Modern Contraception Research Articles

Understanding Multifaceted Determinants of Contraceptive Utilization among Adolescent Females: Insights from Wakiso District, Uganda

Despite global efforts to enhance contraceptive utilization, adolescent females in Uganda face persistent challenges accessing and utilizing modern contraceptive methods, resulting in high fertility rates and maternal mortality. This cross-sectional study investigated the intricate factors influencing contraceptive usage among adolescent females attending Kasangati Health Center IV in Wakiso District, Uganda. Employing questionnaire-based surveys, the study targeted adolescent females attending the health center, utilizing simple random sampling to select 220 participants, as determined by Fisher's formula. Data analysis was conducted using Microsoft Excel and SPSS version 20, presenting comprehensive findings through tables, pie charts, bar graphs, and narratives. The study uncovered a concerning contraceptive prevalence rate (CPR) of 19% among adolescent females, despite existing awareness of family planning methods. Key determinants of contraceptive usage included limited knowledge about contraception, constrained access to services, entrenched societal norms, and gender dynamics. The findings highlight the urgent need to address these multifaceted barriers to enhance contraceptive utilization and mitigate unmet needs among adolescent females. The study's recommendations encompass targeted educational campaigns, improved accessibility of family planning services, and fostering the engagement of both genders in reproductive health decision-making processes. Ethical considerations were meticulously observed, with informed consent obtained from participants and ethical approval secured from relevant authorities. This study contributes seminal insights into the complex landscape of contraceptive utilization among adolescent females in Uganda, offering critical guidance for policy formulation and programmatic interventions aimed at improving reproductive health outcomes and curtailing maternal mortality rates. Keywords: Contraceptive utilization, Adolescent females, Reproductive health, Family planning, Wakiso District and Uganda

18-49 yaş arası evli kadınlarda sağlık okuryazarlığı ve gebeliği önleyici yöntem kullanımının değerlendirilmesi

Objective: To determine the level of health literacy and assess contraceptive use in married women. Methods: From August 2020 to October 2020, a cross-sectional survey was conducted among married women aged 18 years and older residing in various regions across Turkey. The survey targeted this demographic via an online questionnaire, carefully crafted by existing literature and aligned with the study's aims. The study cohort consisted of 1024 married women who voluntarily participated in the research. Results: The study group included women between the ages of 18 and 49, with a mean age of 32.74 years and a standard deviation of 6.85. Scores on the European Health Literacy Survey Questionnaire spanned from 1.11 to 50.0, with a central score at the median of 34.38. Health literacy was found to be lower in those aged 35 years and above, those who graduated from primary school, those who have been married for 20 years or more, those who had given birth 3 times or more, those with 2 and more living children and those with a history of stillbirth. While no significant relationship was found between the use of contraceptive methods and health literacy, health literacy was determined to be higher among women who stated that they would prefer a modern method if they had to use a contraceptive method again. Conclusion: It can be suggested that married women had moderate health literacy. Preference for modern contraceptive methods can be encouraged through informative activities to improve the health literacy of women.

Cervical cancer screening and its associated factors among women of reproductive age in Kenya: further analysis of Kenyan demographic and health survey 2022

