Open access journal of contraception最新文献

{"title":"Improving Voluntary, Rights-Based Family Planning: Experience From Nigeria And Uganda","authors":"K. Hardee, Kaja Jurczynska, I. Sinai, Victoria Boydell, Diana Kabahuma Muhwezi, K. Gray, K. Wright","doi":"10.2147/OAJC.S215945","DOIUrl":"https://doi.org/10.2147/OAJC.S215945","url":null,"abstract":"Background Growing focus on the need for voluntary, rights-based family planning (VRBFP) has drawn attention to the lack of programs that adhere to the range of rights principles. This paper describes two first-of-their-kind interventions in Kaduna State, Nigeria and in Uganda in 2016–2017, accompanied by implementation research based on a conceptual framework that translates internationally agreed rights into family planning programming. Methods This paper describes the interventions, and profiles lessons learned about VRBFP implementation from both countries, as well as measured outcomes of VRBFP programming from Nigeria. Results The intervention components in both projects were similar. Both programs built provider and supervisor capacity in VRBFP using comparable curricula; developed facility-level action plans and supported action plan implementation; aimed to increase clients’ rights literacy at the facility using posters and handouts; and established or strengthened health committee structures to support VRBFP. Through the interventions, rights literacy increased, and providers were able to see the benefits of taking a VRBFP approach to serving clients. The importance of ensuring a client focus and supporting clients to make their own family planning choices was reinforced. Providers recognized the importance of treating all clients, regardless of age or marital status, for example, with dignity. Privacy and confidentiality were enhanced. Recognition of what violations of rights are and the need to report and address them through strong accountability systems grew. Many lessons were shared across the two countries, including the need for rights literacy; attention to health systems issues; strong and supportive supervision; and the importance of working at multiple levels. Additionally, some unique lessons emanated from each country experience. Conclusion The assessed feasibility and benefits of using VRBFP programming and outcome measures in both countries bode well for adoption of this approach in other geographies.","PeriodicalId":74348,"journal":{"name":"Open access journal of contraception","volume":"10 1","pages":"55 - 67"},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAJC.S215945","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46622065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contraceptive Options Following Gestational Diabetes: Current Perspectives","authors":"A. Turner, Emily A. Donelan, Jessica W. Kiley","doi":"10.2147/OAJC.S184821","DOIUrl":"https://doi.org/10.2147/OAJC.S184821","url":null,"abstract":"Abstract Gestational diabetes mellitus (GDM) complicates approximately 7% of pregnancies in the United States. Along with risk factors related to pregnancy, women with a history of GDM also have an increased risk of developing type 2 diabetes mellitus later in life. These women require special consideration when discussing contraception and other reproductive health issues. GDM carries a category 1 rating in the US Medical Eligibility Criteria for all contraceptive methods, which supports safety of the various methods but does not account for effectiveness. Contraceptive options differ in composition and mechanisms of action, and concerns have been raised about possible effects of contraception on metabolism. Clinical evidence is limited to suggest that hormonal contraception has significantly adverse effects on body weight, lipid, or glucose metabolism. In addition, the majority of evidence does not suggest a relationship between development of type 2 diabetes mellitus and use of hormonal contraception. Data are limited, so it is challenging to make a broad, general recommendation regarding contraception for women with a history of GDM. A woman’s history of GDM should be considered during contraceptive counseling. Discussion should focus on potential medical comorbidities and the implications of GDM on future health, with special consideration of issues including bone health, obesity, cardiovascular disease, and thrombosis risk. Providers must emphasize the importance of reliable, highly effective contraception for women with GDM, to optimize the timing of future pregnancies. This approach to comprehensive counseling will guide optimal decision-making on contraceptive use, lifestyle changes, and planning of subsequent pregnancies.","PeriodicalId":74348,"journal":{"name":"Open access journal of contraception","volume":"10 1","pages":"41 - 53"},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAJC.S184821","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45808121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postpartum Contraceptive Use In Parakou (A City In Northern Benin) In 2018: A Community Based Cross-Sectional Study","authors":"F. Hounkponou, Yolaine