Modern Contraception Research Articles

“We provide the methods to others but we don’t use the methods ourselves”: challenges with utilization of modern contraception among Female Healthcare Workers at two tertiary teaching hospitals, Northern Uganda

BackgroundFemale Healthcare Workers (FHCWs) play a crucial role in advocating for, delivering modern contraceptive methods (MCM) to reproductive-age women and potential users. Despite the high frequency of women seeking healthcare annually, less than half receive adequate contraceptive counseling and services. Investigating FHCWs’ adherence to these practices and understanding the obstacles they encounter is essential. This study aimed to explore challenges with utilization of MCM among FHCWs at the two tertiary teaching hospitals in Northern Uganda.MethodsWe conducted a descriptive, cross-sectional study employing a qualitative approach at St. Mary’s Hospital Lacor (SMHL) and Gulu Regional Referral Hospital (GRRH), Northern Uganda. Qualitative data were explored using the principles of descriptive phenomenology to gain deeper insights into the experiences of twenty (20) FHCWs.ResultsFindings revealed various challenges faced by FHCWs, including patient barriers such as religious beliefs, contraceptive myths, fear of side effects, and provider barriers like lack of knowledge, training, and discomfort. Additionally, health system barriers like limited time and competing priorities were identified.ConclusionFemale Healthcare workers experience challenges with utilization of MCM. Efforts should focus on enhancing contraceptive services, particularly in faith-based facilities and among married individuals. Besides, addressing perceived barriers at the patient, provider, and system levels through comprehensive health education, ensuring method availability, and provider training is imperative.

Determinants of suboptimal birth spacing among reproductive-age women in Adama district, Ethiopia: a community-based unmatched case-control study

BackgroundBirth spacing is crucial for ensuring the health of mothers and their children, as well as determining population growth. Short birth intervals represent a universal public health problem associated with adverse maternal, fetal, neonatal, and child outcomes. However, there is limited information in the study area regarding the determinants of suboptimal birth spacing. Thus, this study aimed to identify the determinants of suboptimal spacing among women of reproductive age in the Adama district, Ethiopia.MethodsA community-based unmatched case-control study was conducted among 568 randomly selected reproductive-age women using the multi-stage sampling technique. Data were collected using an interviewer-administered, structured questionnaire. The collected data were entered into Epi Info version 7.2 and analyzed using SPSS version 26. Binary logistic regression analysis was used to model the association between suboptimal birth spacing and independent variables. Adjusted odds ratios with their 95% confidence intervals were calculated to determine the strength of the association. A p-value < 0.05 was considered to declare statistical significance.ResultEducational status (no formal education) (AOR = 2.40; 95% CI: 1.23–1.75), inadequate knowledge of optimal birth space (AOR = 2.60; 95% CI; 1.80–3.90), non-use of modern contraceptives (AOR = 3.00; CI: 1.90–4.20), short breastfeeding duration (AOR = 2.30; 95% CI: 1.50–3.40), and having female index child (AOR = 1.60; 95% CI: 1.13–2.50) were independent determinants of suboptimal birth spacing practice.ConclusionEncouraging women’s education, contraceptive use, and breastfeeding is crucial for birth spacing. Community health initiatives should also focus on preventing sex-based birth intervals.

Utilization of modern contraceptives and associated factors among women of homeless reproductive age in Adama town, Oromia, Ethiopia

