Low Contraceptive Use Research Articles

Addressing the sexual and reproductive health of women with Bipolar Disease

IntroductionBipolar disorder (BD) is a severe mental illness (SMI) with an estimated lifetime prevalence of around 1%, starting in young adulthood and progressing with acute episodes. Although there is no significant prevalence difference between the sexes, the course of the disorder may be more problematic in women, due to hormonal and reproductive factors. Moreover, hypersexuality and impulsive sexual behaviour can manifest as part of a manic or hypomanic episodes, with devastating effects on the physical and emotional health of these patients.ObjectivesTo highlight the pertinent issues related to sexual and reproductive health of women with BD.MethodsA non systematic review of the literature from the last 10 years was carried out using the electronic databases, Pubmed and Google Scholar. The literature search was confined to papers written in English. The keywords ‘sexual health’, ‘reproductive health’, were combined with ‘bipolar disorder’ and ‘women’.ResultsThe literature points to an increased incidence of unsafe sexual practices (unprotected sex, multiple sexual partners, trading sex) as well as poor reproductive and sexual health (increased risk of sexually transmitted diseases, high risk of unwanted pregnancies and abortions, low use of contraceptives, menstrual and fertility problems). Female patients with BD are also more likely to report history of sexual abuse.ConclusionsAttention and counseling regarding effective contraception, planning a pregnancy and risk of sexually transmitted diseases, among others, should be an integral part of health care received by all women with bipolar disorder.DisclosureNo significant relationships.

Gravidity, contraceptive use and acceptability of a proposed three-baby policy in a municipality of Ghana

Background: Childbirth and high total fertility rate among women is traditionally held in high esteem in many African societies. However, the menace of large families and increasing populations has triggered both global and National actions towards population control. This study determined the factors associated with gravidity, the acceptability of a proposed three-baby per couple policy and the prevalence of modern contraceptives in a Ghanaian municipality.Methods: A descriptive cross-sectional study design was adopted and involved 350 women of reproductive age who had a history of past or present pregnancy. Data were collected using a structured questionnaire and analysed using descriptive and inferential statistical analysis with the aid of STATA version 14.Results: The results indicated that 97.39% of the participants had knowledge of modern contraceptives and 33.91% were current users of modern contraceptives. Gravidity showed significant association with age, marital status, educational level, employment status and source of contraceptive (p<0.001). Participants with no formal education had the highest gravidity (Mean±SD=6.0±1.7). Also, 86.29% were aware of the proposed three-baby policy but only 28.37% were willing to accept the policy. A linear regression analysis showed a negative association between age and gravidity (p=0.018; β=-0.008). The participants’ desired number of children was also statistically significant with gravidity (p<0.001­).Conclusions: Efforts towards population control can be challenging due to the low use of modern contraceptives which is effective in reducing the TFR. Also the low acceptability of the proposed three-baby policy amongst reproductive women suggest their desire for more children.

Comparative analysis of contraceptive use in Punjab and Manipur: exploring beyond women\u2019s education and empowerment

BackgroundWomen’s education and empowerment are important predictors of contraceptive use across countries. However, two of the Indian states, namely, Punjab and Manipur, showed large variations in contraceptive use, despite the similar level of women’s educational attainment and empowerment. Therefore, this paper attempts to understand variation in contraceptive use between these states, despite having similar level of educational attainment and empowerment among the married women.MethodsThis study primarily used cross-sectional data of the National Family Health Survey (NFHS) 2015–16 and to some extent the District Level Household Survey (DLHS) 2012–13 data. The analytical sample includes 13,730 currently married women in Punjab and 8,872 in Manipur. Modern contraceptive prevalence rate (mCPR) is the key outcome variable of this study. Bivariate, multivariate, and multilevel regression analysis are applied to understand the differences in mCPR between these states and its determinants.ResultsMean years of schooling was about 8 years among women of both the states, and about 34% of the women in Punjab and 27% of the women in Manipur have high level of autonomy. Despite this, use of modern method was 66% in Punjab and only 13% in Manipur. Coverage of family planning program indicators were significantly lower in Manipur than Punjab – frontline workers’ (FLWs) outreach for family planning was only 18% in Manipur compared to 52% in Punjab. Similarly, only 11% of the public health facilities in Manipur compared to 50% of the health facilities in Punjab were ready to provide at least one clinical method of family planning.ConclusionDespite the similar level of individual level characteristics across the two states, poor coverage of family planning programs – low outreach of FLWs, low level of facility readiness, as well as sociocultural norms discouraging contraceptive use – might be responsible for lower contraceptive use in Manipur than Punjab. This implies for strengthening the health system for family planning in Manipur to meet the contraception needs of women by addressing sociocultural barriers in the state.