Glèlè Ahanhanzo, C. Biaou, Candide Russel Dos-Santos, A. Ahouingnan, A. A. Obossou, Rachidi Sidi Imorou, M. Vodouhè, H. Laourou, K. Salifou, R. Perrin","doi":"10.2147/OAJC.S219709","DOIUrl":"https://doi.org/10.2147/OAJC.S219709","url":null,"abstract":"Background Over 30% of maternal deaths and 10% of infant deaths are avoidable if couples space out births at intervals of 2 years or greater. This study aimed to identify factors associated with contraceptive use in the postpartum period. Methods This was a cross-sectional study among postpartum women living in Parakou. Participants were selected using a two-stage sampling method. Postpartum contraceptive use was defined as the use of at least one contraceptive method at the time of the survey. Independent variables included socio demographic and reproductive history. For the analysis we performed a multiple logistic regression and we calculated odds ratios with 95% confidence intervals. Results The study included 453 postpartum women. Among the participants, 59 (13%) were using a contraceptive method. Injectable contraceptives were the most common method used (25.4%). Factors associated with contraceptive use in the postpartum period included history of contraceptive use (AOR=9.4; p<0.001), resumption of sexual intercourse (AOR=5.7; p<0.001), discussion with partner about contraceptive method (AOR=5.7; p=0.005), need of partner’s approval before adopting a contraceptive method (AOR=0.4; p=0.014) and counseling during pregnancy, in the delivery room, and during postnatal visits (AOR=2.7; p=0.019). Conclusion The prevalence of contraceptive use during the postpartum period remains low. Interventions should be designed with a focus on the associated factors in order to increase postpartum contraceptive use in Parakou.","PeriodicalId":74348,"journal":{"name":"Open access journal of contraception","volume":"10 1","pages":"19 - 26"},"PeriodicalIF":0.0,"publicationDate":"2019-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAJC.S219709","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49130023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contraception counseling for women with premenstrual dysphoric disorder (PMDD): current perspectives","authors":"Andrea J. Rapkin, Yelena Korotkaya, Kathrine C Taylor","doi":"10.2147/OAJC.S183193","DOIUrl":"https://doi.org/10.2147/OAJC.S183193","url":null,"abstract":"Abstract Premenstrual Dysphoric Disorder (PMDD) is a severe form of premenstrual syndrome (PMS) affecting up to 7% of reproductive age women. Women with PMDD are of reproductive age; therefore, contraception and treatment of PMDD are important considerations. The disorder as described in the DSM-V is characterized by moderate to severe psychological, behavioral and physical symptoms beginning up to two weeks prior to menses, resolving soon after the onset of menstruation and significantly interfering with daily functioning. PMDD develops in predisposed individuals after they are exposed to progesterone at the time of ovulation. It has been hypothesized that PMDD is in part attributable to luteal phase abnormalities in serotonergic activity and to altered configuration of ℽ-aminobutyric acid subunit A (GABAA) receptors in the brain triggered by the exposure to the neuroactive steroid progesterone metabolite, allopregnanolone (Allo). A large body of evidence suggests that selective serotonin reuptake inhibitors (SSRIs) can be effective in the treatment of PMDD. Combined hormonal contraceptive (CHC) pills, specifically the 20 mcg ethinyl estradiol/3mg drospirenone in a 24/4 extended cycle regimen has been shown to significantly improve the emotional and physical symptoms of PMDD. Other combined monophasic, extended cycle hormonal contraceptive pills with less androgenic progestins may also be helpful, although not well studied. Copper intrauterine devices (IUDs) are recommended for those not seeking hormonal contraceptives. Progestin-only methods including the progestin-only pill (POP), levonorgestrel (LNG) IUD, etonorgestrel implant or depot medroxyprogesterone acetate (DMPA) have the potential to negatively affect mood symptoms for women with or without baseline mood disorders, including PMDD. Careful counseling and close follow-up is recommended for patients with PMDD seeking these contraceptive methods.","PeriodicalId":74348,"journal":{"name":"Open access journal of contraception","volume":"10 1","pages":"27 - 39"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAJC.S183193","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43113097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"When you least expect, this happens, it's already growing\": Problematizing the definition of unmet need for family planning.","authors":"Ielaf Khalil,&nbsp;Emma Zl Richardson","doi":"10.2147/OAJC.S184909","DOIUrl":"https://doi.org/10.2147/OAJC.S184909","url":null,"abstract":"<p><p><b>Background:</b> Unmet need is an important indicator to understand baselines and set goals for family planning interventions. Women may not fall neatly in categories of met or unmet need for family planning as