Modern Contraceptive Use Research Articles

A retrospective analysis of the trends in modern contraceptive use among adolescents and young women (15–24 years) in the Democratic Republic of the Congo in the last two decades

ABSTRACT Introduction: The increasing rate of unsafe abortion among adolescents and young women (AYW) in Sub-Saharan Africa may be attributed to a high rate of undesirable pregnancies and limited access to contraception services. The study looked at the prevalence of current contraception use among young women (15–24 years old) in the Democratic Republic of the Congo (DRC). Methods: The study analyzed secondary data from the demographic health survey (DHS) and UNICEF concerning AYW aged 15–24 years using IBM Corp. Released 2021. IBM SPSS Statistics for Windows, Version 28.0. (Armonk, NY: IBM Corp.). The study population included 15,319 female adolescents and young adults in DRC. DHS datasets for 2001, 2010, 2017/2018, and UNICEF 2007 and 2013–2014 were downloaded after permission to use the data. Results: The AYW aged 20–24 accounted for 67% of the study population. The use of modern contraceptives has followed a roller coaster course. It dropped significantly from 2.6% in 2001 to 0.1% in 2007; it climbed to 2.7% in 2010 and 3.3% in 2013/14 but dropped to 2% in 2017/18. The most used method was male condoms (1.76%). A higher proportion of unmarried (2.3%) used any methods than married (1.8%). Those who attained secondary/higher education (2.6%) used modern contraceptives more than those with no formal education (1.5%), P < 0.0001. Those residing in the urban areas (4.5%) used modern contraceptives compared to those who lived in rural areas (1.7%) P < 0.0001. Modern contraceptive use among those with birth histories (2.6%) was comparatively higher than those who have not (2.3%), P < 0.0001. Those who lived in urban areas were adjusted odds ratio (AOR) = 2.504 times (95% confidence interval (CI): 1.793–3.497) more likely to use birth control than those in rural areas (P < 0.001) Conclusion: As reported in this study, the proportion of AYW’s awareness of modern contraceptives is deficient in DRC, which might be attributed not only due to a lack of knowledge or enlightenment but also due to healthcare facilities’ limited capacity to provide reproductive and sexual health services. Educating the AYW about modern contraceptive methods and interventions, including parents, the school system, and youth organizations, and strengthening the capacity of health facilities to provide modern contraception should be considered.

Socio- demographic characteristics and women attitude as determinants to practice modern contraceptives uptake as correlated among women of child bearing age in Jigawa State, Nigeria

Background: Universal contraceptive access is one of the key strategies for achieving sustainable developments in any country. Yet, uptake has remained low in most developing nations like Nigeria. The reasons for low use must be contextually understood to aid effective contraceptive programming (Ajibola et al., n.d.). This study assessed socio- demographic characteristics and women attitude as determinants to practice modern contraceptives uptake as correlated among women of child bearing age in Jigawa state, Nigeria. Aim: This study assessed socio- demographic characteristics and women attitude as determinants to practice modern contraceptives uptake as correlated among women of child bearing age in Jigawa state, Nigeria. Methodology: A cross-sectional descriptive research was conducted on the respondents. The study population comprised all the eligible women of child bearing age within the study area, who were selected and agreed to participate in the study. Sample sizes of Four Hundred and four (404), respondents were recruited using a multistage sampling technique. Data was collected using Questionnaire Data collected was coded, entered, and analyzed using the Statistical Package for the Social Sciences (SPSS) version 22. Result: The relationship between socio-demographic characteristics and respondents’ attitude to contraceptive uptake, statistically significant association was found between respondents’ attitude to contraceptive uptake and marital status (χ2=9.1, p=0.036), age (χ2=3.9, p=0.041), religion (χ2=6.3, p=0.023), and level of educational (χ2=8.3, p=0.048) Respondents with no formal education were significantly less likely to have used contraception compared to their educated counterparts (AOR=0.414, 95%CI=0.173-0.861). Also, those with less than 29 years of age were significantly less likely to have used contraception than those with 30 years and above age (AOR=0.563, 95%CI=0.331–1.018). Likewise, those with poor knowledge and negative attitude had significantly lesser odds of modern contraceptive use (OR=0.411, 95%CI=1.131-1.857 and OR=0.147, 95%CI=0.151-0.763). Conclusions: The study revealed that significant number of women had poor knowledge and attitude towards FP. Multiple socio-demographic factors contributed to knowledge and attitude of FP. Therefore, the health sectors of the regions and other stakeholders should strengthen the health extension program to disseminate messages related to FP to improve the knowledge and attitude of women.