Low Use of Long-Acting Reversible Contraceptives in Tanzania: Evidence from the Tanzania Demographic and Health Survey.

We aimed to determine the prevalence and factors associated with the use of long-acting reversible contraceptives (LARCs) among women of reproductive age in Tanzania. We analyzed the Tanzania Demographic and Health Survey (DHS) data from 2015 to 2016. The study included 8189 women aged 15–49 years. The relationship between various factors and LARC use was determined through various analyses. Among women with a partner/husband, 7.27% used LARCs, 21.07% were grand multiparous, and 20.56% did not desire more children. Women aged 36–49 years (adjusted odds ratio (AOR)-2.10, 95% confidence interval (CI): 1.11–3.96), who completed secondary education (AOR-1.64, 95% CI: 1.05–2.55), who did not desire more children (AOR-2.28, 95% CI: 1.53–3.41), with a partner with primary level education (AOR-2.02, 95% CI: 1.34–3.02), or living in richer households (AOR-1.60, 95% CI: 1.12–2.27) were more likely to use LARCs. Further, women with a partner who wanted more children were less likely to use LARCs (AOR-0.69, 95% CI: 0.54–0.90). Tanzania has a low LARC usage rate. Women’s age, wife and partner’s education status, couple’s desire for more children, and household wealth index influenced the use of LARCs, highlighting the need to reach more couples of lower socioeconomic status to improve LARC utilization.

Maternal health, SDG undermined by low contraceptive use

Maternal health, SDG undermined by low contraceptive use

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

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

Assessment of men involvement in family planning services use and associated factors in rural Ghana

BackgroundIn low-and-middle income countries (LMICs) less attention is paid to men’s involvement in Family Planning (FP) programs where public health officials have advocated the involvement of men as a strategy for addressing the dismal performance of FP programs. The study assessed the involvement of men in FP use and the factors which promote or hinder the uptake of FP services among partners in a rural setting of northern Ghana.MethodsA cross-sectional descriptive study was used to collect data from 200 respondents. Study respondents were selected through random cluster sampling.ResultsThe findings showed that male partners’ knowledge (95.5%) and approval (72.8%) of FP services were high. About 48% of men were involved in FP service utilization. Having living children (aOR; 1.71(1.27, 2.15)) and being knowledgeable (aOR; 6.14(1.38, 10.90)) about FP were positively associated men’s involvement in FP service utilization. The findings also indicated that men had a higher propensity (X2 = 4.5534, p = 0.033) of supporting a FP method use. Women who reported that their spouse supported FP method use were more likely to use a contraceptive method (X2 = 9.5223, P = 0.002) if their spouse supported FP method use (X2 = 9.5223, P = 0.002) and if their partners had some education (X2 = 14.1133, P = 0.000). Reasons for low contraceptive use were health risks, side effects, and socio-cultural norms.ConclusionFamily planning programs need to include men at all levels of health promotion and education of FP programs to help reduce misconceptions about contraceptive methods to increase acceptance and use among partners in rural settings of Ghana.

A New Contraceptive Diaphragm in Niamey, Niger: A Mixed Methods Study on Acceptability, Use, and Programmatic Considerations.

Diaphragms have never been widely available in West Africa, a region with very low contraceptive use due in part to health system constraints and low demand for other modern methods of contraception. Research has demonstrated the single-size Caya contoured diaphragm to be a safe and effective barrier method of nonhormonal, self-care contraception, offering features that improve upon the design of traditional diaphragms. No studies have measured continuation of Caya. In Niamey, Niger, this pilot introduction study explored Caya acceptability, use, and programmatic considerations. Women in Niger participated in surveys (n=150) and in-depth interviews (n=25) 6 months after adopting Caya. In-depth interviews were also conducted with men in the community (n=15) and family planning providers (n=15). We conducted descriptive analysis of the percentage of adopters who continued to use the method at 6 months and women's reasons for discontinuation among women who completed the 6-month follow-up survey. We used deductive thematic analysis of in-depth interview data from women, men, and providers to understand program elements and other factors associated with acceptability. Six months after initiation, 76.7% (95% confidence interval=0.70, 0.83) of 150 survey respondents reported continued use of Caya. Top reasons for use included: Caya causes no side effects for most users, works on demand, and is reusable for up to 2 years. Roughly one-quarter of women interviewed reported inconsistent use. Some men supported their partner's use; in other cases, women used Caya without informing or involving their partners. Providers described Caya as compatible with the needs of many women and credited pelvic models with enabling effective counseling. The Caya diaphragm has the potential to be a valuable addition to the range of contraceptive options, especially in settings with high levels of opposition to other modern methods.

