Modern Contraceptive Use Research Articles

Effective strategies for increasing the uptake of modern methods of family planning in South Asia: a systematic review and meta-analysis

BackgroundFamily planning (FP) interventions have improved the use of modern contraceptives, yet a high unmet need for contraception still exists in South Asia. This systematic review of existing research was conducted to identify effective FP interventions that led to an increase in the uptake of modern methods of contraception in South Asia.MethodsFive electronic databases were searched for relevant studies published between January 1st, 2000 and May 4, 2023. Experimental studies that reported data on the impact of FP interventions on modern contraceptive use among women of reproductive age (15–49 years) in the South Asian region were included. A random-effects Inverse Variance weighted model was employed to pool the adjusted odds ratio (OR) on modern contraceptive use and unmet need for contraception. In addition, we computed subgroup meta-estimates based on intervention type and the urban-rural divide.ResultsAmong 643 studies identified, 21 met the inclusion criteria. The overall pooled odds ratio for modern contraceptive use was significantly higher (OR 1.51; 95% CI 1.35–1.70; heterogeneity; I2 = 81%) for FP interventions with a significant reduction in unmet need for contraception (OR 0.86; 95% CI 0.78–0.94, I2 = 50%). The subgroup analysis revealed demand-generation (OR 1.61; 95% CI 1.32–1.96), health system integrated (OR 1.53; 95% CI 1.07–2.20), and franchised FP clinic interventions (OR 1.32; 95% CI 1.21–1.44) had promoted the modern contraceptive uptake. Further, FP interventions implemented in urban settings showed a higher increase in modern contraceptive use (OR 1.73; 95% CI 1.44–2.07) compared to rural settings (OR 1.46; 95% CI 1.28–1.66). Given the considerable heterogeneity observed across studies and the low degree of certainty indicated by the GRADE summary for the primary outcome, caution is advised when interpreting the results.ConclusionThe review collated experimentally evaluated FP interventions that increased modern contraception use and reduced the unmet need in South Asia. The demand generation interventions were the most effective in increasing the uptake of modern contraceptive methods. Furthermore, the urban environment provides a conducive environment for interventions to improve contraceptive usage. However, further studies should assess which aspects were most effective on attitudes towards contraception, selection of more effective methods, and contraceptive behaviors.

Trends and determinants of unmet need for modern contraception among adolescent girls and young women in Tanzania, 2004-2016.

Unintended pregnancy at a young age can lead to poor reproductive health, social and economic outcomes. The high rate of unintended teenage pregnancies in Tanzania is indicative of inadequate availability and uptake of modern contraception. Determining trends and determinants of unmet need for modern contraception among adolescent girls and young women (AGYW) in Tanzania will help address the burden of unintended pregnancies. An analytical cross-sectional study design was conducted using secondary data from three consecutive Tanzania Demographic and Health Surveys (TDHS) 2004/05, 2010 and 2015/6 among AGYW in need of modern contraception. Data analysis considered the complex survey design. Poisson regression model was used to determine factors associated with unmet need for modern contraception. We observed a steady decline in unmet need for modern contraception among sexually active AGYW in need of modern contraception from 31.8% in 2004/05 to 27.5% in 2015/16 survey. In the multivariable analysis, higher prevalence of unmet need for modern contraception was observed among adolescents, participants with at least one live birth, from poor wealth tertile, and those sexually active during the past four weeks compared to their counterparts. Despite declining levels, the unmet need for modern contraception among AGYW in Tanzania remains high. AGYW under 19 years, those from poor households, and those who are postpartum are most at risk. Greater efforts in empowering and educating AGYW at risk on their reproductive health rights and needs will further the uptake of modern contraceptive use, reduce the rates of unintended pregnancies, lower the adolescent fertility rate as a result lower unmet need for modern contraception.

