{"title":"低收入和中等收入国家残疾人使用现代避孕药具的流行率和决定因素:系统回顾和荟萃分析。","authors":"Atika Rahman Chowdhury, Shimlin Jahan Khanam, Mohammad Zahidul Islam, Gulam Khandaker, Md Nuruzzaman Khan","doi":"10.1111/tmi.14130","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>People with disabilities have the same need for contraception as the general population. However, their access to modern contraceptive methods is largely underexplored in low- and middle-income countries.</p><p><strong>Objective: </strong>This study aimed to explore the prevalence of modern contraception use among reproductive-aged (15-49 years) persons with disabilities in low- and middle-income countries and identify the key determinants.</p><p><strong>Methods: </strong>In June 2024, we conducted a systematic search across six databases including PubMed, Web of Science, Embase, Global Health, Medline and Scopus to identify studies on disability and modern contraception in low- and middle-income countries. The search terms included a combination of Medical Subject Headings (MeSH) terms and keywords related to disability, modern contraception and low- and middle-income countries integrated using the Boolean operators (AND, OR). All studies published between January 2015 and June 2024, in English, and conducted in low- and middle-income countries were included. The primary outcomes were the prevalence of modern contraception use and its determinants among persons with any disability. Summary estimates were calculated using meta-analysis with a fixed effects model for lower heterogeneity. Random effects meta-analysis was used for mid-level heterogeneity (50%-74%) and high-level heterogeneity (75%-100%).</p><p><strong>Results: </strong>A total of 18 studies from low- and middle-income countries were included, with 11 included in the meta-analysis. The pooled prevalence of modern contraception use among persons with disabilities was 31.4% (95% CI: 26.5, 36.2). Significant heterogeneity was observed across respondent characteristics (I<sup>2</sup> = 94.55%). Five factors were significantly associated with higher contraception use: being aged over 25 years, having some level of education, being in a higher wealth quintile, having adequate knowledge of family planning and being in a formal marital relationship.</p><p><strong>Conclusion: </strong>This study reveals a significantly lower prevalence of modern contraception use among persons with disabilities in low- and middle-income countries compared to the general population. Improving access to education, addressing social norms and strengthening healthcare systems may contribute to increasing access to contraception and uptake among persons with disabilities in low- and middle-income countries.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"588-597"},"PeriodicalIF":2.3000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12213322/pdf/","citationCount":"0","resultStr":"{\"title\":\"Prevalence and determinants of modern contraception use among persons with disabilities in low- and middle-income countries: A systematic review and meta-analysis.\",\"authors\":\"Atika Rahman Chowdhury, Shimlin Jahan Khanam, Mohammad Zahidul Islam, Gulam Khandaker, Md Nuruzzaman Khan\",\"doi\":\"10.1111/tmi.14130\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>People with disabilities have the same need for contraception as the general population. However, their access to modern contraceptive methods is largely underexplored in low- and middle-income countries.</p><p><strong>Objective: </strong>This study aimed to explore the prevalence of modern contraception use among reproductive-aged (15-49 years) persons with disabilities in low- and middle-income countries and identify the key determinants.</p><p><strong>Methods: </strong>In June 2024, we conducted a systematic search across six databases including PubMed, Web of Science, Embase, Global Health, Medline and Scopus to identify studies on disability and modern contraception in low- and middle-income countries. The search terms included a combination of Medical Subject Headings (MeSH) terms and keywords related to disability, modern contraception and low- and middle-income countries integrated using the Boolean operators (AND, OR). All studies published between January 2015 and June 2024, in English, and conducted in low- and middle-income countries were included. The primary outcomes were the prevalence of modern contraception use and its determinants among persons with any disability. Summary estimates were calculated using meta-analysis with a fixed effects model for lower heterogeneity. Random effects meta-analysis was used for mid-level heterogeneity (50%-74%) and high-level heterogeneity (75%-100%).</p><p><strong>Results: </strong>A total of 18 studies from low- and middle-income countries were included, with 11 included in the meta-analysis. The pooled prevalence of modern contraception use among persons with disabilities was 31.4% (95% CI: 26.5, 36.2). Significant heterogeneity was observed across respondent characteristics (I<sup>2</sup> = 94.55%). Five factors were significantly associated with higher contraception use: being aged over 25 years, having some level of education, being in a higher wealth quintile, having adequate knowledge of family planning and being in a formal marital relationship.</p><p><strong>Conclusion: </strong>This study reveals a significantly lower prevalence of modern contraception use among persons with disabilities in low- and middle-income countries compared to the general population. Improving access to education, addressing social norms and strengthening healthcare systems may contribute to increasing access to contraception and uptake among persons with disabilities in low- and middle-income countries.</p>\",\"PeriodicalId\":23962,\"journal\":{\"name\":\"Tropical Medicine & International Health\",\"volume\":\" \",\"pages\":\"588-597\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2025-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12213322/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Tropical Medicine & International Health\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/tmi.14130\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/5/19 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Tropical Medicine & International Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/tmi.14130","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/5/19 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
Prevalence and determinants of modern contraception use among persons with disabilities in low- and middle-income countries: A systematic review and meta-analysis.
Background: People with disabilities have the same need for contraception as the general population. However, their access to modern contraceptive methods is largely underexplored in low- and middle-income countries.
Objective: This study aimed to explore the prevalence of modern contraception use among reproductive-aged (15-49 years) persons with disabilities in low- and middle-income countries and identify the key determinants.
Methods: In June 2024, we conducted a systematic search across six databases including PubMed, Web of Science, Embase, Global Health, Medline and Scopus to identify studies on disability and modern contraception in low- and middle-income countries. The search terms included a combination of Medical Subject Headings (MeSH) terms and keywords related to disability, modern contraception and low- and middle-income countries integrated using the Boolean operators (AND, OR). All studies published between January 2015 and June 2024, in English, and conducted in low- and middle-income countries were included. The primary outcomes were the prevalence of modern contraception use and its determinants among persons with any disability. Summary estimates were calculated using meta-analysis with a fixed effects model for lower heterogeneity. Random effects meta-analysis was used for mid-level heterogeneity (50%-74%) and high-level heterogeneity (75%-100%).
Results: A total of 18 studies from low- and middle-income countries were included, with 11 included in the meta-analysis. The pooled prevalence of modern contraception use among persons with disabilities was 31.4% (95% CI: 26.5, 36.2). Significant heterogeneity was observed across respondent characteristics (I2 = 94.55%). Five factors were significantly associated with higher contraception use: being aged over 25 years, having some level of education, being in a higher wealth quintile, having adequate knowledge of family planning and being in a formal marital relationship.
Conclusion: This study reveals a significantly lower prevalence of modern contraception use among persons with disabilities in low- and middle-income countries compared to the general population. Improving access to education, addressing social norms and strengthening healthcare systems may contribute to increasing access to contraception and uptake among persons with disabilities in low- and middle-income countries.
期刊介绍:
Tropical Medicine & International Health is published on behalf of the London School of Hygiene and Tropical Medicine, Swiss Tropical and Public Health Institute, Foundation Tropical Medicine and International Health, Belgian Institute of Tropical Medicine and Bernhard-Nocht-Institute for Tropical Medicine. Tropical Medicine & International Health is the official journal of the Federation of European Societies for Tropical Medicine and International Health (FESTMIH).