Disparities in the contraceptive use among currently married women in Muslim densely populated States of India: An evidence from the nationally representative survey.


 Background: The rationalizations for low use of contraception and high fertility among Muslims compared to other religious group in India are highly controversial. The study was aimed to explain to what extent differences in the use of contraception exist among the religious groups and also examine its associated factors in the Muslim populated States in the country.
 Methods: The third round of District Level Household and Facility Survey (DLHS-3) was used to accomplish our objectives. Bivariate analysis was used to show the religion wise distribution of limiting, spacing and traditional methods of contraceptive use in relation to socio-economic characteristics. The multivariate logistic regression was also employed to estimate the odds ratio (95% CI) for contraceptive use. SPSS 20.0 version and Arc GIS 10.0 software were employed to carry out the analyses.
 Results: The study found that the prevalence of limiting contraceptive use was comparatively much lower among Muslims (19.9%) than Non-Muslims (39.3%). In comparison to Non-Muslims, Muslims used 3.5 percentage points and 2.6 percentage points spacing and traditional methods of contraception respectively. The Muslims women from Assam (3.4%), Uttar Pradesh (4.4%) and Bihar (8.3%) reported low use of limiting contraceptive methods as compared to other Muslim populated States. The highest difference in the limiting method was observed in Bihar (21 percentage points) and followed by West Bengal (19 percentage points) between Muslim and Non-Muslim. The level of education and place of residence appeared as the main explaining factors of family planning in the study.
 Conclusion: The study concluded that the significant inequalities exist among Muslims and Non-Muslims concerning the current use of limiting methods. The policy design and programmes should make on rural, uneducated women to take into account the inequalities in the contraceptive use. 

Male involvement in family planning use and its determinants in Ethiopia: a systematic review and meta-analysis protocol

BackgroundThe need to include males who require joint spousal decisions is critical in achieving key reproductive health indicators. Low involvement of males in family planning use is one of the contributing factors for low contraceptive use in Ethiopia. Despite this, there are inconsistent findings on the prevalence and determinants of male involvement in family planning use in Ethiopia. Thus, this systematic review and meta-analysis aimed to determine the pooled prevalence of male involvement in family planning use and its determinants in Ethiopia.MethodsThe Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines will be used to develop the protocol. The online databases PubMed, CINAHL, Google Scholar, and unpublished gray literature will be searched to retrieve available articles from April 10 to August 11, 2021. The two authors will conduct selection of studies, data extraction, and quality assessment. The quality of the studies will be assessed using the Joanna Briggs Institute checklist. The chi-squared test and I-squared statistic will be used to examine heterogeneity among studies. Sources of heterogeneity will be investigated using subgroup analysis and meta-regression based on regions and residence (urban and rural). Publication bias will be examined by observation using funnel plots and statistically by Begg’s and Egger’s tests. A random-effects model will be used to estimate the pooled prevalence and its determinants of male involvement in family planning use.DiscussionThe role of males in family planning and participation in contraceptive use improves women’s uptake and continuity of family planning use. Although there are studies on male involvement in family planning use, there are no synthesis research findings on the pooled prevalence of male involvement in family planning use and its determinants in Ethiopia. Therefore, the findings from this systematic review and meta-analysis will help the national health sector transformational plane emphasize the pooled prevalence and its determinants that drive low male involvement in family planning use in Ethiopia.

Parity and Pregnancy Intention related to the Use of Contraceptives in Women of Reproductive

