Predictors Of Contraceptive Use Research Articles

Contraceptive Characteristics of Women Living with HIV in the Kumasi Metropolis, Ghana.

Contraceptive use among women living with HIV is important to prevent the transmission of the infection to their partners, prevent unintended pregnancies and prevent the mother-to-child transmission of the infection. The study sought to determine the contraceptive characteristics of women living with HIV in the Kumasi metropolis. A cross-sectional study was conducted from July to August 2012 at two HIV/AIDS clinics in the Kumasi Metropolis in the Ashanti Region, Ghana. Interviewer- administered questionnaires were used to collect data from two hundred and ninety five women. Data from one hundred and eighty three women living with HIV and who were sexually active were analyzed. Factors associated with contraceptive use were examined using logistic regression. The overall contraceptive use was high; 84.7% were using a modern contraceptive method. The male condom was the commonest contraceptive method (77.0%) used and this was the main contraceptive method promoted at the HIV/AIDS clinic. Dual method usage was low (4.4%). Multivariate analysis showed that the significant predictor of contraceptive use was HIV status disclosure to partner (AOR = 0.25; 95% CI = 0.07-0.87; p = 0.03). The integration of family planning and HIV/AIDS services could stress dual method use and encourage HIV status disclosure to partner.

Women's Sexual Empowerment and Contraceptive Use in Ghana

Pervasive gendered inequities and norms regarding the subordination of women give Ghanaian men disproportionately more power than women, particularly in relation to sex. We hypothesize that lack of sexual empowerment may pose an important barrier to reproductive health and adoption of family planning methods. Using the 2008 Ghana Demographic Health Survey, we examine the association between women's sexual empowerment and contraceptive use in Ghana among nonpregnant married and partnered women not desiring to conceive in the next three months. Increasing levels of sexual empowerment are found to be associated with use of contraceptives, even after adjusting for demographic predictors of contraceptive use. This association is moderated by wealth. Formal education, increasing wealth, and being in an unmarried partnership are associated with contraceptive use, whereas women who identify as being Muslim are less likely to use contraceptives than those who identify as being Christian. These findings suggest that to achieve universal access to reproductive health services, gendered disparities in sexual empowerment, particularly among economically disadvantaged women, need to be better addressed.

Myths, misinformation, and communication about family planning and contraceptive use in Nigeria

Myths, misinformation, and communication about family planning and contraceptive use in Nigeria Augustine Ankomah1, Jennifer Anyanti1, Muyiwa Oladosu21Society for Family Health, Abuja, Nigeria; 2MiraMonitor Consulting Ltd, Abuja, NigeriaBackground: This paper examines myths, misinformation, factual information, and communication about family planning and their effects on contraceptive use in Nigeria.Methods: A nationally representative sample of 20,171 respondents from two waves of a multiround survey (one in 2003 and the other in 2005), was analyzed at the bivariate level using Chi-square tests and at the multivariate level using logistic regression.Results: Key myths and misinformation about family planning having significant negative effects on contraceptive use included: “contraception makes women become promiscuous”, “it is expensive to practice family planning”, and “family planning causes cancer”. Factual information having significant positive effects on contraceptive use includes the messages that family planning methods are effective and not against religious teaching. The type of people with whom respondents discussed family planning had a significant effect on use of contraception. Respondents who discussed family planning with their spouse, friends, and health workers were more likely to use contraception than those who discussed it with religious leaders. Other significant predictors of contraceptive use were region of residence, gender, and socioeconomic status.Conclusion: Family planning programs should focus on eliminating myths and misinformation, while strengthening factual information. Contraception programs should factor in the role of significant others, particularly spouses and friends.Keywords: contraceptive use, family planning, logistic regression, misconceptions, myths

Inferring gender-power: women’s schooling and relative spousal influence in childbearing in Ghana