IntroductionAlthough cervical cancer screening is one of the most effective strategies to reduce the incidence and mortality of cervical cancer, the percentage of cervical cancer screening in low- and middle-income counties is low. In Kenya, the current nationwide prevalence and associated factors for the detection of cervical cancer is unknown. Therefore, this study aimed to assess the prevalence and associated factors for the detection of cervical cancer screening among women of reproductive age in Kenya using the Kenyan Demographic and Health Survey 2022.MethodsThis study used the most recent Kenyan Demographic and Health Survey data (2022) with a total weighted sample of 16,901 women. A mixed effects logistic regression analysis was performed and in the multivariable analysis, variables with a p-value below 0.05 were considered statistically significant. The strength of the association was evaluated using adjusted odds ratios along with their corresponding 95% confidence intervals.ResultsThe prevalence of cervical cancer screening in Kenya was 16.81%(95% CI: 16.24, 17.38%). Having a history of abortion (AOR = 1.33, 95% CI: 1.171.50, 1.43), using modern contraceptive methods (AOR = 1.57, 95% CI: 1.25, 1.95), media exposure (AOR = 1.31, 95%CI: 1.03, 1.65), primary education (AOR = 1.56, 95%CI: 1.09, 2.22), secondary education (AOR = 21.99, 95% CI: 1.1.38, 2.87), higher education (AOR = 2..50, 95% CI: 1.71, 3.65), visiting health facility within the past 12 months (AOR = 1.61, 95%CI: 1.46, 1.79), positive HIV status (AOR: 3.50, 95% CI: 2.69, 4.57), being from a community with a higher proportion of educated individuals (AOR = 1.37, 95%CI: 1.13, 1.65) and being from a community with high proportion of poor individuals (AOR = 0.72, 9 5%CI: 0.60–0.87)) were significantly associated with cervical cancer screening.ConclusionIn Kenya, the prevalence of cervical cancer screening was found to be low. A history of abortion, use of modern contraceptives, exposure to the media, visits to health facilities in the past 12 months, HIV status, level of education, community educational level, and community wealth were identified as significant associated factors for cervical cancer screening. Therefore, it is recommended to implement targeted public health interventions that focus on these identified factors to improve the adoption of cervical cancer screening in Kenya.

"I don't want my marriage to end": a qualitative investigation of the sociocultural factors influencing contraceptive use among married Rohingya women residing in refugee camps in Bangladesh

BackgroundThe timely provision of comprehensive contraceptive services to Rohingya women is impeded due to a lack of clarity and understanding of their traditional beliefs and cultural frameworks. Recognizing this challenge, our paper aims to explore the socio-cultural factors influencing the utilization of contraceptives among married Rohingya women living in the refugee camps of Cox's Bazar, Bangladesh.MethodA qualitative study was conducted in two unregistered Rohingya camps (Camp 7&14) located in Ukhiya Upazila, Cox's Bazar from January 10th to 20th, 2022. A total of 14 In-Depth Interviews (IDIs) were conducted among married Rohingya women of reproductive age (15–49 years), along with 16 Key Informant Interviews (KIIs) involving stakeholders engaged in reproductive healthcare provision. Participants were selected using purposive sampling. All interviews were conducted in the local language, recorded, transcribed verbatim, and subsequently translated into English. The data were analyzed using NVivo (Version 11), and the analysis process followed Neuman’s three-phase coding system.ResultsFive broad themes were identified: Sociocultural expectations and values attached to births, power imbalances within marital relationships, the role of religious beliefs, fear of side effects, and misperceptions about contraception. Having a larger number of children is viewed positively as it is believed that children play a crucial role in preserving the lineage and contributing to the growth of the Islamic population. Despite expressing an inclination towards contraception, the disapproval of husbands becomes a significant barrier for women. Defying their husbands' wishes can result in instances of Intimate Partner Violence (IPV) and even marriage dissolution within the camps. Moreover, the fear of side effects, such as a particular method would cause infertility, discourages women from using contraception. Many of these fears stem from myths, misconceptions, and mistrust in the existing medical system.ConclusionAddressing the socio-cultural barriers that prevent women from using modern contraception will have important public health implications. These findings can support in crafting culturally sensitive programs and educational interventions. These initiatives can assist Rohingya refugee women in planning their pregnancies and reducing high-risk pregnancies, ultimately leading to a decrease in maternal mortality rates within the community.

