Traditional Contraceptive Methods Research Articles

Trends in contraceptive demands and unmet need for family planning in migrant population of Uttarakhand

Background: The knowledge of contraceptive use and unmet need is important to know the constraints for unmet need based on user perspective. The aim of the study was to find the prevalence of Contraceptive use, Contraceptive preferred and the Un-met demand for contraceptives. Methods: Married, non-pregnant women of reproductive age group (15-49 years) from the migrant population were interviewed by Census method using pre-designed and pre-tested instrument by cross-sectional survey. Operational definitions for unmet need for spacing, limiting and unfelt need used in the study were as per NFHS -4 findings and traditional methods of contraception like abstinence, withdrawal were included in Un-met need for contraceptive due to its very high failure rate. Results: 58.44% study subjects had ‘Ever Used FP’ and 56.78% are currently using FP methods. The CPR is 56.7% by ‘Any Method’ and 43.0% by ‘Modern method’. The method which is most popular is ‘Sterlisation 29% and 20.96% and ‘Others’ i.e. highly unreliable methods like coitus interruptus, calendar method etc. found high number of users. The reasons for non use were apprehension of complication/side effects in 39%) and inconvenience or the difficulties with modern contraceptive methods or lack of knowledge by 7.67% and 6.95% respectively, 16% were relied on traditional methods, such as periodic abstinence, withdrawal and herbal mixtures from traditional healers as well as LAM 8% for a FP method, all of which have high failure rate. Only 24.8% Women were decision maker regarding the time and type of contraceptive to be used. The unmet need was 29.7% out of which the unmet needs for spacing and limiting were 9.6 per cent and 20.1 per cent, respectivelyConclusions: The unmet need is high and can be addressed by removing the constraints such as poor accessibility to the knowledge thus removing apprehension for side effects, improve accessibility to resources and low decision-making autonomy.

Does the Use of Unreliable Contraceptive Methods Increase the Number of Abortions? Results from a National Survey of Women in the United States

ABSTRACTIn this study the authors assessed the association between the types contraceptive use (unreliable or traditional methods vs. modern methods) and number of abortions among a nationally representative sample of abortion patients in the United States from the Abortion Patients Survey 2008. Unadjusted and adjusted prevalence ratios were calculated to determine the association between unreliable contraceptive methods and number of abortions. Results from the unadjusted and adjusted prevalence ratios revealed that women who used modern methods of contraception were more likely to have had previous abortions compared to women who did not use contraceptives and those who used traditional methods of contraception. Implications for practice, policy, and the role of social workers are discussed.

The role of traditional contraceptive methods in family planning among women attending primary health care centers in Kano.

Background:Traditional contraceptive methods (TCMs) have been used by our ancestors for a long time in child spacing before the advent of the modern contraceptive methods but even with the introduction of the modern methods some women prefer and are still using TCMs.Aim:The aim of this study was to assess the utilization of traditional contraceptives in child spacing and its association with family size among women of child-bearing age attending primary healthcare centers in Kano.Materials and Methods:This was a cross-sectional study among 400 women attending primary healthcare centers in Kano. Their sociodemographic characteristics, number of children, knowledge, and use of traditional contraceptives were recorded on a pretested questionnaire.Results:The mean age ± standard deviation (SD) was 29.1 ± 6.22 years. The mean number of children (±SD) was 3.9 ± 2.27. A total number of 280 (70.0%) participants knew about TCMs, but only 147 (36.8%) used these methods and among those that used TCMs, herbal medicine was the most used method (n = 67, 45.6%). There was no statistically significant difference between the mean number of children of the respondents who used traditional contraceptives and those who did not (t = 0.382, df = 398, P = 0.703, 95% confidence interval:−0.374–0.555). Educational status was significantly associated with the use of traditional contraceptives (χ2 = 8.327, P = 0.005).Conclusion:There was more knowledge of traditional than modern contraceptive methods. Herbal medicine was the most commonly used method. There was poor utilization of the modern contraceptive methods and fair utilization of the TCMs. The study showed no clear benefit of traditional contraceptive usage over its nonuse in reducing family size.

