Modern Contraception Research Articles

MODERN CONTRACEPTIVE USE AMONG URBAN AND RURAL YOUNG MARRIED WOMEN IN INDONESIA

Family planning is generally recognized as a crucial key in reducing maternal and neonatal mortality and morbidity. This study aimed to explore whether the predictors of modern contraceptive use among young married women differ by place of residence. The data were drawn from the 2019 Indonesia Population, Family Planning, and Family Development Program Performance and Accountability Survey. This study restricted the sample of non-pregnant married women aged 15-24, resulting in a sample of 3,927 young married women. Logistic regression with the place of residence variable used as an interaction term to model the association between selected social, economic, and demographic variables and the outcome variable, modern contraceptive use for each group of women. The number of living children and region exhibited significant variability in contraceptive use among urban and rural young married women. Urban young married women with 1-2 children had higher odds (OR = 27.10; p = 0.000) of using contraceptives compared to rural ones (OR = 15.60; p = 0.000) in regard to number of living children. Rural women residing other islands (non-Java Bali) were less affected (OR = 0.59; p = 0.000) than urban young married women in accessing modern contraceptives (OR = 0.64; p = 0.002). Disseminating information, education, and communication about the health risk of having more than two children would improve the use of modern contraceptives. Family planning policies should also be tailored to address the specific needs of different places of residence with geographical regions.

Utilization of modern temporary contraceptive methods and its predictors among reproductive-aged women in India: insights from NFHS-5 (2019-21).

Evidence from various studies on modern contraceptive methods shows that the utilization varies greatly. The present study aimed to estimate the magnitude and determinants for temporary modern contraceptive utilization among reproductive-aged (15-49 years) women in India. We analysed National Family Health Survey-5 data using the "svyset" command in STATA software. Modern contraception utilization was estimated using the weighted prevalence, and its correlates were assessed by multivariable regression by reporting an adjusted prevalence ratio (aPR) with 95% confidence interval (CI). QGIS 3.2.1 software was used for spatial analysis of different temporary modern contraceptives. The mean (SD) age of 359,825 respondents was 31.6 (8.5) years with 75.1% (n = 270,311) and 49.2% (n = 177,165) of them being from rural area and having completed education up to secondary school, respectively. The overall utilization of modern temporary contraception was 66.1% [95%CI: 65.90-66.35, n = 237,953]. Multigravida (vs. nulligravida) [aPR = 2.13 (1.98-2.30)], higher education of husband (vs. not educated) [aPR = 1.20 (1.14-1.27)], urban (vs. rural) [aPR = 1.06 (1.03-1.10)], watching television less than once a week (vs. not at all) [aPR = 1.04 (1.01-1.08)], divorced (vs. married) [aPR = 0.65 (0.45-0.94)], and Scheduled Tribe (ST) (vs. unreserved) [aPR = 0.92 (0.88-0.96)] were significant independent determinants. The highest utilization of male condoms, IUCDs, pills and injections were in Himachal Pradesh (86%), Nagaland (64%), Tripura (85%), and Ladakh (20%), respectively. Out of every ten reproductive-aged (15-49 years) women in India, six are using temporary modern contraceptive methods. More intervention strategies should be planned, considering factors like gravida, education, residence, health promotion and caste to attain replacement fertility level.

Association of migration and family planning use among women in Malawi: Evidence from 2019/2020 Malawi Multiple Indicators Survey

