Unmet Need For Spacing Research Articles

Spatial Heterogeneity and association between the survey-based Women’s Empowerment Index (SWPER) and unmet need for birth spacing in sub-Saharan Africa

BackgroundUnmet need for birth spacing can significantly impact maternal and child health outcomes, leading to unintended or mistimed births, neonatal mortality, pregnancy loss, induced abortions, small-sized births, and malnutrition. Considering the role of women empowerment in women’s sexual and reproductive health, we examined the association between the survey-based women's empowerment index (SWPER) and unmet need for spacing in sub-Saharan Africa (SSA).MethodsWe used data from the Demographic and Health Surveys of 21 in SSA conducted between 2015 and 2021. In this study, the unit of analysis was women of reproductive age (15 to 49 years) who were married or living together and required family planning during the survey period. Multilevel logistic regression was fitted to examine the association between SWPER and the unmet need for spacing. The results were presented using adjusted odds ratios (AORs) with 95% confidence intervals (CIs).ResultsThe hotspot countries for unmet need for birth spacing were Angola, Benin, Liberia, Mauritania, and Sierra Leone. The findings showed that with the empowerment indicators, women with high attitude to violence (disagreement or rejection of violence) (AOR = 0.95; 95% CI 0.91, 0.99), and women with high decision-making (AOR = 0.90; 95% CI 0.85, 0.95) exhibited lower odds of unmet spacing need relative to women with low attitude to violence and those with low decision making. Women with high autonomy (AOR = 1.32; 95% CI 1.25, 1.39) were more likely to experience unmet need for spacing compared to those with low autonomy. ConclusionUnmet need for spacing has been linked to indices of women's empowerment such as attitudes toward violence, independence, and decision-making. Organizations such as UNICEF, UNFPA, and the Bill & Melinda Gates Foundation should consider incorporating SWPER indicators when planning interventions to address the high unmet need for spacing among women in SSA. Additionally, various governments and aid organizations must give women's empowerment a high priority as a tactical intervention strategy to increase access to contraception in the countries considered in this study. These programmes would contribute to attaining SDGs 3.1 and 3.7.

Determinants of advanced age pregnancy in Ethiopian; multi-level analysis of Ethiopian demographic health survey 2016.

Advanced maternal-age pregnancy has become a serious public health problem in both developed and developing countries due to adverse birth outcomes for the mother, fetus, or newborn. However, there are limited studies conducted to identify determinants of advanced-age pregnancy in Ethiopia. Therefore, this study aimed to assess individual and community-level determinants of advanced age pregnancy in Ethiopia. This study was based on 2016 Ethiopian Demographic and Health Survey data. Three thousand two hundred ninety-two weighted samples of pregnant women were included in this analysis. A multilevel logistic regression model was conducted to assess the determinants of advanced-age pregnancy among the study participants in Ethiopia. maternal age at first birth (AOR = 4.05, 95% CI: 1.77-9.22), level of maternal education [primary education 2.72 times (AOR = 2.27, 95 CI: 1.55-4.76) and secondary and above education (AOR = 5.65, 95% CI: 1.77-17.70)], having a history of alcohol (AOR = 11.8, 95% CI: 5.71-24.42), parity (AOR = 3.22, 95% CI: 2.69-3.84), number of household member (AOR = 1.22, 95% CI: 1.05-1.41), family planning unmet need for spacing of pregnancy (AOR = 4.79, 95% CI: 2.63-8.74), having sons/daughters elsewhere (AOR = 1.89, 95% CI: 1.22-2.94), had higher community poverty level (AOR = 2.37, 95% CI: 1.16-4.85), those had higher community unmet need for family planning (AOR = 5.19, 95% CI: 2.72-9.92) were more likely to have advanced age pregnancy. Whereas Living in an Emerging region (AOR = 0.29, 95% CI: 0.14-0.59) and living in a metropolitan city (AOR = 0.03, 95% CI: 0.03-0.38), were less likely to have advanced age pregnancy. increased Maternal age at first birth, level of maternal education, history of alcohol drinking, increased number of parity and household members, family planning unmet need for spacing, had sons/daughters elsewhere, had higher community poverty level, those had higher community unmet need for family planning positively, whereas living in the emerging region and living in metropolitan's city was negatively affect advanced age pregnancy. Help women to have informed decision-making and create platforms to women have special care during this age of pregnancy. Empower women on family planning and socioeconomic status.