Применение современного пролонгированного гормонального контрацептива: актуальность, востребованность и опасения. Развенчание мифов

Введение. Современными методами предохранения от нежелательной беременности в России пользуются 68% женщин, что выше среднемирового показателя (57%) и сопоставимо с показателями развитых стран (62%). Также исследователи констатируют, что в РФ достаточно высокий показатель использования современных обратимых средств контрацепции (46%), из которых 30% составляют комбинированные оральные контрацептивы, а на долю внутриматочных систем (и медьсодержащих, и левоноргестрел-содержащих) приходится 14%. Прочим гормональным рилизинг-системам пролонгированного действия с различными способами введения отдают предпочтение лишь 1% заявляющих о желании использовать тот или иной метод гормональной контрацепции. По мнению исследователей, столь малый процент связан с невысоким уровнем информированности пациентов о существующих передовых методах контрацепции – гормональных рилизинг-системах. При этом современные исследования не позволяют усомниться в том, что эффективность гормональных рилизинг-систем достигает самого высокого уровня не только за счет действующего компонента, но и за счет приверженности методу, исключения фактора «невынужденной ошибки пользователя», т. е. в связи с отсутствием необходимости контроля за применением со стороны женщины. Результаты. В статье приведены доводы в пользу пролонгированной гормональной контрацепции, а также данные, свидетельствующие о преимуществах применения подкожного этоногестрел-содержащего одностержневого имплантата – обратимого высокоэффективного метода контрацепции длительного действия. Представлены данные о сложностях, возникающих при приобретении практики установки, извлечения имплантата, и мифах, бытующих в том числе и в медицинской среде в отношении применения подкожного этоногестрел-содержащего одностержневого имплантата у различных групп пациентов. Background. 68% of women in Russia use modern methods of preventing unintended pregnancy, which is higher than the world average (57%) and comparable to indicators in developed countries (62%). Researchers also state that in the Russian Federation there is a fairly high rate of use of modern reversible contraceptives (46%), of which 30% are combined oral contraceptives, and intrauterine systems (both copper-containing and levonorgestrel-containing) account for 14%. Other long-acting hormonal releasing systems with various methods of administration are preferred by only 1% of those declaring a desire to use one or another method of hormonal contraception. According to researchers, such a small percentage is associated with a low level of patient awareness of existing advanced methods of contraception - hormonal releasing systems. At the same time, modern research leaves no doubt that the effectiveness of hormonal releasing systems reaches the highest level not only due to the active component, but also due to adherence to the method, eliminating the factor of ″unforced user error″, i.e. due to the lack of need for control over use by the woman. Results. The article presents arguments in favor of long-acting hormonal contraception, as well as data demonstrating the benefits of using a subcutaneous etonogestrel-containing single-rod implant – highly effective long-acting reversible contraception (LARC). Data are presented on the difficulties that arise when acquiring the practice of installing and removing an implant, and the myths that exist, including in the medical environment, regarding the use of a subcutaneous etonogestrel-containing single-rod implant in various groups of patients.

Prevalence and predictors of post-abortion modern contraceptive utilization among reproductive age women in Ethiopia

The development of a post-abortion family plan is an integral part of comprehensive abortion care. In spite of this, it received insufficient attention as a means of breaking the cycle of repeated abortions, unintended pregnancies, and maternal deaths resulting from abortion. Therefore, this study examined post abortion modern contraceptive utilization among Ethiopian women as well as associated factors. The study was based on secondary data analysis of the Ethiopian Demographic and Health Survey 2016 data. A total weighted sample of 1236 reproductive age women was included. A multilevel mixed-effect binary logistic regression model was fitted to identify the significant associated factors of post abortion contraceptive use. Statistical significance was determined using Adjusted Odds Ratio (AOR) with 95% confidence interval. Overall prevalence of post abortion contraceptive use was observed to be 25.6% (95% CI: 23.24, 28.12). Women's age 15–24 (AOR = 2.34; 95% CI: 1.11, 4.93), and 25–34 (AOR = 1.94; 95% CI: 1.27, 2.98), married women (AOR = 2.6; 95% CI: 1.43, 4.96), women who had 1–4 (AOR = 4.13; 95% CI: 1.79, 9.57) and ≥ 5 number of children (AOR = 8.80; 95% CI: 3.30, 13.49), Being in metropolitan region (AOR = 9.14; 95% CI: 1.79, 12.48), women being in urban area (AOR = 1.85; 95% CI: 1.32, 2.24), and community media exposure (AOR = 1.75; 95% CI: 1.11, 3.56) were associated with post abortion modern contraceptive use. Post abortion modern contraceptive use in this study was low. Women age, current marital status, number of living children, residency, community media exposure, and region were significantly associated with post abortion modern contraceptive utilization. Therefore, it is better to provide ongoing health information about post-abortion family planning and its benefits, especially for people who live in rural and small peripheral regions, and public health policymakers should take both individual and community level factors into account when designing family planning programmes.