BackgroundFamily planning refers to a conscious effort by a couple to limit or space the number of children they have through the use of contraceptive methods. Contraceptive utilization is a practice that helps individuals or couples avoid unwanted pregnancy. A lack of family planning puts homeless individuals at a higher risk of unwanted pregnancies and sexually transmitted infections. However, there is little data about modern contraceptive utilization among homeless women in the study area.ObjectivesIt has aimed to assess the utilization of modern contraceptives and associated factors among homeless reproductive-age women in Adama town, 2023.MethodsA community-based cross-sectional study was conducted in Adama town among 286 homeless women. A convenience sampling technique was used. The data were collected through face-to-face interviews using a pretested structured questionnaire. The collected data were cleaned, coded, and entered into Epi Info, and the data were exported to the Statistical Package for Social Sciences (SPSS) version 22. Descriptive statistics were used to characterize the study population. The associations between dependent and independent variables were modeled using binary logistic regression. The adjusted odds ratio (AOR) and 95% confidence interval (CI) were used to estimate associations, and a P value < 0.05 was considered to indicate statistical significance.ResultsOut of the planned 289 respondents, 286 (98.9%) were participated. The prevalence of modern contraceptive utilization was 56.6% [95% CI: (50.7, 62.2)]. Among the utilizers, implants (52.5%), injectables (42%), and pills (5.5%) were used. Homeless women aged 25–34 years [AOR = 4.22, 95% CI: (1.77, 10.05)], a formal education [AOR = 3.04, 95% CI: (1.21, 7.60)], a slept off-street [AOR = 2.81, 95% CI: (1.25, 6.34)], a monthly income greater than or equal to 2400 Ethiopian birr [AOR = 4.18, 95% CI: (2.11, 8.29)], a sexual intercourse AOR = 3.14, 95% CI: (1.17, 8.40)], and a history of pregnancy after joining the street life [AOR = 9.21, 95% CI: (3.67, 23.12)] were factors significantly associated with the utilization of modern contraceptives.ConclusionThe prevalence of modern contraceptive utilization among homeless women was relatively higher than in previous studies. The associated factors for contraceptive utilization included age, education, place for sleeping, income, sexual intercourse and history of pregnancy after joining the street life. The Regional and Adama town Health Bureau and facilities should develop targeted interventions (considering age, educational, and other disparities) to reduce the unmet need for modern contraception and halt unnecessary health outcomes among homeless women, their children, and families.

Empowering Maternal Choice: Exploring Factors Influencing Early Postpartum Contraceptive Adoption Intention Among Pregnant Women in Northeast Ethiopia

Background: Despite progress in access to family planning services in many sub-Saharan African countries in recent decades, advances in early postpartum contraceptive adoption remain low, and the unmet need for early postpartum contraceptives is high. According to the Ethiopia Demographic and Health Survey report, early postpartum modern contraceptive method uptake is still unacceptably low in Ethiopia. Objectives: This study aimed to determine the magnitude of intention to adopt early postpartum modern contraceptive methods and its associated factors among pregnant women in Dessie and Kombolcha town zones, northeast Ethiopia. Methods: A community-based cross-sectional study was deployed from 15 January–15 February 2023, in the Dessie and Kombolcha zones, northeast Ethiopia, among pregnant women. The study involved 780 pregnant women using the cluster sampling technique. A census was conducted in 20 randomly selected clusters to identify eligible pregnant women. Actual data were collected home-to-home in the community through face-to-face interviews. Data were collected by Open Data Kit (ODK) and exported to STATA 17 for analysis. A multivariable logistic regression analysis was performed, and the goodness of the model was checked by Hosmer–Lemeshow’s test statistic and rock curve. An adjusted odds ratio with a 95% confidence interval and p-value &lt; 0.05 was considered statistically significant. Result: The study revealed that 49.6% of pregnant women lack autonomy and 50% lack knowledge about early postpartum contraception, with participants’ wealth index status ranging from rich (36.6%) to poor (33.2%). The study found that 75.8% of pregnant women intended to adopt early postpartum modern contraceptive methods early after childbirth. After controlling the potential confounders, mother’s age (AOR = 6.2 [2.6–14.6], birth interval (AOR = 2.5 [1.6–3.7]), have paid work (AOR = 1.9 [1.3–2.8]), health facility from home (AOR = 2.6 [1.5–4.4]), last delivery Place (AOR = 2.4 [1.1–5.7]), knowledge on (AOR = 1.5 [1.1–2.1]), and antenatal care follow-up (AOR = 1.9 [1.2–3.3]) were significant associated factors of intention to uptake early postpartum modern contraceptive methods among pregnant women. Conclusions: The study found that 75% of the participants had the intention to adopt contraceptive methods during the early postpartum period. Identified factors influencing this intention were age, birth interval, women’s employment status, area of residence, distance to health facilities, last delivery place, knowledge of early postpartum modern contraception, gravidity, and antenatal care follow-up. These findings highlight the need for targeted interventions to address these factors, framing the intended users and enabling access to early adoption of postpartum contraceptive methods.

Wealth-related inequalities in the utilisation of modern contraceptives in Papua New Guinea: evidence from the 2016–2018 Demographic and Health Survey data

ObjectiveTo examine the wealth-related disparities in modern contraceptives use among women in Papua New Guinea.DesignWe performed a cross-sectional analysis of the 2016–2018 Papua New Guinea Demographic and Health Survey data....