BackgroundFamily planning (FP) is known to bring multiple benefits to people both individually and collectively. Individually, FP has been associated with reduction in risk of unintended pregnancy which also correlates with low child mortality rates. Child mortality rates in women with child spacing of less than two years are 45% higher compared to their counterparts with child spacing of more than two years. Several factors that predict FP utilisation among women of childbearing age have been identified but there is limited literature on how migration impacts FP utilisation in Malawi. Our current study aimed at assessing the association between migration and modern contraceptive use among women of childbearing age in Malawi.MethodsData for this study came from a nationally representative 2019/20 Malawi multiple cluster indicator survey (MICS). At total of 24,543 women aged 15 to 49 participated in the survey. Contraceptive prevalence rate (CPR) analyses were conducted separately on all women of childbearing age and married women. The data was analysed using the complex survey data approach by applying sampling weights to correct unequal representation of participants at cluster, district, and regional level. We used binary logistic regression to assess association between migration status and modern contraceptive use among all women of childbearing age and married women separately. We included age, age at first sex, age at marriage, region of residence, education, residence wealth index and presence of disability as confounders in our final multivariable models.ResultsThe overall CPRs for married women and for all women of childbearing age were 64.7% and 40.5% respectively. The CPRs for all women of childbearing age were 40.5% for non-migrants and 33.0% for migrant women. For married women, CPRs were 51.5% for migrant women and 65.5% for non-migrant women. The fully adjusted odds ratios for the association between migration status and modern contraceptive use were 0.62 (0.49–0.78) for married women and 0.65 (0.52–0.80) for all women of childbearing age.ConclusionsWe conclude from our findings that migrant women were significantly less likely to utilize modern contraceptive methods for both married women and all women of childbearing age. Deliberate efforts are required to ensure that migrant women of childbearing age have equal access to sexual and reproductive health services which includes family planning.

Residential status and household wealth disparities in modern contraceptives use among women in Ghana: a cross-sectional analysis

BackgroundModern contraceptive refers to “a product or medical procedure that interferes with reproduction from acts of sexual intercourse”. The aim of this study was to assess the relationship between residential status and wealth quintile, and modern contraceptive use among women in Ghana.MethodsWe examined residential status and wealth quintile on contraceptive use analysing the 2006, 2011 and 2018 Multiple Indicator Cluster Surveys datasets. A sample of 30,665 women in their reproductive ages (15–49 years) were enrolled in the surveys across Ghana. STATA version 13 was used to process and analyse the data. It examined socioeconomic and demographic characteristics, assessed modern contraceptive use prevalence among women, and used logistic regression models to determine predictors. The results were presented in odds ratio and adjusted odds ratio with 95% confidence intervals. All statistical tests were measured with p < 0.05.ResultsIn the three survey years, the highest prevalence of modern contraceptive usage was observed in 2011 (27.16%). The odds of using modern contraceptive increased by 19% in rural places (AOR = 1.19; 95% CI = 1.097–1.284) compared to urban places. The likelihood of women in second (AOR = 1.17; 95% CI = 1.065–1.289), middle (AOR = 1.24; 95% CI = 1.118–1.385), and fourth (AOR = 1.25; 95% CI = 1.113–1.403) wealth quintile using contraceptives increased compared to those of low wealth quintile. With the interactive terms, rural-second (AOR = 1.38; 95% CI = 1.042–1.830), rural-middle (AOR = 1.45; 95% CI = 1.084–1.933), rural-fourth (AOR = 1.52; 95% CI = 1.128–2.059), and rural-high (AOR = 1.42; 95% CI = 1.019–1.973) were more likely to use contraceptives compared to urban-low women. Despite lower odds, women of the age groups 20–24 (AOR = 2.33; 95% CI = 2.054–2.637), cohabitaing (AOR = 1.07; 95% CI = 0.981–1.173), secondary or higher education (AOR = 1.55; 95% CI = 1.385–1.736), Central (AOR = 1.48; 95% CI = 1.296–1.682) and Eastern (AOR = 1.48; 95% CI = 1.289–1.695) regions significantly predicted modern contraceptive use.ConclusionModern contraceptive use in Ghana is low. Women in rural-rich categories are more likely to use modern contraceptives. Background factors such as age, marital status, educational attainment, and previous child experiences predict modern contraceptive use. It is recommended for the intensification of contraceptive awareness and utilization for all reproductive age women, regardless of education, marriage, or wealth.

Why Pakistani Women Do Not Use Intrauterine Contraceptive Devices: A Systematic Review of Barriers and Misconceptions.

