Traditional Contraceptive Methods Research Articles

A comprehensive analysis of contraceptive safety: Implications for gynecological health and education levels

The use of contraceptives is essential for lowering the net reproduction rate and stabilizing population growth. Developing countries are characterized by high birth rates and rapid population growth. With lower contraceptive usage rates among eligible couples and resistance towards family planning methods, achieving population stabilization seems challenging. Therefore, this study aims to study the effects of various contraceptive methods on gynecological health and their safety profiles, The present observational study, was conducted in Department Obstetrics and Gynaecology at tertiary health care centre, Panjab, India. A total of 450 women were evaluated with the help of a pre-designed and pre-tested questionnaire to address knowledge, awareness, and perception of contraception among the rural and urban population in Punjab. The data were collected and analysed.All the participants were known to the traditional contraception and only few were aware about the modern contraception. Participants preferred tubal ligation (43.78%) over vasectomy (75.78%) and rarely considered hysterectomy (1.11%). Most knew about male condoms (99.56%) but fewer about female condoms (0.44%). Among the participants, 59.78% were aware of contraception side effects. Regarding condom use, opinions were divided, with 48.67% in favor and 51.33% against. Educated individuals were aware of contraception but not its major side effects. Therefore, we suggest investigating social, cultural, and knowledge aspects to improve understanding.

Determinants of Contraception Among Women Undergoing Cancer Treatment: A Cross-Sectional Study from Zahedan, Iran

Objectives: This study investigates the prevalence of contraceptive use among women receiving cancer treatment in Zahedan, southeast Iran. We evaluated the role of various demographic and socio-cultural factors, fertility intentions, and care providers in contraceptive use. Methods: This cross-sectional study was conducted on 133 women of reproductive age receiving cancer treatment (chemotherapy or radiotherapy) in Zahedan. Patients referred to three medical centers in Zahedan from November 2019 to May 2020 were selected via the convenience sampling method and interviewed using a questionnaire. The data were analyzed in SPSS (version 18) using multinomial logistic regression. Results: It was found that 34.6% (N = 46) of women undergoing cancer treatment were at risk of unintended pregnancy, with 23.3% (N = 31) using the withdrawal method and 11.3% (N = 15) not using any form of contraception. Additionally, 37.0% (N = 49) of women reported inadequate knowledge about emergency contraception methods. Furthermore, 46.6% (N = 62) of women stated that the physician responsible for their cancer treatment had never discussed contraceptives with them. The highest prevalence of traditional contraceptive methods and non-use of contraception was observed among illiterate women, women with primary education, women living in polygamous families, women desiring more than four children, women who did not agree with their husbands on the contraceptive method, women who did not receive any physician consultation, and women living far from health centers. The multinomial logistic regression analysis revealed that the main predictors of contraception use were physician consultation about contraception (OR = 13.64, 95% CI: 2.13-87.32, P = .006) and couple agreement on the contraception method (OR = 9.91, 95% CI: 1.69-58.15, P = .011). Conclusions: Considering that, based on new population policies in Iran, access to free family planning (FP) services has ended and access to contraceptives is limited, women of reproductive age with illnesses—especially those with poor socioeconomic status, those living in polygamous families, and those in less developed regions—should be considered as a vulnerable group by the healthcare system. Furthermore, men should be included in consultation sessions with care providers to improve their participation in FP.

Modern Contraception and Anaemia Among Reproductive-age Women in India: Results From a Household Survey.

Chronic anaemia is a significant health concern, particularly among women of childbearing age. Factors such as menstrual blood loss, childbirth, inadequate nutrition, closely spaced pregnancies, and recurrent gastrointestinal bleeding increase the risk of anaemia. This study investigated whether current contraceptive methods are associated with anaemia in Indian women of reproductive age. Cross-sectional data from the fifth round of the National Family Health Survey, conducted in 2019-2021, were used for this investigation. We included only non-pregnant and non-amenorrhoeic women in our analysis, resulting in a final analytical sample of 673 094 women aged 15-49. Bivariate cross-tabulations and multivariable logistic regression were employed to analyse the data. The prevalence of anaemia was 57%, and the adjusted regression models found no significant association between the use of any contraceptive methods and women's haemoglobin status. Women using traditional contraceptive methods had 1.08 (95% confidence interval, 1.05 to 1.11) times higher odds of having anaemia. Among the modern methods, other than injectables, all other methods-such as an intrauterine device, barrier use, and sterilisation-were associated with higher odds of anaemia compared to women who used contraceptive pills. This study explored the relationship between modern contraceptives and haemoglobin levels in India, revealing that injectables were associated with a notable reduction in the odds of anaemia, whereas traditional contraceptives and other modern methods exhibited positive associations with anaemia. These findings prompt policymakers to focus on anaemia reduction and safe contraceptives. More research is needed to inform decisions, given the scant literature.

