Contraception and reproductive medicine最新文献

{"title":"Barriers to modern contraceptive utilization in Ethiopia.","authors":"Tigist Shumet, Nigatu Regassa Geda, Jemal Ali Hassan","doi":"10.1186/s40834-024-00311-w","DOIUrl":"https://doi.org/10.1186/s40834-024-00311-w","url":null,"abstract":"<p><strong>Background: </strong>Contraception is a critical service for women to control their reproductive health, allowing them to determine the number and spacing of their children prevent unintended pregnancies, reduce the risk of morbidity and mortality from associated with childbirth, and reduce the likelihood of abortions. Despite its benefits, the utilization of modern contraceptive methods remains low in certain regions of Ethiopia, Particularly in Afar and Somali, which are also experiencing high fertility rates. However, there is a substantial gap in understanding the sociocultural barriers that hinder the adoption of modern contraception in these regions. This study aims to explore these barriers to contraceptive use among women of reproductive age in Afar and Somali regions, providing qualitative insights that are essential for designing effective strategies to improve contraceptive service utilization.</p><p><strong>Methods: </strong>Asequential mixed method approach was employed, including scoping review and qualitative interviews. Scoping review focused on qualitative or mixed-methods studies conducted in Ethiopia and published between 2013 and 2023 in English, Selecting 14 articles Additionally, qualitative data were collected from Afar and Somali regions through In-depth interviews with women aged 15-49 who are married or in consensual union, and key informant interviews with health extension workers and contraception providers at health center. A total of 20 in-depth interviews and 07 key informants were conducted. Thematic analysis was used to analyze the data.</p><p><strong>Result: </strong>The integrated findings from the scoping review and qualitative study reveal various barriers and determinants influencing contraceptive use among women in Ethiopia. Barriers includes religious or cultural beliefs, myths and misconceptions, fear of side effects, lack of knowledge and misinformation, negative attitude towards contraceptives, partner opposition, socio-cultural factors, fear of being judged by family and friends, and lack of communication between husband and wife, husband altitude, distance from health facility, availability of service and different contraceptive choice, separate room for family planning services, and cost of contraceptive method and transportation. The scoping review corroborates these findings, emphasizing on the role of socio-demographic, economic, cultural, religious, health service, and knowledge-related factors. Higher education, urban residence, higher income, mass media exposure, spousal communication, family size, and access to quality health services were associated with increased utilization, while lack of awareness, misconceptions, myths, side effects, fear of infertility, partner opposition, social stigma, and cultural norms decreased utilization.</p><p><strong>Conclusion: </strong>The study recommended promoting contraceptive use, challenging socio-cultural norms through Social Behavioural Commu","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":"9 1","pages":"47"},"PeriodicalIF":2.2,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11460042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395969","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":"Modern contraceptive utilization among women of reproductive age in Ghana: a multilevel mixed-effect logistic regression model.","authors":"Begetayinoral Kussia Lahole, Debora Banga, Kusse Urmale Mare","doi":"10.1186/s40834-024-00310-x","DOIUrl":"https://doi.org/10.1186/s40834-024-00310-x","url":null,"abstract":"<p><strong>Background: </strong>Worldwide, sexual and reproductive health remains a prominent public health concern for women of reproductive age. Modern contraceptive methods play a crucial role in enabling individuals and families to regulate fertility, thereby reducing unintended pregnancies, abortions, pregnancy-related complications, and mortality. Due to the scarcity of reliable and current data regarding the factors affecting the adoption of modern contraceptives among women of reproductive age at the national level in Ghana, this research aimed to explore the determinants of modern contraceptive usage among reproductive age women.