family planning is the initiation and use of family planning services within the first 12 months following childbirth. Postpartum contraceptives reduce maternal and infant mortality by preventing unplanned and unwanted pregnancies and by spacing pregnancies at least two years after the previous birth. Thus, it is usually designed as an integral part of reproductive and maternal and child health programs. Therefore, the aim of this systematic review and meta-analysis is to estimate the pooled prevalence of postpartum modern contraceptive use and identify its determinants in low-income countries of sub-Saharan Africa. Methods A systematic review and meta-analysis of published and unpublished studies were used. PubMed, HINARI, ScienceDirect, Cochrane Library, Wiley Library, ETH Library, and Google Scholar were used to search all articles. STATA 14 software was used for data analysis. Funnel plots and Egger's test were used to examine the risk of publication bias. Heterogeneity was checked by using Cochran's Q test and I2 test. A random effect model was computed to estimate the pooled prevalence. Results A total of 33 articles were included. The pooled prevalence of postpartum contraceptive use in low-income countries of sub-Saharan Africa was 37.41%, 95% CI: (31.35, 43.48%). Secondary and above level of education (AOR 2.09, 95% CI: (1.52, 2.86)), discussion with husband (AOR 3.68, 95% CI: (1.96, 6.89)), resumption of menses (AOR: 3.98, 95% CI: (2.62, 6.03)), ANC follow-up (AOR; 5.10, 95% CI: (3.57, 7.29)), knowledge of modern family planning (AOR: 5.65, 95% CI: 3.58, 8.93)), and family planning counseling during ANC (AOR =5.92, 95% CI: (2.54, 13.79)) were found to be determinants of postpartum contraceptive utilization. Conclusion In this systematic review and meta-analysis, the prevalence of postpartum modern contraceptive use was found to be low compared to the existing global recommendations. Therefore, empowering maternal education, delivering adequate counseling, and strengthening existing integrated maternal and child health services are highly recommended to increase postpartum contraceptive use. This trial is registered with CRD42020160612.

Total Demand, Use and Unmet Need for Modern Contraceptives Among Women Living in Informal Settlements in Kira Municipality, Wakiso District, Uganda. Implications for Urban Health.

Background: Update and utilization of modern contraceptives has public health benefits including reduction of unintended pregnancies, unsafe abortions, and related maternal mortality. However, paucity of evidence on key indicators of family planning in the informal settlements abounds. Data are usually collapsed within the larger urban communities that tend to mask peculiarities of informal settlements. This study determined the proportion of women using modern contraceptives, the unmet need for modern contraceptives and the total demand in informal settlements of an urban municipality.Methods: A cross-sectional study conducted among 626 women in the reproductive age (15–49 years) in the informal settlements of Kira municipality (part of metropolitan Kampala). Multi-stage sampling was applied in the selection of the respondents. Descriptive and log-binomial regression analysis were conducted to determine percentage of women using modern contraceptives, unmet need, and total demand with their associated factors. All analyses were conducted using STATA version 15.0.Results: The total demand for modern contraceptives was 84.9%, modern contraceptive prevalence was 47.4% nearly meeting the national target of 50%, however the unmet need was 37.3%, which much higher than the national target of 10%. Lower total demand for contraceptives was associated with higher women's education status and preference to have another child, while higher total demand was associated with having at least one living child. Higher modern contraceptives use was associated with older age, having at least one living child and high decision-making power, while lower modern contraceptives use was associated with higher education and undetermined fertility preference. Lower unmet need for modern contraceptives was associated with older age (PR 0.68, 95% CI: 0.48–0.97) and high decision-making power (PR 0.64, 95% CI: 0.50–0.81), while higher unmet need was found among those who having at least one living child (PR 1.40, 95% CI: 1.01–1.93) and undetermined fertility preference (PR 1.70, 95% CI: 1.24–2.34).Conclusions: Total demand and contraceptive use were found to be higher in the informal settlements of Kira municipality, however, the unmet need was much higher among this population as compared to the national urban estimates. This indicates a much higher demand for contraceptives and the need to consider the diverse socio-demographic characteristics of urban spaces. Development of Interventions need to critically consider the diverse urban space, associated explanatory variables and a collaborative systems lens to achieve sustained improvements.

Dual Contraceptive Use and Factor Associated with People Living with HIV/AIDS: A Systematic Review and Meta-Analysis.