Determinants of unmet need for modern contraceptives in Ethiopia

ObjectiveTo identify the determinants of the unmet need for modern contraceptives in Ethiopia.DesignCommunity-based cross-sectional study.SettingEthiopia.ParticipantsA group of 6636 women of reproductive age (15–49 years) who were sexually active were included...

Changes in discourse on unmet need for family planning among married women in India: evidence from NFHS-5 (2019–2021)

Unmet needs for contraception in India have declined over time but the rate has not been uniform among women across geographies and socio-economic strata. Identifying the characteristics of women in communities where unmet need is still high is important to devise appropriate strategies to ensure access and uptake of modern contraceptive methods. The current study examined whether there was a national decline in unmet need over time and if regional disparities exist in unmet need. Demographic variations in unmet need based on factors such as maternal age, education, religion, caste, wealth index quintile, family size, and access to antenatal care (ANC) were also documented. Our approach was to document the prevalence of total unmet need for family planning and unmet need for spacing among married Indian women and quantify variability based on socio-economic and demographic drivers within a hierarchal framework, thus providing both macro and micro perspectives. We used data from the fourth and fifth rounds of the National Family Health Survey (NFHS) collected from all the States and Union Territories (UTs) in India. Quantile regression analysis and multilevel regression techniques were used to understand the predictors for the total unmet need for family planning and the unmet need for spacing. Results show a considerable decline in the prevalence of unmet need for family planning in India from NFHS-4 to 5 (from 12.9 to 9.3%) in the last six6 years. The north-eastern states show a significant reduction in unmet need for family planning in Manipur (17.8%), Nagaland (13.5%), and followed by Sikkim (9.1%). The predictors such as years of schooling, place of residence, caste, religion, wealth quintile, number of antenatal care (ANC) visits, and children ever born have a significant association with unmet needs for family planning and spacing among married women in India. There is a significant association between years of schooling with the total unmet needs for family planning at (q25) quantiles and the unmet need for spacing at (q25, q50) quantiles. Results reveal that the demand for unmet need for spacing and limiting was the highest among the women in the age categories 15–19 (17.8%) and 20–24 (17.3%). The demand for limiting was the highest (6.8%) among Muslim women. Across wealth quantile categories, the overall unmet demand (11.4%) for spacing and limiting was the highest among the women in the lowest socioeconomic groups. We conclude that greater access to frontline health workers among young wives, and significant investment in education in general, will continue to reduce the unmet needs for family planning in India.

Women empowerment domains and unmet need for contraception among married and cohabiting fecund women in Sub-Saharan Africa: A multilevel analysis based on gender role framework.

Low women empowerment, is a known contributing factor to unmet needs for contraception by limiting access to health services through negative cultural beliefs and practices. However, little is known about the association between unmet needs and domains of women empowerment in Sub-Saharan African (SSA) countries. Hence, this study aimed at assessing the influence of women empowerment domains on the unmet need for contraception in the region using the most recent Demographic and Health Survey (DHS) data (2016-2021). The data for the study was derived from the appended women's (IR) file of eighteen SSA countries. A weighted sample of 128,939 married women was analyzed by STATA version 16. The Harvard Institute's Gender Roles Framework, which comprised of influencer, resource, and decision-making domains was employed to identify and categorize the covariates across three levels. The effects of each predictor on the unmet need for spacing and limiting were examined using a multivariable multilevel mixed-effect multinomial logistic regression analysis. Adjusted relative risk ratio (aRRR) with its corresponding 95% confidence interval was used to declare the statistical significance of the independent variables. The pooled prevalence of unmet needs for contraception was 26.36% (95% CI: 24.83-30.40) in the region, with unmet needs for spacing and limiting being 16.74% (95% CI: 16.55, 17.02) and 9.62% (95% CI: 9.45, 12.78), respectively. Among variables in the influencer domain, educational level, family size of more than five, parity, number of children, attitude towards wife beating, and media exposure were substantially linked with an unmet need for spacing and limiting. Being in the poorest wealth quintile and enrollment in health insurance schemes, on the other hand, were the two variables in the resource domain that had a significant influence on unmet needs. The overall decision-making capacity of women was found to be the sole significant predictor of unmet needs among the covariates in the decision-making domain. Unmet needs for contraception in SSA countries were found to be high. Reproductive health program planners and contraceptive service providers should place due emphasis on women who lack formal education, are from low-income families, and have large family sizes. Governments should collaborate with insurance providers to increase health insurance coverage alongside incorporating family planning within the service package to minimize out-of-pocket costs. NGOs, government bodies, and program planners should collaborate across sectors to pool resources, advocate for policies, share best practices, and coordinate initiatives to maximize the capacity of women's decision-making autonomy.