This review explores barriers limiting the adoption of Intrauterine Contraceptive Devices (IUCDs) in Pakistan, focusing exclusively on local articles. As Pakistan's high population calls for widespread contraception, we aim to pinpoint obstacles hindering IUCD utilization, irrespective of parity. We conducted a comprehensive search of PubMed, Google Scholar, PakMedinet, and Wiley Online Library for English-language primary studies published between 2000 and 2022, reporting on IUCD utilization in Pakistan. Our analysis reveals multiple barriers impeding IUCD use in Pakistan. These encompass patriarchal social norms, male dominance, low education, socioeconomic status, and unemployment. Post-insertion health concerns, inadequate counseling, government commitment, and awareness were also identified barriers. Provider confidence, client trust, women's autonomy, social constraints, and limited male partner involvement hindered IUCD adoption. A desire for larger families and male offspring, vague religious beliefs, fear, and misconceptions further restricted usage. Accessibility and high service costs also posed challenges. This review highlights prevailing impediments to IUCD adoption in Pakistan, encompassing knowledge gaps, motivation deficits, resistance from husbands and in-laws, cultural and religious beliefs, limited access, and communication barriers. To promote IUCDs as a modern contraceptive method, it is essential to raise awareness among both men and women. Active involvement of religious leaders and community stakeholders is crucial in addressing these social factors hindering IUCD utilization.

Effect and cost-effectiveness of human-centred design-based approaches to increase adolescent uptake of modern contraceptives in Nigeria, Ethiopia and Tanzania: Population-based, quasi-experimental studies.

Around half of adolescent pregnancies in low- and middle-income countries are unintended, contributing to millions of unsafe abortions per year. Adolescents 360 (A360), a girl-centred initiative, aimed to increase voluntary uptake of modern contraceptives among adolescents in Nigeria, Ethiopia and Tanzania. We evaluated the effectiveness and cost-effectiveness of A360 in increasing modern contraceptive use in selected geographies. We used before-and-after cross-sectional studies of adolescent girls in four settings. Two Nigerian settings had purposefully selected comparison areas. Baseline and endline household surveys were conducted. The primary study outcome was modern contraceptive prevalence rate (mCPR). Secondary outcomes mapped onto the A360 Theory of Change. Interpretation was aided by a process evaluation along with secular mCPR trends and self-reported A360 exposure data. Incremental design and implementation costs were calculated from implementer systems, site visits, surveys, and interviews. mCPR change was modelled into maternal disability-adjusted life years (DALY) averted to calculate incremental cost-effectiveness ratios. In Oromia, Ethiopia, mCPR increased by 5% points (95% CI 1-10; n = 1,697). In Nigeria, there was no evidence of an effect of A360 on mCPR in Nasarawa (risk ratio: 0·96, 95% CI: 0·76-1·21; n = 5,414) or in Ogun (risk ratio: 1·08, 95% CI: 0·92-1·26; n = 3,230). In Mwanza, Tanzania, mCPR decreased by 9% points (-17 to -0.3; n = 1,973). Incremental cost per DALY averted were $30,855 in Oromia, $111,416 in Nasarawa, $30,114 in Ogun, and $25,579 in Mwanza. Costs per DALY averted were 14-53 times gross domestic product per capita. A360 did not lead to increased adolescent use of modern contraceptives at a population level, except in Oromia, and was not cost-effective. This novel adolescent-centred design approach showed some promise in addressing the reproductive health needs of adolescents, but must be accompanied by efforts to address the contextual drivers of low modern contraceptive use.

Unmet need for modern contraception by HIV status: findings from community—based studies implemented before and after earlier ART initiation program in rural Tanzania