Introduction A dual contraceptive method is the usage of any modern contraceptive method with male or female condoms which could lower sexually transmitted diseases and unwanted pregnancy. Ethiopian standard utilization of dual contraceptive is low. The hassle is more severe for HIV/AIDS-infected people. Therefore, this review was aimed at assessing dual contraceptive utilization and factor associated with people living with HIV/AIDS in Ethiopia. Method International databases (PubMed/MEDLINE, Hinari, Embase, African Journals Online, Scopus, and Google Scholar) and Ethiopian university repository online have been covered in this review. Microsoft Excel was used for extraction, and the Stata 14 software program was used for analysis. We detected the heterogeneity between studies using the Cochran Q statistic and I2 test. Publication bias was assessed by funnel plot and Egger's and Begg's tests. Result The overall prevalence of dual contraceptive use among people living with HIV/AIDS was 27.73% (95% CI: 20.26-35.19) in Ethiopia. Discussion with the partner (OR: 3.78, 95% CI: 3.08-4.69), HIV status disclosure to the spouse/partner (OR: 2.810, 95% CI: 2.26-3.48), postdiagnosis counseling (OR: 5.00, 95% CI: 3.71-6.75), schooling in secondary and above education (OR: 3.78, 95% CI: 2.41-5.93), partner involvement in counseling (OR: 2.76, 95% CI: 1.99-3.82), urban residence (OR: 2.84, 95% CI 2.03-3.94), and having no fertility desire (OR: 4.01, 95% CI 2.91-5.57) were significantly associated with dual contraceptive use. Conclusion Dual contraceptive utilization among people living with HIV/AIDS was found to be low in Ethiopia. This will be a significant concern unless future intervention focuses on rural residence, involvement of the partner in postdiagnosis counseling, encouraging the people living with HIV/AIDS to disclose HIV status, and discussion with the partner. Providing counseling during the antenatal and postnatal period also enhances dual contraceptive use.

The association between the COVID-19 pandemic and postpartum care provision

BACKGROUNDThe COVID-19 pandemic led to a rapid transformation in the healthcare system to mitigate viral exposure. In the perinatal context, one change included altering the prenatal visit cadence and increasing the utilization of telehealth methods. Whether this approach had inadvertent negative implications for postpartum care, including postpartum depression screening and contraceptive utilization, is unknown.OBJECTIVEThis study aimed to examine whether preventative health service utilization, including postpartum depression screening and contraceptive utilization, differed during the COVID-19 pandemic when compared with the prepandemic period.STUDY DESIGNThis retrospective cohort study included all pregnant patients who received prenatal care at 1 of 5 academic obstetrical practices and who delivered at Northwestern Memorial Hospital either before (delivery from September 1, 2018, to January 1, 2019) or during (delivery from February 1, 2020, to May 15, 2020) the COVID-19 pandemic. Completion of postpartum depression screening was assessed by reviewing standardized fields in the documentation associated with the screening in the electronic health record system. The method of contraception used was ascertained from the postpartum clinical documentation. Patients were classified as initiating long-acting reversible contraception use if they received NEXPLANON (etonogestrel implant) or an intrauterine device during the hospitalization for delivery or within 3 months following delivery. Bivariable and multivariable analyses were performed.RESULTSOf the 2375 pregnant patients included in this study, 1120 (47%) delivered during the COVID-19 pandemic. Pregnant patients who delivered during the COVID-19 pandemic were significantly less likely to have undergone postpartum depression screening (45.5% vs 86.2%; P<.01); this association persisted after adjusting for potential confounders (adjusted odds ratio, 0.13; 95% confidence interval, 0.11–0.16). Pregnant patients who delivered during the COVID-19 pandemic also were significantly less likely to initiate long-acting reversible contraception use within 3 months of delivery (13.5% vs 19.6%; adjusted odds ratio, 0.67; 95% confidence interval, 0.53–0.84).CONCLUSIONThe onset of the COVID-19 pandemic was associated with a decrease in the completion of postpartum depression screenings and fewer patients initiating long-acting reversible contraception use overall. These results can inform adaptations in healthcare delivery in the midst of the ongoing COVID-19 pandemic.