Magnitude of unmet need for family planning and associated factors among women in the extended postpartum period in Dabat district, Northwest Ethiopia. evidence from Dabat demographic health surveys

BackgroundDue to additional roles and emotional changes that occur during postpartum period, women use contraceptives differs from other times in their life. However, there is limited information about the unmet need for family planning (FP) among women in the extended postpartum period in the study area. Therefore, this study aimed to assess magnitude of unmet need for family planning and associated factors among women in the extended postpartum period in Dabat district, Northwest Ethiopia.MethodsA secondary data analysis was performed using the Dabat Demographic and Health Survey 2021. A total sample of 634 women during the extended postpartum period was included in this study. Stata version 14 statistical software was used for data analysis. Descriptive statistics were described using frequencies, percentages, mean, and standard deviation. Multicollinearity was tested using the variance inflation factor (VIF) and we computed Hosmer and Lemeshow goodness of fit. Both bivariable and multivariable logistic regression analyses were carried out to determine the association between independent variables and outcome variable. Statistical significance was declared at a p-value ≤ 0.05 with a corresponding 95% confidence interval.ResultsThe overall unmet need for FP during the extended postpartum women was 42.43% (95% CI: 38.62, 46.33), of which 33.44% was unmet need for spacing. Place of residence (AOR = 2.63, 95%CI: 1.61, 4.33), place of delivery (AOR = 2.09, 95%CI: 1.35, 3.24), and availability of radio and or TV (AOR = 1.58, 95% CI: 1.22, 2.13) were significantly associated with unmet need for family planning.ConclusionThe magnitude of unmet need for family planning among women during the extended postpartum period in the study area was high when compared to the national average and the United Nations sphere standard of unmet need for family planning. Place of residence, place of delivery, and availability of radio and or TV were significantly associated with unmet need for family planning. Hence, the concerned bodies are recommended to promote intuitional delivery and give spatial attention to those who are residing in rural areas and to those who have had no media exposure in order to reduce the unmet need for family planning among postpartum women.

Unmet need and intention to use as predictors of adoption of contraception in 10 Performance Monitoring for Action geographies

The determinants of fertility typically feature demand as the key motivation driver for contraceptive use. Yet relatively little is known about the extent to which demand for contraception predicts future contraceptive use, primarily due to the lack of longitudinal data that captures these measures at different time points. Two ways in which demand is often measured are unmet need and intention to use. Despite its intended use as a population measure, unmet need is commonly used in individual-level analyses and as a marker for individual-level demand for contraception. Few studies have assessed the extent to which unmet need predicts or reflects women's true latent demand as demonstrated by their future contraceptive use; the same is true for intention to use contraception in the future. We expand on previous research to assess whether and the degree to which unmet need and intention to use contraception predict adoption of contraception within a year, among nonusers in ten representative geographies using Performance Monitoring for Action (PMA) data. Findings show that in nine of ten sites, intention to use within a year was significantly associated with subsequent adoption, while in eight of ten sites, unmet need for spacing or limiting was not associated with adoption. Our results are important for programs as they try to identify true dynamic demand for contraception.