Joint modeling of correlated binary outcomes using multivariate logistic regression: contraception and HIV knowledge in Sri Lanka

Reproductive health significantly contributes to the overall well-being and social welfare of women. Within the spectrum of modern and traditional contraceptive methods in use, condoms have been strongly advocated by numerous HIV programs as a primary means of preventing HIV infection in Sri Lanka. Given the intrinsic relationship between contraceptive utilization and HIV awareness, our study aims to concurrently analyze the patterns of contraceptive usage and HIV knowledge, while accounting for their potential correlation. In this study, we introduced the application of the Gumbel type II distribution to effectively capture the interdependence of these joint probabilities, accounting for various covariates. The outcome of simulation studies demonstrated the superior performance of the integrated joint model, in comparison to the separate univariate models. Our findings highlighted several noteworthy risk factors associated with both contraceptive usage and HIV prevention knowledge. These included variables such as residence, level of education, wealth quintile, husband's education level, number of children, engagement with the newspapers, television viewership, and mobile phone usage. The Result indicates a positive association between the adoption of contraception and the awareness of HIV prevention measures, suggesting that individuals who actively embrace contraception are more likely to possess knowledge about preventing HIV transmission.

Pattern of contraceptive use among reproductive-aged women with disabilities in Bangladesh: Evidence from multiple indicator cluster survey 2019

BackgroundContraception is crucial for reproductive-aged women with disabilities, empowering them to manage reproductive choices and enhancing overall health, autonomy, and well-being. ObjectiveThe objective of this study was to examine the usage patterns of contraceptive methods among reproductive-aged women with disabilities in Bangladesh. MethodsWe analyzed data from 47,465 reproductive-aged women from the 2019 Bangladesh Multiple Indicator Cluster Survey. Outcome variables included contraceptive usage patterns, grouped into any contraceptive methods, any modern contraceptive methods, and any traditional contraceptive methods. The primary explanatory variable considered was disabilities level (women with no disabilities, women with moderate disabilities, and women with severe disabilities), along with types of disabilities. A multilevel mixed-effects logistic regression model was used to assess associations between outcomes and explanatory variables while accounting for confounding. ResultsThe prevalence of any contraceptive methods use was 66.4 %, declining to 54 % among women with severe disabilities. The odd of modern contraception use was 31 % lower (aOR, 0.69, 95 % CI, 0.65–0.73) among women with moderate disabilities and 47 % lower (aOR, 0.53, 95 % CI, 0.47–0.60) among those with severe disabilities, compared to women with no disabilities. Within the individual domains of disabilities, those with vision, walking, cognitive, and self-care-related disabilities reported lower odds of modern contraception uptake than those with no disabilities. ConclusionsThe study highlights that women with disabilities use contraceptives less often, increasing vulnerability to unintended and short interval pregnancies and unsafe abortion. Strengthening family planning and prioritizing women with disabilities for modern contraceptives are vital.

Comprehensive knowledge of mother-to-child HIV/AIDS transmission, prevention, and associated factors among reproductive-age women in East Africa: insights from recent demographic and national health surveys

