Determinants Of Contraceptive Use Research Articles

Determinants of contraceptive use among women of reproductive age attending antenatal clinic at Tumbi Regional Referral Hospital, Coast Region, Tanzania

Background: Contraception is regarded as an important preventive measure of unintended pregnancies among women. This study aimed to assess the determinants of contraceptive use among women of reproductive age attending antenatal clinic at Tumbi Regional Referral Hospital, Coast Region, Tanzania. Material and Methods: This was a descriptive cross-sectional study conducted from June 01 to September 30, 2023. A total 310 women at reproductive age were enrolled in this study. Results: The analysis of 310 women intending to use contraceptive was done. Of these 19.3% were aged between 25 -29 years; 21.3% the husbands were aged between 30 -34 years. Marital status 92.3% were married. Women education level primary school was 68.4%, husband education level primary school was 72.6%. Women′s occupation, government employee 88.7%, husband′s occupation, peasant 73.2%. Living in Rural area was 75.0%. Awareness on contraception was 96.0%, knowledge of methods of contraception 97.7%, known methods of contraception pills 51.6%, known reasons for using contraception 83.9%, sources of information about contraception mass media 38.7%. Attitudes toward contraception; 48.4% contraception is beneficial. Ever used contraception; 52.6% used, reason for using contraception .79.0% to prevent unplanned pregnancy, reason for not using contraception, 52.3% embarrassment to buy or ask for them, place to get contraception, 52.9% pharmacy. Used contraceptive methods, 54.8% pills Conclusion: This study shows that contraceptive use among women of reproductive age attending antenatal clinic at Tumbi Regional Referral Hospital is preferred by women with primary education. Therefore, females should be encouraged to attain education of primary school which is universal education in our country. There is a need for the Government to have good plan, policy and clear strategy for implementation of use of family planning methods.

Socio-Economic and Demographic Factors that Influence Contraceptive Use by Men in Afikpo North Local Government Area of Ebonyi State

This study examines the Socio-Economic and Demographic Factors that influence Contraceptive use by Married Men in Afikpo North Local Government Area of Ebonyi State. It is aimed at identifying the determinants of contraceptive use among married men in Afikpo North Local Government Area of Ebonyi State. A sample of four hundred and sixty one (461) married men were selected for the study through Multi-Stage sampling design. Cross tabulation results revealed that there is a significant relationship between the independent variables and contraceptive use. Logistic regression results showed that the significant socio-economic and demographic determinants of contraceptives use among the study sample are marriage duration of at least five years, religion, education, occupation, parity, number of children living and age. The Hosmer Lemeshow test for goodness of fit of the logistic regression model is 87.9 percent and is highly significant (p-value > 0.05). This indicates that the model fitted is adequate. The study recommends among others that it is necessary for young couples with less than five-year experience, Muslims, the no education group and farmers, to be targeted and carried along in the campaign for the use of contraceptive methods.

Pattern and determinants of contraceptive use among the muslim women in Wajir and Lamu counties in Kenya: a cross-sectional study.

Improving access to family planning (FP) is associated with positive health benefits that includes averting nearly a third of all maternal deaths and 10% of childhood deaths. Kenya has made great strides in improving access to family planning services. However, amid this considerable progress, regional variation has been noted which begs the need for a clearer understanding of the the patterns and determinants that drive these inconsistencies. We conducted a cross-sectional study that involved 663 Muslim women of reproductive age (15-49 years) from Wajir and Lamu counties in Kenya between March and October 2018.The objective of this study was to understand patterns and determinants of contraceptive use in two predominantly Muslim settings of Lamu and Wajir counties that have varying contraceptive uptake. Eligible women were interviewed using a semi-structured questionnaire containing socio-demographic information and history of family planning use. Simple and multiple logistic regression were used to identify determinants of family planning use. The results were presented as Crude Odds Ratio (COR) and Adjusted Odds Ratio (AOR) ratios at 95% confidence interval. A p-value of 0.05 was considered statistically significant. Of the 663 Muslim women of reproductive age consenting to participate in the study, 51.5%, n = 342 and 48.5%, n = 321 were from Lamu and Wajir County, respectively. The prevalence of women currently using contraceptive was 18.6% (n = 123). In Lamu, the prevalence was 32.8%, while in Wajir, it was 3.4%. The determinants of current contraceptive use in Lamu include; marital status, age at marriage, employment status, discussion with a partner on FP, acceptability of FP in culture, and willingness to obtain information on FP. While in Wajir, determinants of current contraceptive use were education, and the belief that family planning is allowed in Islam. Our study found moderately high use of contraceptives among Muslim women of reproductive age in Lamu county and very low contraceptive use among women in Wajir. Given the role of men in decision making, it is critical to design male involvement strategy particularly in Wajir where the male influence is very prominent. It is critical for the government to invest in women and girls' education to enhance their ability to make informed decisions; particularly in Wajir where FP uptake is low with low education attainment. Further, our findings highlight the need for culturally appropriate messages and involvement of religious leaders to demystify the myths and misconception around family planning and Islam particularly in Wajir.

