Contraception and reproductive medicine最新文献

{"title":"Predictors of intention to use contraceptives among married and cohabiting women in Ghana: A cross-sectional study.","authors":"Augustus Osborne, Richard Gyan Aboagye, Camilla Bangura, Bright Opoku Ahinkorah","doi":"10.1186/s40834-024-00312-9","DOIUrl":"10.1186/s40834-024-00312-9","url":null,"abstract":"<p><strong>Background: </strong>Contraceptive use is a cost-effective intervention for reducing unintended pregnancies and sexually transmitted infections and their negative consequences. It is vital to increase contraceptive use among women to improve their reproductive health outcomes. This study examines the factors associated with contraceptive use intention among married and cohabiting women in Ghana.</p><p><strong>Methods: </strong>We analysed data from the 2022 Ghana Demographic and Health Survey. A total of 5,846 married and cohabiting women were included in the study. A multivariable binary logistic regression analysis was used to examine the factors associated with the intention to use contraceptives. The regression results were presented using an adjusted odds ratio (aOR) with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>The proportion of intention to use contraceptives among married and cohabiting women was 33.0% [31.1, 35.0]. Compared to women living in the Greater Accra, those living in Central (aOR = 1.69; 95% CI = 1.06, 2.69), Bono East (aOR = 1.63; 95% CI = 1.02, 2.61), Oti (aOR = 2.68; 95% CI = 1.63, 4.40), and Upper West Regions (aOR = 4.48; 95% CI = 2.68, 7.48) were more likely to have contraceptive use intention. The odds of intention to use contraceptives increased with increasing parity, with the highest odds among women with four or more births (aOR = 2.41; 95% CI: 1.66, 3.51). The intention to use contraceptives decreased with increasing age, with the lowest odds among those aged 45-49 (aOR = 0.04, 95% CI = 0.25, 0.07). Women with no education (aOR = 0.42, 95% CI = 0.28, 0.63), primary education (aOR = 0.56, 95% CI = 0.37, 0.86), and secondary education (aOR = 0.65, 95% CI = 0.45, 0.92) had lower odds of intention to use contraceptives compared to those with higher education. Married women (aOR = 0.61, 95% CI = 0.49, 0.76) had lower odds of contraceptive use intention relative to cohabiting women.</p><p><strong>Conclusion: </strong>Our study revealed a low contraceptive use intention among women, signalling a barrier in access to family planning services in the country. Various factors, including age, region, marital status, parity, and educational level play a role in determining the intention to use contraceptives. These findings underscore the importance of implementing policy changes and enhancing existing programmes to improve the availability of information, contraceptive education, and family planning services, especially for younger women, those living in rural areas, and those with lower levels of education. Additionally, it is vital to address socio-cultural barriers and empower women to address the factors associated with intention to use contraceptives.</p>","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":"9 1","pages":"55"},"PeriodicalIF":2.2,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633836","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":"\"We provide the methods to others but we don't use the methods ourselves\": challenges with utilization of modern contraception among Female Healthcare Workers at two tertiary teaching hospitals, Northern Uganda.","authors":"Jimmyy Opee, Keneth Opiro, Priscilla Manano, Margret Sikoti, Jackline Ayikoru, Harriet Akello, Fiona Gladys Laker, Maria K Wolters, Silvia Awor, Francis Pebalo Pebolo, Felix Bongomin","doi":"10.1186/s40834-024-00313-8","DOIUrl":"10.1186/s40834-024-00313-8","url":null,"abstract":"<p><strong>Background: </strong>Female Healthcare Workers (FHCWs) play a crucial role in advocating for, delivering modern contraceptive methods (MCM) to reproductive-age women and potential users. Despite the high frequency of women seeking healthcare annually, less than half receive adequate contraceptive counseling and services. Investigating FHCWs' adherence to these practices and understanding the obstacles they encounter is essential. This study aimed to explore challenges with utilization of MCM among FHCWs at the two tertiary teaching hospitals in Northern Uganda.</p><p><strong>Methods: </strong>We conducted a descriptive, cross-sectional study employing a qualitative approach at St. Mary's Hospital Lacor (SMHL) and Gulu Regional Referral Hospital (GRRH), Northern Uganda. Qualitative data were explored using the principles of descriptive phenomenology to gain deeper insights into the experiences of twenty (20) FHCWs.