Women’s socio-demographic and cultural factors influencing unmet need for family planning in rural areas of The Gambia: Evidence from a population-based analytical cross-sectional study

Background: Reproductive health is a critical component of overall health and development. Unmet contraceptive needs are one of the regularly cited measures of the efficacy of family planning (FP) initiatives. This study set out to determine the magnitude and associated factors of unmet need for FP among women of reproductive-aged (15-49 years) in the provincial areas of The Gambia. Methods: The study used a community-based cross-sectional analytical design. A multistage sampling strategy, comprising simple random and cluster sampling, was utilized to obtain a sample of 643 childbearing women (15-49 years) from rural Gambia's sampled clusters. Data collection was conducted using pre-tested structured interview questionnaires. The association was examined using chi-square/fisher's exact test with a significance level of p<0.05. Binary logistic regression analysis was performed to examine the effect of sociodemographic and cultural determinants on unmet FP need, with corresponding computed adjusted odds ratios (aOR). IBM SPSS version 24 was used for data entry and analysis. Results: The unmet need for FP among the study participants was 25.2%; unmet need for spacing and unmet need for limiting was 17.4% and 7.8%, respectively. The total demand for FP was 59.4%, while the satisfaction of demand for FP was 57.6%. The significant predictors of unmet need for FP were woman’s age at first pregnancy (aOR=0.899, p=0.033), LGA of origin (aOR=0.240, p=0.001) and frequency of using contraceptives (aOR=1.587, p=0.032). Conclusion: The present study demonstrated a high unmet need for FP among rural women in The Gambia, with the most often cited reason for non-use being fear of side effects. Hence, it is necessary to concentrate FP services for rural populations, stressing education regarding contraceptive side effects, service quality, and gender equality. Additionally, the study suggests that male participation and religious leaders' involvement in FP programs be strengthened and mainstreamed, as well as the establishment of a communication program that specifically promotes inter-spousal communication.

Spatial heterogeneity and socio-economic correlates of unmet need for spacing contraception in India: Evidences from National Family Health Survey, 2015-16

BackgroundThe unmet need for spacing (UNS) is one of the key concerns of family planning programme in India despite the country achieving the replacement level of fertility. ObjectivesThe current study aims to identify spatial heterogeneity and factors associated with the unmet need for Spacing (UNS) in India. Data and methodsThe present study used data from the National Family and Health Survey, 2015–16. The outcome variable was the unmet need for contraception for delaying subsequent births for two or more years (UNS), and the explanatory variables were socio-cultural and demographic factors. The current study included 56,742 currently married women (aged 15–49 years) who had demand for spacing during the survey. Descriptive statistics, bivariate with chi-square significance test, spatial natural break technique, and multivariate logistic regression were used to accomplish the study objectives. ResultsAlmost 51% of women were not using contraception to delay their next birth in India. It was found high across all socio-economic and demographic groups except higher-level education and richest groups. Spatial analysis confirms 248 districts had remarkably high UNS (68% and above). Findings of the multivariate analysis suggest women's education, autonomy, and household wealth status were important factors in reducing UNS. The likelihood of UNS was noticeably higher among women with parity three or more (AOR: 1.42 [1.3–1.55]) compared to their counterparts. Similarly, it was found 44% (AOR: 1.44[1.38–1.51]) more likely among the OBCs than the General caste. It was found 1.24 times more likely in rural (AOR: 1.24[1.19–1.30]) compared to urban. Among the geographical regions, it was found comparatively high in the South (AOR: 6.19 [5.76–6.65]) compared to other regions. ConclusionDealing with the UNS necessitates increasing women's education and autonomy, planning to make client choice-based services more accessible, and promoting birth-spacing focused family planning policies.

Factors associated with unmet need for family planning in sub-Saharan Africa: A multilevel multinomial logistic regression analysis.