Contraceptive prevalence and factors influencing utilization among women in Pakistan: a focus on gender-based violence

PurposeIn this study, the authors determined the prevalence of contraceptive use among Pakistani women and assessed factors influencing the utilization of contraception with a particular focus on the experience of gender-based violence.Design/methodology/approachThe dataset used in this study was the Pakistan Demographic Health Survey 2018, which includes married women only. Bivariate analysis and multivariate logistic regression were used to investigate the association between contraceptive use and a number of explanatory variables including experience of gender-based violence.FindingsFrom 2006 to 2018, the contraceptive prevalence rate (CPR) and the use of modern contraceptive methods increased slowly. The findings of this study demonstrated that higher educational level and wealth index increased the likelihood of contraceptive uptake and the use of modern contraception. Media exposure to family planning and spousal communication were protective factors that encouraged women to use contraception, including modern contraception, to avoid unwanted pregnancy. Women who experienced gender-based violence (GBV) were more likely to use contraception than women who did not experience GBV.Research limitations/implicationsThe use of secondary data limited the variety of important variable that should be investigated including knowledge of women on SRH, the attitude of women toward SRH and family planning, the skills of a healthcare provider on counseling family planning, and other barrier variables such as transportation and willingness to pay for contraceptive methods. 10;The sensitivity of the topic is considered as another challenge when collecting data. Women might be hesitant to share about their GBV experience. The experience to GBV is also hard to define and depends on the feeling of each person, especially emotional violence.Originality/valueThis paper is one of the very few studies to examine the association between GBV and contraceptive use, and thus is valuable in opening up debate about the links between these two factors.

Geographic differences in contraception provision and utilization among federally funded family planning clinics in South Carolina and Alabama.

Access to the full range of contraceptive options is essential to providing patient-centered reproductive health care. Women living in rural areas often experience more barriers to contraceptive care than women living in urban areas. Therefore, federally funded family planning clinics are important for ensuring women have access to contraceptive care, especially in rural areas. This study examines contraceptive provision, factors supporting contraceptive provision, and contraceptive utilization among federally funded family planning clinics in 2 Southern states. All health department and Federally Qualified Health Center clinics in Alabama and South Carolina that offer contraceptive services were surveyed in 2017-2018. Based on these surveys, we examined differences between rural and urban clinics in the following areas: clinic characteristics, services offered, staffing, staff training, policies, patient characteristics, contraceptive provision, and contraceptive utilization. Differences were assessed using Chi-square tests of independence for categorical variables and independent t-tests for continuous variables. Urban clinics had more staff on average than rural clinics, but rural clinics reported greater ease in recruiting and retaining family planning providers. Patient characteristics did not significantly vary between rural and urban clinics. While no significant differences were observed in the provision of long-acting reversible contraceptives (LARCs) overall, a greater proportion of patients in urban clinics utilized LARCs. While provision of most contraceptives is similar between rural and urban federally funded family planning clinics, important differences in other factors continue to result in women who receive care in rural clinics being less likely to choose LARC methods.

The body cannot be cheated: sexual practices and modern contraceptive use among street-involved young people in two South West States in Nigeria

Background: Young people aged 10-24 years constitute about one-third of the total population of Nigeria. Street-involved young people (SIYP) face a double burden of living condition instability and lack of adequate parental monitoring. This leaves them vulnerable to poor sexual and reproductive health (SRH) choices and behaviour. Risky sexual behaviour with poor access to SRH information and interventions increases their vulnerability to adverse SRH outcomes. This study explored the use of modern contraceptives and sexual practices among male and female SIYP (10-24 years) in Nigeria. Methods: This qualitative study used an exploratory research design to guide the development of the focus group discussion (FGD) and in-depth interview (IDI) guides. Participants were asked questions on background information, lived experiences and SRH practices. The FGDs were stratified by sex and age. Both FGD discussions and IDI interviews were recoded; transcripts were transcribed and translated from local dialect into English language. Content analysis was conducted thematically with the aid of NVivo. Results: In total, 17 IDIs and 11 FGDs were conducted among SIYP aged 10-24 years. The total number of respondents interviewed was 109. There is high awareness of modern contraceptives among SIYP; the commonly known method was condom with a few also aware of emergency contraceptives pills. However, participants reported low use of modern contraceptives. The common reasons alluded for not using condoms were reduced sexual pleasure, cost and associated myths. The five themes that emerged under sexual practices of SIYP included early age at first sexual encounter, multiple sex partners, transactional sex, same-sex relationships, and transactional sex. Conclusions: There is low utilization of contraceptives by SIYP against the background of their high-risk sexual practices. SIYP would benefit from free contraceptive education, social safety nets and interventions to dissuade them from transactional sex and other unhealthy sexual practices.

