Disparities In Contraceptive Use Research Articles

Determinants Of Modern Contraceptives Use In Indonesia: A Spatial Analysis

Family planning in Indonesia is deemed as a strategic program to improve the quality of life for women. In reality, this program's development is influenced by social values and policy priorities in every region. Many studies have investigated the use of modern contraceptives in Indonesia, none of which presents the disparities in contraceptive use among regions. We conducted a descriptive and inferential analysis using secondary data from Government Performance and Accountability Survey (GPAS) 2019. This study determines the disparities in the use of modern contraceptives among married women between regions in Indonesia. Regional 1, as a pioneer of family planning program in Indonesia since 1969, has a higher modern contraceptive use prevalence (mCPR) than the national and other regions. Besides, the lowest mCPR is Regional 3 as the youngest of the program implementation. The three regions have diverse determinant factors of modern contraceptive use. This paper discusses the importance of considering the regional complexions to implement Indonesia's family planning program, especially modern contraceptives.

Contraceptive use among women with no fertility intention in Ethiopia.

IntroductionEthiopia is one of the Sub-Saharan African countries with high unintended pregnancy rate. Every woman in Ethiopia experiences at least one unintended birth. Although there were some studies about contraceptive use among all women in Ethiopia, evidence about contraceptive use among women with no fertility intention was limited. Therefore, this analysis was performed to assess the prevalence of contraceptive use and associated factors among fecund, married reproductive-age women who intended no more children.MethodsWe used the 2016 Ethiopian Demography and Health Survey (EDHS) data collected through a two-stage stratified cluster sampling technique. EDHS was a community based, cross-sectional study conducted from January 18, 2016, to June 27, 2016. A total of 2,859 fecund married reproductive age women with no desire to have more children were included in this study. Both descriptive and logistic regression analysis were performed using STATA V.14. A 95% confidence interval was used to declare statistical significance.ResultsContraceptive use among fecund married reproductive-age women who want no more children was 51.1% (95%CI: 47.0–55.24%). Visit by health workers at home (AOR = 1.37, 95%CI: 1.02, 1.83), living in Addis Ababa (AOR = 3.38 95%CI: 1.76, 6.37) and having better wealth index (middle (AOR = 1.76, 95%CI: 1.25, 2.47) and being rich (AOR = 1.96, 95%CI: 1.40, 2.74)) were found positively associated with contraceptive use. On the other hand, living in the Somali region (AOR = 0.10, 95%CI: 0.01, 0.85), and being Muslim (AOR = 0.45, 95%CI: 0.30, 0.67) were found negatively associated with contraceptive use.ConclusionContraceptive use among fecund married reproductive-age women with no fertility intention was low compared to their demand. Therefore, to improve contraceptive use, the provision of family planning counseling and information should be strengthened. Further intervention is needed to narrow disparities in contraceptive use among regions and different population groups.

Spatial variations and socioeconomic determinants of modern contraceptive use in Ghana: A Bayesian multilevel analysis.

The literature on spatial patterns and contextual factors affecting modern contraceptive use is not well-documented in Ghana. This study describes the spatial variations and estimates the socioeconomic determinants of modern contraception among women in reproductive age in Ghana. Using data from the 2014 Ghana Demographic and Health Survey, both global and local Moran’s I test were performed to show spatial autocorrelation and Bayesian multilevel models estimated to determine socioeconomic factors affecting modern contraceptive use. The results show evidence of low prevalence and spatial clustering of modern contraception use across the country. There were also notable regional disparities in contraceptive use that favour mostly the southern regions. Modern contraceptive use is significantly associated with socioeconomic factors such as educational attainment, work status, and marital status, as well as age, religious affiliation, and parity. Contextual factors such as the convenient location of health facility and family planning messages exposure also have a considerable positive effect on modern contraceptive use. Uneducated, unemployed and never-married women are considerably disadvantaged in the utilisation of modern contraception in Ghana. Socioeconomic and contextual factors play a key role in modern contraceptive use in Ghana.

Biomaterials and Contraception: Promises and Pitfalls.