Prevalence, trends, and determinants of contraception use among women in Nigeria: An analysis of Nigeria demographic and health surveys 2008 to 2018.

Within Africa, maternal mortality remains a concern that can be prevented and addressed. Among the various African countries, Nigeria has one of the highest mortality rates, particularly in a context where the population continues to rise. The relationship between contraceptive usage among married Nigerian women and low socioeconomic development contributes to another concerning public health issue- performing unskilled abortions. This cross-sectional study examines how seven (7) key social determinants of health impact the usage of contraceptive methods among Nigerian women ages 15-24. Data were analyzed and acquired from the Nigerian Demographic and Health Survey (NDHS) and the National Population Commission (NPC) in 2008, 2013, and 2018. Bivariate and multivariable logistic regression analyses illustrate social determinants have a deep effect on access and usage of contraceptives in Nigeria. Results yielded that as factors such as age, education, and socioeconomic status increase, the use of contraceptives increases as well. While autonomy has little to no significance, religion and urbanity present challenges to Nigerian women who are interested in using contraceptives. More so, this study suggests a stronger need for education for Nigerian women at an early age and deepening the understanding of the barriers to contraception use with the help of the community and religious leaders.

Understanding adolescent girls’ experiences with accessing and using contraceptives in Zambia

BackgroundGlobally, the unmet need for contraception among adolescent girls is high and is driven by barriers to access and utilisation of contraceptives. Understanding adolescent girls’ experiences with accessing and using contraceptives is crucial because it influences their decision to use and willingness to continue using health products and services. While determinants of contraceptive use have been extensively researched globally, few studies explore how adolescent girls experience contraceptive use in Zambia using qualitative methods. Therefore, this study aimed to understand Zambian adolescent girls’ experiences using contraceptives.MethodsThematic analysis was used to analyse data generated from 7 focus group discussions and three in-depth interviews with adolescent girls aged 15 to 19 years in 4 districts in Zambia. NVivo version 12 pro (QSR International) software was used to manage and organise the data.ResultsResults revealed that adolescents’ experiences concerning contraceptives across the continuum of care are shaped by various factors, including knowledge of contraceptives which comprises sources of information and contraceptives; experience with using contraceptives, challenges with access to contraceptives, and misconceptions about contraceptives; perspectives about existing contraceptives; and preferred types of contraceptives.ConclusionThe multifactorial interaction relating to adolescents’ personal experience, their community and the environment in which they access contraceptive services all contribute to their overall experience and influence their contraceptive decisions. Therefore, qualitative studies exploring adolescents’ experiences with accessing and using contraceptives are vital for tailoring interventions responsive to the contraceptive needs of this age group.