Leveraging Responsive Feedback to Redesign a Demand Generation Strategy: Experience From the IntegratE Project in Lagos State, Nigeria.

Use of modern contraceptives in Nigeria is low (12%) despite very high knowledge of modern methods (92%). Knowledge of modern methods of contraception in Lagos and Kaduna is high at nearly 100% and 94%, respectively, yet contraceptive use in Lagos and Kaduna remains low at 29% and 14%, respectively. Demand generation was a key strategy in increasing contraceptive uptake through the involvement of providers in the private sector (community pharmacists and patent and proprietary medicine vendors) in family planning service delivery.We describe how an interpersonal communication strategy was modified using a responsive feedback approach and detail the insights gained in implementing an individual compared with a group interpersonal communication strategy during the implementation of the IntegratE Project in Lagos State, Nigeria. We conducted monthly pause-and-reflect sessions for interpersonal communication agents to pause and reflect on lessons learned and address challenges. Using the responsive feedback approach helped to improve contraceptive uptake by adopting a group strategy. Also, the monthly pause-and-reflect sessions have helped interpersonal communication agents see program implementation as a collective responsibility.

Which month to give a birth? The analysis on birth seasonality of China

A series of medical and biological studies have identified a strong link between the season during which a child is born and early childhood development and adult health. While providing an explanation for the seasonal determinants of birth remains one of the key challenges for demographers, understanding seasonal birth peaks and troughs can inform both public health planning and efforts to prevent childhood diseases. The seasonality of births varies across and within countries. Nonetheless, there has been scant research into the seasonality of births in China. This study takes an in depth look at the seasonal fluctuations in China’s births since 1960 and investigates the effects on seasonality of several key factors such as parity, residence (urban or rural area), and changes to fertility policies. Traditionally, winter has been the peak season of births in China, while spring and summer have been lean seasons, a pattern which is quite different than patterns in Europe and the United States. After 1990, the sweeping implementation of one-child policy and the wider use of modern contraceptives among Chinese women prompted a fundamental shift in the seasonality of births, with the deviation of births from month to month gradually diminishing over time. People's self-control may serve as a key determinant accounting for such seasonal changes. First births exhibit pronounced and steady seasonality, while second and subsequent births follow a vague seasonal pattern, suggesting that later births are more likely affected by self-choice and self-intervention. The analysis also reveals that the monthly distribution pattern of second births experienced a dramatic change following the roll-out of the selective-two-child policy and the Universal Two-child Policy in 2014 and 2016, changes that reflects the adjustments people made to achieve their fertility plans under the new policy.

Factors contributing to changes in contraceptive use among adolescent girls in Zambia: a decomposition analysis.

Despite its documented benefits, contraceptive use among adolescents remains low, particularly in low-and middle-income countries. This study aimed to decompose the main factors contributing to the changes in contraceptive use among adolescent girls in Zambia over the period 1996 to 2014. Data on adolescent girls aged 15-19 years from Zambia Demographic and Health Survey data were analysed using multivariate decomposition analysis of change. Stata 15/MP (Stata-Corp LLC) was used for analysis, at a 95% confidence level. A P-value of 0.05 was used to determine statistical significance. The sample included 9,072 adolescent girls. Contraceptive use increased by 3% from 7.6% in 1996 to 10.6% in 2013/14. Change in modern contraceptive use among adolescents was mainly due to differences in coefficients (changes in population behaviour). Increases in age contributed to the change in contraceptive use, resulting in 2.94 and 9.33% increases for 17- and 18-year-olds respectively. Marriage or living with a partner contributed the largest change (44%) while living in a rural area accounted for approximately 20%. Interventions targeting improving contraceptive use in adolescents should be responsive to the needs of various age groups, places of residence, and educational levels for maximum benefits.