BackgroundTanzania Health policy insists on the need to provide all women access to contraception despite HIV status. We used data from two HIV epidemiologic serological surveys carried out at different periods of ART provision in rural Tanzania to assess the level of unmet need for modern contraception by HIV status and associated factors.MethodsWe performed secondary data analysis of two surveys conducted at the Magu Health and Demographic Surveillance System site, in Mwanza, Tanzania. Information on unmet need for modern contraception was derived from fertility desire and contraception use. Unmet need, HIV status, and socioeconomic and demographic variables were analysed. The percentage of women with unmet needs for modern contraception by HIV status is presented for the 2012 and 2017 surveys. Bivariate and multivariate analyses using logistic regression were used to investigate associated factors showing adjusted odds ratios (aORs) and 95% confidence intervals (95% CIs).ResultsData from 3352 and 3196 women aged 15–49 years collected in the 2012 and 2017 surveys, respectively, were analysed. The percentages of women with unmet needs for modern contraception in the 2012 and 2017 surveys were 30.9% (95% CI 29.4–32.6) and 31.6% (95% CI 30.0–33.3), respectively. The unmet need for modern contraception was 26% lower in HIV-uninfected women in 2012 (aOR = 0.74; 95% CI 0.569–0.973); p = 0.031). Risk factors for unmet need for modern contraception in 2012 were HIV uninfected (adjusted OR = 0.74; 95% CI 0.569–0.973); p = 0.031), married marital status (adjusted OR = 0.768; 95% CI 0.743–0.794); p < 0.0001), higher education (adjusted OR = 0.768; 95% CI 0.743–0.794); p < 0.0001), and taking alcohol (adjusted OR = 0.768; 95% CI 0.743–0.794); p < 0.0001). Only two factors were associated with unmet need for modern contraception in 2017: married marital status (adjusted OR = 0.46; 95% CI 0.305–0.722); p = 0.001) and women who earned for their families (aOR = 0.66; 95% CI 0.494–0.887); p = 0.006).DiscussionNearly one-third of women had an unmet need for modern contraception, which was lower in HIV-uninfected women than in WLHIV-infected women. The study has identified women whose demand for contraception has not been met: WLHIV, post marital women, women with low education and women who were reported to earn money for their families. Family planning interventions should be tailored to these groups of women.

Social Demographic Factors Affecting the Uptake of Modern Contraceptives Methods Among Female Adolescents After the First Birth in Kitui County, Kenya

Social Demographic Factors Affecting the Uptake of Modern Contraceptives Methods Among Female Adolescents After the First Birth in Kitui County, Kenya

Understanding how social norms influence access to and utilization of adolescent sexual and reproductive health services in Northern Nigeria.

This study explored the influence of social norms on the access and utilization of sexual and reproductive health services by adolescents. Apart from individual and environmental barriers, social norms influence contraceptive decisions and ultimately sexual and reproductive health outcomes. Social norms that shape group behavior describe acceptable standards of behavior and evoke sanctions when such behavior standards are not adhered to. Sexually active adolescents in Nigeria have a relatively low level of modern contraceptive use being influenced by social norms. Scaling up adolescent reproductive health interventions that integrate normative change for a wider impact of programs remains challenging. Using data from 18 communities, 188 married and unmarried adolescents (F52% and M48%) and 69 (F37%; M63%) reference group participants were purposively sampled and participated in a social norms exploration intervention study conducted through focus group discussion and in-depth interviews between October and November 2019. The Advancing Learning and Innovation on Gender Norms (ALIGN) Social Norms Exploration Tool (SNET) was adapted for the data collection into discussion guides and vignettes. Pilot testing of the tools informed review and validation prior to actual data collection. Low contraceptive uptake by adolescents was characterized by early and forced marriage in childhood; a prominent practice enshrined in social norms around girl-childchastity, family honor, and disapproval of pre-marital sex and pregnancy out of wedlock. The understanding of harmful social norms, normative change actors, and potential norm-shifting factors for contraceptive decisions by adolescents is essential for effective adolescent sexual and reproductive health interventions for wider impact and adaptive programming in behavior change interventions for improving the access to and utilization of modern contraceptives by adolescents for improved sexual health outcomes, the attainment of the Family Planning (FP) 2030 commitment and universal health coverage policy.