</p><p><strong>Results: </strong>Findings revealed various challenges faced by FHCWs, including patient barriers such as religious beliefs, contraceptive myths, fear of side effects, and provider barriers like lack of knowledge, training, and discomfort. Additionally, health system barriers like limited time and competing priorities were identified.</p><p><strong>Conclusion: </strong>Female Healthcare workers experience challenges with utilization of MCM. Efforts should focus on enhancing contraceptive services, particularly in faith-based facilities and among married individuals. Besides, addressing perceived barriers at the patient, provider, and system levels through comprehensive health education, ensuring method availability, and provider training is imperative.</p>","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":"9 1","pages":"54"},"PeriodicalIF":2.2,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11526507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559740","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":"Determinants of self-reported sexually transmitted infections among reproductive age women in Senegal: evidenced by Senegal demographic and health survey.","authors":"Beletu Kinfe, Habtemariam Mulugeta Abate, Gosa Mankelkl","doi":"10.1186/s40834-024-00318-3","DOIUrl":"10.1186/s40834-024-00318-3","url":null,"abstract":"<p><strong>Background: </strong>Globally, access to sexual and reproductive health is a significant public health issue for women of the reproductive age group. Senegal is a low-income country with limited access to reproductive health services, such as in the prevention and treatment of STIs. The prevention and treatment of STIs is one of the goals set by the government to decrease reproductive health-related morbidity and mortality among women. So, the main objective of this research was to evaluate the prevalence's and determinant of self-reported sexually transmitted infections among reproductive-age women.</p><p><strong>Methods: </strong>Data from the 2023 Senegal Demographic and Health Survey datasets were used for secondary data analysis. A total of 16,583 women of reproductive age participated in the study. Bivariate analysis was employed in order to select the factors for multivariate analysis. In the multivariate analysis, variables with p < 0.05 significance levels were considered to be significant predictors of sexually transmitted infections among reproductive-age women. Finally, the percentage and odd ratio, together with their 95% confidence intervals, were reported.</p><p><strong>Results: </strong>The prevalence of sexually transmitted infection among women was 3.21% with a 95 CI. [2.95-3.49] in the last 12 months. Being between the age range of 20 and 44 years old; attending higher education [AOR: 2.70, 95% CI (1.74, 4.19); P = 0.0001]; women who were never in union [AOR: 0.09, 95% CI (0.046, 0.17); P = 0.001] were positively associated with sexually transmitted infections among women. In contrast to this, living in Louga [AOR: 0.41, 95% CI (0.23,0.69); P = 0.001]; Fatick [AOR: 0.33, 95% CI (0.18,0.61); P = 0.0001]; Kolda [AOR: 0.23, 95% CI (0.11,0.49); P = 0.0001]; Kedougou [AOR: 0.34, 95% CI (0.17,0.68); P = 0.002]; and Sedhiou [AOR: 0.43, 95% CI (0.23,0.79); P = 0.007] and women who had history terminated pregnancy [AOR: 1.27, 95% CI (1.03,1.58); P = 0.023] were negatively associated with sexually transmitted infections among women.</p><p><strong>Conclusions and recommendations: </strong>Women's sexually transmitted infection has been associated with sociodemographic and geographic determinants such as the age of the woman, region, educational status, marital status, and history of terminated pregnancy. Therefore, to prevent the spread of sexually transmitted infections among women, the governments of Senegal and other concerned stakeholders should give special attention to women by addressing sociodemographic and geographic determinants.</p>","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":"9 1","pages":"53"},"PeriodicalIF":2.2,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11526574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549487","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":"Spatial Heterogeneity and association between the survey-based Women's Empowerment Index (SWPER) and unmet need for birth spacing in sub-Saharan Africa.","authors":"Tarif Salihu, Louis Kobina Dadzie, Aster Ferede Gebremedhin, Bright Opoku Ahinkorah, Sanni Yaya","doi":"10.1186/s40834-024-00305-8","DOIUrl":"10.1186/s40834-024-00305-8","url":null,"abstract":"<p><strong>Background: </strong>Unmet need for birth spacing can significantly impact maternal and child health outcomes, leading to unintended or mistimed births, neonatal mortality, pregnancy loss, induced abortions, small-sized births, and malnutrition. Considering the role of women empowerment in women's sexual and reproductive health, we examined the association between the survey-based women's empowerment index (SWPER) and unmet need for spacing in sub-Saharan Africa (SSA).