Association between empowerment factors and the utilization of long-acting and permanent contraceptive methods among married women in Indonesia

Background and purpose: The use of long-acting and permanent methods (LAPMs) of contraception becomes one of the government’s efforts to ensure the continuity of family planning program. Factors associated with the LAPMs use can be contingent upon the study context or setting that includes socio-demographic, social and cultural norms, and women empowerment factors. This study aims to examine the associations between women empowerment and the LAPMs use.Methods: This was a cross-sectional study involving 97,316 records of married women aged 15-49 years, retrieved from three rounds of the Indonesia Demographic and Health Survey/IDHS (2007, 2012, and 2017). The dependent variable is the LAPMs use, whereas the main independent variables were women empowerment factors (i.e., educational level, occupational status, participation in household decision-making, attitude toward wife-beating). Adjusted associations between women empowerment and the LAMPs use were examined using binary logistic regression by controlling the influence of socio-demographic variables as potential confounders.Results: About half of women in this study were 35-49 years old and completed primary education. Education level was found to be positively associated with the use of LAPMs. Working women increased the likelihood of using LAPMs by 1.10 (95%CI: 1.03-1.17) times. In addition, those who approved for being beaten by their husband in any circumstance were less likely to use LAPMs (OR=0.91; 95%CI: 0.86-0.97). However, participation in household decision-making was not associated with the LAMPs use.Conclusion: Women empowerment factors that included educational level, occupational status, and the attitude toward wife-beating were associated with the use of LAPMs among Indonesian married women. Therefore, improving women empowerment by increasing women’s educational level, participation in labor force, and reducing women’s vulnerability to domestic violence can increase the uptake of LAPMs.

Utilization of Immediate Postpartum Intrauterine Contraceptive Device and Associated Factors among Women Who Gave Birth at Government Hospitals of Gamo Zone, Southern Ethiopia, 2019

Background: An intrauterine contraceptive device is suitable for women of all reproductive age groups for preventing unwanted pregnancies. Immediate post partum family planning services need to be emphasized where in the woman leaves the hospital with safe and effective contraception in place. Despite the accepted demand for post partum family planning, many women do not access the services they need prevent unintended pregnancies. Objective: To assess utilization of immediate postpartum intrauterine contraceptive device and associated factors among women who gave birth at government hospitals of Gamo Zone, Southern Ethiopia. Method: Facility-based crosses sectional study was conducted from March 1 to 30 of 452 participants were studied using systematic random sampling technique. Data were entered into Epi-data v. 4.2.2.1 and exported to SPSS v.23 for analysis. Crude or adjusted odds ratio, and 95% confidence interval were used to assess the strength of association and statistical significance. Variables which had a p-value of ≤0.25 in bivariate analysis were considered as candidates for multivariate regression analysis; variables that had a p-value of ≤0.05 in the multivariate analysis were considered as independent factors associated with utilization of immediate postpartum intrauterine contraceptive device among parturients in the final multiple logistic regression analysis. Results: This finding revealed that about 161 (36%) of the respondents had showed willingness to use immediate PPIUD, however, only about 62 (14%) of study participants were utilized immediate PPIUCD. Mothers who did not plan to have another child (AOR = 2.84, 95% CI, (1.12, 7.21), undecided plan to have another child (AOR = 2.55, 95% CI, (1.21, 5.35), counselled about PPIUCD (AOR=4.35, 95% CI, (2.11, 8.96) and completed ANC follow up (AOR=2.43, 95% CI, (1.28, 4.60) were associated with immediate post partum contraceptive device utilization. Conclusion and Recommendation: Even though 58% and 53% of the mothers were counselled and completed antenatal service respectively but efforts need to improve antenatal care service and integrate counselling service through the whole cascade of pregnancy.

Emergency contraceptive utilization and associated factors among college students in Dire Dawa City, Eastern Ethiopia: A cross-sectional study.

INTRODUCTIONEmergency contraception is a contraceptive method that can be used to prevent pregnancy after unprotected sexual intercourse. Higher education students fall under the sexually active age group and form a high-risk group for unintended pregnancy, because of limited utilization of emergency contraception. The aim of this study was to assess emergency contraceptive utilization and associated factors among college students in Dire Dawa City, Eastern Ethiopia.METHODSAn institutional-based cross-sectional study was conducted in May 2019. A total of 286 students using simple random sampling technique were included in the study. Data were collected by using self-administered questionnaires and entered into EpiData (Classic) Entry version 3.1 and analysed using SPSS version 24.0. Binary and multivariable logistic regression analysis were done to determine the association between the outcome and predictor variables.RESULTSA total of 286 female students participated in the study giving a response rate of 100%. Eighty-six (86) participants had a history of sexual practice, and 60 (69.7%) had ever used emergency contraceptive. Having knowledge about emergency contraceptive (AOR=3.24; 95% CI: 1.32–7.98), age at first sexual intercourse ≥20 years (AOR=4.04; 95% CI: 1.72–9.52), history of previous pregnancy (AOR=3.12; 95% CI: 1.34–7.24) and previous use of regular contraceptives (AOR=5.01; 95% CI: 2.23–11.27) were found to be significant predictors of emergency contraceptive utilization.CONCLUSIONSThis study showed that emergency contraceptive utilization among female college students having unprotected sexual intercourse is still low. Level of knowledge, age at first sexual intercourse, previous use of regular contraceptives and history of pregnancy were major predictors of emergency contraceptive utilization. Therefore, focus on awareness creation activity and delaying sexual activity is recommended.