Background: The use of contraceptives in reproductive women is still a problem today. The association between contraceptive use and parity and pregnancy intention amongs legally married reproductive women has never been studied 
 Objectives: To determine the relationship between parity and pregnancy intention with contraceptive use among legally married women. 
 Methods: A cross-sectional study was conducted with the involvement of 262 legally-married reproductive women, aged 15-49 years, in Bantul District, Indonesia. Socio-demographic data including age, education, income, parity, pregnancy intentions, and use of contraceptives were collected using a structured questionnaire by trained enumerators. Chi-square test was used to test the association between socio-demographic data and parity and pregnancy intention, while simple logistic regression models were used to examine the relationship between contraceptive use and parity and pregnancy intention. Data analysis was performed using statistical software by SPSS. 
 Results: Thirty-eight point five per cent of women of reproductive age who have ≥ 3 children and 16.5% of women of reproductive age who do not want to have children do not use contraception. Parity in women of childbearing age was not related to contraceptives (OR=2.58; 95%:0.67-1.76). Women of reproductive age who had intention of getting pregnant were 61% less likely (OR= 0.39; 95%: 0.37-0.74) to use contraceptives than those who did not have intention of getting pregnant. 
 Conclusions: The pregnancy intention is associated with a low contraceptive use in reproductive-age women. Thus, it is necessary to educate women in the reproductive age, their partners and family regarding the importance of birth spacing.

Knowledge and Practices of contraceptives in married women population; A cross sectional survey from Lahore, Pakistan

Background: About one third of all pregnancies are unplanned and 20% of all pregnancies end n abortion and to cope with this problem nearly all general practitioners provide contraceptive advice. Objectives: A cross sectional study was conducted in the OPD of Gynae and Obstreitics unit of Shama hospital, Government hospital Kot Khawaja Saeed, Ganga Ram , Rasheed latifand Farooq hospital from December 2017-March 2018 to determine the knowledge and practice of contraceptive utilization in married women of Lahore.
 Method: This study was carried out among 308 married women between the ages 17-50 years by administering a well-developed and validated questionnaire. Data was analyzed by using SPSS version 16.
 Results: Study results showed about 85% of participants have knowledge about contraceptives and 19.1% were aware about the ADR’S of contraceptives. The main source of information identified was health care providers (62.2%) and television (37.4%). The most commonly used contraceptives were oral contraceptive pills 36.1%, followed by condoms, injectable, IUD’s and barrier method. Known uses of contraceptives were 41.5% and the major reason for known use were prohibition by religion (23.8%) followed by lack of knowledge, economic problems and other reasons such as opposed by family members.
 Conclusion: The study shows low use of contraceptives despite high level of awareness. It highlights the need to motivate people for effective and appropriate use of contraceptives and to avoid the unwanted pregnancies and abortions.

THE REPRODUCTIVE HEALTH IN ROMANIA -CURRENT STATUS.

Currently, at national level, two representative actions could provide information for supporting policy making in the field of reproductive health, and these two public health actions need improvements in certain aspects: The Reproductive Health Study in Romania (RHS), and the National Health Programme for Mother and Child Health (NHP-MCH). After decades of sexual education and family planning interventions, reproductive health in Romania is still a matter of concern. The current image of this field in Romania is difficult to be precisely configured having few elements and data in this sense. Main available indicators highlight a low contraception use, a high rate of abortion and high birth rate among adolescents is mainly the consequence of insufficient information on contraception among all population strata. Implementation of an action towards the development of a health inequality monitoring system would be of great importance for getting timely information on this subject, and it is favoured by the increased political awareness on the topic after joining EU, the inequalities that should be reduced as mentioned by the National Health Strategy 2014-2020, the existence of structures needed to develop a health inequality monitoring system and the declared political will. Monitoring reproductive health inequalities would provide information on the necessary actions to be implemented towards reaching a better reproductive health, and would also serve as an action implementation evaluation tool. A special attention should be payed to vulnerable groups: young population in rural communities, low socio-economic and educational status, and persons with mental disabilities. Keywords: Reproductive health, monitoring, inequalities, Romania Normal 0 false false false EN-US X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:Table Normal; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin-top:0cm; mso-para-margin-right:0cm; mso-para-margin-bottom:8.0pt; mso-para-margin-left:0cm; line-height:107%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:Calibri,sans-serif; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Times New Roman; mso-bidi-theme-font:minor-bidi; mso-ansi-language:EN-US; mso-fareast-language:EN-US;}

Reproductive Behaviors among Men of a Rural Community in North-Western Nigeria

Background: Fertility is an important component of population change and has attracted the interest of scholars and policy makers. Nigeria's population growth rate has been driven by high fertility, which has fallen in the last few decades but not as rapidly as the fall of the crude death rate. Men and their kinsmen are the decision-makers on issues relating to reproductive health such as timing of the next birth, number of children and when to stop childbearing while their women cooperate. We determined the reproductive behaviors of men in Doka community in Kaduna State Nigeria.
 Methodology: A cross-sectional descriptive community based study of 320 men was conducted.
 Results: The mean age±SD of the male respondents was 40 (±14.2) years. The average age at first marriage among men was 23.32 (±4.62 years), the contraceptive use among men was 10(3.2%). Above a third 118 (37.9%) of men were in polygamous union. There was a statistically significant increase in the mean number of living children as the age of men increased (p=0.001). The mean number of children ever fathered was significantly associated with the educational status of men (p=0.03).
 Conclusion: we found a very low contraceptive use, high number of desired children as well as living children among the men. Government should enlighten married men on the importance of contraceptive use for birth control as well as the social and economic implications of having too many children.
 Keywords: Contraception; Desired children; Fertility; Mean number of children.