More than one out of every ten married women in the world, and one out of every five women in Africa, have unmet family planning needs. Despite this, studies concerning sub-Saharan Africa as well as the community-level factors that may influence the unmet need for family planning are scarce. To assess factors associated with unmet need for family planning in sub-Saharan Africa. This study used the nineteen demographic and health surveys (DHS) conducted between 2015 and 2020 in sub-Saharan Africa. A total weighted sample of 175, 820 women of reproductive age who were married during the survey was used for this study. To assess the factors associated with unmet need for family planning, I have employed a multilevel multinomial logistic regression model. After selecting variables using the bivariable analysis, a multivariable model was fitted. Finally, an adjusted relative risk ratio with its 95% Confidence Interval was reported and variables with a p-value less than 0.05 were declared to be significant predictors of unmet need for family planning. The overall prevalence of unmet need for family planning in sub-Saharan Africa was 23.70%, of which unmet need for spacing and limiting was 15.81% and 7.90% respectively. In the multivariable multilevel multinomial model, women's age, women's education, age at cohabitation, heard about family planning through media, parity, number of under-five children, and knowledge about modern contraceptive methods were among the individual-level factors that were associated with both the unmet need for spacing and limiting. Place of residence, community level of women illiteracy, and region were among the community-level factors that were associated with both unmet needs for spacing and limiting. Household size and visiting the health facility in the last 12 months were associated with unmet need for spacing only and husband education was associated with unmet need for limiting only. Unmet need for family planning in sub-Saharan Africa was high. Both individual and community level factors were associated with both unmet need for spacing and limiting. Therefore, it is better to consider interventions at both individual and community levels.

Unmet need for family planning in Pakistan: prevalence and factors influencing unmet need among women of reproductive age.

Introduction: Despite government efforts, the contraceptive prevalence rate is low in Pakistan. UMNFP still exists in Pakistan like other low-middle income countries. Our study aims to determine the prevalence and factors affecting the unmet need for family planning in Pakistan.
 Methods: The analysis was performed using PDHS 2017-18 data set. In our study, 11847 women of reproductive age were included out of 14498.
 Result: In binary logistic regression, age, wealth index, and the number of living children found statistically significant. UMNFP was lower in women of older age (45-49) in contrast to younger women of age between 15-19 years. Regarding the women's socioeconomic status, those who belong to the middle socioeconomic class had a lower UNMFP in contrast to the poorest. UMNFP was 1.7 times more in women having more than three children in contrast to women who had less than or equal to three children. However, women's age, women socioeconomic status, and working status of women were found to be statistically significant with an unmet need for spacing in the multinomial model. In addition, the age of women, region, number of living children, socioeconomic status, and knowledge of family planning was found to be statistically significant with an unmet need for limiting.
 Conclusion: In the light of our study, overall unmet need is lower in older age and richer wealth quintile while UNMFP is high in women who had more than three children. Policymakers should design interventions to target high-risk populations to overcome the issue of rapid population growth.

Unmet need for family planning among reproductive-age women living with HIV in Ethiopia: A systematic review and meta-analysis.

BackgroundClosing the gap of unmet for family planning is crucial to eliminate new pediatric HIV infections likewise to improve maternal and child health among reproductive-age women living with HIV. However, studies conducted on unmet need for family planning among reproductive-age women living with HIV showed inconsistent and non-conclusive findings on the magnitude of the problem. Moreover, there was no meta-analysis conducted in this area. So this systematic review and meta-analysis were conducted to estimate the pooled prevalence unmet need for family planning among reproductive-age women living with HIV in Ethiopia.MethodsThe Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed to review both published and unpublished studies in Ethiopia. All studies in PubMed, Cochrane Library, Hinari, Google Scholar, CINAHL, and Global Health databases were searched. Meta-analysis was performed using STATA 14 software. The heterogeneity and publication bias were assessed using the I2 statistics and Egger regression asymmetry test, respectively. Forest plots were used to present the pooled prevalence with a 95% confidence interval (CI).ResultsThis review included 7 studies, and 3333 study participants. The pooled prevalence of unmet need for family planning among reproductive-age women living with HIV in Ethiopia was 25.13% (95%CI: 19.97, 30.29). The pooled prevalence of unmet need for spacing and limiting was 13.91% (95%CI: 10.11, 17.72) and 9.11% (95%CI: 6.43, 11.78), respectively.ConclusionsOne-fourths of reproductive-age women living with HIV had an unmet need for family planning. A variety of programmatic investments are needed to achieve more meaningful progress toward the reduction of unmet need for family planning among reproductive-age women living with HIV.