The present state of reproductive and sexual health around the world reveals disparities in contraceptive use and effectiveness. Unintended pregnancy and sexually transmitted infection transmission rates remain high even with current prevention methods. The 20th century saw a contraceptive revolution with biomedical innovation driving the success of new contraceptive technologies with central design concepts and materials. Current modalities can be broadly categorized according to their mode of function: reversible methods such as physical/chemical barriers or hormonal delivery devices via systemic (transdermal and subcutaneous) or localized (intrauterine and intravaginal) administration, and nonreversible sterilization procedures such as tubal ligation and vasectomy. Contraceptive biomaterials are at present dominated by well-characterized elastomers such as polydimethylsiloxane and ethylene vinyl acetate due to their favorable material properties and versatility. Contraceptives alter the normal function of cellular components in the reproductive systems to impair fertility. The purpose of this review is to highlight the bioengineering design of existing methods, explore novel adaptations, and address notable shortcomings in current contraceptive technologies.

Closing the Poor-Rich Gap in Contraceptive Use in Rwanda: Understanding the Underlying Mechanisms.

Evidence suggests that as Rwanda has strengthened its family planning program, disparities in contraceptive use by socioeconomic status have narrowed. However, the changes in these gaps, and the mechanisms that underlie them, are not well understood. Data from the 2005, 2010 and 2015 Rwanda Demographic and Health Surveys on 19,028 in-union women aged 15-49 were analyzed to examine trends in socioeconomic disparities in contraceptive use. Descriptive statistics and multivariate regression with interaction terms were used to identify changes in these disparities, as well as to describe trends in desired fertility, and in types and sources of contraceptives used. Between 2005 and 2015, the prevalence of modern contraceptive use rose from 11% to 48%. In the regression analysis, interaction terms indicated that prevalence increased to a lesser extent among women who were wealthy, had a least a secondary education or lived in urban areas than among those who were poor, were uneducated or lived in rural areas (odds ratios, 0.5-0.7). In parallel, declines in desired fertility were greater among women with no education than among those with at least a secondary education (by 0.7 vs. 0.5 children); among the poorest than the richest women (by 1.0 vs. 0.5 children); and among rural than urban residents (by 0.9 vs. 0.4 children). The shrinking of gaps in contraceptive use by socioeconomic status coincided with narrowing of disparities in demand for children and with improvements in family planning services, suggesting that disadvantaged populations may have especially benefited from public programs to increase contraceptive access.

Spatial Analysis of Socio-Economic and Demographic Factors Associated with Contraceptive Use among Women of Childbearing Age in Rwanda.

Contraceptive use is considered as essential for protecting women’s health and rights, influencing fertility and population growth, and helping to promote economic development. The main objective of this study was to analysis the factors and spatial correlates of contraceptive use among women of childbearing age. The 2015 Rwanda Demographic and Health Survey (RDHS) data were used to identify the factors associated with contraceptive use in Rwanda. A Bayesian geo-additive model was used in order to account for fixed effects, nonlinear effects, spatial and random effects inherent in the data. The overall prevalence of use of any contraceptive method among married women of childbearing age in Rwanda was 52.7%. A woman’s age, wealth quintile, level of education, working status, number of living children, and exposure to the media was found to increase contraceptive use. The findings from the study also found disparities in contraceptive use at provincial and district level, where prevalence was higher in districts of Northern provinces and lower in districts of western provinces. The findings of this study suggest that exposure to information on contraceptive use in health centres, empowerment of women to access quality contraceptive-use services and religions to play an important role in explaining and informing their adherents on the importance of using a contraceptive method.

Factors explaining the North–South differentials in contraceptive use in Nigeria: A nonlinear decomposition analysis