</p><p><strong>Methods: </strong>We used data from the Demographic and Health Surveys of 21 in SSA conducted between 2015 and 2021. In this study, the unit of analysis was women of reproductive age (15 to 49 years) who were married or living together and required family planning during the survey period. Multilevel logistic regression was fitted to examine the association between SWPER and the unmet need for spacing. The results were presented using adjusted odds ratios (AORs) with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>The hotspot countries for unmet need for birth spacing were Angola, Benin, Liberia, Mauritania, and Sierra Leone. The findings showed that with the empowerment indicators, women with high attitude to violence (disagreement or rejection of violence) (AOR = 0.95; 95% CI 0.91, 0.99), and women with high decision-making (AOR = 0.90; 95% CI 0.85, 0.95) exhibited lower odds of unmet spacing need relative to women with low attitude to violence and those with low decision making. Women with high autonomy (AOR = 1.32; 95% CI 1.25, 1.39) were more likely to experience unmet need for spacing compared to those with low autonomy.</p><p><strong>Conclusion: </strong>Unmet need for spacing has been linked to indices of women's empowerment such as attitudes toward violence, independence, and decision-making. Organizations such as UNICEF, UNFPA, and the Bill & Melinda Gates Foundation should consider incorporating SWPER indicators when planning interventions to address the high unmet need for spacing among women in SSA. Additionally, various governments and aid organizations must give women's empowerment a high priority as a tactical intervention strategy to increase access to contraception in the countries considered in this study. These programmes would contribute to attaining SDGs 3.1 and 3.7.</p>","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":"9 1","pages":"52"},"PeriodicalIF":2.2,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514763","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":"From theories of contraceptive use to human rights principles: implications for indicators on the supply and demand side.","authors":"Moussa Lonkila Zan, Clémentine Rossier","doi":"10.1186/s40834-024-00314-7","DOIUrl":"10.1186/s40834-024-00314-7","url":null,"abstract":"<p><p>In this commentary, we examine the evolution of theories and metrics regarding contraception. We contend that while human rights principles are now widely integrated into the \"supply-side factors\" of contraceptive provision, particularly through the concept of quality of care and its metrics, their role in relation to \"demand-side factors\" remains ambiguous. We propose that human rights represent one of several normative frameworks to which both users and non-users may adhere when shaping their fertility preferences and decisions regarding contraception. To gain a deeper understanding of persistent obstacles on the demand side of contraceptive utilization, comprehensive data on attitudes toward sexuality and motherhood at both individual and community levels, as well as nuanced indicators of knowledge and acceptance of contraception among all women, are essential. Such data could facilitate examination of how exposure to human rights-based sexual and reproductive health programs influences normative contexts, individual empowerment among women, and the demand for contraception. Additionally, further research is needed to explore the reciprocal relationship-how contraceptive use influences women's trajectories of empowerment-which requires longitudinal data covering the entire reproductive lifespan.