Factors associated with modern contraceptive utilization among reproductive age women in Cambodia; evidenced by the recent Cambodia demographic and health survey

IntroductionCambodia is a low-income country with limited access to family planning (FP) in terms of modern contraceptive utilization. Despite several FP programs designed to make contraceptives accessible, adoption of contraceptives has been difficult in Cambodia, which has high rates of fertility and maternal mortality. This gap in essential care can put women and adolescent girls at greater risk of adverse outcomes such as stillbirth, spontaneous abortion, unwanted pregnancy, or even maternal death. One of the goals set by the government to decrease both maternal and child mortality and morbidity was increasing the modern contraceptives utilization. So, the main objective of this study was to evaluate spatial variations in modern contraceptives utilization and its contributing factors among women.MethodsData from the Cambodia 2021–22 Demographic and Health Survey datasets were used for secondary data analysis. A total of 19,496 women of reproductive age participated in the study. A spatial and multilevel mixed effects analysis was done on the factors affecting modern contraceptives utilization among Cambodian women. Finally, the percentage, odd ratio, together with their 95% confidence intervals and the results of the spatial analysis were provided.ResultThe prevalence of modern contraceptive use was 31.2% in Cambodia. Living in an urban area [AOR = 1.224; 95% CI = (1.126.1.330); P = 0.0001]; being married [AOR = 34.131; 95% CI= (12.673, 91.921); P = 0.0001]; and having a history of terminated pregnancy [AOR = 1.137; 95% CI= (1.055, 1.225); P = 0.0001] were found to be positively associated with modern contraceptive utilization. In contrast to this, being between the age range of 46–49 [AOR = 0.421; 95% CI = (0.364, 0.487); P = 0.0001]; being a female-headed household [AOR = 0.784; 95% CI = (0.723, 0.850); P = 0.0001]; and current breast feeding [AOR = 0.84; 95% CI = (0.75, 0.93); P = 0.010] were found to be negatively associated with modern contraceptive utilization. Additionally, the spatial analysis of modern contraceptive utilization showed that a higher proportion was utilized in the southern and southwest regions of Cambodia.ConclusionIn this study, living in urban area, being married and having history of terminated pregnancy were found positively associated with modern contraceptive utilization. In contrast to this, being old age, being female headed household and being currently breast-feeding women were found negatively associated with modern contraceptive utilization. In addition to this, there were geographic (spatial) variations in modern contraceptive utilization among Cambodian’s women across the country.

Armed conflict and maternal health service utilization in Ethiopia’s Tigray Region: a community-based survey

BackgroundEvidence generated on utilization of maternal health services during times of conflict can inform the development of targeted interventions. The deadly war in Tigray caused the health system to collapse. However, utilization of maternal health services is not well documented that might help in design effective interventions applicable during armed conflict. Thus, this study aimed to assess maternal health service utilization and bridge the gap in healthcare provision and support during conflict. .MethodsA community-based cross-sectional survey was conducted among mothers of children under the age of 1 year in six accessible zones of Tigray from August 4–20, 2021. The study participants were selected through a random sampling method. The study was conducted during the armed conflict where the access to health services was limited due to the damaged and looted health facilities. A descriptive study was used to characterize the study population and data were presented using proportions and percentages. A Chi-square test was used for categorical variables and a P-value of 0.05 was considered significant. .ResultsA total of 4,381 participants were included in the study. Modern contraceptives were used by 1002 (22.9%) of women, and injectable contraceptives were the most common method used by 472 (47.1%) women. Likewise, only 830 (36.5%),1956 (47.1%), and 623 (15.0%) respondents reported the use of optimal antenatal care (ANC), skilled delivery, and postnatal care (PNC) in the first 24 h by mothers, respectively. About 34% of women received comprehensive abortion care services. Most delivery services took place in hospitals. Residence has shown a significant difference in using maternal health services at p-value < 0.001.ConclusionThe conflict in Tigray has had a profound impact on maternal health services, resulting in a significant disruption that is disproportionately high in rural areas. Immediate action is required to provide access to lifesaving interventions for basic maternal health services. The timely initiation of these services is crucial in addressing the pressing needs of pregnant women and their infants. By implementing comprehensive and targeted interventions, we can mitigate the potential long-term consequences and ensure that maternal health services are effectively reinstated.

Barriers to modern contraceptive utilization in Ethiopia.