The impact of community and provider-driven social accountability interventions on contraceptive use: findings from a cohort study of new users in Ghana and Tanzania

BackgroundAlthough contraceptive use has increased over 15 years, discontinuation rates remain high. Contraceptive use is becoming more important when addressing unmet need for family planning. Social accountability, defined here as collective processes for holding duty bearers to account for their actions, is a rights-based participatory process that supports service provision and person-centred care, as well as, informed decision-making among community members regarding their health. A study implemented in Ghana and Tanzania was designed to understand and evaluate how social accountability and participatory processes influences quality of care and client satisfaction and whether this results in increased contraceptive uptake and use. We report here on the relationship between social accountability and the use of modern contraceptives, i.e., contraceptive method discontinuation, contraceptive method switching, and contraceptive discontinuation.MethodsAs part of Community and Provider driven Social Accountability Intervention (CaPSAI) Project, a cohort of women aged 15 to 49 years who were new users of contraception and accessing family planning and contraceptives services at the study facilities across both intervention and control groups were followed-up over a 12-month period to measure changes contraceptive use.ResultsIn this cohort study over a one-year duration, we did not find a statistically significant difference in Ghana and Tanzania in overall method discontinuation, switching, and contraceptive discontinuation after exposure to a social accountability intervention. In Ghana but not in Tanzania, when stratified by the type of facility (district level vs. health centre), there were significantly less method and contraceptive discontinuation in the district level facility and significantly more method and contraceptive discontinuation in the health centres in the intervention group. In Ghana, the most important reasons reported for stopping a method were fear of side-effects, health concerns and wanting to become pregnant in the control group and fear of side-effects wanting a more effective method and infrequent sex in the intervention group. In Tanzania, the most important reasons reported for stopping a method were fear of side-effects, wanting a more effective method, and method not available in the control group compared to wanting a more effective method, fear of side-effects and health concerns in the intervention group.ConclusionsWe did not demonstrate a statistically significant impact of a six-month CaPSAI intervention on contraceptives use among new users in Tanzania and Ghana. However, since social accountability have important impacts beyond contraceptive use it is important consider results of the intermediate outcomes, cases of change, and process evaluation to fully understand the impact of this intervention.Trial registrationThe CaPSAI Project has been registered at Australian New Zealand Clinical Trials Registry (ACTRN12619000378123, 11/03/2019).

Socioeconomic inequalities in modern contraceptive use among women in Benin: a decomposition analysis

BackgroundContraceptive use is crucial to achieving Sustainable Development Goal 3. Evidence of socioeconomic inequality in the use of modern contraceptives is essential to address the developing inequality in its utilisation given the low prevalence of contraceptive use among women in Benin. This study examined the socioeconomic inequalities in modern contraceptive use among women in Benin.MethodsWe performed a cross-sectional analysis of the 2017-18 Benin Demographic and Health Survey data. A weighted sample of 7,360 sexually active women of reproductive age was included in the study. We used a concentration curve to plot the cumulative proportion of women using modern contraception. Decomposition analysis was conducted to determine factors accounting for the socioeconomic disparities in modern contraceptive use.ResultsWe noted that the richest women had higher odds of modern contraceptive use (adjusted odds ratio [aOR] = 1.67, CI = 1.22–2.30) compared to the poorest women. Other factors that showed significant associations with modern contraception use were age, marital status, religious affiliation, employment status, parity, women’s educational level, and ethnicity. We found that modern contraceptive use is highly concentrated among the rich, with rich women having a higher propensity of using modern contraception relative to the poor. Also, the disadvantaged to modern contraceptive use included the poor, those aged 45–49, married women, those working, those with four or more live births, rural residents, and women of Bariba and related ethnicity. Conversely, favourable concentration in modern contraceptive use was found among the rich, women aged 20–24, the divorced, women with two live births, the highly educated, those with media exposure, and women of Yoruba and related ethnicity.ConclusionThe study has shown that wealthy women are more likely to utilize contraceptives than the poor. This is because wealthy women could afford both the service itself and the travel costs to the health facility, hence overcoming any economic barriers to using modern contraception. Other factors such as age, marital status, religion, employment status, parity, mother’s educational level, and ethnicity were associated with contraceptive use in Benin. The Benin government and other stakeholders should develop family planning intercession techniques that address both the supply and demand sides of the equation, with a focus on reaching the illiterate and under-resourced population without admittance to modern contraception.

Effects of lower tiers of government healthcare facilities on unmet need for contraception and contraception use in Bangladesh.