Attitude and determinants of contraceptive use among the Juang tribe: A cross-sectional study in Odisha, India

BackgroundIn India, Scheduled Tribes (STs) often have the lowest performance across various health measures, including contraceptive use. The condition of the Particularly Vulnerable Tribal Groups (PVTGs) is perceived to be worse. This study assesses attitudes and determinants of contraceptive use among the Juang tribe, a PVTG residing in Odisha, India. MethodsData from a cross-sectional mixed-method research with a three-stage sampling design that was carried out in 2020–2021 were utilized for this study. The analysis was based on quantitative data from 360 currently married women aged 15–49 years, and qualitative interviews with women and men (12 Focus group discussions and 12 Key-Informant Interviews). Binary logistic regression was used to assess the determinants of contraceptive use among Juang women. ResultsTwo-thirds of Juang women had low/moderately favorable attitudes towards contraceptive method use. Thirty-four percent of women were using any contraceptive methods. The adjusted odds ratio (AOR) of using contraception was low among the women aged 15–24 years (AOR = 0.38; 95 % CI: 0.19–0.73), illiterate (AOR = 0.11; 95 % CI: 0.06–0.20), married below 18 years (AOR = 0.38; 95 % CI: 0.18–0.77), and not exposed to mass media (AOR = 0.34; 95 % CI: 0.18–0.65) than their respective counterparts. ConclusionsAmong the Juang tribe, the use of contraception is limited and influenced by socio-cultural factors, including existing gender norms. Illiteracy, marriage below 18, younger age, and non-exposure to mass media are significantly associated with the non-use of contraception. Results suggest strengthening and expanding the family planning program outreach, especially among the young, illiterate Juang women.

Contraceptive awareness and its determinants for use among women of reproductive age: A cross sectional study

Introduction: According to the WHO, family planning is an approach to thinking and living that people and couples freely adopt in order to enhance their health and welfare based on their knowledge, attitude, and responsible choices. Each year, incorrect use of contraceptives or their failure to work as intended results in around one-third of unwanted births. The obstacles that exist in poorer nations include a lack of awareness about contraceptive techniques, the availability of supplies, their cost, or their inadequate accessibility. Method: This was a cross sectional study; conducted to asses o contraception awareness, acceptance, and adoption among women of reproductive age. Women who attended/delivered at the Saidham Hospital affiliated to Dr. Mane Medical Foundation and Research Centre (DMMFARC) Maharashtra, India were included. Face-to-face interviews were conducted while data were collected using a structured questionnaire. Result: Out of total 359 total women the majority 115 (32.02%) belonged to the 21–25 age group, while 197 (54.87%) were housewives, 112 (31.19%) had higher secondary education, 201 (54.98%) belonged to the lower socioeconomic class and were BPL cardholders, 191 (52.20%) belonged to rural areas, and Hindu populations contributed 182 (50.69%). Furthermore,165 (45.96%) study participants had one child, and 21 (5.84%) had a history of one abortion. occupation, level of education, socioeconomic class, area of residence, and religion showed statistically significant relationships with contraception usage. Conclusion: The present study concludes that the majority of women of reproductive age still do not use contraceptives and their opinion is not taken into account. More similar studies are needed to ascertain the determinants of contraceptive use and such knowledge can be used to formulate specific health education needed for adoption of family planning methods.

The Level and Determinants of Contraceptive Use Among Kampala International University Western Campus Students Between March and September 2022

The study aimed to evaluate the level and determinants of contraceptive utilization among students at Kampala International University, Western Campus in Bushenyi District, Uganda. A descriptive cross-sectional study was conducted using online questionnaires and Microsoft Excel v.2019. The majority of respondents were Pentecostals, single, and not formally employed. 24.48% were currently using any contraceptive method, with 69.25% being well-informed about different methods. Barriers to contraceptive utilization included ease of use, affordability, availability, and absence of side effects. Barriers included lack of information about contraceptive methods, rural setting, partner reluctance, and religious constraints. Contraceptive utilization is low among female students at KIU-WC, and stakeholders such as the clergy, women's partners, the university, and the municipal council must work together to address these barriers and address the unmet need for contraceptives among women. Keywords: Family planning, Maternal and child mortality rate, Contraceptive, Female students, Mothers.