</p><p><strong>Methods: </strong>The study analyzed data from the 2022 Ghana Demographic and Health Survey, including a weighted sample of 6,839 reproductive-age women. By employing a multilevel logistic regression model, the study sought to determine factors associated with the utilization of modern contraceptives. Associations between explanatory variables and the outcome were evaluated using adjusted odds ratios (AORs) along with 95% confidence intervals (CIs). Statistical significance was established using a p-value threshold of less than 0.05. All statistical analyses were conducted using STATA version 17 software.</p><p><strong>Results: </strong>The study found that 26.36% (95% CI: 25.33-27.34%) of women of reproductive age in Ghana used modern contraceptives. Secondary education (AOR = 1.26, 95% CI = 1.03-1.53), poorer household (AOR = 1.30, 95% CI = 1.05-1.61), women's marital status, i.e. married (AOR = 1.46, 95% CI = 1.16-1.83), living with a partner (AOR = 1.65, 95% CI = 1.32-2.06), divorced (AOR = 2.53, 95% CI = 1.48-4.31), and separated (AOR = 1.70, 95% CI = 1.21-2.37), multipara (AOR = 1.39, 95% CI = 1.04-1.87), were the factors that promote modern contraceptive utilization. Women's age in years, i.e. 35-39 (AOR = 0.71, 95% CI = 0.52-0.97), 40-44 (AOR = 0.63, 95% CI = 0.44-0.90), and 45-49 (AOR = 0.45, 95% CI = 0.25-0.79), history of pregnancy loss (AOR = 0.86, 95% CI = 0.76-0.98), region, i.e. Greater Accra (95% CI = 0.42-0.92), Bono East (95% CI = 0.32-0.81), Northern (95% CI = 0.28-0.67), Savannah (95% CI = 0.28-0.81), and North East (95% CI = 0.20-0.63), were all associated with a lower use of modern contraceptives.</p><p><strong>Conclusions: </strong>Modern contraceptive utilization was low in this study. Factors such as women's education, socioeconomic status, and marital status were associated with increased modern contraceptive utilization, whereas women's age and regional disparities were linked to lower usage rates. These findings emphasize the need for targeted interventions to address socioeconomic barriers and regional disparities in access to family planning services across Ghana.</p>","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":"9 1","pages":"46"},"PeriodicalIF":2.2,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11438017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142334431","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":"Spousal age differences and women's contraceptive use in sub-Saharan Africa.","authors":"Pearl S Kyei, Ayaga A Bawah","doi":"10.1186/s40834-024-00306-7","DOIUrl":"https://doi.org/10.1186/s40834-024-00306-7","url":null,"abstract":"<p><strong>Background: </strong>This study examines the likelihood of contraceptive use among married women in sub-Saharan Africa, focusing on the influence of spousal age difference.</p><p><strong>Methods: </strong>Binary logistic regressions predicting contraceptive use were estimated using a sample of 478,193 women in first union from 29 sub-Saharan African countries spanning two decades from 1999 to 2022. The data were sourced from the Demographic and Health Surveys (DHS).</p><p><strong>Results: </strong>The regression results indicate that spousal age difference is negatively correlated with the likelihood of contraceptive use with each additional year reducing the odds of using contraception by 1.1 percent. The association between the two variables has remained largely consistent over time. The findings also show substantial variation in the influence of spousal age differences on contraceptive use ranging from statistically significant and negative odds in some countries to not statistically significant but positive odds in others. Measures of female autonomy, education and healthcare decision-making, had a modest influence on the size and significance of the association between spousal age difference and contraceptive use.</p><p><strong>Conclusions: </strong>The relationship between spousal age difference and contraceptive use is of concern given the prevalence of age-disparate relationships in the context. These findings add to the literature on the potentially negative implications of age-disparate relationships, while highlighting that the association is not uniformly negative across countries.</p>","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":"9 1","pages":"45"},"PeriodicalIF":2.2,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11426089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142334444","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":"Comparison of ultra-long gonadotropin releasing hormone agonist versus standard downregulation in women with adenomyosis undergoing frozen-thawed embryo transfer: a randomized clinical trial.","authors":"Soheila Ansaripour, Katayoun Yazdchi, Mohammad Reza Sadeghi, Nasim Nasseri, Atousa Karimi, Mina Ataei, Narges Madadi, Fateme Jalalinejad, Fahimeh Rahimi","doi":"10.1186/s40834-024-00304-9","DOIUrl":"https://doi.org/10.1186/s40834-024-00304-9","url":null,"abstract":"<p><strong>Background: </strong>Adenomyosis can lead to infertility and failure of in vitro fertilization. Limited evidence suggests that the use of long-term treatment with gonadotropin-releasing hormone (GnRH) agonists followed by frozen-thawed embryo transfer (FET) may be the preferred approach for women with adenomyosis.