Our analysis of data on married couples from the 1988-2003 Ghana Demographic and Health Surveys demonstrates men's influence in childbearing decisions increased during a time when women's education was on the rise. This time period marked the beginning of a rapid fertility decline in Ghana, but while women’s education remained a significant predictor of contraceptive use, education became significantly less important while men’s fertility preferences became significantly more important. The findings suggest that traditional cultures of marriage in sub-Saharan Africa that endorse men’s authority in reproductive decision-making will probably not be easily overcome by higher levels of women’s education. Laurie F. DEROSE, Research Assistant Professor, Maryland Population Research Center, University of Maryland, 0124N Cole Student Activities Building (#162), College Park, MD 20742-1315, USA. E-mail: lderose@umd.edu . Lijuan WU, Assistant Professor, Department of Sociology, Peking University, Beijing 100871, China. E-mail: lijuanwu@yahoo.com .. F. Nii-Amoo DODOO, College of Liberal Arts Research Professor, The Pennsylvania State University, 211 Oswald Tower, University Park, PA 16802, USA and Professor and Director, Regional Institute for Population Studies University of Ghana P. O. Box LG 96, Legon, Ghana Africa. E-mail: duf2@psu.edu . DOI: 10.4402/genus-211

Predictors of Contraceptive Use Among Married Youths and Their Husbands in a Rural Area of Myanmar

This study aimed to determine the predictors of contraceptive use among married female youths and their husbands using the behavioral theory of the Health Belief Model (HBM). A community-based survey was conducted in a rural area of Myanmar in 2008. A total of 444 respondents (222 couples) were interviewed separately using a pretested, structured questionnaire. Significant predictors of contraceptive use were determined by univariate and multivariate analysis. Wife's HBM perception was a highly significant predictor of contraceptive use in married youths (adjusted odds ratio = 10; 95% confidence interval = 2.7, 37.6). Wives aged 20 to 24 years and having their own income, experience of spousal communication, and shorter distance from home to health center were also significant predictors of contraceptive use. A poor agreement on HBM perception between wife and husband was noted. This study highlights the importance of HBM perceptions, wife's income, spousal communication, and geographic barriers in contraceptive use among married youths in rural Myanmar.

Contraceptive use by women in Accra, Ghana: results from the 2003 Accra Women's Health Survey.

The study was to determine the predictors of use of modern contraception among women in Accra, Ghana. Data were collected by trained interviewers using questionnaires. Complete data for 2199 women were analysed using Stata 8.2. The study showed that educational status was the most significant predictor of contraceptive use. Women with no formal education had a 48% reduction in the odds of having ever used contraception and a 66% reduction in the odds of currently using contraception. Regular use of health facilities did not affect contraceptive use. Female education should continue to be a priority of the Ghanaian government. Education about family planning and the effects of having large families should be integrated into the school curriculum. Ghanaian health workers need to be active in promoting the use of modern contraceptive methods.

T10-O-06 First sex: an opportunity of a lifetime for sexual health

Objectives International studies demonstrate that non-use of contraception at first intercourse in itself predicts subsequent high-risk behavior (Svare et al, 2002). The objective of this study is to demonstrate what factors influence most contraception use at first sex globally. Methods Findings are based on the 2007 Durex Sexual Wellbeing Global Survey (carried out in July and August 2006 in 26 countries globally). Margin of error in each country was 3% (n=1,000) for a 95% confidence interval. Out of the 26,032 responses, 85.6% were sexually active. A multiple logistic regression model was developed to identify associations between 13 independent variables and contraception use at first sex. Results Gender, age, income, education, age at first sex, relationship, readiness, forced sex and planning for first sex are predictors of contraception use at first sex (p-value Conclusions The study identified areas that merit further attention: a) need for older populations to receive continuous support and sexual education; b) re-emphasizes the importance of planning for first sex; and c) for youngsters, promoting abstinence or postponement of first sex is not enough.

Contraceptive Use among Women Migrants in Nang Rong, Thailand: An Exploratory Study

Understanding the dynamics of contraceptive use among women migrants is considered important, especially to a country like Thailand that is undergoing many changes, and an increasingly female-dominated migration during the last few decades. Using survey data collected in 2000, this study seeks to examine the determinants of modern contraceptive use among women migrants in Nang Rong, Thailand. The study found that several demographic and socioeconomic factors are significant predictors of contraceptive use among women migrants and the magnitude of such effects varies across different migrant types.

