Dana Sarnak , Amy Tsui , Fredrick Makumbi , Simon P.S Kibira , Saifuddin Ahmed
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We conducted descriptive, survival and multivariate Cox regression analysis of the influence of women's baseline measures of unmet need, self-reported intention to contracept and their concordance with time to adoption of modern contraception over 36 months.</p></div><div><h3>Results</h3><p>The study found women classified as having unmet need were slower to adopt contraception than those without unmet need, after adjustment for background covariates (aHR<!--> <!-->=<!--> <!-->0.79, 95% CI<!--> <!-->=<!--> <!-->0.57–1.10). Women intending future contraceptive use were significantly faster to adopt (aHR<!--> <!-->=<!--> <!-->1.45, 95% CI<!--> <!-->=<!--> <!-->1.22–1.73) than those not intending. 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By contrasting a woman's unmet need with her expressed intention to use, we offer reasons to further consider self-reported contraceptive intentions as a better predictor of adoption and the underlying latent demand for volitional regulation of fertility.</p></div>","PeriodicalId":10655,"journal":{"name":"Contraception: X","volume":"2 ","pages":"Article 100022"},"PeriodicalIF":0.0000,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.conx.2020.100022","citationCount":"8","resultStr":"{\"title\":\"The predictive utility of unmet need on time to contraceptive adoption: a panel study of non-contracepting Ugandan women\",\"authors\":\"Dana Sarnak , Amy Tsui , Fredrick Makumbi , Simon P.S Kibira , Saifuddin Ahmed\",\"doi\":\"10.1016/j.conx.2020.100022\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><p>The predictive utility of the unmet contraceptive need indicator is not well known, despite being recognized as a key family planning indicator for showing the extant demand for birth control. This study assesses the dynamic influence of unmet need on time to contraceptive adoption, as compared with that of contraceptive intentions and their concordance.</p></div><div><h3>Study design</h3><p>This observational study analyzed survey data, including a contraceptive calendar, reported by a panel of 747 non-contracepting, fecund and sexually active Ugandan women, first interviewed in a 2014 national survey and re-interviewed in 2018. We conducted descriptive, survival and multivariate Cox regression analysis of the influence of women's baseline measures of unmet need, self-reported intention to contracept and their concordance with time to adoption of modern contraception over 36 months.</p></div><div><h3>Results</h3><p>The study found women classified as having unmet need were slower to adopt contraception than those without unmet need, after adjustment for background covariates (aHR<!--> <!-->=<!--> <!-->0.79, 95% CI<!--> <!-->=<!--> <!-->0.57–1.10). 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引用次数: 8
摘要
目的未满足避孕需求指标是反映现有避孕需求的关键计划生育指标，但其预测效用尚不清楚。本研究评估了未满足需求对避孕措施采用时间的动态影响，与避孕意图及其一致性相比。这项观察性研究分析了调查数据，包括避孕日历，由747名不避孕、生育和性活跃的乌干达妇女组成的小组报告，这些妇女在2014年的一次全国调查中首次接受采访，并在2018年再次接受采访。我们对36 个月内妇女未满足需求的基线测量、自我报告的避孕意图及其与采用现代避孕方法时间的一致性的影响进行了描述性、生存和多变量Cox回归分析。结果本研究发现，在调整背景协变量后，被归类为未满足需求的妇女比未满足需求的妇女采取避孕措施的速度慢(aHR = 0.79, 95% CI = 0.57-1.10)。打算将来使用避孕措施的妇女比不打算使用避孕措施的妇女接受避孕措施的速度要快得多(aHR = 1.45, 95% CI = 1.22-1.73)。没有未满足需求但打算使用的妇女与那些没有需要和无意使用的妇女相比，采用率最高(aHR = 2.78, 95% CI = 1.48-5.25)。结论与避孕意向相比，未满足需求指标在预测未来避孕措施采用方面表现不佳，值得进一步考虑将其作为未来使用的补充预测指标。需要未得到满足但不打算特别使用避孕措施的未避孕妇女需要得到方案上的注意。想要限制或间隔生育的未避孕妇女被定义为需求未得到满足，但她随后是否采取避孕措施则鲜为人知。通过对比女性未满足的需求和她表达的使用意愿，我们提供了进一步考虑自我报告避孕意图的理由，作为更好的预测收养和潜在的自愿调节生育的需求。
The predictive utility of unmet need on time to contraceptive adoption: a panel study of non-contracepting Ugandan women
Objective
The predictive utility of the unmet contraceptive need indicator is not well known, despite being recognized as a key family planning indicator for showing the extant demand for birth control. This study assesses the dynamic influence of unmet need on time to contraceptive adoption, as compared with that of contraceptive intentions and their concordance.
Study design
This observational study analyzed survey data, including a contraceptive calendar, reported by a panel of 747 non-contracepting, fecund and sexually active Ugandan women, first interviewed in a 2014 national survey and re-interviewed in 2018. We conducted descriptive, survival and multivariate Cox regression analysis of the influence of women's baseline measures of unmet need, self-reported intention to contracept and their concordance with time to adoption of modern contraception over 36 months.
Results
The study found women classified as having unmet need were slower to adopt contraception than those without unmet need, after adjustment for background covariates (aHR = 0.79, 95% CI = 0.57–1.10). Women intending future contraceptive use were significantly faster to adopt (aHR = 1.45, 95% CI = 1.22–1.73) than those not intending. Women with no unmet need but intending to use had the highest rate of adoption compared to those with no need and no intention to use (aHR = 2.78, 95% CI = 1.48–5.25).
Conclusions
The unmet need indicator underperforms in predicting future contraceptive adoption compared to contraceptive intentions, which merits further consideration as a complementary predictor of future use. Non-contracepting women with unmet need but no intention to use contraception in particular warrant programmatic attention.
Implications
A non-contracepting woman wanting to limit or space her births is defined as having unmet need, but little is known if she subsequently adopts contraception. By contrasting a woman's unmet need with her expressed intention to use, we offer reasons to further consider self-reported contraceptive intentions as a better predictor of adoption and the underlying latent demand for volitional regulation of fertility.
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