defined by the demographic and health surveys (DHS). We explore women's experiences of unmet need for family planning and provide empirical examples of how the static, binary DHS definitions of met and unmet need for family planning may be problematic. <b>Methods:</b> Based on Social Cognitive Theory, we conducted elicitation interviews with 16 married young women between the ages of 20 and 24 in Chimaltenango, Guatemala to explore barriers to accessing and using family planning. Half the participants (n=8) were using a modern method of family planning and half (n=8) were not. The current analysis focuses on data that was coded as ambiguous or unclear for unmet need status. <b>Results:</b> We identified framings of ambiguity from the women's narratives that are silenced by the dominant binary of met and unmet need. We show inconsistencies between women's lived experiences of unmet need and how their experiences would likely be represented in DHS questionnaires: 1) successful use of natural methods; 2) the complexity of \"wantedness\"; 3) conceptualizing met or unmet need as a trajectory; and 4) laughter obscuring clear response. <b>Conclusion:</b> Family planning status is a complex trajectory that the DHS may not accurately capture. As a way to reflect the diversity of women's family planning experiences, we suggest modifying the DHS classifications to incorporate latent met and unmet need as sub-classifications.</p>","PeriodicalId":74348,"journal":{"name":"Open access journal of contraception","volume":"10 ","pages":"7-18"},"PeriodicalIF":0.0,"publicationDate":"2019-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAJC.S184909","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37344013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contraception with estradiol valerate and dienogest: adherence to the method.","authors":"Franca Fruzzetti,&nbsp;Anna Maria Paoletti,&nbsp;Tiziana Fidecicchi,&nbsp;Giulia Posar,&nbsp;Riccardo Giannini,&nbsp;Marco Gambacciani","doi":"10.2147/OAJC.S204655","DOIUrl":"https://doi.org/10.2147/OAJC.S204655","url":null,"abstract":"<p><p><b>Purpose:</b> The aim of the study was to examine the discontinuation rate of hormonal contraception with estradiol valerate (E2V) and dienogest (DNG). <b>Patients and methods:</b> We collected data at the Family Planning Clinics of the Departments of Obstetrics and Gynecology of Pisa and Cagliari. We included in the analysis 354 consecutive women using oral contraceptive pills containing E2V and DNG. We analyzed the rate and the reason for discontinuation, classifying the reasons in 5 categories: 1) minor side effects, 2) adverse events, 3) other events not directly caused by the drug or conditions for which the pill could represent a risk factor, 4) no compliance with the method and 5) no further need. <b>Results:</b> Of the 354 women examined, 50.8% had discontinued E2V/DNG pill. Excluding women who stopped the pill because of no further need (10.5%), 27.4% discontinued because of minor side effects, 1.7% discontinued for adverse events, 9.9% because of other events not directly caused by the drug or conditions for which the pill could represent a risk factor and 1.4% because of difficulties with compliance. Irregular bleedings were the main reasons reported for discontinuation. The time to discontinuation for irregular bleedings was significantly (<i>p</i><0.02) longer in adults than in adolescents and slightly but not significantly longer in women who received information about this possible effect. <b>Conclusion:</b> Unacceptable cycle control was the principal cause of discontinuation of pill with E2V and DNG. An appropriate information about this possible effect may improve adherence to this combined oral contraceptive.</p>","PeriodicalId":74348,"journal":{"name":"Open access journal of contraception","volume":"10 ","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2019-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAJC.S204655","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37324531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contraceptive use and the risk of sexually transmitted infection: systematic review and current perspectives.","authors":"Jennifer Deese,&nbsp;Subarna Pradhan,&nbsp;Hannah Goetz,&nbsp;Charles Morrison","doi":"10.2147/OAJC.S135439","DOIUrl":"https://doi.org/10.2147/OAJC.S135439","url":null,"abstract":"<p><strong>Purpose: </strong>Evidence on the association between contraceptive use and risk of sexually transmitted infections (STIs) and bacterial vaginosis (BV) is lacking, with few prospective studies. We systematically reviewed the last 10 years' evidence on the association between contraception and STI/BV, building on the most recent systematic reviews published in 2006 and 2009.</p><p><strong>Methods: </strong>We searched the MEDLINE and POPLINE databases for peer-reviewed articles p ublished between January 1, 2008 and January 31, 2018 reporting prospective studies that assessed the association between contraceptive use and incident STI and/or incident or recurrent BV.