The impact of media on behaviour: Evidence from television coverage expansion and declining fertility in Indonesia

AbstractThe media is increasingly recognized as playing an important role in affecting the behaviour of individuals. In this article, we examine the effect of an expansion of private television broadcast on fertility in Indonesia. Our district fixed effects estimation results show that increasing the share of population with access to private television by one‐standard deviation—from a 78% coverage to a universal coverage—reduces crude birth rate by 6.2%, equivalent to 190,000 fewer births. We find evidence that television causes an increase in the use of modern contraceptives, but no change in the use of traditional contraceptives. The finding that expanding television coverage increases the demand for modern contraceptives shows that policy‐makers need to ensure that modern contraceptive is easily accessible.

Pakan banyu (Croton argyratus Blume) stembark ethanol extract effectiveness to total spermatogenic cells of white male rats (Rattus norvegicus)

Stembark of Pakan Banyu ( Croton argyratus Blume ) empirically used as traditional contraception. The stembark contained active substances as steroids, saponins and alkaloids tannins alleged antifertillity for men. The purpose of this study was to demonstrate the potential of Pakan Banyu stembark ethanol extract to the total number of spermatogonium cells, primary spermatocytes, spermatids and spermatozoa in male rats. This study was an experimental research design posttest only control group design using 20 male rats into 4 groups of 5 mice. The control rats were used in treatment group, the rats were given the pakan banyu stembark extract at a dose of 100, 200 and 500 mg / kg with 0.5% CMC Na suspending agent. The treatment was given orally for 15 days at the 16 th days surgery was done to the testicles organs, then microanatomy preparations were made using paraffin method and using HE colour. Analysis of data using One-way ANOVA and Kruskal Wallis with 95% confidence level. The results showed that there is no effect of Pakan Banyu stembark ethanol extract against spermatogonium cells, primary spermatocytes, spermatids and spermatozoa.

Income shocks, contraceptive use, and timing of fertility

This paper examines the relationship between income shocks and fertility decisions. Using panel data from Tanzania, we estimate the impact of agricultural shocks on pregnancies, births, and contraception use. The likelihood of pregnancies and childbirth are significantly lower for households that experience a crop shock. Furthermore, women have significantly higher contraception use after crop losses. The increase in contraceptive use comes almost entirely from traditional contraceptive methods, such as abstinence and the rhythm method. We argue that these changes in behavior are the result of deliberate decisions of the households rather than the shocks' effects on other factors that influence fertility, such as women's health status, the absence or migration of a spouse, the dissolution of partnerships, or the number of hours worked. We also show that, although traditional contraceptives have low overall efficacy, households with a strong incentive to postpone fertility are very effective at using them.

Intimate partner violence and contraception in Pakistan: Results from Pakistan Demographic and Health Survey 2012–13

This study examined the association between reports of IPV and the use of contraceptives among a sample of 658 women from the Pakistan Demographic and Health Survey 2012–13. Sample characteristics, bivariate associations, and multivariate analyses were conducted. Three types of IPV were examined as predictors of different types of contraceptive use/intention. Results from multinomial logistic regressions indicated that if lifetime prevalence of physical violence, past-year physical violence, and emotional violence increased by one unit each, the relative risk for using modern methods of contraception increased significantly by a factor of 3.15, 2.75 and 3.44 respectively. If lifetime prevalence of physical violence and past-year physical violence increased by one unit each, the relative risk for using traditional methods of contraception increased significantly by a factor of 4.02 and 2.34. If lifetime prevalence of physical violence and emotional violence increased by one unit each, the relative risk for intending to use contraceptives increased significantly by a factor of 2.42 and 1.97 respectively. Policy and practice implications are discussed.