</p><p><strong>Objective: </strong>The aim of this randomized controlled trial is to compare the efficacy of an ultra-long GnRH agonist with standard downregulation in women with adenomyosis undergoing FET.</p><p><strong>Materials and methods: </strong>This randomized controlled trial enrolled 72 women with adenomyosis diagnosed by sonographic criteria who underwent FET cycles at the Avicenna Infertility Center. These women were randomly assigned to two equal groups: one received GnRH agonist treatment for three months before the FET cycle and the other served as the standard downregulation group. Results were reported as chemical and clinical pregnancy rates.</p><p><strong>Results: </strong>The two groups were similar in age, body mass index, anti-Müllerian hormone levels, number of previous pregnancies and miscarriages, presence of uterine myomas, and endometriosis. However, the total dose of estradiol used until embryo transfer was significantly higher in the ultra-long GnRH agonist group than in the standard group (96.14 mg vs. 80.52 mg, p-value = 0.004). Nevertheless, chemical and clinical pregnancy rates did not differ significantly between the two groups.</p><p><strong>Conclusions: </strong>Ultra-long GnRH agonist downregulation did not improve the chemical and clinical pregnancy rate in the FET cycle in women with adenomyosis compared with standard GnRH agonist downregulation in the other words, ultra-long GnRH agonist downregulation is not superior to standard protocol. In women with adenomyosis (without history of endometriosis), downregulation of standard GnRH agonists prior to frozen-thawed embryo transfer may be the preferred embryo transfer protocol to gain higher clinical/chemical pregnancy rate.</p><p><strong>Trial registration: </strong>Clinical trial registry: IRCT20160717028967N9, available at: https://irct.behdasht.gov.ir/trial/36103 .</p>","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":"9 1","pages":"44"},"PeriodicalIF":2.2,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11385168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142303419","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":"Assessment of intention to use modern contraceptives among women of reproductive age in Benin: evidence from a national population-based survey.","authors":"Anthony Kolsabilik Kuug, Silas Selorm Daniels-Donkor, Timothy Tienbia Laari, Gideon Awenabisa Atanuriba, Maxwell Tii Kumbeni, Dennis Bomansang Daliri, Richard Adongo Afaya, Vida Nyagre Yakong, Jerry Apiini Akurugu, Emefa Awo Adawudu, Solomon Mohammed Salia, Agani Afaya","doi":"10.1186/s40834-024-00294-8","DOIUrl":"https://doi.org/10.1186/s40834-024-00294-8","url":null,"abstract":"<p><strong>Background: </strong>Women's intentions to use any contraceptive method are critical for better understanding their future needs and making them more likely to act on that intention. This study assessed the factors associated with the intention to use modern contraceptives among women of reproductive age in Benin.</p><p><strong>Methods: </strong>This was a cross-sectional study that used the 2017-2018 Benin Demographic and Health Survey (BDHS). The study analyzed a weighted sample of 13, 582 women of reproductive age who were non-users of contraceptives. The intention to use contraceptives was the outcome variable. Multivariate logistic regression analysis was conducted to determine the factors associated with the intention to use contraceptives among women of reproductive age. The results were estimated using an adjusted odds ratios (aOR) with a 95% confidence interval (CI) and statistical significance set at p < 0.05.  RESULTS: Approximately 35.0% of the women had the intention to use modern contraception. We found that women aged between 30 and 34 (aOR = 0.70, 95%CI: 0.57, 0.86), 35-39 (aOR = 0.52, 95%CI: 0.42, 0.66), 40-44(aOR = 0.30, 95%CI: 0.22, 0.39) and 45-49 (aOR = 0.10, 95%CI: 0.07, 0.14), Muslim women (aOR = 0.68, 95%CI: 0.53, 0.85) and those who perceived the distance to a health facility not to be a big problem (aOR = 0.75, 95%CI: 0.67, 0.84) were less likely to have the intention to use modern contraceptives compared with their counterparts. On the other hand, women who attained primary (aOR = 1.21, 95%CI: 1.07, 1.36), secondary (aOR = 1.39, 95%CI: 1.21, 1.59), and higher education (aOR = 1.60, 95%CI: 1.13, 2.26), women who were employed (aOR = 1.39, 95%CI: 1.23, 1.57), women with no religion (aOR = 1.32, 95%CI: 1.04, 1.69), women whose partners were working (aOR = 1.69, 95%CI: 1.16, 2.44), women who heard about family planning in the media (aOR = 1.51, 95%CI: 1.16, 2.44), and women in the poorer (aOR = 1.31, 95%CI: 1.10, 1.54), middle (aOR = 1.42, 95%CI: 1.20, 1.67]), richer (aOR = 1.23, 95%CI: 1.03, 1.47), and richest households (aOR = 1.42, 95%CI: 1.15, 1.75) were more likely to have the intention to use contraceptives than their counterparts.