Impact of a post-partum family planning intervention on contraception and fertility in Tanzania: two-year follow-up of a cluster-randomised controlled trial

Purpose We evaluate contraceptive use and pregnancy two years following an intervention in Tanzania, which provided antenatal post-partum family planning counselling and post-partum intrauterine device (PPIUD) services following delivery. Methods We analyse data from five hospitals in Tanzania using a difference-in-difference cluster randomised design, with randomisation at the hospital level. We use women-level data collected at the index birth and a follow-up survey two years later among 6,410 women. Outcomes (overall modern contraceptive use, contraceptive type, pregnancy) are modelled with an intent-to-treat (ITT) approach using linear regression. We compare with the complier average causal effect (CACE) of the intervention among those counselled. Results The intervention increased long-term PPIUD use by 5.8 percentage points (95% CI: 0.7–11.2%) through substitution away from other modern methods. There was no impact on overall modern contraceptive prevalence or pregnancy. Only 29% of women reported receiving PPIUD counselling. When accounting for this in the CACE analysis we saw a larger impact with 25.7% percentage point increase in PPIUD use (95% CI: 22.7–28.6%). Conclusion The intervention provided women an additional contraceptive choice, resulting in higher use of PPIUD over two years. Increase in PPIUD use was brought about by shifting methods, not creating new modern contraceptive users.

Children's sex composition and modern contraceptive use among mothers in Bangladesh.

The stagnation and relatively low use of modern contraceptives are ongoing public health concerns in Bangladesh and other low- and middle-income countries. Although a cultural preference for sons may be linked to the current use of contraceptives, this linkage has not been adequately explored in the Bangladesh context. We investigated the effects of child sex composition on the current use of modern contraceptives. We extracted and analysed data from 17,333 women who participated in the 2017/18 Bangladesh Demographic and Health Survey. The outcome variable was the current use of modern contraceptive methods. The study factor was the parity and sex composition of the living children. We used multilevel logistic regressions to determine the association between the study factor and outcome variables, adjusting for potential covariates at the individual-, household-, and community-levels. Women with relatively high parity had higher odds of currently using modern contraceptives. Among the individual parities, compared to women with no live sons, women with one or more live sons were more likely to report currently using modern contraceptives. However, this association is significant for women up to three children. When examining both parity and children's sex composition in a regression model, in each parity category, the likelihood of using modern contraceptives tend to rise with an increasing number of sons compared to women with just one daughter. The findings of this study suggest that while the use of modern contraceptives by women increases with the increasing number of children and son preference is prevalent in Bangladesh, women also want to have a mixed composition of son and daughter. The study findings can be used in family planning programmes to customise contraceptive promotion and counselling messages.

Knowledge of cervical cancer screening and its determinants among 30–49 years old rural reproductive age women in Sadi Chanka district, West Oromia, Ethiopia, 2022: A mixed method study

Background: Cervical cancer is one of the cancers affecting the female organs connecting the uterus and vagina. It is the second most common form of cancer among reproductive-age women living in Ethiopia. It is one of the preventable cancers; through effective interventions with timely screening and treatment can reduce the risk of deaths associated with the disease. The study aimed to assess the knowledge of cervical cancer screening and its determinants among rural reproductive-age women in Sadi Chanka district, Western Ethiopia. Methods: A community-based cross-sectional study supplemented with qualitative findings was conducted from February 1 to 28, 2022, with a total sample size of 867. Data collection was done by using a structured interviewer-administered questionnaire using simple random sampling techniques to select representative rural women aged between 30–49 years from selected kebeles. Bivariable logistic regression analysis was performed, and the variables with a p-value less than 0.25 were recruited to the multivariable analysis. Finally, an adjusted odds ratio with a 95% CI and a p-value less than 0.05 was used to declare the statistically significant determinants of knowledge of cervical cancer screening. For qualitative findings, a key informant interview guide was used to collect the qualitative data through in-depth interviews. A total of nine Key Informants Interviews were selected by a purposive sampling technique. Participants’ interviews were translated, transcribed, coded, categorized, and triangulated with quantitative data. Results: In this study, the prevalence of knowledge of cervical cancer screening among reproductive-age women was 51.3% with a 95% CI of (95% CI: 47.7–54.6). The mean age of the participants was 38.50 (±4.4 SD) years, and their ages ranged from 30 to 49 years. Of all assessed factors: modern contraceptive methods use (AOR = 1.79, (95% CI: 1.21–2.63)), history of sexually transmitted diseases (AOR = 1.97, (95% CI: 1.15–3.38)), family history of cervical cancer (AOR = 2.02, (95% CI: 1.06–3.87)), and knowing women who had cervical cancer (AOR = 2.72, (95% CI: 1.96–3.79)) were significantly associated with knowledge of cervical cancer screening. Conclusion: The study revealed that, the knowledge of cervical cancer screening is found to be low, which is only 51.3% of reproductive-age women knew about cervical cancer screening. The study identified that modern contraceptive methods use, history of sexually transmitted disease, family history with cervical cancer, and knowing those women who had cervical cancer were found to be the determinants of knowledge of cervical cancer screening among reproductive-age women. Thus, the district health office and concerned stakeholders should work on interventions aimed at improving the awareness of cervical cancer screening among reproductive-age women through providing appropriate health communication activities about cervical cancer screening at the community level using health extension workers.