Reproductive care in community health centers: Multi-method evaluation of the Illinois Contraceptive Access Now (ICAN!) demonstration program

ObjectivesNearly one-third of low-income women of reproductive age in the U.S. receive care in federally qualified community health centers, but comprehensive reproductive care is not consistently provided. Illinois Contraceptive Access Now (ICAN!) is an initiative addressing the access gap to high-quality contraceptive care with a focus on normalizing reproductive health screening for patients in federally qualified community health centers (FQHCs). Study designThis multi-method program evaluation used the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework, with retrospective and prospective data collection from three Illinois FQHCs who participated as Quality Hubs, and from a Community Advisory Board. We conducted descriptive analysis of patient surveys using the Person-Centered Contraceptive Counseling (PCCC) measure (n = 142); clinician and staff pre-and post-training surveys (n = 210); and Community Advisory Board surveys (n = 8) collecting quantitative and qualitative feedback. We ran logistic regression on claims data from 15- to 49-year-old patients identified as female at birth (n = 103,756). ResultsReach assessment showed patients receiving contraceptive or preconception care increased from 1063 per month in 2020 to 1236 per month in 2021 (16% increase), while general volume increased 2%. Effectiveness showed most patients (78%) described the quality of contraceptive counseling as “excellent” on the PCCC. Adoption assessment showed knowledge increases after clinical training on Modern Contraception (85% pre-training, 95% post-training) and Reproductive Justice (RJ) (58% pre-training, 70% post-training). Implementation assessment found that most Community Advisory Board members felt ICAN! was responsive to community needs. ConclusionsThe ICAN! demonstration year increased provider knowledge and volume of reproductive care at three Illinois FQHCs. ImplicationsContraceptive access initiatives that operationalize same day access to birth control methods while training FQHC providers on RJ and modern contraception, show promise on several measures. Early evidence from ICAN! indicates increased reproductive health service provision, as well as increases in provider knowledge of RJ and modern contraceptive care.

Socioeconomic and Demographic Determinants of Using Modern Reversible and Permanent Contraceptive for Limiting Family Size in Bangladesh

Birth control, often known as contraception, is the deliberate reduction of the number of live births by the use of techniques that temporarily or permanently prevent conception by disrupting the ovulatory, fertilization, and implantation phases of a woman's reproductive cycle. Countries with rapid population growth are more likely to have a high prevalence rate of contraceptives. For the sake of policy application in Bangladesh, knowledge of the socioeconomic and demographic variables that affect contraceptive prevalence is also valuable. For this purpose the study extracted data set form the Bangladesh national representative survey BDHS 2017-18. The study employed bivariate and multivariate logistic regression to identify the important determinants of using modern contraceptive method. Educated women were more likely to use modern reversible method (OR: .147-1.773) and less likely to use permanent contraception (OR: 0.574-0.831) for limiting family size than illiterate women in Bangladesh. Moreover, women from higher age group were using more likely permanent and traditional contraception than women from lower age group. The other identified determinants of using modern method are husbands’ education, working status of women, age at first marriage, place of residence, division, socioeconomic status, parity, mass media, and religion of women. Findings of this research provide evidence-based guidance for developing a pragmatic strategy to improve modern contraception usage among low socioeconomic status, older age group, and rural women in Bangladesh.

A continuum of individual-level factors that influence modern contraceptive uptake and use: perspectives from community members and healthcare providers in Durban, South Africa

BackgroundSouth Africa faces numerous sexual and reproductive health challenges that can be mitigated with contraceptive use. Contraceptive use is defined and measured as use, non-use, or discontinued use. Research has shown that there are expanded definitions of use beyond these categories. Identifying such categories may assist in a better understanding of factors that influence contraceptive use.Setting and methodologyThis qualitative study was conducted in the eThekwini Municipality in KwaZulu-Natal, South Africa. The aim was to explore the factors influencing the uptake and use of modern contraception. One hundred and twenty-seven participants were enrolled in this study. One hundred and three of those were community members, and twenty-five were healthcare providers. Focus group discussions and in-depth interviews were conducted to gather the data. Data analysis was facilitated using NVivo 10 software. ResultsThe data show that numerous factors influence contraceptive uptake and use. From these factors, a continuum of use that captures a variety of states of use emerged. Five different states of use were uncovered: no-use, vulnerable use, compelled use, conditional use, and autonomous use. The development of the model illustrates the complexity of contraceptive needs and that it extends beyond definitions found in policies and large-scale surveys. Expanding conceptions of use can aid in developing counselling and information support tools that can improve the uptake and continued use of modern contraception.

