Increase In Contraceptive Use Research Articles

Mapping heterogeneity in family planning indicators in Burkina Faso, Kenya, and Nigeria, 2000–2020

BackgroundFamily planning is fundamental to women’s reproductive health and is a basic human right. Global targets such as Sustainable Development Goal 3 (specifically, Target 3.7) have been established to promote universal access to sexual and reproductive healthcare services. Country-level estimates of contraceptive use and other family planning indicators are already available and are used for tracking progress towards these goals. However, there is likely heterogeneity in these indicators within countries, and more local estimates can provide crucial additional information about progress towards these goals in specific populations. In this analysis, we develop estimates of six family indicators at a local scale, and use these estimates to describe heterogeneity and spatial–temporal patterns in these indicators in Burkina Faso, Kenya, and Nigeria.MethodsWe used a Bayesian geostatistical modelling framework to analyse geo-located data on contraceptive use and family planning from 61 household surveys in Burkina Faso, Kenya, and Nigeria in order to generate subnational estimates of prevalence and associated uncertainty for six indicators from 2000 to 2020: contraceptive prevalence rate (CPR), modern contraceptive prevalence rate (mCPR), traditional contraceptive prevalence rate (tCPR), unmet need for modern methods of contraception, met need for family planning with modern methods, and intention to use contraception. For each country and indicator, we generated estimates at an approximately 5 × 5-km resolution and at the first and second administrative levels (regions and provinces in Burkina Faso; counties and sub-counties in Kenya; and states and local government areas in Nigeria).ResultsWe found substantial variation among locations in Burkina Faso, Kenya, and Nigeria for each of the family planning indicators estimated. For example, estimated CPR in 2020 ranged from 13.2% (95% Uncertainty Interval, 8.0–20.0%) in Oudalan to 38.9% (30.1–48.6%) in Kadiogo among provinces in Burkina Faso; from 0.4% (0.0–1.9%) in Banissa to 76.3% (58.1–89.6%) in Makueni among sub-counties in Kenya; and from 0.9% (0.3–2.0%) in Yunusari to 31.8% (19.9–46.9%) in Somolu among local government areas in Nigeria. There were also considerable differences among locations in each country in the magnitude of change over time for any given indicator; however, in most cases, there was more consistency in the direction of that change: for example, CPR, mCPR, and met need for family planning with modern methods increased nationally in all three countries between 2000 and 2020, and similarly increased in all provinces of Burkina Faso, and in large majorities of sub-counties in Kenya and local government areas in Nigeria.ConclusionsDespite substantial increases in contraceptive use, too many women still have an unmet need for modern methods of contraception. Moreover, country-level estimates of family planning indicators obscure important differences among locations within the same country. The modelling approach described here enables estimating family planning indicators at a subnational level and could be readily adapted to estimate subnational trends in family planning indicators in other countries. These estimates provide a tool for better understanding local needs and informing continued efforts to ensure universal access to sexual and reproductive healthcare services.

Contraceptive Use in Females With Advanced CKD: A Qualitative Study

Pregnancy in females with kidney disease is not uncommon and is associated with adverse maternal and fetal outcomes. The use of contraception in females with chronic kidney disease remains low. We sought to describe the perspectives of female patients with advanced chronic kidney disease on the use of contraception. Qualitative study. We conducted 5 focus group interviews involving 16 adult female patients with advanced chronic kidney disease (n=3nondialysis nontransplant chronic kidney disease, n=9kidney transplant, and n=4kidney failure receiving dialysis) in the United States, following which thematic saturation was reached. Interview transcripts were analyzed thematically. We identified the following 5 themes: 1) variable knowledge regarding reproductive health with kidney disease, 2) inadequate counseling about contraceptive use, 3) lack of interdisciplinary coordination regarding contraceptive use, 4) insufficient educational resources available to guide the contraceptive discussion, and 5) need for research to better understand reproductive needs in females with kidney disease. Patients were from a single center in the United States, and the study is limited by the transferability of findings to other settings. Patients with chronic kidney disease report emotional challenges with reproductive health, lack of counseling and care coordination, and insufficient resources for contraceptive use. Strategies to strengthen these factors may improve the quality of reproductive care and increase contraceptive use for females with chronic kidney disease. Pregnancy in females with kidney disease is common and associated with a higher risk of adverse maternal and fetal outcomes, but the use of contraception remains low. Little is known about female patients' experiences in contraceptive use that may contribute to low contraceptive use in this high-risk population. In the present study using focus group interviews, patients with chronic kidney disease reported emotional challenges with reproductive health, lack of counseling and care coordination, and insufficient resources for contraceptive use. Interventions are needed to strengthen these factors to improve the quality of reproductive care and increase contraceptive use for females with chronic kidney disease.

