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。

IF 2.3 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Tropical Medicine & International Health Pub Date : 2025-07-01 Epub Date: 2025-05-19 DOI:10.1111/tmi.14130
Atika Rahman Chowdhury, Shimlin Jahan Khanam, Mohammad Zahidul Islam, Gulam Khandaker, Md Nuruzzaman Khan
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引用次数: 0

摘要

背景:残疾人对避孕的需求与一般人群相同。然而,在低收入和中等收入国家,她们获得现代避孕方法的机会在很大程度上没有得到充分探索。目的:本研究旨在探讨低收入和中等收入国家育龄(15-49岁)残疾人使用现代避孕药具的流行情况,并确定关键决定因素。方法:我们于2024年6月对PubMed、Web of Science、Embase、Global Health、Medline和Scopus等6个数据库进行了系统检索,以确定中低收入国家关于残疾和现代避孕的研究。搜索词包括与残疾、现代避孕和低收入和中等收入国家相关的医学主题词(MeSH)和关键词的组合,使用布尔运算符(and, OR)进行整合。纳入了2015年1月至2024年6月期间在低收入和中等收入国家发表的所有英文研究。主要结局是现代避孕使用的流行程度及其在任何残疾人中的决定因素。采用固定效应模型的荟萃分析计算总结估计值,以降低异质性。随机效应荟萃分析用于中级异质性(50%-74%)和高级异质性(75%-100%)。结果:共纳入了来自中低收入国家的18项研究,其中11项纳入了meta分析。残疾人使用现代避孕方法的总流行率为31.4% (95% CI: 26.5, 36.2)。被调查者的特征存在显著的异质性(I2 = 94.55%)。有五个因素与较高的避孕药具使用率显著相关:年龄在25岁以上,受过一定程度的教育,处于较高的财富五分之一,对计划生育有足够的了解,并处于正式的婚姻关系中。结论:这项研究表明,与一般人群相比,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明显较低。改善受教育机会、解决社会规范问题和加强卫生保健系统可能有助于增加低收入和中等收入国家残疾人获得避孕药具的机会。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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.

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来源期刊
Tropical Medicine & International Health
Tropical Medicine & International Health 医学-公共卫生、环境卫生与职业卫生
CiteScore
4.80
自引率
0.00%
发文量
129
审稿时长
6 months
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).
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