BackgroundMore than 90% of babies acquire HIV/AIDS through vertical transmission, primarily due to low maternal comprehensive knowledge about Mother-To-Child Transmission (MTCT) of HIV/AIDS and its prevention, which is a cornerstone for eliminating MTCT of HIV/AIDS. However, there are limitations in terms of population data and literature evidence based on recent Demographic and Health Surveys (DHS) reports in East Africa. Therefore, this study aims to assess the comprehensive knowledge and PMTCT of HIV/AIDS among women, as well as the associated factors in East Africa.MethodsOur data was obtained from the most recent DHS conducted in East African countries between 2011 and 2022. For our research, we included DHS data from ten nations, resulting in a total weighted sample of 133,724 women for our investigation. A generalized linear model (GLM) with a log link and binomial family to directly estimate prevalence ratios (PR) and 95% confidence intervals (CI) for the association between the independent variables, and the outcome variable. Finally, we reported the adjusted prevalence ratios along with their corresponding 95% CIs. Factors with p-values ≤ 0.2 for univariate logistic regression and < 0.05 were considered statistically significant factors of HIV/AIDS knowledge and prevention in the final model.ResultsIn this study, 59.41% (95% CI: 59.15–59.67) of respondents had a comprehensive knowledge about MTCT of HIV/AIDS and its prevention among reproductive-age women in East Africa. Being in the older age group, better education level, being from a rich household, employment status, having ANC follow up, institutional delivery, and modern contraception usage were associated with higher prevalence ratios of comprehensive knowledge about MTCT of HIV/AIDS and its prevention. However, being single in marital status, rural women, and traditional contraception utilization were associated with lower ratios of comprehensive knowledge about MTCT of HIV/AIDS and its prevention.ConclusionOur findings indicate a significant deficiency in comprehensive knowledge and prevention of HIV/AIDS MTCT among women in East Africa. These results emphasize the need for significant improvements in maternal-related health services. It is crucial to effectively target high-risk populations during interventions, raise awareness about this critical public health issue, and address the catastrophic consequences associated with MTCT. By implementing these measures, we can make substantial progress in reducing the transmission of HIV/AIDS from mother to child and ensuring better health outcomes for both mothers and their children.

Association between women’s empowerment and demand for family planning satisfied among Christians and Muslims in multireligious African countries

BackgroundAlthough the levels of demand for family planning satisfied (DFPS) have increased in many countries, cultural norms remain a significant barrier in low- and middle-income countries. In the context of...

Prevalence and dynamics of contraceptive use by type during the COVID-19 pandemic: Evidence from Western Iran.

Contraception represents a deliberate choice made by individuals, both men and women, to regulate their desired number of children. The primary objective of this study was to examine the prevalence and predictors of contraceptive use, while also exploring the shifts in contraception methods following the COVID-19 pandemic. This study employed a quantitative approach with a survey technique. The survey was conducted in Kermanshah, one of Iran's metropolises located in the western part of the country. The sampling methodology employed in this study involved a combination of multi-stage classification and systematic random methods. The survey took place between July and August 2022. The target population for the survey included women between the ages of 15 and 49. A total of 600 women from this population were selected and included in the survey sample. The sample was described using frequency tables, as well as central and dispersion indices (mean and standard deviation). Additionally, multivariate analysis was conducted through the application of logistic regression. Findings pointed out that approximately 65% of the women in the sample utilized contraception methods. Among these methods, the condom and oral pill were found to be the most prevalent choices. Moreover, the findings indicated that an increase in the number of both living and ideal children was associated with a decreased likelihood of contraceptive use. Following the occurrence of the COVID-19 pandemic, there was an observed increase in the utilization of traditional and natural methods of contraception. This shift highlights the importance of considering a broader range of contraceptive options and not solely focusing on restricting contraception services. In the midst of the coronavirus outbreak, women turned to traditional contraceptives, which may increase the risk of unintended pregnancies and subsequent miscarriages. Therefore, providing in-person services to women at their place of residence is necessary during epidemics.

HIV counseling, testing, and test result receipt among East African women of reproductive age using recent national health surveys.