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.

Examining Contraceptive Ideational Disparities Among Adolescents and Young Women in Nigeria

Nigeria faces a demographic challenge with a growing youth population and increasing fertility rate. However, the use of modern contraceptives among adolescent girls and young women has been declining. The young population emerges as a pivotal group in the country’s efforts to achieving the pledge of 27% modern contraceptive rate by the year 2030. This study aims to explore the disparities in contraceptive ideation among adolescents and young women in Nigeria, focusing on the role of ideational factors. The data for this study were collected through a cross-sectional household survey in four Nigerian states, involving 2,857 sexually active women aged 15-24 years. Using an ideational framework of behavior that highlights psychosocial influences, nine distinct ideational variables were examined. Multivariate logistic regression analyses were used to assess associations between ideational factors and contraceptive use among the total sample, adolescents, and youth. Statistical significance was defined as P<0.05. The study’s results revealed significant associations between the ideational variables and contraceptive use in all groups, ranging from p < .05 to p < .001. Cognitive and emotional domains were found to be the strongest predictors of contraceptive use compared to social domains in the general sample and among both groups. This study’s findings highlight the complex interplay of social, cognitive, and emotional factors in contraceptive use. Understanding these dynamics is crucial in developing effective strategies to overcome barriers and improve access to contraceptive services among young women in Nigeria. Keywords: Adolescents, Contraception, Ideation, Youth.

Empowerment and intervention strategies to strengthen the use of sexual and reproductive health services by ensuring continuity of care for adolescent girls and internally displaced women in Burkina Faso

Background: In Burkina Faso, a security crisis has displaced families within the country, fleeing high-risk areas. One of the major consequences of this displacement is the low use of sexual and reproductive health care and services, and the reduced empowerment of adolescent girls and internally displaced women (IDP). This research aims to analyze the situation and co-develop intervention strategies to strengthen the empowerment of these adolescent girls and IDP women for the use of these services by ensuring the continuity of this care.
 Methods: This study is based on a mixed approach (quantitative and qualitative). The quantitative component is based on a survey of 1,474 randomly selected households in temporary IDP reception sites in the cities of Kaya and Kongoussi in Burkina Faso. Empowerment was analyzed in terms of motivational autonomy and exercise of choice in family planning. Descriptive analysis and multivariate logistic regression have allowed us to describe the empowerment of IDP women and adolescent girls and identify the determinants of the use of modern contraception among IDP adolescents and women. The qualitative component has enabled to co-construct intervention strategies to strengthen empowerment and also ensure continuity of care, using a participatory approach supported by a deliberative workshop.
 Results: Out of a sample of 1,220, adolescent girls (12-19 years old) and women (20-49 years old) represented respectively 17.5% and 82.5%. The analysis showed that 42.5% of IDP adolescent girls and women were using a modern method of contraception at the time of the survey. The analysis also showed that 89.2% and 79.5% of adolescent girls and IDP women have low levels of motivational autonomy and exercise of choice in family planning, respectively. A poor perception of contraceptives side effects and possible difficulties with the partner or even the fear of having difficulties returning to fertility after contraception ""damage"" women's motivation to use contraception methods. In addition, the ability to discuss with the partner hinders the exercise of choice in contraception. Intervention strategies based on community dialogue and communication with IDPs and community members have emerged as those promoted to facilitate the use and continuity of health services. 
 Recommendations: Empowerment appears as a determining factor to enhance the contraceptive demand by adolescent girls and internally displaced women. Community dialogue and communication sessions on family planning for IDPs and the population must be well implemented.