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 &lt; 0.0001. Those residing in the urban areas (4.5%) used modern contraceptives compared to those who lived in rural areas (1.7%) P &lt; 0.0001. Modern contraceptive use among those with birth histories (2.6%) was comparatively higher than those who have not (2.3%), P &lt; 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 &lt; 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.

Attitude toward the acceptability and practice of modern contraceptives among women of child bearing age in Jigawa state, Nigeria

Background: Despite recent improvements in the use of contraceptives amongst married women in Jigawa, the utilization rates are still far below the national figures in the emerging regions of the country. Therefore, there is a need to assess the attitude toward the acceptability and determinants to practice of modern contraceptives among women of child bearing age in Jigawa state, Nigeria. Aim: This study assess the attitude toward the acceptability and determinants to practice of modern contraceptives 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: Majority of the respondents (92.3%) had heard about the contraception while (7.70%) had not. Injection Depo-Provera was the most (85.6%) known method of contraception whereas pills and condom recorded 84.8% and 82.7% respectively. Lactation Amenorrhea (8.2%) was the least method heard. The study shows that majority of the respondents had got information of contraception through mass media (33.2%) and health workers (28.1%). Only few (9.6%) got the information through relatives. The study result shows that avoiding unwanted pregnancy was the most (24.3%) known benefit of contraception However, only 14.3% respondents reported decreases the economic burden of the family as the benefit of family planning. Conclusions: The findings from this study will help to develop programs that can improve knowledge of females and services provided by the health-care system and can reduce adverse effects from contraception and the incidence of unplanned pregnancies.

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.

Reason for the Uptake of Modern Contraceptive Methods Among Women of Reproductive Age Attending Family Planning Clinic in Bauchi State Specialist Hospital

The study examined reasons influencing the uptake of modern contraceptive among women of reproductive age attending Bauchi State Specialist Hospital Bauchi. The research objectives are; to determine reasons for the uptake of modern contraceptive; to assess parity in the uptake of modern contraceptive; and, to find out the influence of age in the uptake of modern contraceptive. Descriptive survey research design was adopted and used 1,320 women of reproductive age attending family planning clinic in Bauchi State Specialist Hospital with sample size of 132 (driven by used of Nwana 1990). The purposive sampling technique was used whereby questionnaire used to collect data. Frequency and simple percentage used to analyze data. The findings indicate that birth spacing control, safety, conveniences, affordability, health providers’ influence, easy accessibility, avoidance of pregnancy, spousal influence, and unmet needs were the major reasons for uptake of modern contraceptive family planning in the study areaIt is also concluded that, parity pregnancy and women’s age have influence in the uptake of modern

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.

Syrian refugee women’s access to family planning services and modern contraception during overlapping crises in Bekaa, Lebanon

BackgroundPolitical, financial, and pandemic crises in Lebanon have affected both provision of reproductive health services including family planning and modern contraception methods as well as women’s interest and ability to seek those services. This study aims to explore the impact of the compounding crises on the provision and use of family planning services including modern contraception methods for Syrian refugees in Lebanon focusing on the perspectives of Syrian refugee women.MethodsWe carried out 12 Focus Group Discussions (FGDs) with 119 Syrian refugee women recruited from two cities in West Bekaa, Lebanon from inside and outside the informal tented settlements. We used Skype video calls to moderate the FGDs due to the limited mobility at the time of the study because of Covid-19. We used thematic analyses to analyse the data.ResultsThe crises seemed to exacerbate supply side barriers, which influenced provision of family planning services and women’s demand for them. These included Covid-19 regulations and maltreatment by staff at public health facilities, disruption of outreach reproductive health services that provide family planning and modern contraception, and reduced supply of modern contraception methods. On the demand side, women reported financial limitations in accessing and paying for services, concern over being infected with Covid-19, and concerns about insecurity.ConclusionsWe suggest possible interventions to address these challenges and better reach these populations. These include using mobile health technology (mHealth) that may provide contraceptive counselling and/or can inform refugee women about where they may receive family planning and modern contraception. These services may also support Syrian refugees to access care they are entitled to receive and may also address disruptions in service provision due to overlapping crises, including availability and rising costs of contraceptives. These can be coupled with mobile outreach reproductive health services that provide family planning. We also suggest considering the provision of Long Acting Reversible Contraception (LARC) for Syrian refugee women, which would reduce a barrier of needing to revisit health facilities to obtain an additional supply of contraception pills.