Determinants of Contraceptive Use among Unmarried Young Women in Kakamega County, Kenya

Adolescent pregnancies adversely impact mental and reproductive health as well as educational and socio-economic outcomes. In Kakamega County, Kenya, 20% of adolescents begin childbearing by age 19. To inform interventions to reduce adolescent pregnancy, Jhpiego used the Barrier Analysis methodology, which is based on the Doer/Non-Doer study model, in which participants are categorized according to whether they are “Doers” or “Non-Doers” of the study behavior. This study examines the determinants of the behavior, “young unmarried women currently use modern contraceptive methods”. Participants included young women aged 15–19 who were sexually active, unmarried, and were using (“Doers”) or not using (“Non-Doers”) modern contraception. The findings reveal that the majority of Doers (88%) and Non-Doers (80%) understand the pregnancy risk associated with non-use, and there is no statistically significant difference between Doers’ and Non-Doers’ understanding of contraceptive benefits. Knowledge of side effects and misconceptions, such as the belief that contraception causes infertility, does not deter Doers from using contraception. Seventy percent of Doers note that contraception is accessible/available, while 39% of Non-Doers state the opposite. Doers are almost three times more likely than Non-Doers to say that most people approve of their contraceptive use, while Non-Doers are twice as likely as Doers to say that most people would not approve. Doers are four times more likely to indicate approval from their mothers and boyfriends. Non-Doers are five times more likely than Doers to have specific professional goals for the future. These findings illustrate the importance of moving away from fear-based messaging and instead highlighting social acceptability and contraception’s role in achieving future goals.

Women's empowerment and contraceptive use: Recent evidence from ASEAN countries.

A fundamental element of gender equity are women's rights to reproductive choice. Women's empowerment is often linked to enabling decisions around contraceptive use and reduced fertility worldwide, although limited evidence is currently available around contraceptive use and decision making in ASEAN countries. To examine the association between women's empowerment and contraceptive use in five selected ASEAN member states. Data from the latest Demographic and Health Survey of Cambodia, Indonesia, Myanmar, The Philippines, and Timor-Leste were used. The main outcome was contraceptive use among married women (15-49 years) from these five countries. We considered four indicators of empowerment: labor force participation; disagreement with reasons for wife beating; decision-making power over household issues; and knowledge level. Labor force participation was found to be significantly associated with contraceptive use in all nations. Disagreement with justification of wife beating was not significantly related to contraceptive use in any country. Decision-making power (higher) was only associated with contraceptive use in Cambodia, while higher knowledge levels were associated with contraceptive use in Cambodia, and Myanmar. This study suggests women's labor force participation is an important determinant of contraceptive use. Policies designed to open the labor market and empower women through education should be implemented to enable women's participation. Gender inequality may also be tackled by engaging women in decision-making processes at national, community and family levels.

Prevalence and determinants of contraception utilization over time in Migori County, Kenya: Repeated cross-sectional household surveys.

Contraception use and family planning have been shown to save lives and benefit women, their families, and their communities. We conducted a cross-sectional study analyzing data from a 2021 survey that was conducted across eight different regions in Migori County, Kenya to examine the potential role that different factors play in meeting family planning targets. Comparisons are made to data collected in 2018/2019 in order to estimate the change over time of contraception uptake. Descriptive statistics were calculated, the Cochran-Mantel-Haenszel test was used to compare contraception use over time, and multivariable logistic regression was used to model determinants of contraceptive use. Sixty-four percent of respondents in 2021 reported that they currently use some form of contraception, and implants are the most popular contraceptive method. Factors associated with higher contraception usage were region, ages 25-34 years, and marital status. Contraception uptake increased significantly in East Kamagambo following a community-driven sexual and reproductive health intervention by the Lwala Community Alliance, suggesting that increased investment in family planning may be influential. We recommend targeted outreach to population groups with low uptake of contraception and investment in both demand- and supply-side interventions to increase contraceptive uptake. Additional research, especially for populations under 18, is needed to further inform effective investment and policy.

Prevalence and determinants of Contraceptive practice in Women Attending Tikrit Teaching Hospital

Background: Family planning assist in achieving the optimal growth and development of each member in the family and protect the women from the side effects of multiple pregnancies. The aim of this study is to determine the prevalence, awareness and practice of contraceptives, and the determinants of contraceptive use among women attending Tikrit teaching hospital.Subjects and Methods: a cross sectional hospital based study was conducted in Tikrit teaching hospital from February to May 2011. A total of 280 married women aged between 15-50years were participated in this study.Results: The prevalence of family planning practice among them was 77.1%. Despite that all of women (100%) knew about contraception but only (80%) were in favor it. Favor and practice of contraception inversely related to educational level. Among users, the modern methods were the most common methods used by women (64.3%) while only (35.7%) used the natural traditional methods. Conclusion: this study revealed high awareness about family planning methods, in the same time the prevalence of practicing it was high. Favor and practice of contraception were more pronounced in low educated and unemployed women.

