Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America.
PLoS One. 2012;7(7):e40670. doi: 10.1371/journal.pone.0040670. Epub 2012 Jul 18.
Contraceptive prevalence is low in the African region despite considerable family planning programmatic efforts. This study is the first to examine how community factors shape contraceptive use for married women in an entire region, comparing results across 21 African countries with a DHS in the last 5 years. The analysis builds on previous studies through an examination of the individual, household and community level factors that shape contraceptive use.
The data used in this analysis were from nationally representative Demographic and Health Surveys completed between 2005 and 2009. A separate multi-level logistic model was fitted for the outcome of current modern contraceptive use in each country.
After controlling for individual and household level factors, community level factors of demographics and fertility norms, gender norms and inequalities, and health knowledge remain significantly associated with contraceptive use, although the magnitude and direction of these community effects varied significantly across countries.
The results highlight the importance of harnessing community level factors in planning interventions for increasing access to and utilization of modern contraceptive methods.
尽管在计划生育项目上投入了大量精力，非洲区域的避孕普及率仍然很低。本研究首次在整个区域内考察了社区因素是如何影响已婚妇女的避孕措施使用情况的，比较了过去 5 年中 21 个进行过 DHS 的非洲国家的结果。该分析通过考察影响避孕措施使用的个人、家庭和社区层面的因素，对以往的研究进行了扩展。
本分析中使用的数据来自于 2005 年至 2009 年间完成的具有全国代表性的人口与健康调查。为每个国家的当前现代避孕措施使用结果分别拟合了一个多水平逻辑模型。
在控制了个人和家庭层面的因素后，社区层面的人口统计学和生育规范、性别规范和不平等、以及健康知识等因素仍然与避孕措施的使用显著相关，尽管这些社区效应的大小和方向在各国之间存在显著差异。
研究结果强调了在规划增加现代避孕方法的获得和利用的干预措施时，利用社区层面因素的重要性。