Socio-demographic factors associated with COVID-19 vaccine uptake and refusal among Ugandan women

BackgroundThis paper analyzes associations of socio-demographic factors with the uptake of COVID-19 vaccines, the refusal to get vaccinated against COVID-19, and various reasons stated for refusing vaccination against COVID-19 among a representative sample of Ugandan women.MethodsThis paper utilizes a representative cross-sectional survey collected among women aged 15-49 years in Uganda between September and November 2021. Regression analyses are used to study the associations of a broad range of socio-demographic characteristics with COVID-19 vaccine uptake, refusal of vaccination, and reasons for refusal among the respondents.Results4211 women were included in the analysis. 11% of them were vaccinated against COVID-19, 76% were willing to get vaccinated, 13% were unwilling to get vaccinated. Fear of side effects was the most commonly stated reason for refusing vaccination (69%). Factors significantly and positively associated with being vaccinated against COVID-19 were age, higher education, urban residency, having savings, partial instead of complete income loss during the pandemic, and usage of modern contraceptives. Factors significantly and positively associated with refusing vaccination against COVID-19 were urban residency and current pregnancy, while age, having savings, and using modern contraceptives were factors associated with a lower likelihood of refusing vaccination, albeit with varying statistical significance. Few factors were strongly related to the stated reasons for refusing the vaccines; the fear of side effects significantly increased with age, while having received negative information on the vaccines was significantly less common among women with higher education.ConclusionsThis study documents a low COVID-19 vaccination rate and a high willingness to get vaccinated among Ugandan women. Positive age and education gradients in vaccine uptake point to inequity in access to vaccination, potentially resulting from prioritizations of groups at particularly high risk. Refusal to be vaccinated was relatively low and systematic factors behind vaccine refusal were hardly to be found, even less so for particular reasons given for refusal.

Contraceptive Use and Its Associated Factors among Women of Reproductive Age in Opu-Nembe, Bayelsa State

Contraception usage continues to be an important public health intervention that is hindered in the majority of low- and middle-income nations, including Nigeria, for a variety of reasons. This research aims at determining the contraceptive usage and related factors in Nembe, Bayelsa State. A descriptive survey design was employed to determine usage of contraception and its related factors among women of child bearing age in the local government area.Result showed that out of the total number of respondents (n = 398), 152(38.2%) have used modern contraceptive methods while 246(61.8%) have not. Among the respondents, only 76(19.1%) are currently using modern contraceptives while majority of the participants 322(80.9%) are currently not using any form of contraceptive. 42(10.6%) currently use male condom, 18(4.5%) use oral pills, 8(2.0%) use implants, 7(1.8%) use injectables, 1(0.3%) use IUD while 322(80.9%) use none. 50(12.6%) always use contraceptives, 8(2.0%) occasional use, 18(4.5%) rarely use while 322(80.9%) use none; 57(14.3%) used contraceptives to prevent pregnancy, 32(8.0%) use it to prevent sexually transmitted disease and pregnancy, 14(3.5%) to prevent sexually transmitted disease, 13(3.3%) to ensure child spacing while 282(70.9%) did not state any reason for not using. Binary logistic regression shows that the lower the knowledge of contraceptives, the less likely females of childbearing age will utilize modern contraceptives in Nembe, Bayelsa State and there was a statistically significant relationship between knowledge and usage of modern contraceptives (P = &lt;0.001) at 95% Confidence Interval.The poor use of contraceptives is worrisome and there is therefore urgent need to design and significantly increase social and behavioral modification interventions and strengthen systems to encourage the usage of contraceptives for an improved maternal and child health outcomes amongst other benefits.