To use or not to use: Exploring factors influencing the uptake of modern contraceptives in urban informal settlements of Mumbai.

Rapid urbanization and a high unmet need for family planning in urban informal settlements point to the significance of identifying gaps that exist in the path of voluntary uptake of contraceptives. We undertook this study to better understand the perspectives related to family planning among women living in informal settlements of Mumbai. We used a mixed-methods approach, including a cross-sectional survey with 1407 married women of reproductive age and face-to-face in-depth interviews with 22 women, both users and non-users of modern contraceptives. 1070 (76%) of the participants were using modern contraceptives and women's age, education, parity, socioeconomic status and exposure to family planning interventions were the main determinants of contraceptive use. Poor contraceptive awareness before marriage coupled with social norms of early childbearing and completing family resulted in unplanned and less spaced pregnancies even among current users. In such cases, women either continued with the pregnancy or opted for abortion which sometimes could be unsafe. The decision to use contraceptives was taken in most cases after achieving the desired family size and was also influenced by belief in traditional methods, fear of side effects, spousal/family awareness and counselling by frontline workers. We recommend strengthening of sexual and reproductive health component of adolescent health programs. It is pertinent to inform women about their reproductive rights and most importantly empower them to practice these rights. This can be achieved by increasing women's age at marriage and continued promotion of formal education. Widespread misconceptions related to the side effects of modern methods need to be mitigated via counselling. Referral, follow-up, and suggestions on available choices of contraceptives should be given in case women face any side effects from the use of contraceptives. At the same time, improving spousal awareness and communication regarding family planning will allow couples to make informed decisions. Finally, roping in role models in the community will create an environment conducive to operationalizing rights-based family planning.

Distance-quality trade-off and choice of family planning provider in urban Pakistan.

There is limited evidence between contraceptive use, availability of commodities and distance to the facility in developing countries. Distance to the facility is an essential determinant of contraceptive use. Still, women may not seek family planning services from the nearest facility and may be prepared to travel the farthest distance to receive quality family planning services. We analyzed women's survey data linked to health facility data and applied an alternate specific conditional logit model to examine the distance a woman is prepared to travel and the quality of services offered by facilities in urban areas in Karachi, Pakistan. This study analyzed data from 336 women and 28 facilities and identified that the mean distance to the nearest facility was 0.44 km; the chosen facility was, on average, 5km away. Women preferred facilities that offered a range of contraceptive methods and additional services provided by female healthcare providers only. Furthermore, on average, women are willing to travel a further 1.7km for a facility that offers more family planning methods, 1.4km for a facility that offers additional health services and 11km for a facility that offers services delivered by female healthcare providers. The findings highlight the quality measures women prioritize over distance and consider essential when choosing a family planning facility.

Determinants of contraceptive use in Abidjan (Côte d'Ivoire).

In Côte d’Ivoire, contraceptive prevalence is low (21%). The search for determinants of contraceptive use could make it possible to redirect existing strategies. The objective is to identify the determinants of the use of contraception among women in Abidjan. A cross-sectional survey was conducted from May to June 2018 in the Dallas neighborhood of Adjamé municipal (Abidjan). Women of reproductive age (15 to 49 years old) were selected there. Sociodemographic, gyneco-obstetrical characteristics, educational level, attitudes and practices of women on contraception were collected. Univariate and multivariate analyzes were performed. A total of 301 women aged 29.34±8.98 years were selected. The proportion of women using modern contraception was 27.24%. In univariate analysis, the factors associated with use were: level of education (p=0.005), unwanted pregnancies (p=0.017), abortions (p<0.001), consultation of the gynecologist (p=0.003) or a family planning service (p=0.001). Hearing about contraception (p=0.043), knowing (p<0.001) and talking about it with their partner (p=0.027) was significantly associated with its use. In the multivariate analyses, the women who consulted a gynecologist and those who knew the contraceptive methods used them respectively 2 times more (OR= 2.16 [1.14-4.15], p=0.019) and 22 times more (OR= 22.38 [8.42-78.56], p<0.001). Women with primary school education used them significantly less (OR= 0.15 [0.05-0.41], p<0.001). Awareness, the gynecologist’s consultation, and the level of education were the main determinants of contraceptive use. Also, it is necessary to adapt awareness messages to the characteristics of women.