In low- and middle-income countries (LMICs), including Bangladesh, modern contraception use remains lower than desired, resulting in a higher unmet need. A potential factor contributing to lower contraceptive use is reduced access to and use of lower tiers of government healthcare facilities, including home visits by family welfare assistants (FWAs), as well as women's visits to community and satellite clinics. These relationships, however, are still unexplored in Bangladesh and LMICs more broadly. The aim of this study was to explore the effects of lower tiers of government healthcare facilities on unmet needs for contraception and contraception use in Bangladesh. Data from 17,585 sexually active married women were analyzed from the 2017 Bangladesh Demographic and Health Survey. The outcome variables were any contraceptive use, modern contraceptive use, unmet need for contraception, and unmet need for modern contraception. The explanatory variables considered were respondents' home visits by FWAs, respondents' visits to a community clinic, and respondents' visits to a satellite clinic. Multilevel mixed-effect Poisson regression with robust variance was used to determine the association between the outcome and explanatory variables, adjusted for individual-, household-, and community-level factors. Approximately 18% of respondents were visited by FWAs in the three months prior to the survey date and only 3.4% and 3.1% of women attended community and satellite clinics, respectively. Women who reported being visited by FWAs in the three months prior to the survey were approximately 36% less likely to report an unmet need for modern contraception and 42% more likely to report using modern contraception than women who did not report such a visit. A higher likelihood of unmet need for contraception and a lower likelihood of contraception use were found among women who did not visit these community or satellite clinics or visited these clinics for other reasons than collecting contraception as compared to women who visited these clinics to collect contraception. Home visits by FWAs to respondents' homes to provide contraception as well as respondents' visits to satellite and community clinics play a major role in Bangladesh to ensure contraception use and reduce the unmet need for contraception. However, their coverage is quite low in Bangladesh. The findings suggest an urgent need for greater government initiatives to increase the number of FWAs and proper monitoring of them at the field level.

Socioeconomic Inequalities and Factors Associated with the Use of Modern Contraceptive Methods in Women of Childbearing Age in Ecuador, 2018.

The objective of this study was to determine the socioeconomic inequalities and factors associated with the use of modern contraceptive methods (MCM) in the population of sexually active women of childbearing age in Ecuador. This was an analytical observational study, based on a secondary data analysis of the 2018 National Health and Nutrition Survey (ENSANUT). Information on 19,106 sexually active, married, or cohabiting women between the ages of 15 and 49 were included. Concentration curves (CC) and Erreygers concentration indices (ECI) were calculated, taking into account the use of MCM as the dependent variable and the wealth index as the independent variable. Crude and adjusted prevalence ratios with 95% confidence intervals were calculated using generalized linear models of the Poisson family. We found that 92.8% of the women surveyed used some type of MCM in the last month. A higher educational level presented a significant pro-rich concentration in the use of MCM (EIC: 0.05; p = 0.004). On the other hand, women belonging to the age group of 20 to 29 years (ECI: -0.027; p = 0.027), women with no job (ECI: -0.025; p = 0.004), and non-indigenous women (EIC: -0.031; p < 0.001), presented a pro-poor concentration. Factors significantly associated with MCM use were age, marital status, occupation, parity, ethnicity, area of residence, and living on the coast. In Ecuador, there are socioeconomic inequalities at different levels of population subgroups in women of childbearing age. Measures to promote the use of MCM are required, focusing on groups that present inequality, taking into account the factors associated with their use.

Willingness to Adopt a Modern Contraceptive Method among Pregnant Women attending Antenatal Care in Primary Health Centres of Rivers State, Nigeria

Background: Modern Contraceptives (MC) use in developing countries is inadequate due to the low involvement of women in decisions on reproduction. This study assessed the willingness to adopt MC methods postpartum by pregnant women attending antenatal care (ANC) in Primary Health Centres (PHCs) of Rivers State Nigeria.&#x0D; Methodology: A descriptive cross-sectional study was conducted among 379 pregnant women attending ANC in PHCs within Rivers State Nigeria. Participants provided information on socio-demographics, reproductive history, awareness and knowledge of MC, partner communication on MC, and willingness to adopt MC postpartum. Data were analyzed using IBM Statistical Package for the Social Sciences version 23. The chi-square test for associations and multivariate logistic regression analysis for predictors of willingness to adopt MC postpartum were computed (P ≤ 0.05).&#x0D; Results: Most of the participants (n = 257; 67.8%) were aged 25 – 34 years, married (n = 370; 97.6%) with good knowledge of MC (n = 316; 86.3%). Tubal ligation was the most known MC method followed by condoms and implants. The most desired MC method was injectables (n = 111, 45.3%) while 245 (64.6%) participants were willing to adopt a method postpartum. Prior thought of adopting MC (AOR 24.628; 95%CI = 11.139 – 54.452) and having one living child (AOR = 0.201; 95%CI = 0.045- 0.905) were predictors of willingness to use MC postpartum.&#x0D; Conclusion: Willingness to adopt MC postpartum was high among women attending ANC in PHCs in Rivers State Nigeria. Reinforcement of MC desires of these women by health workers is recommended.