Unsafe abortion: Combating the silent menace

Medical abortion (MA) is the mechanism by which the administration of one or more drugs willingly interrupts a pregnancy. Around 46 million induced abortions occur annually worldwide. About half of these are unsafe abortions and they occur in developing countries. With the goal of decreasing the number of maternal deaths due to unsafe abortions, the Medical Termination of Pregnancy (MTP) Act of India (1971) was adopted to legalise abortions. Medical method involving ingestion of oral drugs is an accepted mode of MTP. However, self-administration of MTP pill carries number of risks. This study was carried out on women who presented with complaints following self-administration of abortion pills.An observational study was carried out in 100 women who reported with complaints seeking medical help following consumption of abortion pills to the Department of Obstetrics and Gynecology, Kalinga Institute of Medical Sciences and Pradyumna Bal Memorial Hospital (PBM), Bhubaneswar between September 2018 and June 2020.Unmet need for spacing and unwanted pregnancy was the main reason behind self-administration of these pills. Most frequent presenting complaint was excessive bleeding per vaginum (78%). Twelve (12%) of the women presented with severe anemia and another 12% were diagnosed with ectopic pregnancy. Surgical intervention was needed in a majority (84%) of the cases.These unsafe abortions mostly go unnoticed and come to the limelight only when women present with serious consequences. This study highlights the immediate need for regulation and prohibition of unrestricted access to these drugs by the public.

Extent of contraception methods practised by unmet need couples after counselling: a cross-sectional follow-up study in Puducherry, South India.

Information is paucity about the extent of contraception practise among the unmet need eligible couples after counselling. To assess the prevalence and associated factors of unmet need for family planning (FP), the extent to which they practise desired contraception methods after baseline counselling and the reasons for not practicing it. A community-based cross-sectional analytical study was conducted between 2016 and 2019 among 2228 currently married couples with periodic follow ups of unmet need group. Baseline data on unmet need were collected based on the National Family Health Survey questionnaire. Individual and couple counselling were performed through informing choice and the support for decision making was based on the unmet need reasons with follow-ups. The data were analysed using Stata software version 12.0 (StataCorp, College Station, TX). The total study population was 1924. The prevalence of unmet need for FP was 7.1% (137) with 2.9% (55) of unmet need for spacing and 4.3% (82) of limiting births. Age groups between 18 and 24 [adjusted odds ratio (AOR) = 4.463], 25-29 (AOR = 2.339), not having a child (AOR = 0.250), having one child (AOR = 2.369) and having lower socioeconomic status (AOR = 0.155) were significantly associated with unmet need. During the follow-ups, 37.2% (29/78) received who desired limiting births, while 43.6% (34/78) changed to spacing methods. In fact, the main reason for not adopting limiting births is the fear of post-operative surgery-related health problems. This study emphasizes the need for follow-up counselling for guiding contraceptive use and recorded that majority of the unmet need couples started practicing contraception methods during the follow-ups. Besides, change in desired contraception methods was observed.

Reducing the unmet needs of family planning among women of reproductive age in Northern Region of Ghana

The recent Ghana Demographic and Health Survey 2014, estimated that 30 % of currently married women have an unmet need for family planning services, with 17% having an unmet need for spacing and 13% having an unmet need for limiting. The objective of the study was to review the unmet need of family planning in order to make appropriate recommendation to improve family planning use in the Northern Region of Ghana. A conceptual framework which outlines the factors that interplay to determine the use of family planning services in Northern Region of Ghana was designed and used for the study. The data were sought from unpublished documents from the Regional Health Directorate of Northern Ghana, websites of Ghana Health Service, online international publications and University of Leeds Library. The unmet needs of family planning in the region was found to result from a number of factors including inaccessibility to family planning services, non-availability of some type of contraceptive methods in the communities, religious beliefs that contradict the use of family planning, traditional and cultural belief system which promotes high fertility preferences, high illiteracy level, non-approval of family planning by men who are the decision makers, misconception about the use of contraception and high poverty in the region. The identified possible strategies for tackling the factors responsible for unmet need of family planning in the Northern Region, community-based family planning services, family planning health education outreach, peer education and religious-based education were found to be considerably effective, feasible and sustainable.