Temperature anomalies undermine the health of reproductive-age women in low- and middle-income countries

Climate change is expected to undermine population health and well-being in low- and middle-income countries, but relatively few analyses have directly examined these effects using individual-level data at global scales, particularly for reproductive-age women. To address this lacuna, we harmonize nationally representative data from the Demographic and Health Surveys on reproductive health, body mass index (BMI), and temporary migration from 2.5 million adult women (ages 15 to 49) in approximately 109,000 sites across 59 low- and middle-income countries, which we link to high-resolution climate data. We use this linked dataset to estimate fixed-effect logistic regression models of demographic and health outcomes as a function of climate exposures, woman-level and site-level characteristics, seasonality, and regional time trends, allowing us to plausibly isolate climate effects from other influences on health and migration. Specifically, we measure the effects of recent exposures to temperature and precipitation anomalies on the likelihood of having a live birth in the past year, desire for another child, use of modern contraception, underweight (BMI < 18.5), and temporary migration, and subsequently allow for nonlinearity as well as heterogeneity across education, rural/urban residence, and baseline climate. This analysis reveals that exposures to high temperatures increase live births, reduce desire for another child, increase underweight, and increase temporary migration, particularly in rural areas. The findings represent clear evidence that anthropogenic temperature increases contribute to temporary migration and are a significant threat to women's health and reproductive autonomy in low- and middle-income countries.

(146) Sex Education and Pattern of Sexual Behavior among Adolescents in a Sub-Urban High School

Abstract Introduction Adolescence being the transition from childhood to adulthood may be associated with risky sexual behavior with consequences that may last a lifetime. Sex education for teenagers to encourage safe sexual practices is necessary to build a society of adults with healthy sexual lifestyle. The details of the source of information, level of knowledge and actual sexual practices among these adolescents will inform the approach to supplying adequate information. Objective The objective of the study is to demonstrate the level of knowledge of adolescents about safe sexual practices, contraceptives and their pattern of behavior. Methods Data regarding knowledge and sexual behavior was obtained from adolescents in a Sub-Urban high school with the aid of pre-tested self-administered questionnaire. The data was imputed and analyzed with the IBM SPSS software. Results A total of 107 adolescents aged 13 to 19years (mean - 16.078years) with average weight of 47.931Kg; 53(49.5%) were males and 54(50.5%) were females. About half (51.4%) practice Christianity and 48.6% practice Islamic religion and majority (96.3%) were in their penultimate class in high school. Majority of respondents (87.7%) reported having formal sex education, the commonest source of sex education was school in 76.9%, other sources of information were parents (11.0%), friends and peers (8.7%), mass media (4.4%) and siblings (2.2%). The quality of knowledge of these adolescents may be poor, as many as 25% of respondents think that casual sex does not predispose to infections and only 21.8% had any knowledge of modern contraceptives. Nearly one-quarter (23.36%) of respondents have commenced sexual activities with the mean age at coitarche being 12.38±2.38years; majority in this category (92%) being males. The commonest form of sexual practice is peno-vagina intercourse which is seen in 21.7% of respondents, 13.3% practice masturbation, 5.8% of respondents have had homosexual activities, 6.7% practice oral sex and 1.9% practice peno-anal sex. Among the sexually active respondents, 72% have had multiple sexual partners, 32% practice casual sex. Majority (92%) have used male condoms before but only 32% of sexually active respondents regularly use condoms. Majority (98%) of sexually naïve were contented with their status and 13% of sexually active respondents wished they had delayed sexual activities. Conclusions Although, intervention at adolescence with sex and reproductive health services offers the opportunity to form societies with healthy sexual lifestyle, the level of knowledge of sex education among adolescents in Sub-Urban communities remain poor yet a significant proportion of these Adolescents have commenced sexual activities with some practicing risky sexual behavior. Disclosure No.

Demographic, Sociocultural, and Behavioral Predictors of Modern Contraceptive Uptake Among Couples in Northern Ghana.