Determinants of Contraceptive Use at The First Sexual Intercourse among Unmarried Adolescents in Indonesia: 2017 IDHS Analysis

Adolescents confront boundaries in obtaining contraception counting prohibitive policies and adolescents possess failure to obtain contraceptives since of information, transportation, and monetary limitations. The objective of this study is to assign the variables which impact on the use of contraception for the first sexual intercourse among unmarried adolescents. Quantitative research employing cross sectional analysis was implemented in this study, by processing 2017 Indonesian Health Demographic Survey (IDHS) data. Cox regression was utilized to examine the association between sociodemographic, peer and social influences, contraceptive knowledge and contraceptive use. The study populace encompassed 705 single young people; 15 to 24 years old. The study resulted that contraceptive use at the primary sexual intercourse by single young people in Indonesia was approximately 50.35%. After bivariate analysis was applied, it was revealed that there is a significant relationship between education with the contraceptive use at the first sexual intercourse among unmarried adolescents in Indonesia (p-value = 0.049). In the final model, we discovered that the level of education and contraceptive use was statistically significant, and the contraceptive use was higher in adolescents with high education than adolescents with middle and primary education (PR 1.51, 95% CI 1.09 – 2.07, p = 0.012). Therefore, this finding provides information that education is a prominent variable for understanding contraceptive use in adolescents.

Community-based survey on the myths and use of contraceptive methods among married adults in Calabar South, Nigeria

Background: Despite the enormous benefits associated with contraceptive use, only a few sexually active married adults in developing countries like Nigeria use contraceptive methods, this situation is even worst in rural areas across Nigeria. This study examines the influence of myths on the use of contraceptive methods in Calabar South Local Government Area, Cross River State, Nigeria. Methods: Using the mixed approach, data were obtained from 600 respondents, using a multi-stage sampling technique which in this study entails the selection of community clusters, streets, villages, housing units and respondents through simple random and purposive sampling techniques. In the analysis and interpretation of study findings, descriptive statistics were employed, and qualitative data were analyzed using content analysis. Results: The study shows that fear of pregnancy-related complications and fear of infertility are significant determinants of contraceptive use in Calabar South LGA, Cross River State, Nigeria. Conclusion: The study, therefore, concludes that myths associated with contraceptive use are real and a strong factor that discourages most married adults from the use of contraceptive methods.

Determinants of contraceptive use among women 0-23 months postpartum in Kitui County, Kenya: A cross-sectional study.

The risk of unintended pregnancy is high in the postpartum period, especially during the first year of delivery. Yet, short birth intervals are associated with increased risk of adverse maternal and infant outcomes. In Kenya, despite women having multiple contacts with healthcare providers during their pregnancy and postpartum journeys, uptake of contraceptives during the postpartum period remains low. We examine factors that determine contraceptive use among postpartum women in Kitui County, Kenya.A cross-sectional study was conducted in six sub-counties of Kitui County covering a random sample of 768 postpartum women in April 2019. Logistic regression was used to study the association between uptake of contraceptives among women 0-23 months postpartum and several explanatory variables that included socio-demographic characteristics and facility-level factors. Overall, 68% of women in Kitui County reported using contraceptives. The likelihood of contraceptive use increased with the increase in the number of known family planning methods. Women who discussed family planning with a health worker within the last 12 months were 2.58 (95%CI: 1.73, 3.89) times more likely to use contraceptives during the postpartum period compared to those who did not. There was an increased odds of contraceptive uptake among women who received family planning information or service during postnatal care than those who did not (aOR = 2.04, 95%CI: 1.30, 3.24). A positive association was also found between contraceptive use and receipt of family planning information or service during immunization visits or during child well visits. It is evident that facility-level factors such as discussing family planning with women; educating women about different family planning methods; providing family planning information or services during postnatal care, immunization, or well child visits are associated with increased likelihood of contraceptive uptake by women during postpartum period. Programs targeting enhancing women's attendance of postnatal care clinics should be encouraged.