</p><p><strong>Conclusion: </strong>The study provides valuable insights into the intention to use contraceptives among women of reproductive age in Benin. The findings indicate that the proportion of women who have intention to use contraceptives remains low. The findings of this study could inform the development of targeted interventions and policies to increase access to and uptake of contraceptives in Benin, with the ultimate aim of improving the reproductive health and well-being of women and their families.</p>","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":"9 1","pages":"43"},"PeriodicalIF":2.2,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11363446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142116001","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":"Migration of an intrauterine contraceptive device into the bladder complicated by stone formation an exceptional complication: case report and literature review.","authors":"Hanane Houmaid, Karam Harou, Bouchra Fakhir, Ahlam Bassir, Lahcen Boukhanni, Abderrahim Aboulfalah, Hamid Asmouki, Abderraouf Soummani","doi":"10.1186/s40834-024-00302-x","DOIUrl":"10.1186/s40834-024-00302-x","url":null,"abstract":"<p><strong>Background: </strong>We report a rare and unusual case of intravesical migration of an intrauterine device with stone formation. The intrauterine device (IUD) is the most common method of reversible contraception in women. However, its insertion is not without risk, it can cause early or late complications. IUD can perforate the uterus wall and migrate into adjacent structures.</p><p><strong>Case presentation: </strong>A 35 year-old female 5 gravid, 4 para has been benefited from intrauterine contraceptive device (IUCD) 5 years ago, she was presented to gynecological consultation for chronic pelvic pain with urinary symptoms. There was history of a good IUD insertion 5 years ago, considered expelled after one month of its pose. Physical examination was normal, but a pelvic ultrasound and a plain abdominal radiography allowed the detection of an IUD outside the uterine cavity, but inside bladder. A diagnostic and therapeutic cystoscopy was performed, and the IUD with calculus was successfully removed. There were no postoperative complications.</p><p><strong>Conclusion: </strong>This case is reported to highlight and to reiterate the need to think about one of the rare complication of IUD insertion, which every practitioner must know, it's the transuterovesical migration, before concluding wrongly to its expulsion. It's a consequence of, non-compliance with the rules for inserting an IUD and poor monitoring. The evolution towards calcification is a certain consequence; its screening involves rigorous clinical monitoring.</p>","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":"9 1","pages":"42"},"PeriodicalIF":2.2,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11351088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082888","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":"The impact of low oocyte maturity ratio on blastocyst euploidy rate: a matched retrospective cohort study.","authors":"Zhanhui Ou, Jing Du, Nengqing Liu, Xiaowu Fang, Xiaojun Wen, Jieliang Li, Xiufeng Lin","doi":"10.1186/s40834-024-00303-w","DOIUrl":"10.1186/s40834-024-00303-w","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the association between a low oocyte maturity ratio from in vitro fertilization cycle and blastocyst euploidy.</p><p><strong>Methods: </strong>A total of 563 preimplantation genetic testing (PGT) cycles (PGT cycles with chromosomal structural rearrangements were excluded) were performed between January 2021 and November 2022 at our center (average oocyte maturity rate: 86.4% ± 14.6%). Among them, 93 PGT cycles were classified into the low oocyte maturity rate group (group A, < mean - 1 standard deviation [SD]), and 186 PGT cycles were grouped into the average oocyte maturity rate group (group B, mean ± 1 SD). Group B was 2:1 matched with group A. Embryological, blastocyst ploidy, and clinical outcomes were compared between the two groups.