Use of any contraceptive method among women in rural communities in the eastern region of Ghana: a cross-sectional study

BackgroundIn Ghana, there is an increase in contraceptive use for traditional and modern methods in rural areas. This study seeks to examine the prevalence and determinants of current use of any contraceptive method among women of reproductive age in the rural Eastern Region of Ghana.MethodsA community-based cross-sectional study was conducted among women of reproductive age in the rural Eastern region of Ghana. A structured questionnaire was used to interview women in rural Lower Manya and Upper Manya Krobo districts of Eastern region who were selected using a simple random sampling technique. The data were analysed using Stata version 16. A Binary logistic regression was used to examine the determinants of current use of any contraceptive use (traditional and modern methods).ResultsThe prevalence of contraceptive use was 27.8%. In the adjusted analysis of binary logistic regression, contraceptive use was significantly lower (aOR = 0.24; 95%CI = 0.10–0.56; p = 0.001) among respondents aged 41–49 years compared to those aged 18–35 years. Contraceptive use was significantly lower among migrants (aOR:0.53; 95%CI:0.28–0.99; p = 0.048) compared with non-migrant.ConclusionThe prevalence of any contraceptive use among rural women was low. Government and other stakeholders need to create awareness about contraception in the rural areas of Eastern region of Ghana and that would help increase contraceptive methods utilization. In addition, family planning programs should target migrants to design an intervention to increase contraceptive use in rural areas.

Trends and determinants of modern contraceptive utilisation among adolescent girls aged 15-19 years in Sierra Leone: an analysis of Demographic and Health Surveys, 2008-2019

Background Modern contraceptives are effective interventions for preventing unwanted pregnancies, but their use remain low among adolescent girls in sub-Saharan Africa. First, we aimed to assess the trends of modern contraceptive use among adolescent girls aged 15-19 years in Sierra Leone in the period 2008-2019. Second, we explored how individual and contextual determinants of their use changed during this period. Methods We used a combined sample of 8,774 adolescent girls aged 15-19 years from the 2008, 2013, and 2019 Sierra Leone Demographic and Health Surveys (SLDHS), respectively, to estimate the modern contraceptive prevalence rate (MCPR) and unmet need for family planning. We described the method mix and sources of contraceptives among modern method users. We then conducted a multivariable logistic regression to examine the determinants of modern contraceptive use among sexually active adolescent girls, separately for 2008 and 2019. Results MCPR increased from 5.9% (95% CI=4.5-7.8) in 2008 to 21.0% (95% CI=19.2-22.9) in 2019. Most of the increase had occurred by 2013. Norplant (48.8%) and injectables (39%) were the common methods in 2019. Unmet need for family planning declined from 15.4% (95% CI=13.2-17.9) in 2008 to 11.3% (95% CI=9.9-12.7) in 2019, while the prevalence of modern contraceptive use among sexually active adolescent girls increased from 13.1% (95% CI=10-17.0) in 2008 to 43.5% (95% CI=40.2-46.9) in 2019. In both the 2008 and 2019 surveys, the adjusted odds of using modern contraceptives among sexually active adolescent girls were higher among those with more than one sexual partner in the past 12 months, and with secondary or tertiary education. In 2019, the adjusted odds of using a modern contraceptive were also lower among adolescent girls who were married or living with a partner, had more than one child, and lived in the Western province. Conclusions The increase in contraceptive use among adolescent girls in Sierra Leone had stalled since 2013. Interventions, including increasing awareness and accessibility to modern contraceptives, are urgently needed, particularly for adolescents without formal education. Comprehensive and affordable community and school-based interventions, including adolescent-friendly services, would be helpful.