Assessment of segmentation and targeted counseling on family planning quality of care and client satisfaction: a facility-based survey of clients in Niger

BackgroundNiger demonstrates high fertility and low contraceptive use that are typical in much of the West and Central African region. The government of Niger has committed to increasing modern contraceptive use as part of its health strategy. Designing and testing strategies to improve quality of care and satisfaction of family planning clients is important for addressing low contraceptive use in contexts like Niger.MethodsThis study uses recently collected client exit interview data from 2720 clients surveyed in the Dosso region of Niger to examine whether implementation of segmentation-based counseling leads to improved quality of services and client satisfaction. We compare three scenarios: a) facilities where segmentation counseling was implemented since 2017; b) facilities where segmentation counseling began in late 2019; and c) facilities without segmentation counseling. Bivariate and multivariate analyses are undertaken to determine if there are differences in quality of services and client satisfaction between the facility groups and between clients that were segmented and those who were not segmented in the first two scenarios.ResultsResults demonstrate that clients in facilities with segmentation generally received better quality services than clients in facilities without segmentation. Clients in facilities implementing segmentation longer reported higher quality services than the recent segmentation facilities. Clients who were segmented compared to those who were not segmented also reported better quality services. New clients reported higher quality services than returning clients and among new clients, those who were segmented also reported higher quality services. No differences were found in client satisfaction between facility scenarios or between segmented and non-segmented clients.ConclusionsThese findings demonstrate that segmentation or another targeted counseling strategy could be useful to the government of Niger to improve the quality of services offered. As part of the scale up process, the government needs to consider strategies that ensure that all new clients are segmented and design an approach that is sustainable and does not risk failing should there be stock-out of segmentation sheets or loss of counseling cards. This type of targeted counseling could improve the quality of services offered and ideally lead to increased contraceptive use in Niger.

FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN PEMAKAIAN KONTRASEPSI KONDOM PADA PASANGAN USIA SUBUR DI WILAYAH KERJA PUSKESMAS CAMPALAGIAN

The research objective: To determine the factors associated with the use of contraceptive condoms in fertile aged couples in the Campalagian Community Health Center. Methods: This study is an analytical survey research with a "Cross Sectional Study" approach where the independent and dependent variables are collected at the same time to obtain information about several factors associated with the use of the condom contraceptive method in reproductive age couples (EFA). Results: The results showed that the results of the analysis using the Chi-square test between knowledge and the low use of condom contraception obtained p value = 0.003 (P value <0.05), which means that Ha is accepted, between side effects and low use of condom contraception, the p value is obtained. = 0.002 (P value <0.05), which means that Ha is accepted, between parity and the low use of condom contraceptives, the value of p = 0.010 (P value> 0.05) means that Ho is rejected. So that statistically it is considered that there is a relationship between knowledge, side effects and the low use of the condom contraceptive method, while parity is considered to have no relationship with the low use of condom contraception. Discussion: family planning is an action that helps husband and wife to avoid unwanted pregnancies, get births that are very desirable, adjust the interval between pregnancies, control the time at birth in relation to the age of the husband and wife and determine the number of children in the family. The fertile period of a woman has a role in the occurrence of pregnancy so that the chances of a woman giving birth are quite high. According

An Assessment of Women’s Experiences and Challenges Faced with Post Abortion Care (PAC) Services in Buea