</p><p><strong>Results: </strong>The oocyte maturity (metaphase II [MII oocytes]), MII oocyte rate, and two pronuclei (2PN) rates were significantly lower in group A than in group B (5.2 ± 3.0 vs. 8.9 ± 5.0, P = 0.000; 61.6% vs. 93.0%, P = 0.000; 78.7% vs. 84.8%, P = 0.002, respectively). In group A, 106 of 236 blastocysts (44.9%) that underwent PGT for aneuploidy were euploid, which was not significantly different from the rate in group B (336/729, 46.1%, P = 0.753). However, euploid blastocysts were obtained only in 55 cycles in group A (55/93, 59.1%), which was lower than the rate in group B (145/186, 78.0%, P = 0.001). The clinical pregnancy rate in group B (73.9%) was higher than that in group A (58.0%) (P = 0.040).</p><p><strong>Conclusion: </strong>Our results suggest that a low oocyte maturity ratio is not associated with blastocyst euploidy but is associated with fewer cycles with euploid blastocysts for transfer, lower 2PN rates, and lower clinical pregnancy rates.</p>","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":"9 1","pages":"41"},"PeriodicalIF":2.2,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11346022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074755","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":"Religious leaders' nuanced views on birth spacing and contraceptives in Sierra Leone - qualitative insights.","authors":"Regina Mamidy Yillah, Florence Bull, Alhaji Sawaneh, Beryl Reindorf, Hamid Turay, Haja Ramatulai Wurie, Mary Hamer Hodges, Augustus Osborne","doi":"10.1186/s40834-024-00301-y","DOIUrl":"10.1186/s40834-024-00301-y","url":null,"abstract":"<p><strong>Background: </strong>Sierra Leone is a religiously diverse country, with Christianity and Islam being the dominant faiths. This religious landscape plays a significant role in shaping attitudes towards family planning and contraceptives. We examined religious leaders' knowledge of family planning and modern contraceptive methods.</p><p><strong>Methods: </strong>In September 2021, data was collected from 116 religious leaders in Sierra Leone, including 32 Muslims and 84 Christians from nine different denominations from sixteen districts, through 16 focus group discussions. The data was subjected to a thematic analysis using NVIVO 12 software.</p><p><strong>Results: </strong>The study found a spectrum of opinions among religious leaders, both between religions (Christianity vs. Islam) and within denominations of Christianity. There was a general acceptance of natural birth spacing methods, like abstinence during fertile periods, across both Christian and Muslim leaders. Views on modern contraceptives were more divided. Catholics generally opposed them, citing religious doctrines against interfering with procreation. Pentecostals and some Muslims, however, found them permissible under certain circumstances, like promoting family well-being or spacing births for health reasons.</p><p><strong>Conclusion: </strong>The study reveals that religious leaders' views on family planning in Sierra Leone are multifaceted. Understanding these nuances is crucial for designing effective family planning programs. By working with denominations that are more accepting of modern methods and leveraging the support for natural birth spacing methods across religions, there's potential to improve reproductive health outcomes in Sierra Leone.</p>","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":"9 1","pages":"40"},"PeriodicalIF":2.2,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11342541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142047681","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":"\"I will find the best method that will work for me\": navigating contraceptive journeys amongst South African adolescent girls and young women.","authors":"Zoe Duby, Kate Bergh, Brittany Bunce, Kim Jonas, Nevilene Slingers, Catherine Mathews, Fareed Abdullah","doi":"10.1186/s40834-024-00298-4","DOIUrl":"10.1186/s40834-024-00298-4","url":null,"abstract":"<p><strong>Background: </strong>Given that South Africa has one of the highest rates of pregnancy amongst adolescent girls and young women (AGYW) globally, the provision of contraceptives to this group has been a key focus in recent years. Pregnancy prevention involves an on-going continuum of decision-making around contraceptive method choice, uptake, use, experience, continuation, and discontinuation.</p><p><strong>Methods: </strong>This paper presents analysis of data from a cross-sectional survey with 2376 AGYW, as well as qualitative in-depth interviews (IDIs) with 54 AGYW, inclusive of contraceptive journey narratives. We examine the preferences, valued characteristics, choices, beliefs, understandings and experiences of choosing and using contraceptives amongst AGYW in two South African communities characterised by high rates of pregnancy.