Community perspectives on family planning service quality among users and non-users: a qualitative study from two cities in Burkina Faso

BackgroundMost studies that focus on quality of family planning (FP) services collect data from facilities. These studies miss the perspectives of quality from women who do not visit a facility and for whom perceived quality may be a barrier to service utilization.MethodsThis qualitative study from two cities in Burkina Faso examines perceived quality of FP services from women who were recruited at the community level to avoid potential biases based on recruiting women at facilities. Twenty focus group discussions were undertaken with varying groups of women of different ages (15–19; 20–24; 25+), marital statuses (unmarried; married), and current modern contraceptive use experiences (current non-users; current users). All focus group discussions were undertaken in the local language and transcribed and translated into French for coding and analysis.ResultsWomen discuss FP service quality in a variety of locations, depending on their age group. Perspectives on service quality for younger women are often informed by others’ experiences whereas for the older women, they are formed by their own and others’ experiences. Two important aspects of service delivery emerge from the discussions including interactions with providers and selected system-level aspects of service provision. Important components of provider interactions relate to (a) the initial reception from the provider, (b) the quality of counseling received, (c) stigma and bias from providers, and d) privacy and confidentiality. At the health system level, discussions revolved around (a) wait time; (b) stockouts of methods; (c) costs of services/methods; (d) the expectation for tests as part of service provision; and (e) difficulties with method removal.ConclusionsTo increase contraceptive use among women, it is crucial to address the components of service quality they identify as related to higher quality services. This means supporting providers to offer services in a more friendly and respectful manner. In addition, it is important to ensure that full information is provided to clients on what to expect during a visit to avoid false expectations that lead to poor perceived quality. These types of client-focused activities can improve perceptions of service quality and ideally support use of FP to meet women’s needs.

Age, geographical and socio-economic related inequalities in contraceptive prevalence: evidence from the 1993–2014 Ghana Demographic and Health Surveys

BackgroundContraceptives afford individuals the opportunity to meet their reproductive needs and reduce maternal mortality. We aimed at assessing the trend and inequalities of contraceptive use in Ghana based on the 1993–2014 Ghana Demographic and Health Surveys.MethodsWe used the World Health Organization’s Health Equity Assessment Toolkit (HEAT) software in analysing the data. We adopted two approaches for the analysis. First, we disaggregated inequalities in contraceptive use using four equity stratifiers: wealth index, education, residence, and region. Second, summary measures (D), (PAR), (R), and (PAF) were also employed. A 95% uncertainty interval (UI) was constructed for point estimates to measure statistical significance.ResultsContraceptive prevalence increased from 20.3% in 1993 to 26.7% in 2014. The contraceptive prevalence among women aged 20–49 increased from 20.6% [95% UI = 19.1, 22.3] in 1993 to 26.8% [95% UI = 24.9, 28.9] in 2014 and this exceeded the increase that was recorded among those aged 15–19 (from 13% [95 UI = 8.7, 19] to 18% [95% UI = 11.5, 28.6]), in the same period. It was evident that substantial inequality existed with respect to contraceptive use, from 1993 to 2014, with widest inequality occurring in 2003 (PAF = 2.7, 95% UI = -16.6–21.9; D = 17.4, 95% UI = 12.7–22.1). In terms of wealth index, the least inequality was observed in 2014 (PAR = 1.3, 95% UI = -1–3.6; D = 5.9, 95% UI = -0.1–12). Regarding education, the widest inequality occurred in 1993 (PAF = 138.6, UI = 132.1–145.1; D = 40.1, 95% UI = 34.4–45.9). With place of residence, the widest gap in inequality occurred in 1993 (PAF = 51.2, 95% UI = 46.2–56.3; D = 15.3, 95% UI = 11.8–18.7). There was inequality in contraceptive use with respect to sub-national regions. In 2014, the Difference (D = 21, 95% UI = 14.6–27.4) and the PAF (PAF = 20.9, 95% UI = 11.2 − 30.5) measures revealed substantial absolute and relative regional inequality between the regions.ConclusionThere was a steady increase in contraceptive use from 20.3% in 1993 to 26.7% in 2014. Nevertheless, the percentage change is minimal. The trends of inequality indicate that inequalities in contraceptive use was evident across the dimension of age, place of residence, wealth index, education, and region. Yet, there was a substantial reduction in inequalities related to contraceptive use in 2014. Therefore, targeting adolescents, women in rural areas, low wealth quintile, and those with no formal education is key to substantially improving contraceptive use across the country.