Despite efforts to increase modern contraceptive use in Ghana, prevalence rates remain low; particularly in Northern Ghana. This study, therefore, sought to determine the predictors of modern contraceptive use among couples in Northern Ghana. This research was the baseline assessment for a broader study aimed at determining the effect of an intervention to improve outcomes of modern contraception. The study was a cross-sectional design. Data was collected from 508 couples (1016 participants), using a multistage sampling technique; both members of each couple were interviewed separately. Univariate and stepwise multivariate logistic regression were used to identify predictors associated with modern contraceptive use. Qualitative data were analyzed to triangulate the findings from the quantitative data. More than 97% of couples were Muslims. Qualitative data indicates that Muslims are less inclined to use Modern Contraceptives. Most participants had no education. The regression model shows that all demographic characteristics were not significant in Model 3 for men. Socio-culturally, men who gave the reason of "unconcerned" for men's non-involvement in contraceptive adoption, had less odds of using modern contraception (AOR=0.19). Men with high subjective norms were more than 15 times more likely to use modern contraception. Female farmers were less likely to use contraceptives (AOR= 0.45). Women who reported that "nothing prevented men" from getting involved in contraceptive adoption had greater odds of adopting modern contraception (AOR= 11.15). Women with good perceived behavioral control were more likely to use modern contraception (AOR=5.03). Women with high enacted stigma and men and women with high interspousal communication were more likely to adopt modern contraception. Taking cognizance of demographic and sociocultural characteristics and behavioral constructs is needed when determining the predictors of modern contraceptive use among couples in Northern Ghana.

Prevalence and determinants of minimum dietary diversity for women of reproductive age in Uganda

BackgroundGlobally, over a billion women of reproductive age (WRA) suffer from some kind of undernutrition micronutrient deficiencies, and/or anemia as a result of inadequate dietary diversity. This leads to poor maternal and child health outcomes, however, there is limited research on population level research on minimum dietary diversity for women (MDD-W). This study assessed the prevalence and predictors of MDD-W among WRA in Uganda.MethodsThis study was a secondary analysis of data from the lot quality assurance sampling (LQAS) survey conducted across 55 Ugandan districts between May and September 2022. Women of various ages were interviewed across 5 study subgroups that this study used to construct its study population (WRA). Descriptive analyses, tests for outcome differences, and multilevel mixed-effects logistic regression were conducted at a 5% statistical significance level using STATA version 17. The results were reported using Adjusted Odds Ratios (aOR) as the measure of the outcome.ResultsThe study analyzed responses from 29,802 WRA with a mean age of 27.8 (± 6.8) years. Only 8.8% (95% CI 8.5–9.3) achieved the MDD-W, the least proportion was observed in the South-Central region (3.13%). In the adjusted analysis, WRA who were older than 25 years (aOR 1.1, 95% CI 1.1–1.3, p < 0.001), had secondary education (aOR = 1.4, 95% CI 1.1–1.7, p = 0.003) or above (aOR = 1.7, 95% CI 1.3–2.2, p < 0.001), and used modern contraceptives (aOR = 1.1, 95% CI 1.0-1.3, p = 0.01) were more likely to achieve the MDD-W. Conversely, WRA who travelled longer distances to the nearest household water source (aOR = 0.8, 95% CI 0.7–0.9, p = 0.002) and those residing in larger households (aOR = 0.9, 95% CI 0.8-1.0, p = 0.019) were less likely to achieve the MDD-W.ConclusionA low proportion of WRA met the MDD-W. Age, education level, household sizes and use of modern contraception were predictors of MDD-W among WRA in Uganda. MDD-W-related program efforts in Uganda should strengthen multisectoral collaboration with prioritization of younger women, education, household sizes and access to safe water sources.

Demographic, Sociocultural, and Behavioral Predictors of Modern Contraceptive Uptake Among Couples in Northern Ghana [Letter

Demographic, Sociocultural, and Behavioral Predictors of Modern Contraceptive Uptake Among Couples in Northern Ghana [Letter

Knowledge, Attitude and Practice of Modern Family Planning Methods among Men in Ogbogu Community in Ogba-Egbema-Ndoni Local Government Area of Rivers State