Modern Contraceptive Use and Associated Factors In USSA Local Government Area Of Taraba State, Nigeria

With the high rate of unintended pregnancy in the world, encouraging the use of contraceptives has become necessary. However, some factors may influence whether a woman agrees to utilize contraceptives or not. This paper examines the impact of individual factors, sociocultural factors, and health system factors on the utilization of contraceptives in Ussa Local Government Area of Taraba State, Nigeria. Through a literature-based analysis and the application of rational choice theory, the findings highlight the complex interplay of these factors in shaping contraceptive utilization patterns in Ussa Local Government Area. Individual hurdles to uptake were identified as a lack of information about contraception, socioeconomic status, misconceptions, and unfavorable attitudes. Individuals' decision-making processes are influenced by sociocultural variables such as religion and cultural traditions that oppose contraception. Furthermore, a lack of contraceptive availability, a shortage of skilled healthcare practitioners, and a weaker healthcare infrastructure all restrict access to and utilization of contraceptive therapies. The paper recommended that focused interventions should address these various challenges to boost contraceptive usage in Ussa LGA. Individuals, communities, and religious leaders should be targeted for education and awareness efforts to debunk misunderstandings, enhance knowledge, and encourage favorable attitudes regarding contraception. Engaging community leaders and religious organizations in family planning advocacy can assist transform sociocultural norms in favour of family planning. Improving the availability, price, and quality of contraception, as well as training healthcare practitioners, will be crucial for boosting the utilization of contraceptives.

Factors that influence modern contraceptive use among women aged 35 to 49 years and their male partners in Gomoa West District, Ghana: a qualitative study

BackgroundFertility declines with age, but it remains important to protect women from unplanned pregnancies throughout their reproductive lives. The objective of this study was to describe factors that influence modern contraceptive use among women aged 35 to 49 years and their male partners in Gomoa West District of Ghana.MethodsIn-depth interviews were conducted remotely for 22 women, 15 male partners of the women interviewed and seven family planning (FP) providers. In all, a total of 44 participants took part in the study. Seven refusals were recorded, four females and three males. Four focus group discussions were organized for 21 participants who took part in the in-depth interviews. Data collected were transcribed and coded after exporting to Nvivo12 qualitative analysis software. Thematic analysis was undertaken using an abductive approach.ResultsFactors that influenced the use of modern contraceptives included: achieved desired family size, providing for the family, counselling by health professionals, influence of the male partner, and health reasons. Barriers cited included: religious or socio-cultural reasons, experience or fear of side effects, rumors or misconceptions, declining fertility, and the belief that contraceptive use is a matter for women. Within the study group, roughly half of women used modern contraceptives, while the majority of male partners were non-users.ConclusionContraception among women aged 35 to 49 years and their male partners is influenced by several factors such as achieved desired family size, influence of the male partner, rumors or misconceptions, and declining fertility. Strengthening male involvement in family planning activities and health educational activities could alleviate fear and reduce misconceptions about using modern contraceptives.

Health insurance and contraceptive use, Indonesian Family Planning Census 2021.

To assess the association between health insurance coverage and sociodemographic characteristics, and the use of modern contraception in Indonesia. We used data from the 2021 Indonesian family planning census which included 38 408 597 couples. Contraception is covered by the national health insurance scheme: members are non-contributory (for poor families who do not make any monetary contribution) or contributory (for better-off families who pay for the insurance). We used regression analyses to examine the correlation between each type of health insurance (non-contributory, contributory, private or none) and contraceptive use and type of contraceptive used. The prevalence of the use of modern contraceptives in Indonesia was 57.0% (21 897 319/38 408 597). Compared with not having health insurance, having health insurance was associated with a greater likelihood of contraceptive use, odds ratio (OR): 1.14 (95% confidence intervals, CI: 1.13-1.14) and OR: 1.01 (95% CI: 1.01-1.01) for women with non-contributory and contributory health insurance, respectively. Having private health insurance was associated with lower use of modern contraceptives (OR: 0.94; 95% CI: 0.94-0.94). Intrauterine devices, lactational amenorrhoea and tubal ligation were the most common forms of contraceptive used by women. The prevalence of modern contraceptive use in Indonesia is lower than the 75% target of the 2030 sustainable development goals. As national health insurance positively correlated with modern contraceptive use, extending its coverage on remote Indonesian islands is recommended to increase the use of such contraceptive methods in those areas.