The Methodological Approach to a Process Evaluation of a Community and Provider-Driven Social Accountability Intervention to Increase Contraceptive Uptake and Use

The community and provider-driven social accountability intervention (CAPSAI) project was a complex intervention consisting of interacting components, actors and processes, implemented in Ghana and Tanzania from 2018 to 2020. It aimed to measure the impact of a social accountability intervention implemented in family planning services, on contraceptive uptake and use. The intervention incorporated a process evaluation to identify key causal pathways and better understand factors influencing uptake and use, in the context in which the intervention was implemented. This study used a unique methodology to conduct the process evaluation, and looked at several outcomes, including service utilisation, continuation rates and attitudes and behaviours. Qualitative methods were used to evaluate the effects of the intervention – (1) context mapping, (2) a process evaluation of the different steps of the intervention, and (3) compiling cases of change. Document review, non-participant observation and in-depth interviews were conducted. Data analysis included summaries and coding of the qualitative data. Coding and thematic content analysis were conducted collaboratively across two countries and used a single codebook that was relevant to both countries, yet enabled country specific analysis. Each country team drafted reports that drew on the three data sets. Various lessons were learnt – including the importance of teamwork, development of standard operating procedures to guide practical study components, and how to prioritise study activities over a long study timeline. The study demonstrated that a process evaluation of a complex intervention across multiple countries is feasible, and was also able to yield differentiate results based on specificity in each country’s context. Based on this study, similar process evaluation activities can be replicated in future work.

Induced abortion incidence and safety in Burkina Faso in 2020: Results from a population-based survey using direct and social network-based estimation approaches.

This study aims to estimate induced abortion incidence and safety in Burkina Faso using direct and indirect methods, overall and by women's background characteristics. Data come from a nationally representative survey of reproductive aged women (n = 6,388). To address social desirability bias in abortion reporting, we asked about respondents' closest female friends' experience with abortion. The one-year abortion incidence in 2020 for respondents was 4.0 (95% CI 2.2-5.9) per 1,000 women aged 15-49 while the adjusted friend incidence was 22.9 (95% CI 15.8-30.0). Although not significant, abortion incidence was higher for adolescents, unmarried women, those with higher education, and those in urban areas among both respondents and their friends. Approximately nine out of ten abortions were unsafe (90% respondents, 95% friends), with respondent and friend findings suggesting higher risk of unsafe abortion among older women, less educated women, and women residing in rural areas. Despite recent increases in contraceptive use and continued legal restrictions, abortion remains common in Burkina Faso and is largely unsafe, with evidence of potential disparities.

Tuberculosis and Sexual and Reproductive Health of Women in Four African Countries.