Utilization and its factors of post abortion modern contraceptive in Ethiopia: a systematic review and meta-analysis

BackgroundProviding post-abortion care service is a widely accepted to reduce maternal morbidity and mortality by promoting, preventing and treating maternal and neonatal health, identifying the utilization and its factor of post abortion contraceptive is crucial. Therefore we tried to review post abortion contraceptive utilization and its factors in Ethiopia.MethodsA review was performed by using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A systematic and a comprehensive literature searching mechanism were used without any restriction, through Google scholar, PubMed, EMBASE, Scopus, Web of Sciences, and Grey literature databases for reporting utilization of post abortion family planning. Pilo-tested were performed in random sample studies and a standardized data extraction form was used. All statistical analyses were done using STATA version 14 software for windows, and meta-analysis was used with a random-effects method. The results are presented using texts, tables and forest plots with measures of effect and 95% confidence interval.ResultsAmong 1221 records, 11 studies were taken in the meta-analysis with 4336 Participants that full fill the inclusion criteria. The pooled prevalence of post abortion contraceptive in Ethiopia was 74.56% (95% CI (73.31%, 75.81%)). Married women (OR 2.01 (95% CI (1.52, 2.66), I2: 0.0%)), women who were counseled (OR 5.36 (95% CI (3.10, 9.29), I2: 79.5%)), women whose educational level tertiary and above (OR 2.28 (95% CI (1.66, 3.17), I2: 0.0%)), women who had ever used contraceptive (OR 3.76 (95% CI (2.19, 6.47), I2: 67.8%)) and those women’s age 15–24 years old (OR 8.35 (95% CI (2.74, 14.74), I2: 87.4)) were statistically significant.ConclusionAccording to World Health Organization (WHO) guideline, "after a miscarriage or induced abortion, the recommended minimum interval to next pregnancy is at least 6 months in order to reduce risks of adverse maternal and perinatal outcomes".. According to this post abortion contraceptive utilization in Ethiopia is not optimal. Marital status, education, Counsel, previously exposed and age were significantly associated. Therefore, the Ministry of Health should work target fully to address those problems to maintain maternal and child health in Ethiopia.

A STUDY OF FACTOR AFFECTING THE USE OF TEMPORARY AND PERMANENT METHODS OF CONTRACEPTION AMONG MARRIED WOMEN

Introduction: According to World Health Organization (WHO), 'Family planning allows individuals and couples to anticipate and attain their desired number of children and the spacing and timing of their births. It is achieved through use of contraceptive methods and the treatment of involuntary infertility'. This study provides the relationship between sociodemographic factors and use of temporary contraceptive methods and permanent contraceptive methods. 1.To de Objectives: termines the factor affecting utilization of temporary and permanent contraceptives among married women. 2. To determine the relationship between socio demographic factors and use of modern contraceptive method among married women.Material &amp; methods: This study was community based descriptive cross sectional study, conducted in urban area of Bilaspur (C.G.). Total 600 married women were interviewed by predesigned and pretested questionnaire. Data were analyzed using SPSS software. Chi-square test and logistic regression was applied to know the association among the various socioeconomic factors and contraceptive practices. In this study 600 married wome Result: n were studied. Out of all 600 respondent (172)28.7% were using sterilization and rest were using temporary method of contraception. Only 8.6% and 32.8% illiterate women were using temporary method and permanent method of contraception and only 42.9% and 21.4% women of lower socio economic class were using permanent method and spacing method of contraception respectively. Signicant association was found between various factors like age, education, parity, socio economic class, and number of living children. In this study choice of method of contrace Conclusion: ption (temporary and permanent methods) was associated with education, occupation, socioeconomic class, number of living children and parity. It was found that the female sterilization (permanent method) was more popular than temporary method. Education and mass media show signicant association in use of temporary methods.