Intention to Use Modern Contraception among Spouses of Women With Diabetes and its Associated Factors

Women with diabetes are at high risk of adverse pregnancy outcomes if glycemic control is poor. Delaying pregnancy with effective contraception is crucial to allow diabetes to be optimised. Lack of encouragement and disapproval from the husbands leads to poor contraceptive use among women. Therefore, this study assessed the intention to use modern contraception among spouses of women with diabetes and its associated factors. A cross-sectional study was conducted in two clinics from December 2022 to March 2023. A total of 207 men aged 18 years and above, with wives having diabetes, within the reproductive age group were recruited. An online questionnaire was distributed, comprising sociodemographic characteristics, reproductive aspects, including intention for modern contraception use, past experience of contraception, spousal communication, a desire for children, and received contraceptive counselling. Knowledge of diabetes-related pregnancy risk and perception of contraception use in women were also included in the questionnaire. Only 52.7% of men had the intention. Educational level (AOR 2.41, 95% CI: 1.17-4.96), previous experience (AOR 3.3, 95% CI: 1.55-6.99), spousal communication (AOR 2.63, 95% CI: 1.19-5.85), wife’s age (AOR 0.94, 95% CI: 0.89-0.99) and perception towards contraception (AOR 0.98, 95% CI: 0.96-0.99) were the significant factors. Efforts should be made to ensure men have knowledge and correct perceptions towards contraception.

Knowledge, Attitude and Use of Contraceptives Among Women of Reproductive Age in a Nigerian Rural Community

BACKGROUND: The use of contraception, encompassing various methods such as hormonal pills, condoms, intrauterine devices, and natural techniques like abstinence, plays a pivotal role in family planning and reproductive health. Despite its importance, the utilization of contraceptives, particularly in low-resource nations like Nigeria, has remained notably low. This is concerning, considering the positive impact of contraception on maternal and child health and its contribution to national development by curbing population growth. In Nigeria, awareness of contraception is relatively high, but the adoption of modern contraceptive methods is alarmingly low, with only 10% of females utilizing them. This rate is notably insufficient given the high levels of sexual activity, especially among adolescents and young adults. Furthermore, regional disparities exist within Nigeria, with the south-south geopolitical zone exhibiting a higher prevalence of modern contraceptive use at 15.5%. Factors influencing contraceptive usage include education, religious beliefs, and awareness of available methods. In Yenagoa, Bayelsa state, the prevalence of modern contraceptives was notably higher at 36.8% in 2017, underscoring the impact of education and knowledge of contraceptive options. Increasing contraceptive use is crucial for Nigeria, a lower-middle-income country, as it not only aids in averting unplanned pregnancies and maternal mortality but also in controlling population growth. AIM: The study aimed to shed light on contraceptives' profound health advantages to both women and families. By investigating the knowledge, attitude, and use of contraceptives within the context of the study community, it sought to contribute to the promotion and enhancement of contraceptive use among women of reproductive age in the rural community of Sagbama, South-south Nigeria. METHODS: A descriptive cross-sectional study was conducted among women of reproductive age, over a period of 3 months in Sagbama Community, Bayelsa state. Multi-stage sampling was employed. Data was obtained using interviewer-administered semi-structured 31-item questionnaire and analyzed using IBM SPSS version 26. Bivariate analysis with p-value <0.05 was significant. RESULTS: Among the 314 respondents, the mean age was 29.96 years. Nearly half were married (48.4%), with varying numbers of children. The majority had some form of education, with 46.8% having secondary education. Most respondents (95.9%) had heard of contraceptives, primarily from friends (76.4%) and hospitals (58%). The most well-known contraceptive methods were male condoms (95.9%), contraceptive pills (79.9%), and implants (72.3%). Positive attitudes toward contraceptive use were observed in 83.4% of respondents, driven by the desire to prevent unwanted pregnancies and space births (80.9%). Of sexually active women (81.4%), 53.3% used contraceptives, with male condoms (44%) and pills (15.7%) being the most common methods. Reasons for non-use included a perceived lack of need (28.6%) and fear of side effects (26.5%). CONCLUSION: Despite high knowledge levels, the use of contraceptives among women of reproductive age in the community was poor. Education and addressing misconceptions are essential to promote effective contraceptive use. Comprehensive health and sex education involving both men and women should be provided to dispel misconceptions and encourage correct contraceptive use.