Background: Northern Nigeria has some of the worst reproductive health indicators worldwide. Conspicuous North–South variations exist in contraceptive use; not much is known about the drivers of contraceptive use disparities in the North compared to the South. Objective: In this study, we examine the relative weights of the factors that contribute to this North–South gap in contraceptive prevalence. Methods: Using the women’s 2013 Demographic Health Survey dataset, we applied a nonlinear decomposition technique to determine the contribution of sociodemographic and socioeconomic characteristics, conjugal relationship dynamics, intimate partner violence, ideational variables, and Islamic culture to the North–South disparities in contraceptive use. Results: There was a gap of 12.4 percentage points in contraceptive prevalence between the north and south of Nigeria (5.2% vs 17.6%). The largest contributors to the gap were ideational characteristics (explaining 42.0% of the gap) and socio-economic profiles (explaining 42.6%). Patterns of conjugal relationship dynamics (11.1%), socio-demographic characteristics (‒11.0%), Islamic religious culture (7.6%), and exposure to family planning messaging (6.1%) were also significant contributors. Conclusions: Effective interventions to increase contraceptive use in northern Nigeria should aim at addressing socioeconomic disadvantage in the North, impacting ideational characteristics and specifically targeting poor women and those with low levels of education. Working with Islamic religious leaders is also critical to bridging the gap. Contribution: This paper broadens the knowledge on the determinants of contraceptive use in Nigeria by identifying contextual factors that operate differently in the North compared to the South.

Racial and Ethnic Disparities in Contraceptive Use in Young Women [27A

INTRODUCTION: Young women have the highest rates of unintended pregnancies among reproductive-aged women. Black and Latina women are at highest risk. Few studies have examined reasons for these differences. In this study, we examined disparities in contraceptive use and contraceptive counseling by race and ethnicity among young women. METHODS: Using the 2011-2013 National Survey of Family Growth (NSFG), a cross-sectional, nationally representative database, our analysis included women aged 15-24 years who had sexual intercourse within the past year, and were not pregnant or seeking pregnancy. The primary outcomes were contraceptive use and receipt of contraceptive services within the past 12 months. RESULTS: We found no difference in overall contraceptive use or rates of contraceptive counseling. However, Hispanics (H) and Non-Hispanic Blacks (NHB) primarily relied on Tier 3 methods of contraception (H: 56.7%, NHB: 60.2%, Non-Hispanic Whites (NHW): 45.1%, Non-Hispanic Others (NHO): 40.2%), despite being more likely than NHW and NHO to use Tier 1 methods (H: 9.2%, NHB: 9.9%, NHW: 8.2%, NHO: 8.3%). NHW and NHO were most likely to use Tier 2 methods (H: 34.1%, NHB: 29.8%, NHW: 46.7%, NHO: 51.48%; p=0.026). Additionally, NHW and NHO were most likely to have been prescribed contraception within the last 12 months (H: 49.6%, NHB: 49.0%, NHW: 60.1%, NHO: 64.8; p=0.047). CONCLUSION: Black and Latina women are more likely to rely on Tier 3 methods for pregnancy prevention despite similar rates of contraceptive counseling. Future studies should explore reasons for the predominance of the use of less effective contraceptive methods among young black and Latina women.

Factors associated with contraceptive use in Tigray, North Ethiopia

BackgroundFamily planning interventions are cost-effective and have several cross-cutting benefits. Despite these benefits of family planning, progress in ensuring universal access to family planning to women in developing countries has been slow. In light of this; this study investigated the prevalence and factors associated with contraceptive use in Tigray Region, Northern Ethiopia.MethodsA community-based cross-sectional study was conducted among 1966 women of reproductive age group (15–49) in 13 districts (3 urban and 10 rural) from May-June 2015. Multistage sampling technique was employed to approach the study participants. Data were analyzed using SPSS version 20. Multiple variable logistic regression analysis was used to identify the effect of independent variables on utilization of contraceptive use.ResultsOut of total 1966 women, 1879 (95.6%) have ever heard about family planning. Depo-Provera (depot medroxyprogesterone acetate, or DMPA) was the most popular contractive method as mentioned by 1757 (93.5%) of the participants. The overall contraceptive prevalence rate among all women was 623 (35.6%) while the contraceptive prevalence rate among married women was 543 (41.0%). Seven-in-ten women had ever used short acting contraceptive. In fact Depo-Provera was the most common type of contraceptive used as mentioned by 402 (64.5%) of the women.The odds of using family planning by married women living in urban areas was two times more than their counterparts (AOR = 2.0, 95% of CI: 1.33, 3.06). Similarly, the odds of using family planning among mothers with primary education was 1.3 times more as compared with no education (AOR = 1.3, 95% of CI: 1.02,1.93). However, as regards to long acting contraceptive methods, the odds of using long acting contraceptive methods use among married women in urban areas was 50% less when compared to rural married women (AOR = 0.5, 95% of CI: 0.3, 0.88).ConclusionContraceptive prevalence rate in Tigray region increased almost four fold in just 15 years. However, the increase is not yet enough to meet national and global targets. Further interventions are needed to narrow disparities in contraceptive use among different population groups and increase long acting contraceptive users. Moreover, improving quality of family planning in terms of the content of information provided to clients is crucial.