Abortion as a Process of Birth Limiting Rather than Spacing among Educated Urban Couples in West Bengal, India

D espite the high level of usage of traditional contraceptive methods, particularly among the urban and educated couples, the eastern Indian state of West Bengal has achieved the replacement level of fertility. This paper attempts to understand the patterns, dynamics of contraceptive use and associated outcomes (method failure and abortions) during the inter-pregnancy intervals among the urban educated-couples who ever used any traditional contraceptive methods in Howrah, West Bengal using both quantitative and qualitative approach. The findings showed that the use of traditional contraceptive methods was high due to lower comprehen- sive knowledge and misconceptions about modern methods, particularly among men. High prevalence of unintended pregnancies and induced abortions was observed, particularly for traditional contraceptive users. The calculated unintended pregnancy rate and ratio in the study population were 235 per 1,000 pregnancies and 570 per 1,000 women, respectively. Similarly, the calculated rate of induced abortion was 78 per 1,000 pregnancies with an abortion ratio of 99 per 1,000 live births. Due to the motivation to have small families, couples if they had at least one surviving child, opted to regulate their unintended pregnancies with induced abortion, especially among only traditional contraceptive users. This indicates that women considered abortion as a process of birth limiting rather than spacing to maintain the desired family size and the choice of contraceptives determining number of pregnancies.

Pregnancy risk during menstrual cycle: misconceptions among urban men in India

BackgroundIn India, where men take most decisions in the family, it is useful that they have adequate knowledge about pregnancy risks during women’s menstrual cycles. Since traditional contraceptive methods are still employed by a large population in India, the knowledge regarding the pregnancy risk during the menstrual cycle is indispensable. This research paper attempts to assess the knowledge among urban men in Uttar Pradesh, India about the fertile window of the menstrual cycle; it also attempts to discover the rationales behind the misconceptions about the concept.MethodsThis study utilizes the baseline data of the Measurement, Learning, and Evaluation project for the Urban Reproductive Health Initiative in Uttar Pradesh. Descriptive Statistics has been used to assess the prevalence of knowledge among urban men regarding the concept. Using the Discriminant Analysis, we also investigate the rationales behind the misconceptions among urban men about the concept.ResultsOnly one-fifth of the men have the correct knowledge about the concept. Further, we find that education, societal perception, caste, and spousal discussion about the reproductive issues are the primary factors affecting the knowledge about the pregnancy risk during the menstrual cycle.ConclusionsThere is an urgent need for sex education in the region to make the urban men more educated about the reproductive process of women; this may reduce unwanted births and abortion due to an unwanted pregnancy as well. The study promotes the higher education and motivates couples to discuss the reproductive health issues among them. In this manner, we can provide better reproductive health to the women of urban India.

Prospects for Fertility Decline in Africa

Prospects for Fertility Decline in Africa

Contemporary Use of Traditional Contraception in sub-Saharan Africa.

In this chapter we use DHS data to explore patterns of traditional contraceptive method use in sub-Saharan Africa. In so doing we must work with the assumption that any bias in the reporting of these methods is fairly constant across categories of women and that it will not distort comparisons across groups. While this assumption imposes an important limitation on our study smaller studies on traditional methods tend to corroborate the differentials documented here. For example in the detailed survey conducted in Ouagadougou in 2010 better-educated women and women born in the capital are more likely to use periodic abstinence (Rossier Senderowicz and Soura 2014) as shown in the DHS data for the same city and year. The characterization of these informal methods as “traditional” is somewhat misleading. “Traditional” contraception implies a method used in the past and likely to be abandoned with the spread of modern contraception and the advance of socioeconomic development (Johnson-Hanks 2002; Basu 2005). This term may have been appropriate for describing the Western fertility transition as when modern methods were introduced in these countries traditional methods had been in use there for a long time and were indeed largely replaced by newer methods. In contemporary developing countries however it is not clear how widespread the practices of periodic abstinence and withdrawal were prior to the introduction of modern contraception and thus the designation of “traditional” may be less accurate in these settings. Further it is uncertain whether the pattern of method switching seen in Western countries will play out similarly in these regions. A number of recent studies have questioned the appropriateness of considering these informal methods as traditional as they have found that better-off urban women are the greater “traditional” method users in Cameroon (Johnson-Hanks 2002) India (Basu 2005) and Ghana (Machiyama and Cleland 2014). (excerpt)

Associations between women's perceptions of domestic violence and contraceptive use in seven countries in West and Central Africa