The Use of Modern Contraceptives among Women and its Implications to Menstrual Cycle According to Shariah

The Use of Modern Contraceptives among Women and its Implications to Menstrual Cycle According to Shariah

Prevalence and predictors of use of long-term and short-acting reversible contraceptives among women of reproductive age in Wakiso and Hoima districts, Uganda: A cross-sectional study

Modern contraceptive use has increased globally, but unmet needs persist in low- and middle-income countries. This study in Uganda aimed to examine the prevalence and factors influencing the use of short-acting reversible contraceptives (SARC) like pills and long-term methods such as intrauterine devices. Limited evidence exists on the use of SARC and long-term methods in Uganda. Data from the Africa Medical and Behavioural Sciences Organization (AMBSO) Population Health Surveillance (APHS) in Hoima and Wakiso districts were analysed. Among the 1642 women aged 15–49 years, the prevalence of modern contraceptive use was 30% for SARC, and 18% for long-term method. Women with formal education were three times more likely to use long-term methods than those without formal education, relative risk ratios (RRR), 3.1–3.4, (95%CI 1.2–8.2). Joint decision-making for contraceptive use increased SARC usage, RRR 1.4 (95%CI 1.1–1.8). Urbanization played a role, with women in more urbanized Wakiso district less likely to use any modern contraception, RRR 0.6–0.7 (95%CI 0.5–0.9) compared to those living in the less urbanized Hoima. About half of the women in the study used modern contraceptives and the use of SARC was almost twice that of long-term methods. Increased access to contraception education for all women of reproductive age could significantly improve the use of long-term methods which offer more reliable protection against unintended pregnancies. The findings shed light on the need to strengthen both general and sexuality education to girls and women and to tailor contraception access for all in need, for mobile semi-urban as well as rural women. Well-informed strategies that engage young men and male partners in informed decision-making for contraceptive use could enhance progress.

Time to initiation of modern contraceptive method use after childbirth and its predictors in Southern Ethiopia: a retrospective follow-up study

BackgroundTimely initiation of modern contraceptive use is vital to prevent unintended pregnancy and its related morbidities and mortalities. However, there is a scarcity of evidence about the duration of time elapsing from childbirth to initiating modern contraceptive use following childbirth and its associated factors in the study area for evidence-based interventions. Therefore, we aimed to assess the time to initiation of modern contraceptive method use and its predictors in Hossana town, southern Ethiopia.MethodsA retrospective follow-up study was conducted at public health facilities in Hosanna town. A total of 503 study participants were included in the study using a systematic random sampling technique. The Box and Whisker plot was used to estimate the time to initiation of modern contraceptive use. A Weibull regression model was applied to identify predictors of time to initiation of modern contraceptive use. Adjusted Hazard Ratio (AHR) with a 95% confidence interval (CI) was used to interpret the strength of the association.ResultsThe median time to initiation of modern contraceptive use was 6 months, with an interquartile range of 3 months. Husband/partner attending higher education [AHR = 1.64, 95% CI: 1.04, 2.57], women who had parity of more than two [AHR = 1.93, 95% CI: 1.01, 3.67], and women who had communicated with their husband/partner about modern contraceptive methods [AHR = 3.03, 95% CI: 1.41, 6.67] were more likely to initiate modern contraceptive method use within six months after childbirth. In contrast, women with an older age of greater than or equal to 30 years [AHR = 0.32, 95% CI: 0.13, 0.82] and who did not resume sexual intercourse after childbirth [AHR = 0.02, 95% CI: 0.01, 0.03] were less likely to initiate modern contraceptive method use within six months after childbirth.ConclusionsThe median time to initiation of modern contraceptive method use after childbirth in the postpartum period was delayed from the World Health Organization recommendation of at most 6 weeks. Emphasis should be given to older women, women with lower parity, and men’s participation in contraceptive communication to improve timing for initiation of modern contraceptive use after childbirth and to curb the five-month lag periods.

The Effect of a Decade Implemented Project in Improving the Uptake of Comprehensive Contraception: Difference-In-Difference Analysis.