Tuberculosis (TB) is a major reason of maternal mortality in low-income countries, and it increases the probability of adverse sexual and reproductive health (SRH) outcomes, including ectopic pregnancy and perinatal mortality. The data presented here is from the TB Sequel observational cohort conducted in four African countries. For this sub-study, we selected only female participants, who were diagnosed with drug susceptible TB and followed-up until the end of anti-TB treatment. The data collection included questionnaires, clinical examination and laboratory tests at TB diagnosis, day 14, month 2, 4 and 6. A total of 486 women, with 88.3% being 18-49 years old, were included in the analysis. Around 54.7% were HIV positive. Most of the participants (416/486; 85.6%) in our cohort were considered cured at month 6. Only 40.4% of non-pregnant women of reproductive age used contraception at TB diagnosis. A total of 31 out of 486 women experienced pregnancy during TB treatment. Pregnancy outcomes varied between live birth (16/31; 51.6%), induced abortion (6/31; 19.4%), miscarriage (4/31; 12.9%) and stillbirth (3/31; 9.6%). Integration and linking of SRH services with TB programmes are vital to increase contraception use and protect women from obstetric risks associated with pregnancy during TB treatment.

Exposure to family planning messages and contraceptive use among women of reproductive age in sub-Saharan Africa: a cross-sectional program impact evaluation study

Many women of reproductive age in sub Saharan Africa are not utilizing any contraceptive method which is contributing to the high burden of maternal mortality. This study determined the prevalence, trends, and the impact of exposure to family planning messages (FPM) on contraceptive use (CU) among women of reproductive age in sub-Saharan Africa (SSA). We utilized the most recent data from demographic and health surveys across 26 SSA countries between 2013 and 2019. We assessed the prevalence and trends and quantified the impact of exposure to FPM on contraceptive use using augmented inverse probability weighting with regression adjustment. Sensitivity analysis of the impact estimate was conducted using endogenous treatment effect models, inverse probability weighting, and propensity score with nearest-neighbor matching techniques. The study involved 328,386 women of reproductive age. The overall prevalence of CU and the percentage of women of reproductive age in SSA exposed to FPM were 31.1% (95% CI 30.6–31.5) and 38.9% (95% CI 38.8–39.4) respectively. Exposure to FPM increased CU by 7.1 percentage points (pp) (95% CI 6.7, 7.4; p < 0.001) among women of reproductive age in SSA. The impact of FPM on CU was highest in Central Africa (6.7 pp; 95% CI 5.7–7.7; p < 0.001) and lowest in Southern Africa (2.2 pp; 95% CI [1.3–3.0; p < 0.001). There was a marginal decline in the impact estimate among adolescents (estimate = 6.0 pp; 95% CI 5.0, 8.0; p < 0.001). Exposure to FPM has contributed to an increase in CU among women of reproductive age. Programs that are geared towards intensifying exposure to FPM through traditional media in addition to exploring avenues for promoting the appropriate use of family planning method using electronic media remain critical.

Does abolishing user fees for family planning increase contraception use? An impact evaluation of the national policy in Burkina Faso.

BackgroundUnmet needs for contraception constitute a major public health problem in sub-Saharan Africa. Several mechanisms have been tested to reduce the financial barrier and facilitate access to family planning services, with inconclusive results. Based on the positive impacts following the introduction of free health care for pregnant women, Burkina Faso decided to extend its national policy and abolished direct payment for family planning services. This study aims to evaluate the impact of this policy on contraceptive use and unmet needs for contraception among women of reproductive age (WRA) in Burkina Faso.MethodsThis study uses two different study designs to examine the impact of a user fee removal policy on contraceptive use across a panel of 1400 households randomly selected across eight health districts. Data were collected using a standardized socio-demographic questionnaire at three different time points during the pilot and scale-up phases of the fee abolition program. The questionnaire was administered six months after the launch of the pilot fee abolition program in four health districts. For the remaining four health districts, the survey was conducted one year prior to and six months after the implementation of the program in those areas. All WRA in the households were eligible to participate. A cross-sectional study design was used to determine the association between knowledge of the fee abolition policy among WRA and actual use of contraceptives by WRA six months after the policy’s implementation and across all eight districts. Additionally, a pre-post study with a non-randomized, reflexive control group was designed using repeated surveys in four health districts. Hierarchical logistic mixed effects models were adjusted for a set of time-variant individual variables; the impact was assessed by a difference-in-differences approach that compared pre-post changes in contraception use in women who knew about the new policy and those who did not.ResultsOf the 1471 WRA surveyed six months after the removal of user fees for family planning services, 56% were aware of the policy’s existence. Knowledge of the fee abolition policy was associated with a 46% increase probability of contraceptive use among WRA six months after the policy’s implementation. Among the subset of the participants who were surveyed twice (n = 507), 65% knew about the fee removal policy six months after its introduction and constitute the intervention group. Pre-post changes in contraceptive use differed significantly between the intervention (n = 327) and control groups (n = 180). Removing user fees for family planning led to an 86% (95% confidence interval (CI) = 0.49, 1.31) increase in the likelihood of using contraception. In the study area, the policy reduced the prevalence of unmet needs for contraception by 13 percentage points.ConclusionsRemoving user fees for family planning services is a promising strategy to increase access to, and reduce unmet needs for, contraception. A broader dissemination of the policy’s existence will likely increase its impact on the overall population.