</p>","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":"9 1","pages":"51"},"PeriodicalIF":2.2,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11492779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142483245","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":"Factors associated with modern contraceptive utilization among reproductive age women in Cambodia; evidenced by the recent Cambodia demographic and health survey.","authors":"Beletu Kinfe, Gosa Mankelkl","doi":"10.1186/s40834-024-00315-6","DOIUrl":"https://doi.org/10.1186/s40834-024-00315-6","url":null,"abstract":"<p><strong>Introduction: </strong>Cambodia is a low-income country with limited access to family planning (FP) in terms of modern contraceptive utilization. Despite several FP programs designed to make contraceptives accessible, adoption of contraceptives has been difficult in Cambodia, which has high rates of fertility and maternal mortality. This gap in essential care can put women and adolescent girls at greater risk of adverse outcomes such as stillbirth, spontaneous abortion, unwanted pregnancy, or even maternal death. One of the goals set by the government to decrease both maternal and child mortality and morbidity was increasing the modern contraceptives utilization. So, the main objective of this study was to evaluate spatial variations in modern contraceptives utilization and its contributing factors among women.</p><p><strong>Methods: </strong>Data from the Cambodia 2021-22 Demographic and Health Survey datasets were used for secondary data analysis. A total of 19,496 women of reproductive age participated in the study. A spatial and multilevel mixed effects analysis was done on the factors affecting modern contraceptives utilization among Cambodian women. Finally, the percentage, odd ratio, together with their 95% confidence intervals and the results of the spatial analysis were provided.</p><p><strong>Result: </strong>The prevalence of modern contraceptive use was 31.2% in Cambodia. Living in an urban area [AOR = 1.224; 95% CI = (1.126.1.330); P = 0.0001]; being married [AOR = 34.131; 95% CI= (12.673, 91.921); P = 0.0001]; and having a history of terminated pregnancy [AOR = 1.137; 95% CI= (1.055, 1.225); P = 0.0001] were found to be positively associated with modern contraceptive utilization. In contrast to this, being between the age range of 46-49 [AOR = 0.421; 95% CI = (0.364, 0.487); P = 0.0001]; being a female-headed household [AOR = 0.784; 95% CI = (0.723, 0.850); P = 0.0001]; and current breast feeding [AOR = 0.84; 95% CI = (0.75, 0.93); P = 0.010] were found to be negatively associated with modern contraceptive utilization. Additionally, the spatial analysis of modern contraceptive utilization showed that a higher proportion was utilized in the southern and southwest regions of Cambodia.</p><p><strong>Conclusion: </strong>In this study, living in urban area, being married and having history of terminated pregnancy were found positively associated with modern contraceptive utilization. In contrast to this, being old age, being female headed household and being currently breast-feeding women were found negatively associated with modern contraceptive utilization. In addition to this, there were geographic (spatial) variations in modern contraceptive utilization among Cambodian's women across the country.</p>","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":"9 1","pages":"50"},"PeriodicalIF":2.2,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11481420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142483244","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":"Barriers and enablers to utilisation of postpartum long-acting reversible contraception in Eastern Uganda: a qualitative study.","authors":"Assen Kamwesigye, Daphine Amanya, Brendah Nambozo, Joshua Epuitai, Doreck Nahurira, Solomon Wani, Patience Anna Nafula, Faith Oguttu, Joshua Wadinda, Ritah Nantale, Agnes Napyo, Julius N Wandabwa, David Mukunya, Milton W Musaba, Merlin Willcox","doi":"10.1186/s40834-024-00308-5","DOIUrl":"10.1186/s40834-024-00308-5","url":null,"abstract":"<p><strong>Introduction: </strong>In Uganda, although most women wish to delay or prevent future pregnancies, uptake of postpartum family planning (PPFP) is low. We explored behavioural factors influencing the utilisation of postpartum long-acting reversible contraceptives (LARCs) in Eastern Uganda.</p><p><strong>Methods: </strong>We conducted a qualitative study in two districts of Eastern Uganda. We conducted 20 in-depth interviews and three focus group discussions with postpartum women, male partners, midwives, and village health team members. We analysed transcripts using framework analysis, based on the COM-B framework.