Risk factors for short birth interval: A hospital-based cross-sectional study among women in the Nkongsamba Health District, Littoral Region, Cameroon.

Short birth interval remains a major reproductive health problem, especially in the developing world. It is associated with maternal, neonatal, infant and under-five morbidity and mortality. This study identifies the risk factors of short birth interval among women in Cameroon. Women in early postpartum (with at least one previous live birth) from four health facilities in the Nkongsamba Health District were consecutively included in the study from September 2021 to December 2021. All data were collected by interview, using a semi-structured questionnaire, and analysed in Epi-Info version 7.2.3.1. With a statistically significant threshold of 5%, the adjusted odds ratio was used in multiple logistic regression to measure the association between short birth interval and potential factors. This study included a total of 679 participants with an age range of 18 to 47 years. Short birth interval was recorded in 46.10 [95%CI: 42.38-49.86]% of these women. A little more than half (56.72%) had at most 4 pregnancies already, while only 06.35% had at least 8 pregnancies in their reproductive life. Maternal age ≤ years (AOR = 2.66[1.80-3.93]), less than or equal to 10 months of breastfeeding of the previous child (OR = 2.48[1.80-3.41]), use of modern contraception before conception (AOR = 0.62 [0.43-0.89]), and the number of household occupants below 5 (AOR = 0.60[0.40-0.92]) were significantly associated with short birth interval. Short birth interval remains a significant call for concern in Cameroonian women. The likelihood of short birth interval is affected by maternal age, duration of breastfeeding, use of modern contraception and number of household occupants. Interventions to promote effective breastfeeding and postpartum family planning uptake are indispensable in the fight against short birth interval in Cameroon.

Unmet needs for modern contraceptive methods among sexually active adolescents and young women in Togo: a nationwide cross-sectional study.

The unmet need for modern contraceptives among sexually active adolescent and young women (AYW) in Africa contributes to high morbidity and mortality. To investigate the prevalence of unmet need for modern contraceptives and its associated factors among AYW in Togo, we performed a secondary analysis of data from the MICS-62017 survey. We extracted data from sexually active AYW aged 15-24 years for the analysis and used multi-level logistic regression models to identify factors associated with unmet need for modern contraceptives. Among the AYW, the median age was 20 years. The prevalence of unmet need for modern contraceptives was 27.02%. Factors that increased the likelihood of having unmet need for contraceptives included being in the "Poor" or "Middle" quintile of household wealth, aged 20-24 years, and completing primary or secondary education. Living in a household headed by a woman and having a household head aged 19-38, 39-58, or greater than 78 years decreased the likelihood of unmet need for modern contraceptives. The study highlights the high-unmet need for modern contraceptives among sexually active AYW in Togo and emphasizes the importance of addressing individual and household/community factors to improve their sexual and reproductive health. Interventions such as increasing AYW awareness, providing social marketing campaigns in schools, and targeting men-headed households could help promote modern contraceptive use and improve the sexual and reproductive health of AYW in Togo.

Modern contraceptive method utilization and determinant factors among women in Ethiopia: Multinomial logistic regression mini- EDHS-2019 analysis

BackgroundGlobally, approximately 290,000 women between the ages of 15 and 49 died from pregnancy-related problems in 2014 alone, with these sub-Saharan Africa accounts for 65% (179,000) of the deaths. Although studies are conducted on modern contraceptives, information is scarce on multinomial regression analysis at the national level data. Therefore, this study aimed to assess modern contraceptive method utilization and determinant factors among women in Ethiopia.MethodsData for this study were extracted from the national representative 2019 Ethiopian Mini Demographic and Health Survey. Data was collected using a 2-stage cluster design, in which enumeration areas formed the first stage and households made the second stage. The survey was conducted from March 21, 2019, to June 28, 2019. The analysis was done using multinomial logistic regression using STATA software version 14. The overall categorical variables with a P value of < 0.25 at the binomial analysis were included in the final model of the multinomial logistic regression model in which odds ratios with 95% CIs were estimated to identify the independent variables of women’s modern contraceptive utilization. P values less than 0.05 were used to declare statistical significance. All analysis was done on weighted data.ResultsA total of 8885 (weighted) participants were included in the current study from these,. The current study revealed that the prevalence of modern contraceptive utilization was 28.1% (95%CI: 27.6.7-28.6%). Factors like: women 25 to 34 years (aRRR = 1.5;95% CI:1.2–1.9), 35 to 44 years (aRRR = 2.4; 95% CI: 3.3–5.4), and greater than 45 years (aRRR = 2.9; 95% CI: 2.2–3.7); place of residence (rural; aRRR = 0.89; 95% CI 0.81–0.99), higher educational status (aRRR = 0.035;95%CI:0.61–0.98), grandmultipara (aRRR = 1.73;95%CI:1.6–1.9), and wealth index (poorer aRRR = 0.541;95%CI:0.46–0.631.9) were the factors significantly associated with the outcome variable.ConclusionsIn this, modern contraceptive utilization is low as compared to other countries. It was influenced by age, place of residence, education, the number of children, and wealth index. This suggests that creating awareness of contraceptive utilization is paramount for rural residence women by policymakers and health managers to empower women for family planning services. Moreover, all stakeholders, including governmental and nongovernmental organizations, better to emphasize on modern contraceptive use.