One of the most important public health concerns is still the Human Immunodeficiency Virus (HIV) and acquired immunodeficiency syndrome (AIDS), particularly in developing countries. Although HIV testing is an important step in both prevention and treatment, its uptake remains low, and no study has looked into the scale of HIV counseling, testing, and test result receipt among East African women all at the same time. Therefore, this study aimed to investigate HIV counseling, testing, and test result receipt, as well as the factors that influence them, among East African women. This analysis used Demographic and Health Survey data collected from 10 East African countries between 2011 and 2022. We examined the coverage of HIV counseling, testing, and test result receipt among East African women, as well as other characteristics. To select candidate factors and identify significant explanatory variables related to the outcome variable, binary and multiple logistic regression analyses were conducted, and the results were presented using adjusted odds ratios (AORs) with 95% confidence intervals. In the binary and multiple logistic regression analyses, P values of less than or equal to 0.2 and <0.05 were used to assess significant variables, respectively. A total of 41,627 weighted women included to this study. HIV counseling, testing, and test result receipt among East African women were found to be 77.86% (95% CI = 77.46, 78.26). Being 25-34 years old (AOR = 1.13, 95% CI, 1.06, 1.21), 35-49 years old (AOR = 1.15, 95% CI, 1.05, 1.26) as compared to 15-24 years old women, primary education (AOR = 1.75, 95% CI, 1.64, 1.86), secondary/higher education level (AOR = 1.96, 95% CI, 1.82, 2.13) as compared to not educated women, poor, (AOR = 1.22, 95% CI, 1.14, 1.29), middle wealth (AOR = 1.12, 95% CI, 1.04, 1.21) as compared to rich wealth index, mass media exposure (AOR = 1.29, 95% CI, 1.22, 1.35), 3-5 parity (AOR = 1.29, 95% CI, 1.21, 1.37), more than 5 parity (AOR = 1.46, 95% CI, 1.33, 1.61) as compared to <3 parity, health institution delivery (AOR = 1.65, 95% CI, 1.53, 1.76), were associated positively with the outcome variable respectively. However, being married (AOR = 0.79, 95% CI, 0.72, 0.87), not using contraceptive (AOR = 0.58, 95% CI, 0.51, 0.61), and traditional contraceptive method user (AOR = 0.47, 95% CI, 0.41, 0.54) as compared to modern users were associated negatively with outcome variable respectively. This study found that HIV counseling, testing, and test result receipt are still unsatisfactory. Strengthening maternal health services such as institutional delivery, family planning, and women's empowerment, as well as changing mass media and taking advantage of these opportunities, will boost the region's coverage of HIV counseling, testing, and obtaining results.

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.

Contraception Crisis in Somalia: Unveiling the Shocking Reality of a Nation Left Behind

Background. Despite global efforts to promote contraceptive use and ensure reproductive health, Somalia continues to face significant challenges in this regard. This study aims to explore the prevalence of contraceptive use in Somalia and identify the determinants influencing its use. Methods. A total of 8,162 reproductive‐aged women’s data were analyzed extracted from 2020 Somali Health and Demographic Survey. The outcome variable was contraception use, classified as any contraception use (yes vs. no), any modern contraception use (yes vs. no), and any traditional contraception use (yes vs. no). The explanatory variables were factors at the individual, household, and community level. The multivariate binary logistic regression model was used to explore associations of outcome variables with explanatory variables. Results. The findings revealed low prevalence of contraceptive use among Somalia women, with only 7% reporting its use. Among them, less than 1% utilized modern contraceptive methods. Several determinants of contraception use were identified, including younger age, higher educational attainment (primary and secondary education), higher parity, exposure to family planning messages through mass media, urban place of residence, and residing in the northwest and northeast regions of Somalia. Conclusion. The results underscore the urgent need for substantial efforts to improve contraceptive use in Somalia. Strengthening healthcare facilities to provide comprehensive sexual and reproductive health services, with a particular focus on promoting contraception uptake, is crucial. Public awareness campaigns and educational programs should also be prioritized to enhance knowledge and understanding of contraception among Somali women.

Effect modification of socioeconomic status in the association between contraception methods and couple's education: A secondary analysis of PDHS 2017-18.