Determinants of intrauterine contraceptive device utilization at primary health care facilities in Mekelle City, northern Ethiopia

BackgroundEach year, the current level of modern contraceptive use averts 188 million unintended pregnancies, which in turn results in 112 million fewer abortions. Of the 867 million women in the developing world who are sexually active and want to avoid becoming pregnant, approximately 222 million of them have an unmet need for modern contraception. In spite of several advantages and potential effectiveness of Intra Uterine Contraceptive Device, its utilization still too low in Sub Saharan African countries including Ethiopia.ObjectivesTo identify the determinant factors for utilization of intra uterine contraceptive device among women visiting primary health care facilities in Mekelle city.MethodFacility based unmatched case-control study design was conducted among 234 women (78 cases and 156 controls). Data was collected by structured questionnaire. Data entry and cleaning was done using EPI- Info version 5.3.1 and analysis done using SPSS version 20.0 statistical software. During analysis the variables were defined, categorized and the difference in variables was determined. Odds ratio used to show degree of association between independent variables with Intra Uterine Contraceptive Device.ResultMarital status ([AOR (95%CI) =8.59(2.60–28.43)], number of pregnancies (AOR (95%) CI = 5.69(1.020–31.802), number of alive children [AOR (95%CI) =3.5 (1.03–11.9) are variables continued to have statistically significant association with use of Intra Uterine Contraceptive Device. Other determinants found to have significant association includes awareness about Intra Uterine Contraceptive Device, visual exposure to Intra Uterine Contraceptive Device, and participants told about availability of health care provider able to insert Intra Uterine Contraceptive Device.ConclusionThis study has identified marital status, Gravidity, number of alive children and awareness to Intra Uterine Contraceptive Device as major determinants for use of Intra Uterine Contraceptive Device. Thus, it is vital at addressing the aforementioned determinants will be vital to improve utilization of Intra Uterine Contraceptive Device.Plain English summaryAmong long acting reversible modern contraceptive methods, Intra Uterine Contraceptive Devices (IUCDs) are the most reliable and effective as well as with fewer side effects. Despite these advantages and cost effective potential of Intra Uterine Contraceptive Device its utilization is still too low in Sub Saharan countries like Ethiopia. Thus, this study intended to identify the factors that limit the utilization of Intra Uterine Contraceptive Device among women of Ethiopia in Mekele City. The study identify that the utilization of Intra Uterine Contraceptive Device was determined by the marital status of the women, the number of previous pregnancy and recent alive children and the level of awareness about Intra Uterine Contraceptive Device of the women. Therefore, providers training that focus on promoting Intra Uterine Contraceptive Device, centering on increasing awareness and practice about Intra Uterine Contraceptive Device is very important.

Determinants of maternal high-risk fertility behaviors and its correlation with child stunting and anemia in the East Africa region: A pooled analysis of nine East African countries.

In low-income nations, high-risk fertility behavior is a prevalent public health concern that can be ascribed to unmet family planning needs, child marriage, and a weak health system. As a result, this study aimed to determine the factors that influence high-risk fertility behavior and its impact on child stunting and anemia. This study relied on secondary data sources from recent demography and health surveys of nine east African countries. Relevant data were extracted from Kids Record (KR) files and appended for the final analysis; 31,873 mother-child pairs were included in the final analysis. The mixed-effect logistic regression model (fixed and random effects) was used to describe the determinants of high-risk fertility behavior (HRFB) and its correlation with child stunting and anemia. According to the pooled study about 57.6% (95% CI: 57.7 to 58.2) of women had at least one high-risk fertility behavior, with major disparities found across countries and women's residences. Women who lived in rural areas, had healthcare access challenges, had a history of abortion, lived in better socio-economic conditions, and had antenatal care follow-up were more likely to engage in high-risk fertility practices. Consequently, Young maternal age at first birth (<18), narrow birth intervals, and high birth orders were HRFBs associated with an increased occurrences of child stunting and anemia. This study revealed that the magnitude of high-risk fertility behavior was higher in east Africa region. The finding of this study underscores that interventions focused on health education and behavioral change of women, and improvement of maternal healthcare access would be helpful to avert risky fertility behaviors. In brief, encouraging contraceptive utilization and creating awareness about birth spacing among reproductive-age women would be more helpful. Meanwhile, frequent nutritional screening and early intervention of children born from women who had high-risk fertility characteristics are mandatory to reduce the burden of chronic malnutrition.