Promotion and use of family planning in countries with high birth rates have the potential to avert a third of all maternal deaths and nearly a tenth of childhood deaths. To support government efforts in creating wider access to comprehensive contraceptive methods, EngenderHealth has contributed to the government of Ethiopia's long-term goal of improving maternal health outcomes through its Access to Better Reproductive Health Initiative project. Difference-in-Difference approach is the main methodology in this analysis to estimate the "contribution" or "effect" of the ABRI intervention by comparing the changes in family planning outcomes from 2005 to 2016 between the ABRI and non-ABRI areas. This analysis was based on pooled data from the 2005 and 2016 Ethiopian Demographic and Health Surveys. To track temporal changes in the family planning indicators in the ABRI and non-ABRI areas, we employed simple trend analysis. The results show that overall contraceptive prevalence rate, use of injectables, women's knowledge of Long-Acting Reversible Contraception (LARC) methods, and their exposure to family planning information/messages from health workers all significantly improved in the ABRI intervention areas beyond what occurred in the non-ABRI areas. The greatest increase in the use of modern contraception was among adolescents aged 15-19 years, with a DID estimate of 22.4% (p=0.007), ABRI areas compared to no-ABRI areas. In the ABRI areas, family planning indicators recorded positive and significant changes. EngenderHealth has contributed its part in improving access to the uptake of comprehensive contraception and supporting government programs.

The impacts of family planning and HIV service integration on contraceptive prevalence among HIV positive women in Tanzania: a comparative analysis from the 2016/17 Tanzania HIV impact survey

BackgroundPrevention of unplanned pregnancies through modern contraceptives among HIV-positive women is one of the essential strategies for reducing mother-to-child transmission of HIV. Family planning and HIV services integration is a national strategy designed to scale-up modern contraceptives among HIV-positive women. This study aims to evaluate the success of a service integration strategy by comparing the prevalence of modern contraceptive use among HIV-positive women receiving ART within integrated services and those not on integrated services (HIV-negative women and HIV-positive women unaware of their status).MethodsWe used data from the Tanzania HIV impact survey (THIS) of 2016/17. THIS provided HIV counselling and testing with a return of results in over 30,000 adults over 15 years of age. Women tested positive self reported their enrollment into ARV with further confirmation through laboratory analysis for any detectible ARV in their blood. All non-pregnant women reported their contraceptive use. Univariate and multivariate logistic regression was used to assess the effect of accessing integrated services controlling for potential confounders.ResultsA total of 14,986 women were included in the analysis; HIV-positive women were 1,066 and HIV-negative women were 13,830. Modern contraceptive use prevalence was 35% among HIV-positive women and 30% among HIV-negative women. Among HIV-positive women, those enrolled in integrated services (ART) had a higher prevalence of modern contraceptive (40%) compared to HIV-positive women unaware of their status (27%, p-value = 0.0014). The most common contraceptive methods in HIV-positive women were injectables (32%) and male condoms (31%), while in HIV-negative women, injectables (39%) and implants (30%, n = 1032) were the most preferred methods. Among HIV-positive women, enrolment into integrated services (currently on ART) demonstrated an increase in the odds of modern contraceptives by 85% (AOD = 1.85, 95%CI: 1.27–2.71).ConclusionThis study found relatively low modern contraceptive use among HIV-positive women in the general population despite the existance of service integration program and guidelines to guide its implementation.Our study therefore calls for the evaluation on the implementation of the integration programme to identify factors that constrain or facilitate programme effectiveness.

Family planning uptake and its associated factors among women of reproductive age in Uganda: An insight from the Uganda Demographic and Health Survey 2016.