</p><p><strong>Results: </strong>We identified 33 articles that evaluated combined oral contraceptives (COC), depot medroxyprogesterone acetate (DMPA), the copper intrauterine device (Cu-IUD), the levonorgestrel intrauterine system (LNG-IUS) and other methods. The strength of the evidence for many specific contraceptive method/STI associations is limited by few prospective studies with comparably defined exposures and outcomes. Available data suggest no association of COCs and <i>Neisseria gonorrhoeae</i>, <i>Trichomonas vaginalis</i>, HSV-2 or syphilis, and mixed evidence on the association with HPV, <i>Chlamydia trachomatis</i>, and BV. For DMPA, none of the studies identified found an association with <i>N. gonorrhoeae</i> or syphilis, and data on <i>C. trachomatis, T. vaginalis,</i> HPV and BV were mixed. Two large studies showed a highly clinically significant increased risk of HSV-2 infection with DMPA use. Data on the effect of Cu-IUD and the LNG-IUS on the acquisition of <i>C. trachomatis</i>, <i>N. gonorrhoeae</i> and <i>T. vaginali</i>s are sparse, and data on HPV and BV are mixed.</p><p><strong>Conclusion: </strong>Few data are available from prospective studies, including randomized trials, to draw strong conclusions about the relationships between contraceptive methods and specific STIs. The overall evidence on the association between contraceptive use and STI/BV risk is limited by the lack of any randomized trials, few published prospective studies designed to analyze these associations, wide variability in exposure definitions and comparator groups, potential for confounding due to inaccurate sexual behavior data, differential confounder adjustment and differences in study populations and sizes. Despite these limitations, new evidence is supportive of a significantly increased risk of HSV-2 infection among DMPA users which warrants additional research to better understand this association.</p>","PeriodicalId":74348,"journal":{"name":"Open access journal of contraception","volume":"9 ","pages":"91-112"},"PeriodicalIF":0.0,"publicationDate":"2018-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAJC.S135439","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36799528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postpartum family-planning barriers and catalysts in Burkina Faso and the Democratic Republic of Congo: a multiperspective study.","authors":"Nguyen Toan Tran, Wambi Maurice E Yameogo, Mary Eluned Gaffield, Félicité Langwana, James Kiarie, Désiré Mashinda Kulimba, Seni Kouanda","doi":"10.2147/OAJC.S170150","DOIUrl":"10.2147/OAJC.S170150","url":null,"abstract":"<p><strong>Purpose: </strong>To address the high unmet need for postpartum family planning (PPFP) in resource-limited settings, particularly in sub-Saharan Africa, this study aimed to identify PPFP-related barriers and catalysts to inform policies and programs to increase access to postpartum contraception.</p><p><strong>Methods: </strong>Using qualitative methodology, we explored the perspectives of women, adolescent girls, men, religious and community leaders, service providers, and decision makers from three rural communities in Burkina Faso and three rural-urban communities in the Democratic Republic of Congo. Both countries have high unmet need for PPFP and are priority countries of the French Muskoka Fund for Maternal and Child Health.</p><p><strong>Results: </strong>Perceived catalysts included negative traditional views on the consequences borne by closely spaced children and their mothers; a 6-week postpartum visit dedicated to PPFP (albeit poorly attended); political will and enabling policies for FP; and support from certain religious leaders and men. Main reported barriers were the lack of male engagement; out-of-pocket copayment for contraceptives; reliance on amenorrhea for pregnancy prevention without knowing its limits; misconceptions about modern contraceptives, including prerequisites for the lactational amenorrhea method; sexual abstinence supported by religious and traditional norms for up to 3-6 months, although women reported earlier resumption of sexual activity; low prioritization of scheduled postpartum visits by women; and limited availability of readily accessible methods, PPFP counseling materials, and clinic days and scheduled visits dedicated to contraceptive services.</p><p><strong>Conclusion: </strong>Based on results found to be most actionable, the following interventions have the potential to optimize access to PPFP services: counseling women on postpartum-pregnancy risks and options at different points in time before and after childbirth through the use of appropriate information, education, and counseling materials; integrating PPFP services into existing maternal and child health visits; making contraceptives readily available and affordable; and meaningfully engaging male partners.</p>","PeriodicalId":74348,"journal":{"name":"Open access journal of contraception","volume":"9 ","pages":"63-74"},"PeriodicalIF":1.8,"publicationDate":"2018-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1c/4a/oajc-9-063.PMC6236096.