Contraception is a critical service for women to control their reproductive health, allowing them to determine the number and spacing of their children prevent unintended pregnancies, reduce the risk of morbidity and mortality from associated with childbirth, and reduce the likelihood of abortions. Despite its benefits, the utilization of modern contraceptive methods remains low in certain regions of Ethiopia, Particularly in Afar and Somali, which are also experiencing high fertility rates. However, there is a substantial gap in understanding the sociocultural barriers that hinder the adoption of modern contraception in these regions. This study aims to explore these barriers to contraceptive use among women of reproductive age in Afar and Somali regions, providing qualitative insights that are essential for designing effective strategies to improve contraceptive service utilization. Asequential mixed method approach was employed, including scoping review and qualitative interviews. Scoping review focused on qualitative or mixed-methods studies conducted in Ethiopia and published between 2013 and 2023 in English, Selecting 14 articles Additionally, qualitative data were collected from Afar and Somali regions through In-depth interviews with women aged 15-49 who are married or in consensual union, and key informant interviews with health extension workers and contraception providers at health center. A total of 20 in-depth interviews and 07 key informants were conducted. Thematic analysis was used to analyze the data. The integrated findings from the scoping review and qualitative study reveal various barriers and determinants influencing contraceptive use among women in Ethiopia. Barriers includes religious or cultural beliefs, myths and misconceptions, fear of side effects, lack of knowledge and misinformation, negative attitude towards contraceptives, partner opposition, socio-cultural factors, fear of being judged by family and friends, and lack of communication between husband and wife, husband altitude, distance from health facility, availability of service and different contraceptive choice, separate room for family planning services, and cost of contraceptive method and transportation. The scoping review corroborates these findings, emphasizing on the role of socio-demographic, economic, cultural, religious, health service, and knowledge-related factors. Higher education, urban residence, higher income, mass media exposure, spousal communication, family size, and access to quality health services were associated with increased utilization, while lack of awareness, misconceptions, myths, side effects, fear of infertility, partner opposition, social stigma, and cultural norms decreased utilization. The study recommended promoting contraceptive use, challenging socio-cultural norms through Social Behavioural Communication and Counselling (SBCC), engaging partners and community members, and improving the quality of care.

Factors Associated with use of Modern Contraceptives amongst Sexually Active Adolescent Girls Aged 15-19 in Homa Bay Town Sub-County, Kenya

Factors Associated with use of Modern Contraceptives amongst Sexually Active Adolescent Girls Aged 15-19 in Homa Bay Town Sub-County, Kenya

Pregnancy intentions and outcomes among young married women in Nepal

BackgroundApproximately 44% of Nepalese women ages 15–49, desiring to avoid pregnancy, do not use modern contraceptives, resulting in an estimated 539,000 unintended pregnancies annually. ObjectivesThis study aims to investigate the association between young, newly married women's pregnancy intentions and subsequent pregnancies. Study designData were collected longitudinally from 200 recently married women aged 18–25 in Nepal. Surveys conducted every six months over 18 months covered various health domains. The study used mixed-effects logistic regression models to account for repeated measurement of correlated data over time. The primary outcome was pregnancy. Pregnancy intention was determined based on responses to, “When would you like to have a child in case you were to have one?” Participants were recategorized into a dichotomous variable for analytical purposes: “Right away” or “Not right away.” ResultsA total of 133 participants became pregnant during the study, with sociodemographic characteristics showing minimal differences between pregnant and nonpregnant groups. Women intending to become pregnant right away had significantly higher odds of becoming pregnant (OR, 4.03; 95% CI, 2.51–6.48) after adjusting for covariates. Among those not intending immediate pregnancy, over 70% became pregnant, suggesting potential barriers to achieving reproductive goals. ConclusionsYoung, newly married women in Nepal intending immediate pregnancy have higher odds of becoming pregnant. However, a substantial proportion of those hoping to delay pregnancy still experience unintended pregnancies, indicating challenges in meeting reproductive goals. The findings underscore the need for addressing barriers to contraceptive access and societal norms impacting women's reproductive autonomy in Nepal.

Community-based distribution program's response to increased contraceptive demand in the Democratic Republic of Congo during COVID-19.