Prevalence and determinants of unmet need for contraception in North Gonja District, Ghana

BackgroundUnmet need for contraception contributes to the burden of unwanted pregnancies, which are correlated with a host of adverse maternal and child outcomes. The aim of this study was to determine the prevalence and identify the determinants of unmet need for contraception in North Gonja District, Ghana.MethodsA cross-sectional survey involving 386 randomly selected women of childbearing age was conducted in North Gonja district, Ghana, with the use of a questionnaire in household interviews. Women were classified as having unmet need for contraception if they were fecund, sexually active and wished to postpone the next birth or halt childbearing completely but were not using any form of contraception. Chi-square/Fisher’s exact test and logistic regression analysis were used to identify the determinants of unmet need.ResultsThe mean age of the study population was 26.1 (±8.4) years and awareness on contraception was almost universal in the district (95.9%). The overall prevalence of unmet need for contraception was 38.9%, with 27.5% having unmet need for limiting and 12.2% unmet need for spacing. In multivariate analysis, compared to women aged 25–29 years, those aged 20–24 years [Adjusted Odds Ratio (AOR) 0.26; 95% Confidence Interval (CI) 0.11–0.58] and 30 years and above (AOR 0.25; 95% CI 0.09–0.73) were less likely to have unmet need for contraception. However, uneducated women (AOR 5.06; 95% CI 1.07–24.01) compared with those educated to tertiary level; those unaware of family planning (AOR 3.93; 95% CI 1.12–13.80) compared to those aware; and those who had not previously practised contraception (AOR 1.81; 95% CI 1.09–3.00) compared to those who did were more likely to have unmet need.ConclusionsThe present study found high prevalence of both awareness on and unmet need for contraception among the study population. Unmet need for contraception is associated with age, educational status, awareness on family planning and previous contraception practice. Educational campaigns to promote contraception should prioritize women of middle age and low educational status. Further studies are needed to understand the low correlation between awareness on and unmet need for contraception.

Predictors of Unmet Need for Family Planning among HIV Positive Women in Care in Federal Teaching Hospital Gombe, Nigeria

Background: Elimination of mother-to-child transmission (EMTCT) of Human Immunodeficiency Virus (HIV) requires adequate and continuous use of family planning commodities among women of reproductive age. This can be made possible by reducing the proportion of HIV positive women with unmet need for family planning. The study aims to determine the factors associated with having unmet need among women in HIV care.
 Methods: A cross sectional study was conducted using an interviewer administered questionnaire to study 325 women on HIV care. Cluster sampling technique was used to select the study respondents from the clinic.
 Results: Less than half of the respondents (40%) were currently using family planning, 35% had unmet need for family planning with 53.6% having unmet need for spacing while 46.4% having unmet need for limiting. Women with no history of previous use of family planning were fifteen times more likely to have unmet need for family planning than those with history of previous use of family planning (p value <0.001, CI 2.511-15.770). Also women with more than five deliveries were eight times more likely to have unmet need for family planning (p value 0.004, CI 0.001-0.279) while women with 2-5 deliveries are four times likely to have unmet need for family planning (p value 0.035, CI 0.005-0.832).
 Conclusion: A high proportion of women receiving ART care still have unmet need for family planning despite incorporating this service in HIV care. It is therefore important to target high risk groups to reduce the proportion of women with unmet need for family planning which will invariable reduce mother to child transmission of HIV.

Determinants of unmet need for family planning among married women in Zambia.