Effective Interventions to Prevent Repeat Pregnancies in Adolescents: A Systematic Review

Repeat adolescent pregnancy is a public health problem worldwide. Different interventions aimed at increasing the use of contraception and preventing repeat pregnancies have been implemented and their effectiveness has been evaluated. This systematic review evaluates the results of the efficacy of diverse interventions for contraceptive use and prevention of repeat pregnancies in adolescents. A search was conducted for articles published from 1985 to 2018 in the PubMed, Scopus, EBSCOhost, Web of Science, and ProQuest databases, including interventions with adolescents 15 to 19 years of age who were pregnant, postpartum or had a history of pregnancy. Significant results were found for an increase in contraceptive use and prevention of repeat adolescent pregnancy, leading to the conclusion that there are reports of high methodological quality multicomponent interventions for the prevention of repeat adolescent pregnancy that could be tested in other socio-economic and cultural contexts.

Effectiveness and Harms of Contraceptive Counseling and Provision Interventions for Women : A Systematic Review and Meta-analysis.

The effectiveness and harms of contraceptive counseling and provision interventions are unclear. To evaluate evidence of the effectiveness of contraceptive counseling and provision interventions for women to increase use of contraceptives and reduce unintended pregnancy, as well as evidence of their potential harms. English-language searches of Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, PsycINFO, SocINDEX, and MEDLINE (1 January 2000 to 3 February 2022) and reference lists of key studies and systematic reviews. Randomized controlled trials of interventions providing enhanced contraceptive counseling, contraceptives, or both versus usual care or an active control. Dual extraction and quality assessment of studies; results combined using a profile likelihood random-effects model. A total of 38 trials (43 articles [25472 participants]) met inclusion criteria. Contraceptive use was higher with various counseling interventions (risk ratio [RR], 1.39 [95% CI, 1.16 to 1.72]; I 2= 85.3%; 10 trials), provision of emergency contraception in advance of use (RR, 2.12 [CI, 1.79 to 2.36]; I 2= 0.0%; 8 trials), and counseling or provision postpartum (RR, 1.15 [CI, 1.01 to 1.52]; I 2= 6.6%; 5 trials) or at the time of abortion (RR, 1.19 [CI, 1.09 to 1.32]; I 2= 0.0%; 5 trials) than with usual care or active controls in multiple clinical settings. Pregnancy rates were generally lower with interventions, although most trials were underpowered and did not distinguish pregnancy intention. Interventions did not increase risk for sexually transmitted infections (STIs) (RR, 1.05 [CI, 0.87 to 1.25]; I 2= 0.0%; 5 trials) or reduce condom use (RR, 1.03 [CI, 0.94 to 1.13]; I 2= 0.0%; 6 trials). Interventions varied; few trials were adequately designed to determine unintended pregnancy outcomes. Contraceptive counseling and provision interventions that provide services beyond usual care increase contraceptive use without increasing STIs or reducing condom use. Contraceptive care in clinical practice could be improved by implementing enhanced contraceptive counseling, provision, and follow-up; providing emergency contraception in advance; and delivering contraceptive services immediately postpartum or at the time of abortion. Resources Legacy Fund. (PROSPERO: CRD42020192981).