This study examined the knowledge, attitude and practice of modern family planning methods among men in Ogbogu Community in Ogba/Egbema/Ndoni Local Government Area of Rivers State. Introduction: Family planning is the practice that helps individuals or couples to attain certain objectives such as avoiding unwanted pregnancies, bringing about wanted babies at the right time, regulating the interval between pregnancies, controlling the time at which birth occurs in relation to the ages of the parents. Methodology: The study used a descriptive survey research design. The study population comprised married men currently residing in Ogbogu Community in Ogba/Egbema/Ndoni Local Government Area of Rivers State. A sample size of 389 persons was selected using a simple random technique. A structured questionnaire was used for data collection and data were analyzed using Statistical Package for Social Sciences (SPSS) windows (version 20.0). Results: The study showed that there is high awareness of family planning of among the married couples used for the study. Majority of the participants had detailed knowledge of condom. Also, the study indicated that married couples had a favourable attitude toward modern family planning methods of 51%, out of the married couples that were aware of modern family planning methods. Again, the study revealed that high percentage of married couples practice modern family planning methods. Conclusion: Knowledge of modern contraceptives is high in the study population. Substantial proportion of married couples had positive attitude towards modern contraceptives and hence more room for increasing modern contraceptive use in the study population.

НЕЖЕЛАННАЯ БЕРЕМЕННОСТЬ: АНАЛИЗ ПРИЧИН И ФАКТОРОВ АРТИФИЦИАЛЬНЫХ АБОРТОВ

The article examines the problem of abortion and its consequences for the demographic component of the country. Based on the research conducted in a questionnaire format, the results of an analysis of the reasons and factors that influenced women’s decision to terminate their pregnancy are presented. The results of the research have shown that the leading cause of abortion is unplanned pregnancy which arose against the background of difficult social conditions and financial difficulties. In 70% of cases, women who chose abortion had not been informed about modern methods of contraception as well as about its consequences and complications. 80% of respondents have noted that they did not have the opportunity to share their fears and experiences with qualified specialists having found themselves in a difficult life situation at the time of making a decision. In a number of cases, a previously performed abortion was complicated by the development of acute metroendometrium and salpingoophoritis in 26.7%, cervicitis in 6.8% of cases, and 3.4% of respondents were operated on due to tubal pregnancy. Thus, the results of the research have shown that it is important to solve this problem by creating an accessible information environment telling about the dangers of abortion and alternative methods of contraception for women of different age groups. Organization and implementation of offices to provide timely psychological assistance to women who find themselves in difficult life situations at the decision-making stage as well as social and financial support from government bodies for women who decide to end their pregnancy with childbirth

The factors associated with contraceptive use among young female students in rural Guinea

The low use of modern contraceptive methods by young girls is a real public health problem in sub-Saharan Africa, especially among young female students living in rural areas. The purpose of this study was to analyze the factors associated with contraceptive use among young female students in rural Guinea. This was an analytical cross-sectional study including 607 students from 10 secondary schools in the rural district of Kankan, Guinea. A total of 607 female students were interviewed and included in this study. They had an average age of 17.3 ± 1.7 years, 50.9% were in junior high school, and 49.1% were in high school. During our survey period, 67.7% of the girls reported being sexually active, while only 24.4% were on modern contraception. In the bivariate analysis, factors such as age, religion, school level, having heard of contraception, and having had sexual intercourse were statistically associated with contraceptive use. In the multivariate analysis, factors such as age (OR = 2.1; CI = 1.1–3.8), religion (OR = 5.1; CI = 2.8–9.5), and having had sexual intercourse (OR = 2.2; CI = 1.4–3.5) remained statistically associated with the use of contraceptive methods among young female students. Our study highlights the need to increase awareness of, and access to, contraceptive methods in schools in order to improve contraceptive practice and, in turn, to reduce the frequency of unwanted and early pregnancies among young female students in rural areas of Guinea.

Contraindicated use of modern contraceptives among mothers from a Pelotas Birth Cohort.