Unmet need for family planning remains a major family planning problem in most countries around the world. It presents serious consequences for the women, their families and society at large. This study was undertaken to establish the factors that affect total unmet needs for family planning and its components in Zambia. This study used the 2013/14 Zambia Demographic Health Survey (ZDHS) dataset focusing on currently married women aged 15 to 49. Data analysis took the form of descriptive, binary logistic and multinomial logistic regressions. The study shows that, although there has been a substantial increase in the use of contraceptives, combined unmet need for family planning has only decreased slightly over time, and currently stand at 21%, made up of 14% limiters and 7% spacers. Various factors were identified as determinants of unmet need for spacing, limiting or total unmet need for family planning. These included age, partner’s level of education, contraceptive side effects, husband opposition to contraceptives and number of living children. To enhance utilization, policy should not be blind to the respective factors that influence combined unmet needs for spacing and limiting.

Prevalence and pattern of contraceptive use and unmet need among women of reproductive age in urban Mysuru

BackgroundUncontrolled population growth is an ongoing global concern. Rapid population growth contributes not only to the incidence of poverty but also to the transmission of poverty across generations. Adoption of family planning is crucial to limiting the unsustainable growth of the population. Although family planning services are offered free of cost, the acceptance of contraceptive methods shows wide regional variations. ObjectivesTo determine the prevalence and pattern of contraceptive usage and to determine the magnitude of unmet need among the married women of reproductive age in an urban area of Mysuru. Material and methodsA community based Cross-Sectional study was carried out among 457 married women in the reproductive age group. House to house survey was conducted and data was collected by interview method using a pre-tested, semi-structured proforma after obtaining informed consent. Data was coded and entered into MS Excel 2016 and analysed. ResultsThe prevalence of contraceptive use was found to be 55.1%. The most common contraceptive used was the terminal method of tubectomy. Male Condom was the most common temporary method of contraception used. The unmet need for contraception was found to be 18.16% with an 8.06% unmet need for spacing and a 10.6% unmet need for limiting. ConclusionContraceptive prevalence was 55.1% with 18.16% unmet need for contraception. Misapprehension and fear of side effects was a major reason for non-utilization of contraceptives. Routine Family Planning counselling and peer discussions will go a long way in dispelling the myths associated with family planning.

Modern contraceptive use among postpartum women living with HIV attending mother baby care points in Kabarole District, Uganda

BackgroundPreventing unintended pregnancies among women living with HIV is important for improving maternal and child health outcomes. Despite multiple contacts between postpartum women and healthcare providers at health facilities, modern contraceptive use during postpartum period remains low even among women with intentions to limit or delay childbearing. We estimated postpartum modern contraceptive use, unmet need and factors associated with modern contraceptive use among HIV positive women attending mother-baby HIV care points.MethodsWe conducted a cross-sectional study, between April and May 2016, among HIV positive women attending postpartum care at six health facilities in Kabarole district, Uganda. Health facilities were stratified by level prior to selecting participants using systematic sampling. We administered structured questionnaires to women who had delivered within the last two to 18 months. Women who reported current use of a modern method were categorized as modern contraceptive users. Women not using but wanted to stop childbearing or space childbirth by at least 2 years were considered to have unmet need for modern contraception. We estimated a modified Poisson regression model to examine variations in the use of modern methods by various characteristics of participants.ResultsWe interviewed 369 women. Forty percent of them were using a modern method, with injectables being the most widely used. A third (33%) of the women had unmet need for modern methods, with unmet need for spacing (24%) being higher than for limiting births (9%). Modern contraceptive use was significantly higher among women who had delivered seven or more months earlier (Adj.PR = 2.02; CI: 1.49, 2.74); women who were counseled on family planning during antenatal care (Adj.PR = 1.53; CI: 1.07, 2.18); those who obtained methods through the care points (Adj.PR =2.27; CI: 1.32, 3.90); and those who jointly made decisions regarding childbearing with their partners (Adj.PR = 1.49; CI: 1.02, 2.17).ConclusionUse of modern contraceptives was low while unmet need was high among postpartum women living with HIV. The findings suggest that there are gaps which indicate the need to strengthen contraceptive service delivery at these care-points. Providing family planning counseling early would improve uptake of contraception upon resumption of menses and sexual activity.