Identifying inequity in family planning: The Track20 equity tool

Background: With increases in contraceptive use in most countries in the world, within country inequities persist. Equity in family planning does not mean an equal level of contraceptive use among all groups; differences in use of contraception could reflect variation in cultural beliefs and values and therefore not inequity. Methods: Focusing on demand satisfied for modern methods and five dimensions (age, education, geography, parity, and wealth), we map inequities within 15 sub-Saharan African countries and across time. We create a “Concentration of Inequity” to highlight the intersectionality of inequities in family planning and allows for more data informed programming. Results: Inequities exist in all countries included in this analysis, though the range varies substantially. Over 85% of the countries included in this analysis had at least 1 subgroup in the population with demand satisfied 30% or more below the national level of demand satisfied. To help visualize inequities and stimulate discussion, we create an online tool to display multiple aspects of inequity. Conclusions: Using demand satisfied with modern methods to measure inequity for family planning allows us to focus attention on women with desire to delay or limit childbearing. Studying the intersections of demographic factors is fundamental for a deeper understanding of family planning equity.

Hubungan Tingkat Pengetahuan, Dukungan Suami, dan Sikap Ibu dengan Penggunaan Kontrasepsi IUD

Based on data from the World Health Organization (WHO), the highest increase in contraceptive use occurred in Asian and Latin American countries, and the lowest was in Sub-Saharan Africa. In Africa from 23.6% to 28.5%, in Asia it has increased slightly from 60.9% to 61.8% while in Latin America and the Caribbean it has remained sTabel at 66.7% (WHO, 2015). This study aims to determine the relationship between the level of knowledge, husband's support, and mother's attitude with the use of IUD contraception in Sukagerak Village, OKU Regency in 2021. This study used a quantitative method with a cross sectional approach. The population in this study were active family planning participants in Sukagerak Village in 2021 with a total of 294 and a sample of 169 which was determined by the Slovyn formula and was taken using a random sampling interval system. Data analysis used univariate analysis and bivariate analysis and Chi-Square statistical test with 95% confidence level. In the bivariate analysis, it was found that there was a significant relationship between the level of knowledge, husband's support, and mother's attitude with the use of IUD contraception in Sukagerak Village, OKU Regency in 2021. This was evidenced by the results of the Chi-Square test with Pvalues of 0.015, 0.027, and 0.009 &lt; 0.05. The conclusion is that there is a significant relationship between the level of knowledge, husband's support, and mother's attitude with the use of IUD contraception in Sukagerak Village, OKU Regency in 2021. It is recommended to health workers who are at the research site to increase counseling about IUD contraception, because there is still a lack of knowledge and interest of mothers towards IUD as an effective contraception.

Faktor-Faktor yang Berhubungan dengan Penggunaan Alat Kontrsepsi Suntik 3 Bulan di PMB Villy Agustin Palembang Tahun 2021

WHO explained that the increase in contraceptive use was highest in Asia and Latin America, and the lowest in Sub-Saharan Africa. Injec Tabel contraception is in great demand because it is a good alternative for contraception for women who want long-term and effective contraception. A person's decision to choose contraceptives is influenced by age, education, knowledge, parity, income. The purpose of the study was to determine the relationship between age, education, and parity with the use of 3-month injec Tabel contraceptives at PMB Villy Agustin Palembang in 2021. Analytical Survey Research with a Cross Sectional approach. The population is all active family planning acceptors who come to PMB Villy Agustin Palembang, namely 283 mothers, and 74 samples taken using the Slovin formula and simple random sampling technique. The secondary data used were processed and analyzed by univariate and bivariate analysis with the Chi-Square test. The results showed that there was a relationship between age (P-value = 0.037), education (P-value = 0.002) and parity (P-value = 0.034) with the use of 3-month injec Tabel contraceptives at PMB Villy Agustin Palembang in 2021. In conclusion, there was a relationship between age, education and parity with the use of 3-month injec Tabel contraceptive device at PMB Villy Agustin Palembang in 2021. It is hoped that health workers will be able to improve the quality of health services and public knowledge about all contraception so that they can increase the use of appropriate contraceptives in EFA.