To describe the prevalence of contraindicated use of combined hormonal contraceptives, progesterone-only contraceptives, and intrauterine devices in mothers participating in the 2015 Pelotas Birth Cohort according to the WHO medical eligibility criteria. The biological mothers of children belonging to the 2015 Pelotas birth cohort who attended the 48-month follow-up were studied. The 48-month follow-up data were collected from January 1, 2019, to December 31, 2019. Contraindicated use of modern contraceptives was considered to occur when these women presented at least one of the contraindications for the use of modern contraceptives and were using these methods. The prevalence of contraindicated use was calculated according to each independent variable and their respective 95% confidence intervals (95%CI). The analyzed sample consisted of 3,053 women who used any modern contraceptive method. The prevalence of contraindicated use of modern contraceptives totaled 25.9% (95%CI: 24.4-27.5). Combined hormonal contraceptives showed the highest prevalence of contraindicated use (52.1%; 95%CI: 49.3-54.8). The prevalence of contraindicated use of modern contraceptives methods was greater in women with family income between one and three minimum wages, a 25-30 kg/m2 body mass index, indication by a gynecologist for the used method, and purchasing the contraceptive method at a pharmacy. The higher the women's education, the lower the prevalence of inappropriate use of modern contraceptives. In total, one in four women used modern contraceptives despite showing at least one contraindication. Policies regarding women's reproductive health should be strengthened.

Maternal Mortality and Morbidity Following Unsafe Abortion in a Tertiary Medical College Hospital

Background: Unsafe abortion refers to the termination of an undesired pregnancy by individuals lacking the requisite skills in an environment lacking minimal medical standards, or both. It stands as a prominent contributor to pregnancy-related mortality in Bangladesh. Notably, approximately one-third of all births in Bangladesh are unplanned and unwanted. The initiation of unsafe abortion may be attributed to the woman herself, an unqualified practitioner, or health workers operating in unhygienic conditions. Objectives: The primary aim of this study was to implement interventions aimed at mitigating maternal mortality and morbidity resulting from unsafe abortion. Materials and Methods: This cross-sectional study was conducted in the Department of Obstetrics and Gynecology at Khulna Medical College and Hospital, Khulna, spanning from July 2010 to June 2011. After applying exclusion criteria, which involved cases of medical termination of pregnancy and individuals with known medical conditions, a total of 145 abortion cases were admitted to two maternity units at Khulna Medical College Hospital. These cases exhibited a history of menstrual regulation (MR) and induced abortion performed by unskilled individuals, in unhygienic conditions, or both, throughout the study period. The primary outcome variables assessed in this study included age, marital status, education level, socio-economic status, parity, duration of amenorrhea, methods of induction, and maternal complications. Results: In this study, it has been seen that 588 (29.80%) of gynecological admissions are of abortion, and the incidence of unsafe abortion is 145 (24.65%) of all abortion patients. The majority are primarily educated and their socio-economic status is below average. Most of them are multipara. They had come to the hospital after the development of complications. Among the unsafe abortions, 9 (6.20%) expired and 136 (93.79%) improved after experiencing some sort of minor or major suffering. Conclusion: Maternal mortality is a key women’s health indicator. Reducing it is a global goal, but tracking progress is challenging, especially in developing countries with weak health data systems. Unsafe abortions are underreported, and many deny the truth even when in dire conditions. To address this, promoting modern contraceptives, training personnel for abortions, and emphasizing contraception’s importance is vital. Relaxing abortion laws may be necessary, as women may seek abortions regardless, risking their lives. Ensuring safe abortion access is essential for women’s rights and preventing harm to them and their families. Reducing unplanned pregnancies and providing safe abortion services are critical.