Globally, the region of South Asia reports the highest number of women (87 million) with unmet needs of contraception. Amongst the lower-middle-income countries of South Asia, Pakistan has performed poorly in enhancing contraceptive prevalence, as evident by the Contraceptive Prevalence Rate (CPR) of 34%. Factors including restricted access to contraception, a restricted selection of techniques, cultural/religious resistance, gender-based hurdles, and societal factors, such as the couple's education level, are among the most important causes for this gap in desire and usage. Thus, this study aimed to evaluate the association between couple's education level and their influence on their choice of contraception. In addition, the study also assessed the role of socioeconomic status in modifying the association between couple's education and contraception choice. Using PDHS 2017-18 data, couple's education status, preferences of contraceptive use and wealth quintiles were analyzed through multinomial logistic regression after adjusting for other confounding factors. The findings of our study revealed that out of the total sample of 14,368 women, 67.52% (n = 9701) were categorized as non-users, 23.55% (n = 3383) employed modern contraceptive methods, and 8.94% (n = 1284) utilized traditional contraceptive methods. Multivariable analysis showed that educated couples belonging to higher socioeconomic status (SES) had the highest adjusted odds ratio [7.66 (CI: 4.89-11.96)] of using modern contraceptives as opposed to uneducated couples of low socioeconomic statuses. Our analysis also revealed that the odds of using modern contraceptives were higher amongst mothers with five or more children [8.55 (CI:7.09-10.31)] as compared to mothers with less children when adjusted for other covariates. Thus, this study concludes the dynamic interplay between couple's level of education, contraceptive preference, and socioeconomic status This study contributes valuable insights for the policy makers and stakeholders to understand the intricate relationship between these factors.

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.

Male characteristics and contraception in four districts of the central region, Ghana

BackgroundA lack of male involvement in contraception can negatively affect its practice. To promote male participation in family planning, there is a dire need to understand male attributes that play a role in contraception. This study focuses on the male characteristics that influence the practice of traditional and modern methods of contraception.MethodsThis study is a secondary analysis of quantitative data obtained from the baseline assessment of the Ghana Community-Based Action Teams Study that aimed to prevent violence against women in the Central Region of Ghana in 2016. The analysis included 1742 partnered males aged 18–60 years. Chi-square test, t-test and logistic regression analyses were used to assess the association between male characteristics and the practice of contraception (significance level = 0.05).ResultsThe prevalence of contraception was 24.4% (95% CI = 20.8–28.5). Significant male characteristics that were positively associated with the practice of contraception in adjusted models were: post-primary education (AOR = 1.96, 95% CI = 1.27–3.04), perpetration of Intimate Partner Violence (AOR = 1.83, 95% CI = 1.49–2.26), and the number of main sexual partners (AOR = 1.78, 95% CI = 1.15–2.75). However, wanting the first child (AOR = 0.71, 95% CI = 0.54–0.94) and male controlling behaviour (AOR = 0.7, 95% CI = 0.49–0.99) statistically significantly associated with reduced odds of practicing contraception.ConclusionMale partner characteristics influence the practice of contraception. Family planning sensitization and education programs should target males who are less likely to practice contraception.

Examining the influence of Mother-in-law on family planning use in South Asia: insights from Bangladesh, India, Nepal, and Pakistan

BackgroundContraceptive use contributes to improved maternal and child health, education, empowerment of women, slow population growth, and economic development. The role of the family in influencing women’s health and health-seeking behavior is undergoing significant changes, owing to higher education, media exposure, and numerous government initiatives, in addition to women’s enhanced agency across South Asia. Against this backdrop, this study assesses the relationship between women’s living arrangements and contraceptive methods used in selected south Asian countries (India, Pakistan, Nepal, and Bangladesh).MethodsData of currently married women aged 15–49 from the recent round of Demographic and Health Survey (DHS) of four South Asian countries, i.e., Nepal (2016), Pakistan (2017–18), Bangladesh (2017–18), and India (2019–21) had been used. Bivariate and multinomial logistic regression was performed using Stata with a 5% significance level.ResultsLiving arrangement of women had a significant association with contraceptive use in South Asia. The Mother-in-law (MIL) influenced the contraceptive method used by the Daughter-in-law (DIL), albeit a country-specific method choice. Modern limiting methods were significantly higher among women living with MIL in India. The use of the modern spacing method was considerably high among women co-residing with husband and/or unmarried child(ren) and MIL in Nepal and India. In Bangladesh, women living with husband and other family member including MIL were more likely to use modern spacing methods.. Women co-residing with the MIL had a higher likelihood of using any traditional contraceptive method in India.ConclusionsThe study suggests family planning program to cover MIL for enhancing their understanding on the benefits of contraceptive use and modifying norms around fertility. Strengthening the interaction between the grassroots level health workers and the MIL, enhancing social network of DIL may help informed choice and enhance the use of modern spacing methods. Women’s family planning demands met with modern contraception, and informed contraceptive choices, must also be achieved to reach the 2030 Agenda for Sustainable Development.