Applying a gender lens to social norms, couple communication and decision making to increase modern contraceptive use in Ethiopia, a mixed methods study

BackgroundEthiopia, sub-Saharan Africa’s second most populous country has seen improvements in women’s reproductive health. The study objectives are (1) using mixed methods research, to identify determinants of contraceptive use in four regions of Ethiopia, and (2) to explore the relationship between social norms, gender equitable norms, couple communication and contraceptive use.MethodsThe study includes both quantitative and qualitative methods. Researchers interviewed a total of 2770 women of reproductive age (15–49 years) in 2016 using a structured survey covering six health areas. Eligible households were identified using a multi-stage cluster-sampling technique. Using probability proportionate to size sampling, the researchers selected 10% of the proposed target woredas (24 of 240 woredas). The qualitative study included 8 rapid assessments, 16 in-depth interviews, 24 key informant interviews, and 16 focus group discussions. Qualitative data were analyzed using NVivo version 8.ResultsAdjusted odds ratios were estimated for current modern family planning use among married women with logistic regression. The primary influencing factors for contraceptive use are gender equitable norms, high self-efficacy, and weekly exposure to the radio. Qualitative data indicate that the timing of contraceptive use is linked to the social norm of the desired family size of 4–5 children. Gender inequity is evident in couple communication with men controlling decision making even if women initiated conversations on family planning. A key finding based on an inductive analysis of qualitative data indicates that the micro-processes of couple communication and decision making are often dictated by male advantage. The study identified six micro-processes that lead to gender inequity which need to be further examined and researched.ConclusionsBarriers to contraceptive use include unequal couple communication and compromised decision making. Inequitable gender norms are also barriers to modern contraceptive use. The study recommends using a gender lens to study couple communication and decision making, with the goal of making both processes more equitable to accelerate the adoption of modern family planning methods in Ethiopia.

Levels, patterns and determinants of using reversible contraceptives for limiting family planning in India: evidence from National Family Health Survey, 2015\u201316

BackgroundDemand for family planning is predominantly for birth limiting rather than birth spacing in India. Despite several family planning programmes in India, the use of reversible contraception for limiting family planning has been stagnant and largely depends on female sterilization. Though many researchers have examined patterns and determinants of using modern contraception for total family planning, studies on patterns and determinants of contraceptive use for birth limiting are limited in India. This paper examines the patterns of contraceptive use for liming demand and its determinants in India.MethodsThe National Family Health Survey-4, 2015–16 data was used. Bivariate chi-square significant test and multivariate binary logistic regression model used to accomplish the study objectives.ResultsMajority of women (86.5%) satisfied limiting demand (SLD) in India; the SLD was found significantly low among the women’s age 15–19 years (53.1%) and parity 0 (42%). The satisfied limiting demand by modern reversible contraception (mrSLD) was found significantly high in age group 15–19 years (49.1%), Muslims (30.6%) and North-east region (45.4%). The satisfied limiting demand by traditional contraception (tSLD) was almost three times higher in North-east region (26.1%) than national average of India (8.7%). The women’s years of schooling, wealth status, religion and presence of son child found to be significant determinants of mrSLD. The likelihood of tSLD was found significantly high among the women who had no son child (AOR = 1.41; 95% CI:1.34, 1.48), Muslim (AOR = 1.78; 95% CI:1.70, 1.87). A considerable regional variability in levels of SLD, mrSLD and tSLD was found in India.ConclusionPublic investment in family planning is required to promote and provide subsidized modern reversible contraception (MRC) services, especially to women from North-east region, Muslim, Scheduled tribe, poor household and who had no son child. Improving the quality and availability of MRC services in public health centre will be helpful to increase SLD among the above mentioned women. Besides, the promotion of MRC will be supportive to overcome the issues of sterilization regrets in India.