ObjectivesThis study examined associations of women’s attitudes toward domestic violence (DV) and contraceptive use in West and Central Africa. Study designWe used data from the Multiple Indicator Cluster Surveys for women in seven countries in West and Central Africa (2009–2011, n=80,055). Main outcome measureWe measured contraceptive use as none, traditional, or modern contraceptives.DV approval was measured as no, low, or high tolerance of wife beating. Multinomial logistic regression estimated odds of using traditional or modern methods versus none, adjusting for age, education, wealth, residence, parity, marital structure, spousal age-difference, and religion. ResultsMany women had no or low DV tolerance (41%, 44%, respectively); most used no contraception (81%). In adjusted results, women with low DV tolerance had lower odds of using traditional contraceptive methods (odds ratio, OR=0.87; 95% confidence interval, CI: 0.78–0.98) or modern methods (OR=0.86; 95% CI: 0.78–0.95) compared to women with no tolerance. Women with high DV tolerance had 28% lower odds of traditional contraceptive use (95% CI: 0.60–0.90), and 38% lower odds of modern contraceptive use (95% CI: 0.59–0.88) compared to women with no tolerance. ConclusionThe high prevalence of DV approval may threaten the success of programs aimed at improving women’s reproductive health, including contraceptive use.

Factors Behind the Preference in Contraceptives Use Among Non-pregnant and Sexually Active Women in Benin Republic

Despite the amounting interest in improving access to and utilization of family planning methods, contraceptives prevalence rates remain low in Benin Republic. Rates of increase in contraceptives’ prevalence are low and underlying risk factors for use and non-use are not well known. This study investigates similarities and differences in factors associated to contraceptive use by type of method among 6,237 women recruited in 2011/2012 BDHS data using multiple logistic regression models. Most women (78.9%) involved in the current study did not use any contraceptive during their last sexual activity, 13.6% were currently using modern contraceptive methods and 7.8% was using traditional contraceptive methods. Significant covariates for modern contraceptive use were: female education, discussion about FP, number of living children, fertility preference, marital status, household wealth index, sex of household head, religious membership, and the area of residence. Concerning traditional methods use, they were: women’s ethnic background, discussion about FP, fertility preference and household wealth index. To improve contraceptives usage especially modern contraceptives, findings suggest, among other: fighting against sociocultural barriers; ensuring female’s formal education till secondary; encouraging good health behaviours (ANC follow-up, institutional delivery by skilled attendant, enhancing PNC visits) for women during childbirth and to increase FP education during those check-ups.

Son Preference and Family Limitation in Pakistan: A Parity- and Contraceptive Method-Specific Analysis.

Son preference exerts a strong influence over contraceptive and fertility decisions in many South Asian countries. In Pakistan, where fertility remains high and contraceptive use low, research on son preference has been limited. Data from Pakistan Demographic and Health Surveys conducted in 1990-1991, 2006-2007 and 2012-2013 were used to examine potential indicators and outcomes of son preference. Descriptive analyses looked at sex composition preferences of men and women, as well as the sex ratio at last birth. Multivariate logistic regression analyses examined parity progression by birth order, while multinomial logistic regression was used to identify associations between sex composition and use of permanent, temporary and traditional contraceptive methods. Parity progression and choice of contraceptive method are increasingly associated with the sex composition of children. Many respondents wanted at least two sons, though most also wanted at least one daughter. Analyses suggest that the prevalence of modern contraceptive use among parous women would have been 19% higher in 2012-2013 in the absence of son preference. Permanent method use was extremely low among women with no sons and increased significantly with number of sons. The association between number of sons and use of temporary methods was weaker, while son preference had little relationship with traditional method use. The association of son preference with parity progression and modern contraceptive use has become stronger in Pakistan. Continuation of the fertility transition may be difficult unless the degrees of differential stopping behavior and differential contraceptive use decline.