Racial/ethnic differences in contraceptive preferences, beliefs, and self-efficacy among women veterans

Significant racial/ethnic disparities in unintended pregnancy persist in the United States, with the highest rates observed among low-income black and Hispanic women. Differences in contraceptive preferences, beliefs, and self-efficacy may be instrumental in understanding contraceptive behaviors that underlie higher rates of unintended pregnancy among racial/ethnic minorities. Our objective was to understand how contraceptive preferences, beliefs, and self-efficacy vary by race and ethnicity among women veterans. We analyzed data from the Examining Contraceptive Use and Unmet Need Study, a national telephone survey of women veterans aged 18-44 years who had received primary care at the Veterans Administration in the prior 12 months. Participants rated the importance of various contraceptive characteristics and described their level of agreement with contraceptive beliefs using Likert scales. Contraceptive self-efficacy was assessed by asking participants to rate their certainty that they could use contraception consistently and as indicated over time using a Likert scale. Multivariable logistic regression was used to examine associations between race/ethnicity and contraceptive attitudes, controlling for age, marital status, education, income, religion, parity, deployment history, and history of medical and mental health conditions. Among the 2302 women veterans who completed a survey, 52% were non-Hispanic white, 29% were non-Hispanic black, and 12% were Hispanic. In adjusted analyses, compared with whites, blacks had lower odds of considering contraceptive effectiveness extremely important (adjusted odds ratio; 0.55, 95% confidence interval, 0.40-0.74) and higher odds of considering the categories of does not contain any hormones and prevents sexually transmitted infections extremely important (adjusted odds ratio, 1.94, 95% confidence interval, 1.56-2.41, and adjusted odds ratio; 1.99, 95% confidence interval, 1.57-2.51, respectively). Hispanics also had higher odds than whites of considering the category of does not contain any hormones and prevents sexually transmitted infections extremely important (adjusted odds ratio, 1.72, 95% confidence interval, 1.29-2.28, and adjusted odds ratio, 1.63; 95% confidence interval, 1.21-2.19, respectively). Compared with whites, blacks and Hispanics had higher odds of expressing fatalistic beliefs about pregnancy (adjusted odds ratio, 1.79, 95% confidence interval, 1.35-2.39, and adjusted odds ratio, 1.48, 95% confidence interval, 1.01-2.17, respectively); higher odds of viewing contraception as primarily a woman's responsibility (adjusted odds ratio, 1.92, 95% confidence interval, 1.45-2.55, and adjusted odds ratio, 1.77; 95% confidence interval, 1.23-2.54, respectively); and lower odds of being very sure that they could use a contraceptive method as indicated over the course of a year (adjusted odds ratio, 0.73, 95% confidence interval, 0.54-0.98, and adjusted odds ratio, 0.66, 95% confidence interval, 0.46-0.96, respectively). Women veterans' contraceptive preferences, beliefs, and self-efficacy varied by race/ethnicity, which may help explain observed racial/ethnic disparities in contraceptive use and unintended pregnancy. These differences underscore the need to elicit women's individual values and preferences when providing patient-centered contraceptive counseling.