Factors in Consistency between Attitudes and Behavior: Implications for Policies and Programs

The paper deals with the factors which affect contraceptive attitudes, behaviors, and the relationship between the two. The analysis is based upon original survey data from 2,446 women in Venezuela and related literature. The results suggest that both positive attitudes and contraceptive accessibility are major determinants of contraception but at the aggregate level neither has a decisive advantage over the other. The three best predictors of contraceptive use are: specific contraceptive attitudes, social support, and accessibility of contraceptives. Their impacts on behavior are direct and additive; however, their impacts vary significantly by education and number of living children. In general attitude change strategy is more effective with younger women while improving accessibility affects older women more often. Implications for policy and programs are presented.

Spousal Communication, Power, and Contraceptive Use in Burkina Faso, West Africa

In most developing countries, despite increased knowledge and approval of family planning, contraceptive use is still low. Lack of spousal communication was identified as an important explanatory factor in the low level contraceptive use by spouses. This study describes the pathways of influence between spousal communication, power, and contraceptive use in Burkina Faso, West Africaa high fertility country with low prevalence of contraceptive use. The Burkina Faso society is patriarchal in which husbands have control over sexual and fertility matters and they extend authority over their wives on these issues and, therefore, the power dimension of the spousal communication model needs clarification. The data source for this paper was the 2003 Burkina Faso Demographic and Health Survey. From the individual recode file, married respondents were selected for inclusion in the sample (n = 9,537) and for analysis. The independent variables were spousal communication and relative power. The dependent variables were contraceptive use and the effects of age, education, number of living children, wealth, and marriage types were adjusted for. Results show that education, wealth, place of residence, and religion are some of the correlates of inter-spousal communication about contraceptive use. Additionally, the data have revealed that spousal communication and marital power were important and significant predictors of contraceptive use, with relative marital power being the Stronger predictor of the two.

Young women's contraception use as a contextual and dynamic behaviour: A qualitative study

A number of models of behaviour have been applied to contraception use including subjective expected utility theory and social cognition models. Whilst correlates of contraception use have been identified, the limitations of these models include their failure to consider either contextual factors or changes in contraception use over time. Researchers have called for integrated and dynamic models of contraception use, which can be related to the changing contraception use of individual women and can also be readily operationalised to explore within and between subject differences in contraception use. The present study therefore used a qualitative methodology to explore women's contraceptive histories and to enable women to define the issues from their perspectives, resulting in a model of contraception use that is firmly located within the context of their own lives and allows an investigation of the factors and processes involved in changes in contraception use/non-use over time. This model conceptualises the predictors of contraception use in terms of the meaning and importance of a range of social goals, perceptions of vulnerability and constraints on or facilitators of contraception. Further the dynamic nature of these factors is described and it is illustrated how these core components vary over time according to situation, experience, and new information. The paper outlines the relevance of the findings for different models of decision-making processes and highlights the way that the model addresses the limitations of previous approaches.

Women on Top: The Relative Influence of Wives and Husbands on Contraceptive Use in KwaZulu-Natal

ABSTRACT Objectives: The purpose of this paper is to examine the relative influence of husband and wife on contraceptive practice. Methods: A cross-sectional survey was conducted among adult men and women in KwaZulu-Natal, South Africa. A matched file for 238 married or cohabiting couples was created. Results: Knowledge of methods of contraception was virtually universal and attitudes to contraception were favorable both in men and women. A substantial proportion of men and women reported using a method of contraception. The wife's desire to stop childbearing was the most powerful predictor of contraceptive use among couples, after adjustment for possible confounders. The husband's approval (or not) of family planning and his preference for future childbearing were not significantly related to contraceptive use. Conclusion: Contraceptive use within marital and cohabiting unions is high and the wife's fertility preference was found to be a key determinant of use. This conclusion challenges conventional wisdom that men are the dominant decision-makers in fertility and family planning decisions.