In the Democratic Republic of Congo (DRC), the United States Agency for International Development (USAID) Integrated Health Program supports the Ministry of Health to strengthen family planning (FP) services through a Community-Based Distribution (CBD) program. As a part of this project, we investigated whether the CBD program responded to the increased need for contraceptives in nine provinces of the DRC during COVID-19 pandemic. Analysis compared distribution rates of contraception methods, uptake by new users, and renewal rates among women before and during the pandemic. Data sourced from women of childbearing age using modern contraceptives through CBD across 179 health zones were analyzed using chi-square tests in MedCalc software to examine proportion differences pre-COVID-19 versus during COVID-19. The CBD program distributed about 348,958 contraceptives during the pandemic, with 18.3% being new users, significantly higher than pre-pandemic levels (14.5%; P &lt; 0.0001). Renewal rates were higher pre-pandemic overall (26.3% vs. 24.6%; P &lt; 0.0001), but urban areas saw increased renewals during COVID-19 compared to before (34.8% vs. 24.1%; P &lt; 0.0001). Despite pandemic-induced healthcare challenges, the CBD program effectively met escalated contraceptive demands. These findings underscore CBD's efficacy in crisis response, offering insights for governments on optimizing CBD services during health emergencies

A REVIEW STUDY ON ROLE OF CONTRACEPTIVES AND THEIR VARIOUS TYPES.

Contraception is the process used to stop unwanted pregnancy and control birth rate. Contraceptives reduces the chances of pregnancy after sexual intercourse. Contraceptives prevent pregnancies by interfering with the procedure of fertilization. Contraceptives reduces the chances of abortion by preventing unintended pregnancies on their partners, in which 842 million (44%) are modern using modern methods of Contraceptives are accessible in huge varieties and types . Numerous contraceptives are available, 790 million (42%) are traditional method users according the statistical data of 2019. The most common contraceptive techniques that are use of contraceptives are increasing day by day, 922 million of women of reproductive age used worldwide are female sterilization and male condoms, female sterilization are used in 219 million users (24%), male condoms are used in 189 million users (21%) according the data of 2019. The use of traditional methods and IUDs has reduced worldwide since 1994. According to WHO, The only form of birth control is a condom,that can prevent both unintended pregnancies and sexually transmitted diseases. The need of family planning is increased globally up to 77% from 2015 to 2020.. Over the past 20 years, the number of women using family planning methods has grown, rising from 900 million in 2020 to 2000 million. Use of modern contraceptive methods is also increased from 663 million to 851 million with the prevalence rate of 47.7% to 49.0%. Numerous contraceptive methods exist, including hormonal methods like CHC vaginal ring, CHC transdermal patch, and combination hormonal contraceptives. Progestin-only techniques include hormonal male contraceptives, progestin-only pills, DMPA injections, implants, and progestin-only IUDs. The other approach is non-hormonal and consists of vaginal pH modulators, barrier techniques like condoms, and copper IUDs. Traditional methods, such as the LAM method, the fertile cycle method, and the withdrawal approach, comprise the third type of contraception. Herbal contraceptives, which use a variety of herbs and plant preparations, are the fourth technique of birth control.

Health Transitions and the Rise of Modern Contraceptive Prevalence: Demand, Access, and Choice

Health Transitions and the Rise of Modern Contraceptive Prevalence: Demand, Access, and Choice

Modern contraceptive utilization among women of reproductive age in Ghana: a multilevel mixed-effect logistic regression model