Understanding patterns of contraceptive use among never married Mexican American women

Author(s): Choi, KH; Hamilton, ER | Abstract: BACKGROUND Non-marital fertility differs considerably by race, ethnicity, and nativity. These differences arise largely from racial and ethnic disparities in contraceptive practices. Empirical work has not assessed the relative importance of the various mechanisms proposed to account for racial, ethnic, and nativity differences in contraceptive behavior among never married women. OBJECTIVE Our objective is to describe racial, ethnic, and nativity disparities in contraceptive practices and determine the relative importance of the various mechanisms proposed to explain those disparities among never married, non-cohabiting women. METHODS Pooling data from the 2006-2010 and 2011-2013 National Survey of Family Growth (NSFG), we compare the age- and parity-standardized patterns of contraceptive use among never married, non-cohabiting Mexican immigrants, US-born Mexican Americans, Blacks, and Whites. We also examine the extent to which socioeconomic characteristics, access to family planning, and attitudes towards family life give rise to group differences in patterns of contraceptive use. RESULTS Never married, non-cohabiting Whites are more likely than their minority counterparts to use very effective methods of contraception. Socioeconomic disparities explain some of the group differences in contraceptive practice. Differing levels of access to family planning also explain a significant portion of the difference in contraceptive practice between Whites and Mexican immigrants. CONCLUSION Policies aimed at alleviating socioeconomic inequality and differential access to family planning services may be effective at reducing disparities in contraceptive use between White and non-White never married, non-cohabiting women, especially White/Mexican-immigrant differences.

Racial and Ethnic Differences in Contraceptive use Among Women Who Desire No Future Children, 2006–2010 National Survey of Family Growth

Unintended pregnancies are either mistimed pregnancies occurring sooner than desired or unwanted pregnancies occurring when no children (or no more children) are desired. Unwanted pregnancies appear to be associated with poor pregnancy outcomes, specifically higher risk of preterm delivery and premature rupture of membranes. Women from racial and ethnic minority groups are more likely than white women to experience an unwanted pregnancy. Racial/ethnic differences in contraceptive use patterns among black and Hispanic women are the most likely proximal cause of observed disparities in unintended pregnancy. Several studies have reported that black women are more likely than white women to not use contraceptives or use contraception inconsistently, to have more contraceptive failures, and to less frequently use some prescription methods. Little is known about disparities in contraceptive use among the specific subset of women who do not want any (more) children and who may be at particularly high risk for having an unwanted pregnancy. This study evaluated racial/ethnic differences in contraceptive use among women who do not desire future pregnancy. Nationally representative data were obtained from the 2006–2010 National Survey of Family Growth (NSFG) to examine the relationships between race/ethnicity and contraceptive use among a sample of sexually active, reproductive-age women who stated that they do not desire any (more) children. The primary study outcome measures were (1) use of any contraceptive method and (2) the effectiveness of contraceptive methods used by women using any method at last heterosexual intercourse. Multivariable logistic regression models were used to assess the independent effect of race/ethnicity on contraceptive use patterns, adjusting for sociodemographic factors, reproductive characteristics, and indicators of health care access and utilization. The study sample comprised 2900 sexually active women, aged 15 to 44 years, who were at risk of an unwanted pregnancy. The vast majority (91.2%) used contraception at last sex, although use varied significantly by race/ethnicity; 93.2% of white women reported use of any method, compared with 84.7% of black and 90.5% of Hispanic women; P < 0.01. In the fully adjusted model, black women were significantly less likely than whites to use any contraception at last sex (odds ratio [OR], 0.43; 95% confidence interval, 0.27–0.73); in contrast, there was no significant difference among Hispanic women (OR, 0.95; 95% confidence interval, 0.52–1.72). In bivariate analysis, the type of contraceptive method used at last sex among women who used a method at last sex varied significantly by race/ethnicity (P < 0.01), although most women (59%) used a highly effective method. In the fully adjusted model, however, racial/ethnic differences were no longer significant: There were no significant differences between white women and black or Hispanic women with regard to use of highly/moderately effective contraception. Among the subset of women who report that they do not want (more) children, black women are significantly less likely than white women to use any contraception at last intercourse; this disparity does not appear to be due to differences in sociodemographic characteristics, reproductive factors, or utilization of health care.

Seeking causes for race-related disparities in contraceptive use.

An attempt to investigate correlations between race, attitudes, and contraceptive use did not find meaningful associations between race and attitudes about birth control or pregnancy that could influence contraceptive choice.