Background: Unsafe abortion is one of the commonest causes of maternal mortality and post-abortion care services have been acclaimed as the best remedy for this situation. Yet, high maternal mortality still prevails pointing to issues with the quality of services. The paper was designed to investigate women's motives for engaging in unsafe abortion; assess women's experiences on the quality of PAC services and identify the challenges women faced in accessing PAC services in Buea.
 Methods: This study recruited 10 participants in Buea. Using a structured interview, data was collected on women's motives for engaging in unsafe abortion; assess women's experiences on the quality of PAC services, and identify the challenges women faced in accessing PAC services in Buea. Thematic and grounded theory analytical techniques were used to organize and interpret the data.
 Results: Majority of women in Buea did not use contraceptives for different reasons ranging from personal, spousal consent, ignorance, and the fear of side effects of contraceptive use. The low contraceptive use accounts highly for unwanted pregnancy cases which results in the decisions to induce. Most of these women involuntarily engage in induced abortion, highly driven by second party influence like the request from spouse/partner, disappointment from the spouse, and fear of parents’ reactions; while some occur as a result of missed abortion. The quality of PAC services received by most of these women were merely emergency treatments without proper PAC activities like family planning counseling, provision of modern contraceptive methods, linkages to other reproductive health care services. Women in Buea encounter some challenges in the use of PAC services, pains associated with the procedure, the cost, the absence of some family planning methods, the absence of counselling before PAC and above all, non constant availability of blood in the bood bank for transfusion.
 Conclusion: This study concluded that most women in Buea engage in induced abortion on account of the pressure to terminate an unwanted pregnancy; resulting from low contraceptives use; desire to avoid problems from their spouses/partners as well as to pursue career ambition. Moreover, the quality of PAC services offered to women in Buea was emergency treatment; void of important aspects like family planning services, linkage to other reproductive health care services, and facilitating their social reinsertion and preventing future induce abortion.

Prevalence and determinants of contraception use in Pakistan: trend analysis from the Pakistan Demographic and Health Surveys (PDHS) dataset from 1990 to 2018

Background: In developing countries, pregnancy and childbirth are the leading causes of death among women. In this context, family planning and access to contraceptives are crucial for reducing pregnancy-related morbidity and mortality. Therefore, we aimed to look into the trends of contraception and determinants of contraceptive use in Pakistan.Methods: This study used data for women of reproductive age from four Pakistan Demographic and Health Surveys datasets. Contraception was the outcome variable, whereas, women’s and partner’s education, occupation, wealth quintile, region, place of residence, and exposure to family planning messages were the explanatory variables. Pooled prevalence was estimated using SUMARI and regression analysis was undertaken using SPSS to produce an adjusted prevalence ratio with 95% confidence intervals.Results: Data of 40,259 ever-married women of reproductive age (EMWRA) was analysed. Of the total EMWRA, 30% were using contraception. Of these, 26% were using traditional methods and 74% were using modern methods. The most common method of contraception was condoms (30.5%). The pooled prevalence of contraception used was 29.5% (95% CI 29.1 to 30.0). Through multivariate analysis, women's age, place of residence, region, wealth index, women’s education, their working status, and exposure to family planning messages were found to be significant determinants of contraception usage.Conclusions: There is a noticeable gap regarding awareness and uptake of contraception leading to low contraceptive use among women in Pakistan. In the light of our results, it is important to highlight the importance of girl’s education for building awareness and empowerment.

Prevalence and determinants of contraception use in Pakistan: trend analysis from the Pakistan Demographic and Health Surveys (PDHS) dataset from 1990 to 2018.

Background: In developing countries, pregnancy and childbirth are the leading causes of death among women. In this context, family planning and access to contraceptives are crucial for reducing pregnancy-related morbidity and mortality. Therefore, we aimed to look into the trends of contraception and determinants of contraceptive use in Pakistan. Methods: This study used data for women of reproductive age from four Pakistan Demographic and Health Surveys datasets. Contraception was the outcome variable, whereas, women's and partner's education, occupation, wealth quintile, region, place of residence, and exposure to family planning messages were the explanatory variables. Pooled prevalence was estimated using SUMARI and regression analysis was undertaken using SPSS to produce an adjusted prevalence ratio with 95% confidence intervals. Results: Data of 40,259 ever-married women of reproductive age (EMWRA) was analysed. Of the total EMWRA, 30% were using contraception. Of these, 26% were using traditional methods and 74% were using modern methods. The most common method of contraception was condoms (30.5%). The pooled prevalence of contraception used was 29.5% (95% CI 29.1 to 30.0). Through multivariate analysis, women's age, place of residence, region, wealth index, women's education, their working status, and exposure to family planning messages were found to be significant determinants of contraception usage. Conclusions: There is a noticeable gap regarding awareness and uptake of contraception leading to low contraceptive use among women in Pakistan. In the light of our results, it is important to highlight the importance of girl's education for building awareness and empowerment.

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

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