</p><p><strong>Results: </strong>These findings shed light on the preferences towards, beliefs about, and experiences of choosing, using and discontinuing contraceptive methods amongst this population, with survey data suggesting that the most popular methods were the injection, followed by the implant, and then the oral pill. Findings illustrate the complexity and dynamic nature of contraceptive decision-making and the varied embodied and lived experiences of contraceptive use, and how these are impacted by contraception service provision.</p><p><strong>Conclusions: </strong>Our findings show that contraception experiences of each individual are cumulative, and comprise a continuum of method initiation, use, discontinuation, method switching and on-going circular decision-making influenced by multiple social, structural, contextual and interpersonal factors, combined with shifting preferences, values and needs. To maximise the use of contraceptives amongst South African AGYW, it is necessary to provide responsive contraception service provision to reflect the changing contexts and preferences of users, in order to ensure that pregnancy prevention needs are catered for throughout their reproductive life course.</p>","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":"9 1","pages":"39"},"PeriodicalIF":2.2,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11295340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876965","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":"Early contraceptive implant removal and associated factors among women attending public family planning clinics, Mbarara City, Southwestern Uganda: a cross-sectional study.","authors":"Joseph Rwebazibwa, Richard Migisha, Gideon Munaru, Onesmus Byamukama, Lenard Abesiga, Godfrey R Mugyenyi, Paul Kato Kalyebara, Leevan Tibaijuka, Joseph Ngonzi, Rogers Kajabwangu, Stuart Turanzomwe, Fadumo Mohammed, Joy Muhumuza, Agaba David Collins, Yarine Tornes Fajardo, Wasswa G M Ssalongo, Musa Kayondo, Hamson Kanyesigye","doi":"10.1186/s40834-024-00299-3","DOIUrl":"10.1186/s40834-024-00299-3","url":null,"abstract":"<p><strong>Background: </strong>Early implant removal not only results in method wastage and strains healthcare resources but also exposes women to the risk of unplanned pregnancies and associated complications if an alternative contraceptive is not promptly adopted. Studies have demonstrated that prevalence and factors associated with contraceptive use vary across different cultures and regions even within Uganda. We determined the prevalence and associated factors of early implant removal, among women attending public family planning clinics in Mbarara City, southwestern Uganda.</p><p><strong>Methods: </strong>We conducted a cross-sectional study from April to July 2023 at four public family planning clinics in Mbarara City. We consecutively enrolled women and administered a questionnaire to obtain data on demographic, and medical characteristics. We defined early removal as implant discontinuation within a period < 2 years. We excluded women who did not have a written record of the date of insertion of the contraceptive implants. We used modified Poisson regression analysis to determine factors associated with early implant removal.</p><p><strong>Results: </strong>We enrolled 406 women, with a mean age of 29 ± 6 years. The prevalence of early contraceptive implant removal was 53% (n = 210; 95%, CI: 48-58%). Factors associated with early implant removal were experiencing side effects (adjusted prevalence ratio [aPR] = 1.63, 95% CI: 1.20-2.21), inserting an implant to achieve career goals (aPR = 1.88, 95% CI: 1.26-2.81) and intending to use the implant for < 24 months (aPR = 1.36, 95% CI: 1.11-1.66).</p><p><strong>Conclusion: </strong>Approximately half of the surveyed women removed their contraceptive implant early. Women who experienced side effects, chose an implant due to career obligations and those whose intended implant use was < 2 years were more likely to have an early contraceptive implant removal compared to their counterparts. We recommend strengthening of pre- and post- insertion counselling to address concerns among those who may experience side-effects. Women who intend to use implants for < 2 years and those who have career obligations should be encouraged to use short-acting methods as an option.</p>","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":"9 1","pages":"38"},"PeriodicalIF":2.2,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11289939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141857421","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}