A grand multipara woman in the modern era: A case of public health dilemma from an urban slum

With the advancement in family planning practices and shifting norms from “hum do hamare do” to “one child,” there still exist mothers who are delivering their 10th children. Such an example is a woman residing in an urban slum in the Khordha district of Odisha, India. She has never used any modern methods of contraception. Neither the health workers in that area could fulfill her unmet need for family planning. The helpless mother missed all the antenatal checkups as she did not have anyone to accompany her to the hospital. Three of her children were delivered at home and none of them were immunized to date. She has become a victim of domestic violence by her husband, who is addicted to alcohol. She has done two medical terminations of pregnancy due to non-usage of any contraception. Neither she is able to provide herself nor her children sufficient food every day, as she is not able to go to work in her post-partum period. Her alcoholic husband is not able to earn regularly and there is no other family member to support her. There is no Accredited Social Health Activist appointed for that area whom she can rely on. We need to look at what is the cause of such a scenario – Is it poverty, lack of awareness, lack of education, or our health system has failed to achieve universal health coverage.

Utilization and associated factors of cervical cancer screening service among eligible women attending maternal health services at Adare General Hospital, Hawassa city, Southern Ethiopia

This particular study aimed to assess the magnitude of cervical cancer screening service utilization and associated factors among eligible women attending maternal health services at Adare General Hospital, Hawassa city, Southern Ethiopia, 2022. Institution-based cross-sectional study was conducted using a systematic random sampling technique among 299 eligible women from March 1- to April 30, 2022. Data was collected through face-to-face interviews using a pretested structured questionnaire. Data was also entered into Epi-data version 3.1 and exported to SPSS version 25.0 for analysis. Both bivariable and multi-variable logistic regression model was fitted and the presence of association was declared at a p value of less than 0.05. The strenth of association was determined using adjusted odd ratios together with a 95% confidence interval. Among interviewed women, 19.8% (95% CI 15.5%, 24.0%) of them had screened for cervical cancer at least once within the past five years. Place of residence (AOR = 0.37; 95% CI 0.14–0.96), modern contraception use (AOR = 2.49; 95% CI 1.04–5.96), discussion about cervical cancer with healthcare providers (AOR = 2.34; 95% CI 1.08–5.07), and comprehensive knowledge about cervical cancer (AOR = 0.25; 95% CI 0.10–0.62) were independently associated with cervical cancer screening service utilization. The study depicted relatively low utilization of cervical cancer screening services. The women were more likely to utilize the service if they are dwellers of urban residences, used modern contraception, had discussion about cervical cancer with healthcare providers, and had good comprehensive knowledge about cervical cancer. Thus, women living in rural areas should get more emphasis on cervical cancer prevention strategies, and improving consistent discussion about cervical cancer with clients visiting for maternal health services by healthcare providers in health facilities also be recommended.

Assessment of unintended pregnancies, contraception, and abortion in Botswana.

Botswana has a policy of contraception for all that is delivered through a rights-based family planning program. The program combines a "rights-based family planning approach" with "supportive policies for contraception," and "a commitment to promote equitable access to modern contraception, and expand availability, method mix and uptake of modern contraceptive methods for all women and girls." However, abortion is legally restricted up to 16 weeks of pregnancy provided that provisions of Section160-162 of the Botswana Penal Code Amendment Act 1991 are met, and that the termination of pregnancy is carried out by a registered medical practitioner in a health facility approved for the purpose. In 2020, the Ministry of Health and Wellness, Botswana, in collaboration with United Nations Population Fund and World Health Organization, conducted a strategic assessment of unintended pregnancies, contraception, unsafe abortion, and abortion services in Botswana. A consensus operational plan to address these issues was developed during a national stakeholder meeting in Gaborone, Botswana. The consensus reached was to avert unintended pregnancies, improve access to modern contraception, and open nationwide discussions around abortion in the community to enable positive change and decrease maternal morbidity and mortality from unsafe abortion. This article describes the findings of the assessment and outlines the foundation for new or modified services or practices to be developed and pilot tested.

Correlates of Unmet Need for Modern Contraception Among Reproductive-Aged Women Involved in New York City Criminal Legal Systems.