\u201c\u2026the availability of contraceptives is everywhere.\u201d: coordinated and integrated public family planning service delivery in Rwanda

BackgroundContraceptive use in Rwanda tripled since 2005. This study aims to understand the role of coordinated and integrated public family planning service delivery in achieving this increase in contraceptive use in Rwanda.MethodsThis qualitative study in 2018 included eight focus group discussions with family planning providers and 32 in-depth interviews with experienced family planning users.ResultsResults indicate a well-coordinated public family planning service delivery system with community health workers and nurses filling different and complementary roles in meeting family planning client needs at the local level. In addition, integration of family planning into other maternal and child health services is the norm.ConclusionsThe coordination and integration of family planning across both providers and services may help explain the rapid increase in Rwanda’s contraceptive use and has potential applications for enhancing family planning service delivery in other settings.

Contraceptive Use and Missed Opportunities for Family Planning Discussions in Women Living with Human Immunodeficiency Virus at an HIV Clinic.

The objective of this study was to examine contraception use and family planning discussions (FPD) in female people living with HIV (PLWH). A retrospective cohort study was conducted. Female PLWH were included if they were 18-44 years and received care in 2019 at an HIV clinic. 74 patients met inclusion; mean age was 35 years, 53% were white. All patients were prescribed antiretroviral therapy. 48.6% of patients had documented FPD. 64.9% of patients were using contraception; sterilization was most common (41.7%). Only five patients had a contraindication to hormonal contraception. No differences in contraception use were observed based on age, race, HIV viral load, number of visits, or past pregnancies. However, patients with documented FPD were more likely to use contraception (OR 4.55; 95% CI 1.35-15.29). Routine FPD and contraception use in female PLWH were low. Rates of sterilization were high in female PLWH. Providing quality family planning services is critical to increase contraception use and selection of the most appropriate contraception form.

Impact of the COVID-19 pandemic on sexual and reproductive health among women with induced abortion

The coronavirus disease (COVID-19) has already been declared a global pandemic. To our knowledge, there is very little information regarding the effects of COVID-19 on women seeking reproductive health services, specifically abortion. This study was aimed to assess the impact of the COVID-19 pandemic on reproductive and sexual health among women seeking abortion services. We conducted a series of preliminary analyses using data collected from ten maternal and child health hospitals of seven provinces in China before and during the COVID-19 lockdown. The present study showed that a significant decrease was observed in the frequency of sexual intercourse during the COVID-19 pandemic. Moreover, a significant increase in contraceptive use including condom, rhythm method and coitus interruptus whereas a decrease in choosing oral contraceptives were observed during the COVID-19 pandemic. In addition, the pandemic was associated with increased intention of seeking induced abortion due to social factors. Future research should look into the long-term impact of the COVID-19 pandemic on sexual and reproductive health.

SOCIODEMOGRAPHIC ASPECTS OF CONTRACEPTION USE IN KAMPUNG KB KOTA YOGYAKARTA

Background: One of the government's efforts to control the population growth rate is to reduce the birth rate through the family planning program by utilizing the contraceptive method.This study aims to analyze the factors that influence contraceptive use at Kampung KB in Yogyakarta Method: It belongs to obsvational research with cross sectional layout using quantitative approach. Sampling was performed using Accidental Random Sampling.Collecting data using online quitioner that was shared to women in reproductive years in all Kampung KB. Data processing using STATA version 14. The data analysis was performed gradually covering univariable analysis, bivariable. Result: Age, education, desire to have children, parity, knowledge and attitudes have the pto increase contraceptive use, while economic level is not positively related to contraceptive use.The reasons for not using contraception are lack of permission from a partner and external environmental pressure. Conclusion: Sociodemographic aspects have the opportunity to increase contraceptive use at Kampung KB in Kota Yogyakarta.