Religious distributions of knowledge and practices of sexual behaviors among young married women in India

Background: Sexually transmitted infections (STIs) remain one of the determinants of HIV transmission in India. Most interestingly, women have little knowledge of their basic physiological functions, which is a risk factor for STI and HIV. Objectives: This study aimed to find the sexual behaviors and practices among young married women of various religions of the country and their knowledge and attitude toward sexuality. Materials and Methods: The data source for this study was the third round of the National Family Health Survey-3, conducted in 2005-2006. Bivariate analysis and Chi-square test were performed. Results: Around 5% of women had known that they were in ovulation period only during their periods. It was also found that 30.8% of women did not have any knowledge about their ovulation. Hindu women (5.4%) acquired more knowledge about their ovulation period during their first menstruation as compared to the other religions. Knowledge of ovulation after completion of the period was 26.8% among Muslims, 23% among Hindu, and 19.5% among other religious communities. The use of the traditional contraceptive method was high among Muslims compared to the non-Muslims. More than 14% of women had experienced their first sexual intercourse before marriage. Conclusion: There is an urgent need for educating young women on the promotion of safe sex and provision of knowledge on physiological functions of the human body.

Evaluation of the effectiveness of selected natural fertility symptoms used for contraception: estimation of the Pearl index of Lady-Comp, Pearly and Daysy cycle computers based on 10 years of observation in the Polish market.

Cycle computers are medical devices which use sophisticated statistical methods in addition to a comprehensive on-board database. Their main function is to precisely indicate the fertile and infertile phases of the menstrual cycle, based on daily basal body temperature measurements. A recent medical research program aimed at evaluating the EFFECTIVENESS of cycle computers for contraceptive purposes was conducted. This study was conducted between May and June 2016 on 3,450 Polish women. The Polish distributor sent an anonymous questionnaire to the participants. To date, 361 women, representing 17,322 cycles have returned accurately completed questionnaires. In the resultant group only 4 unintended pregnancies were observed, resulting in a Pearl index of 0.4989. This suggests that fewer than 5 in 1000 women, who use a cycle computer correctly over a period of one year, may become pregnant unintentionally. This result is slightly better than the results from 2010, when the Pearl index was 0.64. The results obtained from the study indicate that the effectiveness of cycle computers for contraceptive purposes is comparable with other methods, such as hormonal contraception, and therefore cycle computers can be recommended for women who either cannot use or do not wish to use traditional contraception. These results confirm the effectiveness of using natural fertility symptoms, such as basal body temperature changes in the context of cycle computer technology for the purposes of contraception.

Scale up use of family planning services to prevent maternal transmission of HIV among discordant couples: a cross-sectional study within a resource-limited setting.

BackgroundIntegration of family planning services (FPS) into human immunodeficiency virus (HIV) care for HIV-infected women is an important aspect of the global prevention of mother-to-child transmission (PMTCT) strategy. We assessed the integration of FPS into routine care of HIV-infected mothers by evaluating the uptake and barriers of contraception and PMTCT services.MethodsWe conducted an interventional study using the interrupted time series approach in the health care facilities located in Yaounde, Cameroon. First, structured questionnaires related to family planning use, PMTCT services use, and infection risk of the sexual partner were administered to the first trimester pregnant women who were HIV infected and living with uninfected partners. Second, 2 weeks before the delivery date, the women were interviewed according to the prior counseling interventions received, in order to assess their behavior on FPS, antiretroviral therapy (ART) use, delivery option, and infant nourishment to be adopted. P-values below 0.05 were considered statistically significant in the statistical analyses.ResultsOf 94 HIV-infected women, 69% were stable couples. Only 13% of women had attended FPS before conception. Although the vast majority were knowledgeable about modern and traditional contraception methods, only 19% had experienced effective contraceptive methods. However, 66% preferred condom use, 45% having three children still expressed a desire to conceive, while 44% reported abortions, 65% had tried to avoid the current pregnancy, and 12% of women were ART naïve. Several predictors such as education, abortion rate, unplanned pregnancies, and partners’ decision were associated with the nonuse of effective contraceptive methods. Moreover, barriers including sex inequity, lack of partner support, ART shortages, and lack of HIV viral load monitoring were prevalent among the participants (P=0.001). However FPS use, ART compliance, and safe options to PMTCT significantly increased after the educational counseling interventions (P=0.001).ConclusionScaling up the FPS by incorporating routine PMTCT services into reproductive health care should contribute to preventing both horizontal and vertical transmission of HIV.