Women Deprivation Index and Family Planning Utilisation in Urban Geography of West African Countries.

Inequalities in health care utilisation and outcomes vary significantly across geographies. Though available evidence suggests disparity in contraceptive uptake in favour of urban compared with rural geographies, there are unassessed nuances among women in urban communities. This study examines some of these disparities within the context of socioeconomic deprivations and family planning utilisation among urban women in West Africa. A secondary analysis of the most recent Demographic and Health Survey dataset of five selected West African countries was conducted, using pooled data of 21,641 women aged 15–49 years. Associations between family planning utilisation and women's deprivation status were investigated using a binary logistic regression model. The findings show that more than one-quarter of the women were severely deprived across the countries except Senegal (17.4%), and the severely deprived consistently have relatively low contraceptive prevalence rates (CPR) (16.0–24.3%) compared with women with no/low deprivation across the countries except Senegal (39.8%). The results for long-acting reversible contraceptives (LARC) were not consistent across the five countries: whereas, LARC utilisation was lower among severely deprived women in Nigeria (9.1%), Guinea (9.6%), and Mali (19.3%), utilisation was similar across the deprivation groups in Benin and Senegal. In the multivariable analyses, the log-odds of modern contraceptive utilisation decreases by 0.27 among the moderately deprived (ß = −0.27, SE = 0.05, p < 0.01) and by 0.75 among the severely deprived women (ß = −0.75, SE = 0.05, p < 0.01) compared with those with no/low deprivation, with variations across the countries. Similarly, the log-odds of LARC utilisation decreases by 0.44–0.72 among the severely deprived women compared with those with no/low deprivation across the countries except Senegal. This study concluded that family planning intervention programmes and policies need to underscore the deprivation context of urban geographies, particularly among women living in informal settlements.

Geographic variation and associated factors of long-acting contraceptive use among reproductive-age women in Ethiopia: a multi-level and spatial analysis of Ethiopian Demographic and Health Survey 2016 data

BackgroundHigh fertility rates and unintended pregnancies are public health concerns of lower and middle income countries such as Ethiopia. Long acting contraceptives (LACs) take the lion’s share in reducing unintended pregnancies and high fertility rates. Despite their numerous advantages, the utilization of LACs remains low in Ethiopia. This study is aimed to explore the geographic variation and associated factors of long acting contraceptive use among reproductive-age women in Ethiopia.MethodsThis is a secondary data analysis of 2016 Ethiopian Demographic and Health Survey (EDHS) data. A total of weighted sample sizes of 10,439 reproductive-age women were included in the final analysis. To clean and analyze the none-spatial data Stata 14 was used while ArcGIS 10.6 and SaTScanTM version 9.6 software were used for spatial analysis. Multilevel Mixed-effect Logistic regression model was used to identify associated factors of LACs utilization. An Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was reported to identify significant variables.ResultsLong acting contraceptive utilization was non-random (Moran’s I: 0.30, p-value < 0.01). Statistically, clusters with significant low utilization of LACs were found in Somali, Afar, Gambela, northern Amhara, eastern Oromia and western part of Southern Nations Nationalities and Peoples (SNNP) regions. Adjusting for other factors such as being married (AOR = 2.51, 95% CI: 1.29–4.87), having one to two (AOR = 2.14, 95% CI: 1.43–3.22), and three to four children (AOR = 1.68, 95% CI: 1.02–2.76), urban (AOR = 1.59, 95% CI: 1.16–2.19), want no more children (AOR = 1.40, 95% CI: 1.08–1.83), working status of women (AOR = 1.33, 95% CI: 1.07–1.65) increased the odds of LACs utilization. While previous history of abortion (AOR = 0.56, 95% CI: 0.39–0.80), and living in the pastoralist community (AOR = 0.22, 95% CI: 0.14–0.35) reduced the odds of LACs utilization in EthiopiaConclusionsSignificant geographic variation of LACs utilization was observed in Ethiopia. Spots with Low LACs utilization were found in the eastern, north eastern and western part of the country. Socio-demographic and pregnancy related factors were significant determinants of LACs utilization. Designing intervention programs targeting the identified hot spot clusters, and variables that can hinder the utilization of LACs is very important to increase the utilization.