Racial/ethnic disparities in contraceptive use: variation by age and women's reproductive experiences

Disparities in unintended pregnancy in the United States are related, in part, to black and Hispanic women being overall less likely to use effective contraceptive methods. However, the fact that these same groups are more likely to use female sterilization, a highly effective method, suggests there may be variability in disparities in contraceptive use across a woman's life course. We sought to assess the relationship between race/ethnicity and contraceptive use in a nationally representative sample and to approximate a life course perspective by examining effect modification on these disparities by women's age, parity, and history of unintended pregnancy. We conducted an analysis of the 2006 through 2010 National Survey of Family Growth to determine the association between race/ethnicity and: (1) use of any method; (2) use of a highly or moderately effective method among women using contraception; and (3) use of a highly effective method among women using contraception. We then performed analyses to assess interactions between race/ethnicity and age, parity, and history of unintended pregnancy. Our sample included 7214 females aged 15-44 years. Compared to whites, blacks were less likely to use any contraceptive method (adjusted odds ratio, 0.65); and blacks and Hispanics were less likely to use a highly or moderately effective method (adjusted odds ratio, 0.49 and 0.57, respectively). Interaction analyses revealed that racial/ethnic disparities in contraceptive use varied by women's age, with younger women having more prominent disparities. Interventions designed to address disparities in unintended pregnancy should focus on improving contraceptive use among younger women.

Atitudes Surrounding Contraceptive Responsibility: Do Latino Youth Difer from Other Groups?

Recent estimates demonstrate that more than 75% of young women and men ages 15 to 19 used contraception at first sex and their most recent intercourse.1 However, there are notable disparities in contraceptive use by race/ethnicity. Female and male Latino adolescents are less likely than African American and white teens to report contraceptive use at first sex.2 In addition, Latino adolescents are less likely to report using condoms at last intercourse (54.9%) compared to African Americans (62.4%) and whites (63.3%) and were also less likely than whites to state they used hormonal methods (14.0% compared to 29.3% among whites).3 These lower rates of contraceptive use may be due, in part, to differences in attitudes about contraceptive decision-making. Several studies have noted that Latinos report that women are primarily responsible for contraception and preventing pregnancy,4-8 which is associated with less effective method use compared to when both partners are responsible for deciding on contraception.6,9-12 However, it is not clear whether attitudes placing responsibility for contraceptive use on women are more widely endorsed among Latinos compared to other racial/ethnic groups. Some of these studies have only included Latinos,4,7 and others that assessed attitudes across racial/ethnic groups found few differences.13 Additionally, little is known about the underlying beliefs and values that shape ideas about which partner or partners have responsibility for contraception and how these might vary by race/ethnicity. Such information is important in order to identify target areas for interventions that promote shared decision-making, and therefore increase effective use of contraception. In this study, we explore youths' attitudes toward contraceptive responsibility. The specific questions we address are: Which partner is usually responsible for contraception and why? How do these attitudes and beliefs vary, if at all, across racial/ethnic groups and gender? To answer these questions we used data collected from focus groups with Latino, African American and white young women and men. Focus groups are particularly well-suited for the study of this topic because they highlight values and norms within groups sharing similar characteristics, as well as identify beliefs underlying attitudes and behaviors.14

Racial/ethnic disparities in contraceptive use: variation by age and women's reproductive experiences

Racial/ethnic disparities in contraceptive use: variation by age and women's reproductive experiences

Racial and Ethnic Differences in U.S. Women's Choice Of Reversible Contraceptives, 1995–2010

In the United States, unintended pregnancies disproportionately affect minority populations. Persistent disparities in contraceptive use between black and Hispanic women and white women have been identified, but it is unclear whether racial and ethnic differences in use of the most effective methods have changed. Data on 4,727 women from the 1995 National Survey of Family Growth and 5,775 women from the 2006-2010 cycle were used to examine the association between race and ethnicity and women's choice of reversible contraceptives according to level of method effectiveness. Stepwise multinomial logistic regressions were used to identify changes in this association between cycles. Analyses controlled for demographic, socioeconomic, family, religious, behavioral and geographic characteristics. The proportion of women using the most effective reversible contraceptive methods increased from 46% in 1995 to 53% in 2006-2010. In 1995, black and Hispanic women's use of the most effective reversible contraceptives did not differ from that of white women. By 2006-2010, however, black women were substantially less likely than white women to use highly effective reversible contraceptive methods rather than no method (relative risk ratio, 0.6). An analysis that combined the two data sets and included a term for the interaction between survey year and race and ethnicity found that relative to white women, black women were less likely in 2006-2010 than in 1995 to use more effective methods rather than no method (0.6). Further research is needed to identify factors that may be causing racial and ethnic disparities in contraceptive decisions to widen.