Despite the government efforts to reduce the high fertility levels and increase the uptake of family planning services in Uganda, family planning use was still low at 30% in 2020 which was the lowest in the East African region. This study was undertaken to determine the prevalence and factors associated with the uptake of family planning methods among women of reproductive age in Uganda. This community-based cross-sectional study utilized secondary data from the Uganda Demographic and Health Survey (UDHS) of 2016. The survey data was downloaded from the Measure Demographic Health Survey website after data use permission was granted. Data was collected from a representative sample of women of the reproductive age group (15-49 years) from all 15 regions in Uganda. A total of 19,088 eligible women were interviewed but interviews were completed with 18,506 women. Data analysis was performed using SPSS statistical software version 32.0 where univariable, bivariable, and multivariable analyses were conducted. The prevalence of family planning use was found to be 29.3% and that of modern contraceptive use was found to be 26.6%. Multivariable analysis showed higher odds of current family planning use among older women (40-44 years) (aOR = 2.09, 95% CI: 1.40-3.12); women who had attained the secondary level of education (aOR = 1.91, 95% CI: 1.32-2.76); those living in households with the highest wealth index (aOR = 1.87, 95% CI: 1.29-2.72); and awareness of the availability of family planning methods (aOR = 1.41, 95% CI: 1.17-1.72). In conclusion, the study suggests improving women's education attainment, socio-economic position, and awareness may help increase use in the population.

Geographic weighted regression analysis of hot spots of modern contraceptive utilization and its associated factors in Ethiopia.

Utilization of modern contraceptives is a common healthcare challenge in Ethiopia. Prevalence of modern contraception utilization is varying across different regions. Therefore, this study aimed to investigate Geographic weighted regression analysis of hotspots of modern contraceptive utilization and its associated factors in Ethiopia, using Ethiopian Demographic and Health Survey 2016 data. Based on the 2016 Ethiopian Demographic Health Survey data, a total weighted sample of 8,673 women was included in this study. For the Geographic Weighted Regression analysis, Arc-GIS version 10.7 and SaTScan version 9.6, statistical software was used. Spatial regression was done to identify factors associated with the hotspots of modern contraceptive utilization and model comparison was carried out using adjusted R2 and AICc. Variables with a p-value < 0.25 in the bi-variable analysis were considered for the multivariable analysis. Multilevel robust Poisson regression analysis was fitted for associated factors since the prevalence of modern contraceptive was >10%. In the multilevel robust Poisson regression analysis, the adjusted prevalence ratio with the 95% confidence interval was reported to declare the statistical significance and strength of association. The prevalence of modern contraceptive utilization in Ethiopia was 37.25% (95% CI: 36.23%, 38.27%). Most of the hotspot areas were located in Oromia and Amhara regions, followed by the SNNPR region and Addis Ababa City administration. Single Women, poor Women, and more fertility preference were significant predictors of hotspots areas of modern contraceptive utilization. In the multivariable multilevel robust Poisson regression analysis, Women aged 25-34 years (APR = 0.88, 95% CI: 0.79, 0.98), 35-49 years (APR = 0.71, 95% CI: 0.61, 0.83), married marital status (APR = 2.59, 95% CI: 2.18, 3.08), Others religions (APR = 0.76, 95% CI: 0.65, 0.89), number of children 1-4 (APR = 1.18, 95% CI: 1.02, 1.37), no more fertility preference (APR = 1.21, 95% CI: 1.11, 1.32), Afar, Somali, Harari, and Dire Dawa: (APR = 0.42, 95% CI: 0.27, 0.67), (APR = 0.06, 95% CI: 0.03, 0.12), (APR = 0.78, 95% CI: 0.62, 0.98), and (APR = 0.75, 95% CI: 0.58, 0.98), respectively. Amhara region (APR = 1.34, 95% CI: 1.13, 1.57), rural residence (APR = 0.80, 95% CI: 0.67, 0.95) High community wealth index (APR = 0.78, 95% CI: 0.67, 0.91) were significantly associated with modern contraceptive utilization. There were significant spatial variations of factors affecting modern contraceptive use across regions in Ethiopia. Therefore, public health interventions targeting areas with low modern contraceptive utilization will help to increase modern contraception use considering significant factors at individual and community levels.The detailed map of modern contraceptive use cold spots among reproductive age group and its predictors could assist program planners and decision-makers to design targeted public health interventions.Government of Ethiopia must develop more geographic targeted strategies for improving socioeconomic status of women and availability & accessibility of health facilities in rural areas of the countries.