BackgroundWorldwide, sexual and reproductive health remains a prominent public health concern for women of reproductive age. Modern contraceptive methods play a crucial role in enabling individuals and families to regulate fertility, thereby reducing unintended pregnancies, abortions, pregnancy-related complications, and mortality. Due to the scarcity of reliable and current data regarding the factors affecting the adoption of modern contraceptives among women of reproductive age at the national level in Ghana, this research aimed to explore the determinants of modern contraceptive usage among reproductive age women.MethodsThe study analyzed data from the 2022 Ghana Demographic and Health Survey, including a weighted sample of 6,839 reproductive-age women. By employing a multilevel logistic regression model, the study sought to determine factors associated with the utilization of modern contraceptives. Associations between explanatory variables and the outcome were evaluated using adjusted odds ratios (AORs) along with 95% confidence intervals (CIs). Statistical significance was established using a p-value threshold of less than 0.05. All statistical analyses were conducted using STATA version 17 software.ResultsThe study found that 26.36% (95% CI: 25.33-27.34%) of women of reproductive age in Ghana used modern contraceptives. Secondary education (AOR = 1.26, 95% CI = 1.03–1.53), poorer household (AOR = 1.30, 95% CI = 1.05–1.61), women’s marital status, i.e. married (AOR = 1.46, 95% CI = 1.16–1.83), living with a partner (AOR = 1.65, 95% CI = 1.32–2.06), divorced (AOR = 2.53, 95% CI = 1.48–4.31), and separated (AOR = 1.70, 95% CI = 1.21–2.37), multipara (AOR = 1.39, 95% CI = 1.04–1.87), were the factors that promote modern contraceptive utilization. Women’s age in years, i.e. 35–39 (AOR = 0.71, 95% CI = 0.52–0.97), 40–44 (AOR = 0.63, 95% CI = 0.44–0.90), and 45–49 (AOR = 0.45, 95% CI = 0.25–0.79), history of pregnancy loss (AOR = 0.86, 95% CI = 0.76–0.98), region, i.e. Greater Accra (95% CI = 0.42–0.92), Bono East (95% CI = 0.32–0.81), Northern (95% CI = 0.28–0.67), Savannah (95% CI = 0.28–0.81), and North East (95% CI = 0.20–0.63), were all associated with a lower use of modern contraceptives.ConclusionsModern contraceptive utilization was low in this study. Factors such as women’s education, socioeconomic status, and marital status were associated with increased modern contraceptive utilization, whereas women’s age and regional disparities were linked to lower usage rates. These findings emphasize the need for targeted interventions to address socioeconomic barriers and regional disparities in access to family planning services across Ghana.

Addressing disparity in attitudes and utilization of family planning among married couples in the pastoralist community of Fentale District, Eastern Ethiopia.

Despite progress in national reproductive health programs, pastoralist regions like Fentale District in Eastern Ethiopia face challenges with low contraceptive coverage, attributed to insufficient positive attitudes and uptake among couples. This cross-sectional study was conducted from October 1 to December 25, 2021, in Fentale District, Eastern Ethiopia. It involved 1,496 couples selected using multistage sampling. Data were entered into EPI Data and analyzed with SPSS (v23.0) and STATA (v14.0), employing descriptive statistics, bivariate analysis, and binary logistic regression to identify predictors of contraceptive attitudes and use. The study's response rate was 93.8%, with 1,404 pastoralist couples participating, equally split between women and men. A nomadic-pastoralist lifestyle was common (64.6%), and family planning discussions were rare (93.2%). Gender disparities in contraceptive attitudes and use were evident. Contraception use was reported by 27.4%, with women (41.2%) outnumbering men (13.5%). Women showed more positive attitudes towards contraception (87.9% vs. 31.9% for men). Only 33% had favorable attitudes towards different contraceptive methods, with women more likely to be positive. Modern contraception use was low (18.2%), with women (34.8%) predominating over men (1.7%). Among users, women had a more favorable attitude (78.5% vs. 6.6% for men). Health extension workers were key information providers. Predictors of contraceptive attitudes and use included sex, education, occupation, electronic device ownership, migration frequency, treatment preferences, and family planning discussions. The limited positive attitude towards and use of family planning in Fentale District may stem from unfavorable attitudes, low adoption, and couple disparities. Key factors include gender, education, occupation, electronic device ownership, migration, treatment preferences, and family planning discussions. Targeted educational campaigns for men are needed to address these issues and reduce the gender gap in contraceptive attitudes and use.

ANALYZING SOCIODEMOGRAPHIC DISPARITIES AND FACTORS INVOLVED IN NON-USE OF MODERN CONTRACEPTIVES AMONG YOUNG AND NON-YOUNG MARRIED FEMALES IN INDIA: EVIDENCE FROM NFHS 2019-21