Ethnic Disparities in Contraceptive Use and its Impact on Family Planning Program in Nepal

Aims: Regardless of three decades of implementation of family planning program in Nepal, need of family planning services is largely unmet. Systematic studies, evaluating the impact of family planning program on several ethnic groups of Nepal has not been carried out in large scale. This study sheds light on the investigation of, whether the use of contraceptives varies among different ethnic groups in Nepal and what are the predictors of contraceptive variance in ethnic groups in Nepal. Methods: The study is based on data collected from Nepal Demographic Health Survey (NDHS) 2006. Multilevel logistic regression analyses of 10793 married women of reproductive age nested within 264 clusters from the surveys were considered as the sample size. Individual, household, and program variables were set and a multilevel logistic regression model was fitted to analyse the variables, using GLLAMM command in STATA-9. Results: Multilevel logistic regression analysis indicated that Muslims, Dalits and Terai Madheshi women were significantly less likely to use modern contraceptives compared to the Brahmins and Chhetries (Higher Castes). Women who were exposed to family planning information on radio were more likely to use modern contraceptives than women not exposed to radio information (OR=1.22, P&gt; 0.01). An odd of using contraceptives by Newars was (OR 1.09, P&gt;0.05), the highest among all ethnic groups. Exposure of women to family planning messages through health facilities, family planning workers and means of communication, increased the odds of using modern contraceptives. However, impact of the family planning information on contraceptive use varied among ethnicity. Conclusions: Special attention needs to be paid, in particular to the ethnicity, while formulating family planning policies in Nepal, for better success rate of family planning intervention programs. NJOG 2011 Nov-Dec; 6 (2): 14-19 DOI: http://dx.doi.org/10.3126/njog.v6i2.6750

Racial and Ethnic Disparities in Contraceptive Method Choice in California

Unintended pregnancy, an important public health issue, disproportionately affects minority populations. Yet, the independent associations of race, ethnicity and other characteristics with contraceptive choice have not been well studied. Racial and ethnic disparities in contraceptive use among 3,277 women aged 18-44 and at risk for unintended pregnancy were assessed using 2006-2008 data from of the California Women's Health Survey. Sequential logistic regression analyses were used to examine the independent and cumulative associations of racial, ethnic, demographic and socioeconomic characteristics with method choice. Differences in contraceptive use persisted in analyses controlling for demographic and socioeconomic characteristics. Blacks and foreign-born Asians were less likely than whites to use high-efficacy reversible methods-that is, hormonals or IUDs (odds ratio, 0.5 for each). No differences by race or ethnicity were found specifically for IUD use in the full model. Blacks and U.S.-born Hispanics were more likely than whites to choose female sterilization (1.9 and 1.7, respectively), while foreign-born Asians had reduced odds of such use (0.4). Finally, blacks and foreign-born Asians were less likely than whites to rely on male sterilization (0.3 and 0.1, respectively). Socioeconomic factors did not explain the disparities in method choice among racial and ethnic groups. Intervention programs that focus on improving contraceptive choice among black and, particularly, Asian populations need to be developed, as such programs have the potential to reduce the number of unintended pregnancies that occur among these high-risk groups.

How Australian Female Adolescents Prioritize Pregnancy Protection

Grounded theory principles were systematically employed to reveal key differences in pregnancy risk and underlying disparities in contraceptive use in (a) never-pregnant (b) pregnant-terminated and (c) pregnant-continued teenagers. Analysis of 69 semistructured interviews revealed a bicausal model of pregnancy protection that accounted for variation in contraceptive use across the sample. Diverging pregnancy/childbearing desires and risk perceptions were conceptualized into three behavioral patterns that represented higher and lower levels of commitment to prevent pregnancy. The various ways that teenagers made sense of their behavior highlight the importance of acknowledging and respecting diversity in perspectives and experiences and provide a useful framework for educational and practitioner-delivered interventions with greater relevance and impact.