Demand and unmet need for modern contraception among mothers from a Pelotas Birth Cohort.

To determine the total demand and unmet need for contraception with modern methods and their determinants among mothers participating in the 2015 Pelotas Birth Cohort. Data from the 48-month follow-up of mothers participating in the 2015 Pelotas Birth Cohort were analyzed. Only biological mothers (aged up to 49 years) of children belonging to the 2015 Birth Cohort and who answered the 48-month questionnaire were included in the study sample. Logistic regression and respective 95% confidence intervals were used to determine associated factors. The study sample consisted of 3577 biological mothers. The prevalence of use of any contraceptive and of modern contraceptives was 86.0% (95%CI: 84.8-87.1) and 84.9% (95%CI: 83.7-86.1), respectively. The prevalence of unmet need for modern contraceptives was 10.7% (95%CI: 9.7-11.7), and the total demand for contraceptives was 95.6%. The factors associated with an unmet need for modern contraception were being over 34 years of age (OR = 0.6, 95%CI: 0.5-0.8), not having a husband or partner (OR = 1.9, 95%CI: 1.4-2.6), not being the head of the household (OR = 0.6, 95%CI: 0.4-0.9), having had three or more pregnancies (OR = 1.9, 95%CI: 1.3-2.6), and having had an abortion at least once after the birth of the child participating in the cohort (OR = 1.9, 95%CI: 1.0-3.6). Despite the high prevalence of modern contraceptive use, one in ten women had an unmet need for modern contraception and was at risk of unplanned pregnancy.

Factors Associated with Modern Contraceptive Use Among Out of School Adolescent Girls in Majengo and Njoro Wards of Moshi Municipality, Tanzania.

Low uptake of modern contraceptives among adolescents remains a serious public health concern with over 20 million adolescents in need of modern contraceptives are not using any. In Tanzania where the adolescent fertility rate is 112 per 1000, only 15.2% of adolescents are using modern contraceptives. Contraceptive use stands out to be one of the key interventions to reduce the burden of adolescent pregnancy which is high in the country at 22%. There is little information on factors associated with modern contraceptive use among out of school adolescents, who are at an increased risk of adolescent pregnancies. To determine the prevalence and factors associated with modern contraceptive use among out of school adolescent girls in Moshi municipality, Kilimanjaro region. This was a population based cross-sectional study, conducted in Moshi municipality in Kilimanjaro region 2 wards; Majengo and Njoro. The wards were randomly selected out of the 21 wards in the region. Household survey was conducted in the wards and adolescents aged 10 to 19 years who were out of school and consented and or assented to participate in the study were recruited. Data was collected using Kobo Collect TM on an Android device. Data was analysed using SPSS version 20. To determine the factors associated with modern contraceptive use, crude and adjusted analysis using logistic regression analysis was done. A total of 298 out-of-school adolescents were enrolled, with a median age of 19 (IQR 17-19) years. The prevalence of ever use of modern contraceptives among 154 sexually active adolescents was 51%, and 35% were current users of the methods. Two of common methods ever used were; injectables (27.3%) and male condoms (3.2%) respectively. Factors independently associated with ever use of modern contraceptives were; being married or cohabiting (aOR: 5.7) and having 2 or more sexual partners in the past 12 months (aOR: 5.9). Ever and current use of modern contraceptives among out-of-school adolescents were reported at 51% and 35% respectively. Respondent's marital status and number of sexual partners was associated with ever use of modern methods. Strengthening of adolescent-friendly SRH services outside facility setting is needed given very few are currently using a modern method. Further, through inter-sectoral collaboration interventions to keep adolescent girls at school should be strengthened.