It has been observed that married women refrain from utilizing contraceptive methods owing to a variety of reasons, including postpartum-amenorrhea, side-effects-worries, rarely or never having sex, no contraception while breastfeeding, or frustration with a particular method. The current study sought to investigate the sociodemographic disparities and contributing factors related to married women who are young (15–24 years old) and non-young (25–49 years old) and who do not utilize contemporary contraceptive methods. The research utilized cross-sectional data obtained from the fifth round of the National Family Health Survey (NFHS-5) to explore the determinants of contraceptive non-utilization among 175,652 married women in India. Multiple logistic regression analysis was utilized for the examination. The study found that non-young married females (25-49) had a higher prevalence of not using contemporary contraceptives (72%) compared to young married females (45.8%). The majority of non-users were from the central region (24.4%), followed by the east (17.4%), north-east (17.2%), north (15.9%), south (15.2%), and west region (9.9%). The majority of non-users were non-working and had male and female household heads. Most non-users knew about modern contraceptives but were unaware of family planning on radio and TV. Higher odds ratios in the non-use among married females were found significant among central-region females (OR=2.189, CI: 1.815-2.641), East-region (OR=1.324, CI: 1.148-1.527), South-region (OR=1.262, CI: 1.063-1.497), females who don’t know caste (OR=1.898, CI: 1.176-3.062), females having primary (OR=3.466, CI: 2.889-4.157) and secondary education (OR=2.281, CI: 1.890-2.753), females who used since last birth (OR=1.851, CI: 1.658-2.068) and never used (OR=1.632, CI: 1.474-1.806). The study found that economically disadvantaged females, household heads, and those with multiple children are less likely to avoid birth control methods, while marital status, religion, caste, education, and birth order did not have a significant impact on non-usage. The study highlights sociodemographic disparities in contraceptive use, emphasizing the need to address issues like low education, media exposure, and ignorance towards birth-control practices, and recommends immediate actions to reduce non-use among married females.

Birth rate decline in the later phase of the COVID-19 pandemic: the role of policy interventions, vaccination programmes and economic uncertainty

Abstract STUDY QUESTION What are the factors influencing the decline in the birth rates observed in higher-income countries in the later phase of the COVID-19 pandemic? SUMMARY ANSWER Our results suggest that economic uncertainty, non-pharmaceutical policy interventions, and the first wave of the population-wide vaccination campaign were associated with the decline in birth rates during 2022. WHAT IS KNOWN ALREADY During the COVID-19 pandemic, birth rates in most higher-income countries first briefly declined and then shortly recovered, showing no common trends afterwards until early 2022, when they unexpectedly dropped. STUDY DESIGN, SIZE, DURATION This study uses population-wide data on monthly total fertility rates adjusted for seasonality and calendar effects provided in the Human Fertility Database (HFD). Births taking place between November 2020 and October 2022 correspond to conceptions occurring between February 2020 and January 2022, ie, after the onset of the pandemic but prior to the Russian invasion of Ukraine. The data cover 26 countries, including 21 countries in Europe, the United States, Canada, Israel, Japan and the Republic of Korea. PARTICIPANTS/MATERIALS, SETTING, METHODS First, we provided a descriptive analysis of the monthly changes in the total fertility rate (TFR). Second, we employed linear fixed effects regression models to estimate the association of explanatory factors with the observed seasonally adjusted total fertility rates. Our analysis considered three broader sets of explanatory factors: economic uncertainty, policy interventions restricting mobility and social activities outside the home, and the progression of vaccination programmes. MAIN RESULTS AND THE ROLE OF CHANCE We found that birth trends during the COVID-19 pandemic were associated with economic uncertainty, as measured by increased inflation (p &amp;lt; 0.001), whereas unemployment did not show any link to births during the pandemic (p = 0.677). The stringency of pandemic policy interventions was linked to a postponement of births, but only in countries with lower institutional trust and only in the early phase of the pandemic (p = 0.003). In countries with higher trust, stricter containment measures were positively associated with birth rates, both for conceptions in the first year of the pandemic (p = 0.019) and, albeit only weakly significant, for conceptions later in the pandemic (p = 0.057). Furthermore, we found a negative association between the share of the population having received the first dose of the COVID-19 vaccination and total fertility rates (p &amp;lt; 0.001), whereas the share of the population having completed the primary vaccination course (usually consisting of two doses) was linked to a recovery of birth rates (p &amp;lt; 0.001). LARGE SCALE DATA N/A LIMITATIONS, REASONS FOR CAUTION Our research is restricted to higher-income countries with relatively strong social support policies provided by the government as well as wide access to modern contraception. Our data did not allow analyses of birth trends by key characteristics, such as age, birth order and social status. WIDER IMPLICATIONS OF THE FINDINGS This is the first multi-country study of the drivers of birth trends in the later phase of the COVID-19 pandemic. In the past, periods following epidemics and health crises were typically associated with a recovery in births. In contrast, our results show that the gradual phasing out of pandemic containment measures, allowing increased mobility and a return to more normal work and social life, contributed to declining birth rates in some countries. In addition, our analysis indicates that some women avoided pregnancy until completion of the primary vaccination protocol. STUDY FUNDING/COMPETING INTEREST(S) This study did not use any external funding. The authors acknowledge funding from their home institution, the Vienna Institute of Demography of the Austrian Academy of Sciences, and from the Open-Access Fund of the Austrian Academy of Sciences. For the purpose of open access, the authors have applied a CC BY public copyright licence to any Author Accepted Manuscript versions arising from this submission. All authors declare that they have no conflicts of interest.