Role of Partner and Health Workers on Modern Contraceptive Use Among Married/In-union Women in Uzbekistan

Many factors contribute to the declining total fertility rate, including family planning programs. The successful implementation of the family planning method might be influenced by how the decision to choose a contraceptive method was made. This study aimed to examine the correlation between family planning decision makers and modern contraceptive use among married/in-union women of reproductive age in Uzbekistan. The 2021-2022 Multiple Indicator Cluster Survey was used by selecting only married/in-union women of reproductive age of 15 to 49 years, totaling 2,794 eligible samples. The modern family planning use variables were divided into not using, using Long-Acting Contraceptives (LAC), and Short-Acting Contraceptives (SAC). The univariate, bivariate(Chi-square and ANOVA), and multinomial logistic regression were performed. Family planning decision-makers from both women and husbands/partners, health workers, or others were significantly associated with modern contraceptive use for SAC and LAC, respectively. The type of family planning methods was significantly influenced by decision-makers. Spouses, family members, and health workers need to implicate women to decide the most applicable contraceptive method.

Trend, geographical distribution, and determinants of modern contraceptive use among married reproductive-age women, based on the 2000, 2005, 2011, and 2016 Ethiopian demographic and health survey

BackgroundThe most common family planning method is modern contraception. It is a cost-effective way to reduce maternal and neonatal morbidity and mortality and enable women to make informed choices about their reproductive and sexual health. The trend of modern contraceptive utilization has shown drastic change in Ethiopia, and identifying the major factors contributing to such a drastic change is vital to improving plans and strategies for family planning programs. Therefore, this study analyzed the trend, geographical distribution, and determinants of modern contraceptive use among married reproductive-age women in Ethiopia.MethodThis study used secondary data from the EDHS 2000–2016, collected from a population-based cross-sectional study by the Central Statistical Agency, focusing on married reproductive-age women aged 15–49. The study analyzed the modern contraceptive use trends through descriptive analyses conducted in three phases: 2000–2005, 2005–2011, and 2011–2016. The study utilized bivariable and multivariable logistic regression analyses to identify determinant factors, with significant variables declared using a P-value of 0.05 and an adjusted OR with 95% confidence interval. Analysis was conducted using STATA.14 and R. Spatial analysis was done using ArcGIS version 10.8 and SatScan™ version 9.6.ResultA weighted total of 33,478 women are included in the study, with a mean age of 31.4 years (8.6 SD). There was a significant increase in the trend of modern contraceptive use among married women over the study period, from 2000 to 2016, from 7.2% to 2000 to 15.7% in 2005, to 30% in 2011, and to 39.5% in 2016. The maximum increase was seen in the second phase (2005–2011), with a 14.3% increase. Factors like age of respondents, educational status, religion, residence, region, wealth index, number of living children, husbands’ desire to have more children, and media exposure were found to be predictors for modern contraceptive utilization.ConclusionThe prevalence of modern contraceptive use is below 50%, and there is also evidence of wide geographical variation in modern contraceptive use in Ethiopia. Thus, policymakers, high institutions, and other stakeholders must work collaboratively with the government in order to improve awareness about modern contraceptive use.

History of national sex surveys in Europe.

The historical background of European national sex surveys dates back to the late 1960s and early 1970s when the first such surveys were conducted in Europe. That was an era of Western sexual revolution, a time of increasing openness to discussion and debate of sexual issues, and legal reforms in many countries. During this period, there was a growing interest in understanding sexual behaviour, attitudes, and modern contraceptive use in the general population. Evidence was also needed for sexuality education that was emerging in some European countries. Despite this need for evidence, only a few countries (Sweden, Finland, France) conducted national surveys on the topic in the early 1970's, becoming pioneers in national sex surveys in Europe and in the world. It was the HIV and AIDS epidemic of the 1980s that gave more researchers and funders the impetus to conduct sex studies in many European countries. As a result, medical perspectives on sexuality became prioritised around Europe. Balancing the perspectives of the diverse disciplines (including public health, sociology, psychology) that use the data from national sex surveys remains a challenge for the modern surveys. The European Sexual Medicine Network (ESMN) is a part of European cooperation in science and technology (COST), which includes a strand of work on national sex surveys among the adult population. Since 2021, a subgroup of nationally representative sex surveys, co-chaired by Osmo Kontula and Hanneke de Graaf have worked together to further the field. This submission is based on a review of the literature, combined with Kontula's personal reflections following a history of participation in European collaboration in this field since the early 1990s.