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36799525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Venous thrombosis and hormonal contraception: what's new with estradiol-based hormonal contraceptives?","authors":"Franca Fruzzetti,&nbsp;Angelo Cagnacci","doi":"10.2147/OAJC.S179673","DOIUrl":"https://doi.org/10.2147/OAJC.S179673","url":null,"abstract":"<p><strong>Objective: </strong>Estradiol (E2)-based hormonal contraceptives impact less than ethinylstradiol (EE) contraceptives on venous thromboembolism (VTE) in comparison to formulations with EE.</p><p><strong>Study design: </strong>In this article, the pharamacologic data of EE and E2 were briefly reviewed, along with the induced biologic effect. These data were then related to a recent large international prospective, controlled, non-interventional cohort active surveillance study, on the cardiovascular risk of users of different types of combined estroprogestin contraceptive (CEPC).</p><p><strong>Results: </strong>The crude HR for E2-valerate (E2V)/dienogest vs other CEPCs with EE was 0.8 (95% CI, 0.4-1.6), but when the data were corrected for age, body mass index, duration of use, and family history of VTE, the corresponding adjusted HR was 0.5 (95% CI, 0.2-1.0). A comparison of the E2V/dienogest and EE/levonorgestrel groups showed that the two contraceptives induced a similar VTE risk with the crude and adjusted VTE HRs of 0.7 (95% CI, 0.3-1.8) and 0.5 (95% CI, 0.2-1.3), respectively. Similar results were obtained when the observation was prolonged to January 2017.</p><p><strong>Conclusions: </strong>The reduced impact of E2 vs EE on coagulation translates into the epidemiologic evidence of a reduced number of events in E2V vs EE users, when progestins other than levonorgestrel are used. However, E2 may continue to negatively impact on the risk of VTE, and this should not be forgotten at the time of prescription. Family history of VTE or thrombophilia, age, and obesity are risk factors for VTE too. If these risk factors are not taken into consideration and excluded, they can overcome or hide the higher safety of E2 vs CEPCs with EE.</p>","PeriodicalId":74348,"journal":{"name":"Open access journal of contraception","volume":"9 ","pages":"75-79"},"PeriodicalIF":0.0,"publicationDate":"2018-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAJC.S179673","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36799526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Programmatic implications of unmet need for contraception among men and young married women in northern Nigeria.","authors":"Irit Sinai, Jabulani Nyenwa, Olugbenga Oguntunde","doi":"10.2147/OAJC.S172330","DOIUrl":"10.2147/OAJC.S172330","url":null,"abstract":"<p><strong>Purpose: </strong>The study was designed to provide programmatic recommendations for interventions to increase contraceptive prevalence in northern Nigeria. Family-planning use in North-East and North-West regions of Nigeria has remained very low, despite years of domestic and donor investments. We examine respondents' perceptions of their own need for contraception and specifically focus on young women because of their higher risk for maternal mortality.</p><p><strong>Methods: </strong>In this cross-sectional study, we interviewed 1,624 married women younger than 25 years and 1,627 men married to women younger than 25 years, in Kaduna and Katsina states in northern Nigeria. We classified respondents into five categories: 1) having no real need for contraception, 2) perceiving no need for contraception, despite physical or behavioral need, 3) having met need by using a modern contraceptive method, 4) perceiving met need by employing traditional practices, and 5) having unmet need for contraception.</p><p><strong>Results: </strong>Half of female respondents had no need for contraception because they were either pregnant or desiring a pregnancy at the time of the survey. A quarter of female and male respondents were not using contraception because of their religious beliefs. Less than 2% of respondents had unmet need because of lack of availability or access, or due to poor quality of care. Men had more positive views of family planning than women.</p><p><strong>Conclusion: </strong>Our findings suggest that young women in northern Nigeria would benefit from a programmatic approach that targets men, utilizes religious leaders, and addresses the prevalent religious and sociocultural norms that present barriers to contraceptive use. Such interventions have the potential to increase contraceptive prevalence more substantially, but the literature on these types of interventions in northern Nigeria is scarce. Therefore, more research is needed to identify and document what approaches work or do not work to increase contraceptive use in northern Nigeria.</p>","PeriodicalId":74348,"journal":{"name":"Open access journal of contraception","volume":"9 ","pages":"81-90"},"PeriodicalIF":16.4,"publicationDate":"2018-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/08/bd/oajc-9-081.PMC6236097.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36799527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}