Women's decision-making power can influence modern contraceptive use: Evidence from Bangladesh.

It is generally believed that gender inequality and women's lack of decision-making power may restrict women's use of modern contraception, leading to high rates of unwanted pregnancies, abortions, and deaths. Evidence shows that empowered women are more likely to use modern contraception methods, but few studies have investigated this across multiple domains of empowerment. This study examined the associations between women's empowerment and modern contraception use in Bangladesh. Data from a sample of 16,834 married women aged 15-49years from the Bangladesh Demographic and Health Survey 2017-2018 were analysed. Complex survey weight adjusted logistic models were fitted to evaluate the associations after adjusting for clusters, strata, and sampling weights. indicate that just over half of the married women (55.7%) had used modern contraception methods. Women's empowerment was associated with contraceptive use, especially decision-making power. Women who had medium or high autonomy of household decision making were likely to have 20% (AOR=1.20; 95% CI: 1.04-1.39) and 27% (AOR=1.27, 95% CI: 1.11-1.45) increased odds of using modern contraceptives compared to those who scored low in the decision-making domain. The findings demonstrated strong evidence of direct influence of women's decision-making power on modern contraception use. The results also found influence of several socio-demographic factors including area of residence, husband's age, wealth index andmobile phone ownership on the use of modern contraceptives. Future interventions can focus on integrating women's empowerment into family planning programming, with a particular focus on enhancing women's autonomy in decision making.

From data to decisions: Exploring family planning services utilization in Karnataka and India through the prism of NFHS-4 and NFHS-5.

Family planning (FP) services are pivotal in assessing a country's healthcare efficacy. Despite India's strides in FP promotion, disparities persist in its utilization rates. This study analyzes Karnataka's FP trends by using National Family Health Survey (NFHS) rounds 4 and 5, comparing its indicators with national averages. A retrospective record review-based descriptive study design was employed. Data from NFHS-4 (2015-16) and NFHS-5 (2019-21) were analyzed using MS Excel 365. Key variables included age at marriage, total fertility rate (TFR), and various contraceptive methods. Karnataka exhibited a stable rate of early marriages for women and a decline among men aged 25-29 years. TFR in Karnataka slightly decreased, with increased contraceptive usage and significant growth in modern contraceptive methods. However, male sterilization rates remained low. There was an improvement in health workers' engagement with female non-users and in providing information on contraceptive side effects. While Karnataka has progressed in FP, challenges such as early marriages persist. Enhancing integration, leveraging technology, and empowering women are essential for comprehensive FP services in India.

Factors influencing modern contraceptive usage among women aged 15-49 years: a cross-sectional study

Introduction: This study aimed to examine the factors that influence modern contraceptive use among married women of reproductive age in Kirkuk City, Iraq. Methods: A cross-sectional study was conducted to gather data from a convenience sample of 500 married women of reproductive age attending family planning units at 10 healthcare facilities, Azadi, Kirkuk Teaching Hospital, and private gynecological and obstetric clinics. Data were collected using a structured questionnaire from October 1st, 2023, to February 1st, 2024. The statistical analysis involved descriptive and inferential techniques. Results: The prevalence of contraceptive use among participants was 74.6%, with about (21%) reporting condom use and (16.0%) withdrawal usage. However, intrauterine devices were reported in (12.6%). Side effects were significantly (p&lt;0.001) associated with contraceptive method choices, with 52% of the users experiencing adverse effects. External pressures to have additional children or become pregnant significantly (p=0.037) influenced contraceptive method choices. There were fewer modern contraceptive methods due to unsafety (30.9%), discomfort (23.6%), and side effects, such as headache (18%), weight gain (16%), and irregular bleeding (14%). Conclusions: Modern contraceptive use is affected by healthcare, safety, side effects, reproductive health, and personal choices. Providing complete knowledge and access to modern contraceptives helps couples make informed reproductive health decisions, empowers women to regulate their fertility, supports their personal and reproductive objectives, and promotes their health and well-being. Keywords: birth control, childbearing age, Iraq, modern contraceptive, side effects