Oral contraceptive pills shortage in Lebanon amidst the economic collapse: a nationwide exploratory study

BackgroundThe political instability, economic crisis, and devaluation of the national currency left Lebanese females suffering from a scarcity of oral contraceptive pills (OCPs). Therefore, we aimed to identify the incidence of OCPs shortage in Lebanon and its impact on women’s sexual and reproductive health, as well as physical and psychological well-being.MethodsCommunity pharmacies were selected randomly across Lebanon, using a stratified sampling approach, where female clients asking for OCPs were interviewed using a standardized data collection form.ResultsA total of 440 females were interviewed. More than three-quarters of the participants (76.4%) reported not finding their preferred OCPs brands, almost 40% were affected by the increased prices, and 28.4% declared stockpiling OCPs. More than half of the participants using OCPs for pregnancy prevention reported adopting alternative traditional contraceptive methods (55.3%). Unplanned pregnancy was reported by 9.5% of participants, where 75% of them disclosed intentional abortion while the remaining (25%) reported experiencing a spontaneous miscarriage. Other consequences of OCPs shortage included mood disturbances (52.3%), dysregulation of menses (49.7%), dysmenorrhea (21.1%), weight gain (19.6%), acne (15.7%), and hirsutism (12.5%). Of the participants taking OCPs for birth control, 48.6% reported a reduced frequency of sexual intercourse, which led to conflicts with their partners (46%) and a decreased libido (26.7%).ConclusionsOCPs shortage has seriously and negatively exposed women to various undesirable consequences including unplanned pregnancy and dysregulation of menses. Therefore, there is an urgent need to bring the attention of healthcare authorities to support the national pharmaceutical industry in manufacturing affordable OCPs generics to meet women’s reproductive health demands.

We have almost accepted child spacing. Let's wait on family planning and limiting children': Focus group discussions among young people with tertiary education in Somalia

ObjectiveSomalia has high rates of maternal mortality, fertility and pregnancy among young women. Factors contributing to this situation are a lack of knowledge regarding sexual and reproductive health, early marriages, cultural norms and the unmet need for or use of contraceptives. This study aimed to explore the perceptions of family planning among young men and women with tertiary education in Mogadishu. MethodsA purposeful and convenience strategy using snowballing was used to recruit participants. Four focus group discussions were held online with 26 young women and men aged 19–25 years old. All participants were studying at five different universities in Mogadishu, and only one participant was married. The data were analysed using thematic analysis. FindingsThe findings showed that participants objected to the concept of family planning but supported the concept of child spacing. They highlighted that people of their generation with tertiary education practise child spacing to combine careers with family life. Although all the participants knew of the benefits of child spacing, they had different opinions on whether modern contraceptive methods were an option for them. They were more comfortable with traditional contraceptive methods and believed that the quality of the modern contraceptive medicine available in the country was unreliable. ConclusionOur findings suggest that it is crucial not only to include young people in family planning awareness initiatives and implementation but also to give them a voice to advocate family planning and start dialogues within their own communities.

Informal healthcare providers of abortion services among three scheduled tribes of Jharkhand.

There is a dominant role of informal healthcare providers (IHPs) in the current cultural and sociological context of tribal communities. They outnumber formal health-care providers, thus bridging the gap between existing and nonexisting public health facilities despite not having formal training or accreditation. The study examines the role, relevance, and extent of abortion services provided by IHPs- in Jharkhand among three Scheduled Tribe groups. Based on in-depth interviews with 15 IHPs and 42 married women among three Scheduled Tribe groups in three districts of Jharkhand, a qualitative study was conducted. Interview guidelines addressed reasons for preferring IHP services, their scope of practice, dissemination, and quality of services. The majority of women seeking abortions used traditional contraceptives, which often resulted in unwanted pregnancies. The economic, cultural, social, access to services, and confidence factors encouraged women to seek abortion services from IHPs. There were differences in the nature of access to abortion services among tribal groups. The Chero and Korwa tribes continued to rely heavily on simpler life technologies that shaped their beliefs and practices regarding reproduction. The Ho tribe, however, preferred to use the formal health-care system since they were close to a more complex society. IHP plays a significant role in the social structure of Tribes, demonstrating their marginalization in access to formal health-care services. Eventually, they replaced traditional healers with their function as physicians.