The population of women involved in criminal legal systems (WICL), a majority of whom are reproductive-aged, has risen steadily in the United States. They contend with numerous barriers to sexual and reproductive health services resulting in high rates of unmet need for contraception and unintended pregnancy. This study included 132 non-pregnancy seeking reproductive-aged WICL enrolled in the baseline assessment of the HIV prevention intervention, "Women on the Road to Health" (WORTH). A multivariate generalized linear logistic regression model with robust estimation examined effects of past 6-month intimate partner violence (IPV; sexual and physical/injurious), past 3-month substance use (binge drinking, cannabis, other illegal drug use), and lifetime mental health diagnoses (anxiety, depression, bipolar disorder) on women's unmet need for modern contraception, adjusting for significant demographic and socioeconomic factors. Women who were younger in age (odds ratio [OR]: 0.74; 95% confidence interval [CI]: 0.63-0.88) and reporting lifetime diagnoses of anxiety disorders (OR: 13.64; 95% CI: 2.71-68.34) were significantly more likely to meet the criteria for unmet need for modern contraception. Women with a regular gynecologist (OR: 0.11; 95% CI: 0.01-0.86) reporting lifetime diagnoses of bipolar disorder and past 6-month sexual IPV histories (OR: 0.04; 95% CI: 0.002-0.86) were significantly less likely to meet the criteria for unmet need for modern contraception. Distinct mental health diagnoses and experiences of IPV may uniquely impact unmet need for modern contraception among WICL. These findings emphasize the need for a more nuanced comprehension of these relationships to deliver comprehensive and holistic health services that address the intersecting needs of this population.

Empowering Women, Securing Futures: Contraception’s Role in Socioeconomic Progress in India

Introduction: It is necessary to empower women to enable them to make their own reproductive choices, including contraception as well as use of modern contraception. Our article aims to highlight the importance of women’s empowerment regarding contraceptive use in family planning and poverty eradication. Methods: Our literature search included data on family planning programs, contraceptive use, awareness of and access to contraception, and women empowerment regarding contraceptive use in India; approaches to policymaking regarding family planning; and international data on early legal access, women’s reproductive rights, and barriers to contraceptive use. Results: Despite the introduction of oral contraceptives, 38% of currently married women in the 15–49 age group use sterilization as a method of contraception. Only 28% of married Indian adolescents use contraception. The highest reliance on sterilization is found in women married off early, conceiving early, and with little access to education and information. There are barriers to both use of contraceptives and reversible contraceptives. Discussion: Family planning programs in India can focus on women’s reproductive rights, rather than population control, to bridge the gap in the unmet need for family planning, apart from making information and resources on contraception available to women from all socioeconomic strata.

Rural Residence, Motorcycle Access, and Contraception Use in South and Southeast Asia☆

AbstractAccess to contraception is critical for limiting fertility. Yet, in South and Southeast Asia, access to these resources is often limited by spatial inequalities between rural and urban areas. Access to a motorcycle may empower women living in rural areas to attenuate these spatial inequalities, increase their educational attainment and participation in labor markets, and thereby facilitate a shift in fertility preferences. Concomitantly, motorcycle access may increase access to contraception for geographically isolated women who desire to limit fertility. We employ logistic regression models to examine associations with contraception use and unmet need for contraception for women living in rural versus urban areas and for women with versus without access to a motorcycle. Roughly 40 percent of women reported current use of contraception while another 21 percent indicated an unmet need for contraception. After adjusting for other variables, women with a motorcycle were more likely to report current contraception use (AOR = 1.55, 95% CI [1.50, 1.61]), modern contraception use (AOR = 1.60, 95% CI [1.54, 1.66]), and traditional contraception use (AOR = 1.49, 95% CI [1.41, 1.58]) compared with women who did not own a motorcycle. Women with a motorcycle were less likely to report an unmet need for contraception (AOR = 0.65, 95% CI [0.62, 0.68]) after adjusting for other variables. Our results are consistent with the premise that motorcycles facilitate contraception use among women living in resource‐limited countries in South and Southeast Asia and thereby contribute to decreases in fertility. These relationships are contextualized by whether a woman lives in an urban or rural setting, and the number of children already present in their household; they are robust to controlling for household‐level wealth and other factors that may mediate associations with contraception use.