Emergency contraception use and non‐use in young women: The application of a contextual and dynamic model

There have been many approaches to understanding contraception use including social cognition models which have been criticised for their individualistic approach and their static nature. The present quantitative study developed and refined a contextual and dynamic model of contraception use that was derived using qualitative research. This model conceptualizes the predictors of contraception use in terms of the meaning and importance of a range of social goals, perceptions of vulnerability, and constraints on or facilitators of contraception use each of which changes over time. The present study operationalized this model in relation to emergency contraception and explored differences between users and non-users and between episodes of use and non-use. In terms of users and non-users, the results showed that the users of emergency contraception showed a more positive view of an emergency contraception user, perceived greater support from their partner for emergency contraception use, rated themselves more at risk of pregnancy, and felt more confident about asking for emergency contraception. In terms of use and non-use, use was related to an increased belief about the risk of pregnancy, increased partner support, increased concern about health care professionals and the side-effects of the drug, and a more positive identity of an emergency contraception. The study has helped to develop and refine the model and has identified some key factors that are specifically relevant to emergency contraception use in a sample of women in education in and around London.

Risky parental behavior and adolescent sexual activity at first coitus.

Data from the National Longitudinal Study of Adolescent Health (Add Health) were used to examine the impact of parents' behavior on adolescents' sexual experience and contraceptive use. All else being equal, adolescents whose parents engage in risky behaviors are especially likely to be sexually active and to have had sex before age 15. These findings are only partly attributable to the link between parents' risky behaviors (smoking, drinking, driving without seatbelts) and adolescents' risky behaviors (smoking, drinking, delinquent activity, association with substance-using peers). Although parental behaviors are effective predictors of adolescents' sexual activity, they are not effective predictors of contraceptive use or of method choice at first coitus. Overall, parents with low levels of self-efficacy seem to be especially likely to have children at risk of engaging in problem behaviors.

Promoting Birthspacing Among the Maya-Quiche of Guatemala

This program-based and population-based study assessed the effects of an intervention project conducted in 1993-96 in the Mayan department of El Quiche Guatemala. The intervention project was undertaken to increase the knowledge on the use of contraceptives and improve attitudes toward birth spacing. Findings revealed that knowledge of at least one method and positive attitudes toward birth spacing increased dramatically over the period between surveys. Moreover the proportion of subjects who responded that birth spacing was good more than doubled over the period (from 43% in 1992 to 88% in 1996). Current contraceptive use similarly rose from 5% to 18% in the period between surveys. The number of volunteer promoters who are able to reach Maya-Quiche women in remote rural areas increased notably from 79 in 1993 to 144 in 1995. The study design could not rule out the confounding factors. However logistic regression revealed that program-related variables such as contact with the private family planning clinic and exposure to birth spacing messages in the mass media and previous reproductive experience such as having experienced a mistimed pregnancy were the important predictors of contraceptive use once social and demographic factors were controlled for.

How Relationships of U.S. Men Affect Contraceptive Use and Efforts to Prevent Sexually Transmitted Diseases

Comparatively little is known about how U.S. adult men's attitudes and characteristics influence their decision to use contraceptives to prevent pregnancy and to take actions to protect themselves from infection with sexually transmitted diseases (STDs). Attitudinal and background data on 1,595 men from the 1991 and 1993 waves of the National Survey of Men (NSM) were used, through logistic regression techniques, to predict the likelihood of current contraceptive use to prevent pregnancy and recent efforts to avoid STD infection among men in three types of sexual relationship--marriage, cohabitation and dating. At the 1993 interview, 58% of men were using contraceptives to prevent pregnancy and 22% had recently taken actions to protect themselves from STDs. Men's concern about how easy a method was to use reduced the likelihood of STD protection, but had no influence on contraceptive use to prevent pregnancy; however, concerns about a method's risks to the female partner increased the likelihood of both outcomes. Couples in which the man expected his partner to take primary responsibility for contraception were 40% as likely to be protecting themselves against STDs as were couples in which the man believed he shared or had greater responsibility. Married men were the least likely to be protecting themselves against STDs, whereas men who were dating were the most likely to do so. Men's attitudes and characteristics were important predictors of contraceptive use to prevent pregnancy and of efforts to protect against STDs, even after controls for the female partner's characteristics were entered in the analysis. The findings emphasize the need to include men in interventions aimed at reducing unintended pregnancy and STD transmission.