Predictors of modern contraceptive usage among sexually active rural women in Ethiopia: A\xa0multi-level analysis

BackgroundEthiopia is one of the Sub-Saharan Africa countries with the lowest modern contraceptive prevalence rate and the highest fertility rate. This study aimed to assess individual and community-level predictors of modern contraceptive use among sexually active rural women in Ethiopia.Data and methodsA sample of 9450 sexual active rural women aged 15-49 was extracted from the 15, 683 nationally representative samples of 2016 Ethiopian Demographic and Health Survey (EDHS). Multi-level logistic regression model was considered to identify determinant factors of modern contraceptive use among sexually active rural women in Ethiopia.ResultThe prevalence of modern contraceptive use among respondents was 20% in rural Ethiopia. Injection (66.35%) was the most common type of modern contraceptive use. In the last full model of the multilevel analysis, individual and community-level factors accounted for 86.69% of the variation in the use of modern contraceptive methods. Secondary and above-educated women (AOR = 1.39, 95%CI: 1.06, 2.81), having 1-4 living children (AOR = 2.70, 95%CI: 2.07, 3.53), rich wealth status (AOR = 2.26, 95%CI: 1.96, 2.60), married women (AOR = 17.31, 95%CI: 10.72, 27.94), having primary educated husband (AOR = 1.45, 95%CI: 1.27, 1.67) and being working husband (AOR = 2.26, 95%CI: 1.96, 2.60) were significantly positively associated with individual-level factors of the use of modern contraceptive methods. Besides, modern contraceptive use was negatively associated with Muslim women (AOR = 0.29, 95%CI: 0.25, 0.33). Compared to the Tigray region, women living in the Afar, Somali, Harari, and Dire Dawa regions had lower use of modern contraceptive methods. Women who had access to mass media (AOR = 1.35, 95%CI: 1.16, 1.57) were more likely to use contraceptives than their counterparts.ConclusionThe prevalence of modern contraceptive use among rural women has very low. Both individual and community-level factors were significant predictors of modern contraceptive use. Consequently, the government and other stakeholders need to address educational opportunities; creating awareness about modern contraception and valuable counseling would increase modern contraceptive methods utilization.

Socio-demographic and economic determinants of awareness and use of contraceptives among adolescents in Ebonyi State, South-east, Nigeria.

Understanding factors that explain levels of awareness and use of contraceptives among adolescents is a critical entry point for improving their sexual and reproductive health. This study assessed the demographic and socioeconomic determinants of awareness and use of contraceptives among adolescents in rural and urban communities in Ebonyi State, Nigeria. A cross-sectional household survey was conducted in three rural and urban communities in August, 2018. Modified cluster sampling technique was used to select eligible households. A total of 1045 adolescents (598 females and 447 males) were randomly selected from the households and interviewed using a pre-tested structured questionnaire. The mean age is 15.4years (15.3 - 15.5) and the median age is 15.5years. Univariate, bivariate and multivariate analysis were undertaken. Statistical significance was set at p-value of <0.05. Majority of respondents, 723 (68.9%), were aware of male condom. Place of residence predicts awareness of contraceptive pills (AOR 0.66, CI 0.48-0.91); schooling predicts awareness of male condoms (AOR 0.57; CI 0.32-0.99). Predictors of awareness of female condoms are place of residence (AOR 0.66, CI 0.47-0.93), gender (AOR 0.57, CI 0.32-0.99) and wealth index (AOR 1.16, CI 1.03-1.30). Demographic and socioeconomic characteristics of respondents did not predict contraceptive use in the last sex. Although awareness of contraceptives is high, utilization is low among sexually active adolescents. Hence, the need to promote access to and utilization of contraceptives through comprehensive contraceptive education to improve adolescents sexual and reproductive health.

Knowledge, Attitude and Practice of Emergency Contraceptive among Undergraduate Female College Students: A Cross-Sectional Study

Background: Emergency contraceptive is a unique type of family planning methods, which has been available since 1970s and can prevent pregnancy, when used after unprotected sex around the time of ovulation. Objectives: The main purpose of the study was to investigate the knowledge level, attitude towards and practice of emergency contraceptive among female college students. Methods: A cross-sectional study design was used and data were collected by structured pre-tested questionnaire that 456 students were randomly selected. Logistic regression analysis was used and p &lt;0.05 was considered statistically significant. Results: About 53.3% of the study participant’s knowledge level were good and 56.1% of them showed a positive attitude towards emergency contraceptive. Field of study, year of study and awareness were associated with the knowledge level. Age, year of study and sexual behavior were associated with attitudes towards emergency contraceptive. Attitude towards emergency contraceptive and sexual behavior were associated with the utilization of emergency contraceptive. Conclusions: The knowledge level, attitude towards and practice of emergency contraceptives were affected by age, field of study, level of study, awareness and sexual behavior.