Understanding the rise in traditional contraceptive methods use in Uttar Pradesh, India

BackgroundThe sustainable development goals (SDG) aim at satisfying three-fourths of family planning needs through modern contraceptive methods by 2030. However, the traditional methods (TM) of family planning use are on the rise, along with modern contraception in Uttar Pradesh (UP), the most populous Indian state. This study attempts to explore the dynamics of rising TM use in the state.MethodsWe used a state representative cross-sectional survey conducted among 12,200 Currently Married Women (CMW) aged 15–49 years during December 2020–February 2021 in UP. Using a multistage sampling technique, 508 primary sampling units (PSU) were selected. These PSU were ASHA areas in rural settings and Census Enumeration Blocks in urban settings. About 27 households from each PSU were randomly selected. All the eligible women within the selected households were interviewed. The survey also included the nearest public health facilities to understand the availability of family planning methods. Univariate and bivariate analyses were conducted. Appropriate sampling weights were applied.ResultsOverall, 33.9% of CMW were using any modern methods and 23.7% any TM (Rhythm and withdrawal) at the time of survey. The results show that while the modern method use has increased by 2.2 percentage points, the TM use increased by 9.9 percentage points compared to NFHS-4 (2015–16). The use of TM was almost same across women of different socio-demographic characteristics. Of 2921 current TM users, 80.7% started with TM and 78.3% expressed to continue with the same in future. No side effects (56.9%), easy to use (41.7%) and no cost incurred (38.0%) were the main reasons for the continuation of TM. TM use increased despite a significant increase (66.1 to 81.3%) in the availability of modern reversible methods and consistent availability of limiting methods (84.0%) in the nearest public health facilities.ConclusionInitial contraceptive method was found to have significant implications for current contraceptive method choice and future preferences. Program should reach young and zero-parity women with modern method choices by leveraging front-line workers in rural UP. Community and facility platforms can also be engaged in providing modern method choices to women of other parities to increase modern contraceptive use further to achieve the SDG goals.

Predictors of Modern Contraceptive Use Among Married Women in Pakistan, India, and Bangladesh

Background: Pakistan, Bangladesh, and India are all facing challenges related to large, growing populations with low levels of contraception. While, Bangladesh has the highest CPR (62%), close to the world’s CPR of 64%, India stands at 58%, followed by the lowest for Pakistan at 35%. Objective: To analyze the differences in the socio-economic determinants of modern contraception use in Pakistan, India, and Bangladesh. Methods: This study uses data from the latest rounds of Demographic and Health Surveys for Pakistan (2017-2018), Bangladesh (2017-2018), and India (2015-16) to examine the socioeconomic determinants of traditional, modern, and the most popular method of contraception among married women across the three countries by employing logistic regressions. The sample consists of currently married and fecund women only (Bangladesh=10,738; India=224,070; Pakistan=4,255). Results: In Bangladesh, Oral contraception Pills (OCPs) are the most popular method of contraception (44%), followed by the use of other modern contraception(38%) and traditional contraception(18%). In India, 60% of women using contraception, reported using female sterilization, 27% uses other forms of modern contraception, and 13% reported using traditional methods. For Pakistan, 29% of the women reported using condoms as a source of contraception, 43% of women reporting using other modern methods, and 29% of women reported using traditional methods of contraception. Logistic regressions in Bangladesh and Pakistan show that female educational attainment level is positively associated with the use of modern methods and the country’s most popular method of contraception but negatively associated with female sterilization, the most popular contraception method in India. Additionally, the socioeconomic status of the household is positively associated with the use of the most popular method of contraception in Pakistan but negatively associated with other modern methods. Contraception decision making if done by women in Bangladesh is positively associated with the use of both the most popular methods as well as modern methods of contraception. In India, the household's socioeconomic status and women’s age are positively associated with the use of modern contraception. Conclusion: For these countries to lower the population growth rate, achieve replacement-level fertility, and increase the use of modern contraception, they need to focus on relevant determinants that would help them achieve the desired results.