Impact of Economic Crisis to Family Planning Realination on Poor Household in Banjarsari District, Surakarta

This study is carried out in Nusukan, Banjarsari, Surakarta. The problems that are related to economic crisis in Indonesia are the supply of contraception, the weakening of people purchasing power so they influence the realization of family planning program. The goals of the study are: to know the supply of contraception for poor household, to study the influence of the effect of economic crisis for the participant of family planning, to study the change of birth control and its effective strategy and to know the quality of family planning service. The data are collected using observation, and questionnaire. The study takes the area in which it has more productive couple, the percentage of poor families and the prosperous families I that belong to productive couple whose age 20 to 49 years old, at least they have two children, and participant of family planning or ever followed it. The result of the study shows that 82% respondents can get contraception easily before and at economic crisis. It is one of the important factors, for which the participant of family planning is still high. Although the economic crisis influences the price of contraception and family Income, it does not affect the participant of family planning. 87% respondents participate actively the family planning. This shows that the people have realized the importance of family planning program. There is an impact of economic crisis for the change of the ways of birth control. 38% respondents have changed over their strategy from modern to traditional contraception and the contrary, and from modern contraception to the other one. Some of them are abstention. The level of the people adaptation is high enough. They use various ways to prevent of being pregnant. 92% respondents do not want to be pregnant. If it happens an unwanted pregnancy, 15% of the respondents will abort their pregnancy. This is the challenge for the officers and the government to supply safe and accurate contraception and to give clear explanation about the effect of abortion from healthy and religious aspect. The service of family planning by the government and private institution is good enough (81%). Respondents can get contraception (especially tablet) easily; cheap and free of charge, but the other ones such as spiral is more difficult because it is more expensive and limited.

Adolescents and Long-Acting Reversible Contraception: Lessons from Mexico

Objectives We describe current use of long acting reversible contraception LARC (tier 1), hormonal (tier 2), barrier and traditional contraceptive methods (tier 3) by adolescent women in Mexico. We test whether knowledge of contraceptive methods is associated with current use of LARC. Methods We used the 1992, 1997, 2006, 2009 and 2014 waves of a nationally representative survey (ENADID). We used information from n = 10,376 (N = 3,635,558) adolescents (15–19 years) who reported ever using any contraceptive method. We used descriptive statistics and logistic regression models to test the association of knowledge of method tiers with use of tier 1 (LARC) versus tier 2, tier 3, and no contraceptive use. Results Over time, LARC use in the overall sample was flat (21 % in 1992, 23 % in 2014; p = 0.130). Among adolescents who have had a pregnancy, LARC use has increased (24 % in 1992 to 37 % in 2014). Among adolescents who did not report a pregnancy, current LARC use has remained low (1 % in 1992 and 2 % in 2014). We found positive association between LARC use and knowledge of tier 1 methods. In the overall sample LARC use is strongly correlated with exposure to marriage compared to use of tier 2 or tier 3 methods. Discussion Among adolescents in Mexico who are currently using modern methods, LARC use is relatively high, but remains primarily tied to having had a pregnancy. Our study highlights the need to expand access to LARC methods outside the post-partum hospital setting.

Income Shocks, Contraceptive Use, and Timing of Fertility

This paper examines the relationship between household income shocks and fertility decisions. Using panel data from Tanzania, we estimate the impact of agricultural shocks on pregnancy, births, and contraception use. We estimate individual level fixed effect models to account for potential correlation between unobservable household characteristics and both shocks and decisions on fertility and contraceptive use. The likelihood of pregnancies and childbirth are significantly lower for households that experience a crop shock. Furthermore, women significantly increase their contraception use in response to crop losses. We find little evidence that the response to crop loss depends on education or wealth levels. The increase in contraceptive use comes almost entirely from traditional contraceptive methods, such as abstinence, withdrawal, and the rhythm method. We argue that these changes in behavior are the result of deliberate decisions of the households rather than the shocks’ effects on other factors that influence fertility, such as women’s health status, the absence or migration of a spouse, the dissolution of partnerships, or the number of hours worked. We also show that, although traditional contraceptives have low overall efficacy, households with a strong incentive to postpone fertility are very effective at using them.