Reproductive Goals and Family Planning Attitudes in Pakistan: A Couple-level Analysis

Based on the responses of 1260 matched couples in the 1990-91 Pakistan Demographic and Health Survey, this study examines how congruent wives’ and husbands’ attitudes towards fertility and family planning are, and to what extent the similarity or difference in attitudes affects their reproductive control behaviour. The results show that about 60 percent of the couples have given similar responses (agreeing either positively or negatively) to several fertility-related questions, whereas the remaining 40 percent differ in their attitudes. Multivariate analyses indicate that a couple’s joint approval of family planning, husband’s desire for no more children, and spousal discussion about family planning stand out as the strongest predictors of contraceptive use. These findings clearly suggest that the role of couple agreement is important in promoting the use of family planning, and that men should be made as equal targets of such programmes in Pakistan.

Mass media messages and reproductive behaviour in Nigeria.

This paper examines the effects of exposure to mass media messages promoting family planning on the reproductive behaviour of married women in Nigeria using cross-sectional data. Longitudinal data are also used to ensure that exposure to media messages pre-dates the indicators of reproductive behaviour. Cross-sectional analysis suggests that: (1) contraceptive use and intention are positively associated with exposure to mass media messages, and (2) women who are exposed to media messages are more likely to desire fewer children than those who are not exposed to such messages. Similarly, analysis of the longitudinal data shows that exposure to mass media messages is a significant predictor of contraceptive use. Thus, exposure to mass media messages about family planning may be a powerful tool for influencing reproductive behaviour in Nigeria.

Differentials in Contraceptive Use and Method Choice in Vietnam

Data for this study were taken from the 1988 Demographic and Health Survey of Vietnam (VNDHS) which provided the first nationally representative data on contraceptive use in Vietnam. The VNDHS was based on a national sample designed to provide independent estimates for the two major regions of the country. The sample was limited to 3497 women exposed to the risk of conception. The second part of the analysis which examined the odds of choosing a modern method over a traditional method was limited to 2142 women who were current users. A stepwise logistic regression model was used to examine determinants of contraceptive practice. Some 60% of currently married nonpregnant Vietnamese women use a contraceptive method and 2/3 of these rely on a modern method generally the IUD. In comparison with wives 40 or older wives younger than 20 were 73% less likely to practice contraception. The odds of method use peaked among women ages 30-34 and 35-39 who were significantly (15% and 38% respectively) more likely to use contraception than the reference group. The odds of use were 45% lower among illiterate wives and 12% lower among those with primary education than among wives with secondary or higher education. The odds of method use among illiterate women were 34% lower than those among women with a secondary or higher education but husbands education was a stronger predictor of contraceptive use. Couples with daughters only were 27% less likely to use a method than were those with children of both sexes and they were also less likely to use a modern method. Couples with 4 or more children were 27% less likely to practice contraception than those with fewer than 3 children. Urban women were 56% more likely to use contraception than their rural counterparts. Northern Vietnamese were 37% more likely to use contraceptives than southern Vietnamese and they were also more likely to use modern methods.

Contraceptive risk‐taking in a medically underserved, low‐income population

This study examines the phenomenon of contraceptive risk-taking, which is the nonuse of contraception by women who are sexually active, fertile and not pregnant or trying to become pregnant. Based on a survey sample of low-income women in their childbearing years who had not received family planning care or advice from a doctor or clinic for at least three years, the study analyzed demographic predictors of contraceptive risk-taking and also compared levels of contraceptive knowledge and pregnancy histories of noncontraceptors versus barrier contraceptors. Contraceptive risk-taking was found to be higher for minority women, for parous women, for those age 30 and younger, and for those whose knowledge of the fertility cycle is incorrect, but risk-taking was found to be unrelated to the women's marital status. Noncontraceptors were less knowledgeable concerning contraceptive methods and substantially more likely to have had previous unwanted pregnancies due to nonuse of contraception, suggesting that current contraceptive risk-taking probably represents a relatively enduring feature of reproductive behavior for a subgroup of the medically undeserved low-income population.