</p><p><strong>Results: </strong>The use of immediate postpartum LARC was affected by the capabilities of women in terms of their knowledge and misconceptions. Limited capabilities of health workers to provide counselling and insert IUDs, as well as shortages of implants, reduced the physical opportunites for women to access PPFP. Social opportunities for women were limited because men wanted to be involved in the decision but rarely had time to accompany their partners to health facilities, and health workers often appeared too stressed. Men also feared that PPFP would enable their partners to be unfaithful. Motivation to take up immediate postpartum LARC included the desire to space births, preference for contraceptive implants over intra uterine devices (IUD) at the 6-week postpartum period, resumption of sex and menses, partner support, and perceived effectiveness of postpartum contraception. Participants thought that uptake of immediate postpartum LARC could be improved by health education and outreach visits, male involvement and couples' counselling in antenatal clinic appointments, and enabling switching between family planning methods (in case of side-effects) .</p><p><strong>Conclusion: </strong>Low uptake of PPFP was caused by inadequate knowledge and misconceptions about LARC by women and their partners, insufficient numbers of midwives trained to provide PPFP, stock-outs of PPFP methods, and few social opportunities for couples to be counselled together. These factors could be addressed by scaling up effective, low cost and innovative ways to provide health education (such as films), involving men in decision-making, as well as training more midwives to provide PPFP services, and ensuring that they have sufficient time and supplies.</p>","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":"9 1","pages":"49"},"PeriodicalIF":2.2,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11465926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142402356","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":"Comparative effectiveness of sildenafil citrate and estradiol valerate as adjuvants during clomiphene citrate-assisted ovarian stimulation cycles in patients with unexplained infertility: a double-blind randomized controlled trial.","authors":"Jean-Didier Bosenge-Nguma, Antoine Modia O'yandjo, Roland Marini Djang'eing'a, Juakali Skv, Noël Labama Otuli, Justin Kadima Ntokamunda, Alexis Heng Boon Chin, Gédéon Katenga Bosunga","doi":"10.1186/s40834-024-00307-6","DOIUrl":"10.1186/s40834-024-00307-6","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the effect of sildenafil citrate and estradiol valerate as adjuvant therapy during ovarian stimulation cycles with clomiphene citrate in patients with unexplained infertility in Kisangani.</p><p><strong>Method: </strong>A double-blind, randomized controlled trial was conducted for two years at two specialized health facilities in Kisangani (University Clinics of Kisangani and \"Clinique des Anges Kisangani\"). The population included 148 patients, 74 of whom were on clomiphene citrate + sildenafil citrate (CCSC) regimens and 74 of whom were on clomiphene citrate + estradiol valerate (CCEV) regimens for three months. The primary indicator was the conception rate, with secondary outcomes encompassing endometrial thickness, appearance and vascularity, the number of mature follicles and ovulation rate.</p><p><strong>Results: </strong>The two groups were comparable in terms of sociodemographic and clinical characteristics. The mean duration of attempting to conceive was 4.39 years versus 4.36 years (P = 0.839), while the mean AFC was 11.51 versus 11.46 (P = 0.831), in the CCSC group versus CCEV group respectively. Secondary infertility was the most frequent diagnosis in each of the two groups. The biochemical pregnancy rate was comparable between the two groups (P = 0.385), while the clinical pregnancy rate was significantly higher in the CCSC group versus CCEV group (P = 0.04). Both perifollicular flow and the ovulation rate were significantly higher in the CCSC group versus the CCEV group (P = 0.006 and P = 0.002 respectively). However, endometrial vascularity/thickness, and the number of Graafian follicles were not significantly different between the two groups.</p><p><strong>Conclusion: </strong>As an adjuvant, sildenafil increases the rate of clinical pregnancy more than does estradiol in patients with unexplained infertility undergoing ovarian stimulation with clomiphene citrate.</p><p><strong>Study registration: </strong>PACTR 202,310,849,449,401 (Pan African Clinical Trials Registry).</p>","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":"9 1","pages":"48"},"PeriodicalIF":2.2,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11462857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395970","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":"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":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Result: &lt;/strong&gt;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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;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}