OlaOlorun Funmilola M, Hindin Michelle J
Department of Preventive Medicine & Primary Care, College of Medicine, University of Ibadan, Ibadan, Nigeria.
Department of Population, Family & Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
PLoS One. 2014 Jun 4;9(6):e98702. doi: 10.1371/journal.pone.0098702. eCollection 2014.
Research suggests that women of reproductive age who are involved in household decision-making are more likely than those who are not involved to be able to control their fertility. Little is known, however, about this relationship among women at the upper end of the reproductive spectrum. The aim of this study was to determine the association between household decision-making power and modern contraceptive use among Nigerian women ages 35-49 years.
A descriptive, cross-sectional study involving a secondary analysis of data from the Nigerian 2008 Demographic and Health Survey was conducted among women ages 35-49 years who were considered to be in need of contraception. The outcome was modern contraceptive use while the main independent variable was a woman's household decision-making power score, constructed using principal component analysis. Multivariate logistic regression was performed to determine whether the women's household decision-making power score, categorized into tertiles, was independently associated with modern contraceptive use. Data were weighted and adjusted for the complex survey design.
Prevalence of modern contraceptive use among Nigerian women deemed to be in need of contraception in this study was 18.7%. Multivariate logistic regression showed that women's decision-making power remained statistically significantly associated with modern contraceptive use, even after adjusting for age, education, religion, polygyny, parity, wealth and domicile. Women who were in the highest decision-making power tertile had more than one and a half times the odds of using modern contraception compared with women in the lowest tertile [Adjusted Odds Ratio = 1.70; 95% Confidence Interval = 1.31-2.21, p<0.001].
Older Nigerian women who are involved in making household decisions are also able to make decisions related to their fertility. Programs in Nigeria focused on increasing modern contraceptive use should include strategies to increase women's status through encouraging more visible involvement in decision-making across different spheres of their lives.
研究表明，参与家庭决策的育龄妇女比未参与家庭决策的妇女更有可能控制自己的生育能力。然而，对于处于生育年龄上限的女性之间的这种关系，人们知之甚少。本研究的目的是确定35 - 49岁尼日利亚女性的家庭决策权与现代避孕方法使用之间的关联。
对2008年尼日利亚人口与健康调查数据进行二次分析，开展了一项描述性横断面研究，研究对象为35 - 49岁被认为需要避孕的女性。研究结果是现代避孕方法的使用情况，主要自变量是使用主成分分析构建的女性家庭决策权得分。进行多变量逻辑回归分析，以确定分为三分位数的女性家庭决策权得分是否与现代避孕方法的使用独立相关。对数据进行加权，并针对复杂的调查设计进行调整。
在本研究中，被认为需要避孕的尼日利亚女性中，现代避孕方法的使用率为18.7%。多变量逻辑回归分析表明，即使在调整了年龄、教育程度、宗教信仰、一夫多妻制、生育次数、财富和居住地等因素后，女性的决策权与现代避孕方法的使用在统计学上仍显著相关。决策权得分处于最高三分位数的女性使用现代避孕方法的几率是最低三分位数女性的一倍半以上[调整后的优势比 = 1.70；95%置信区间 = 1.31 - 2.21，p < 0.001]。
参与家庭决策的年长尼日利亚女性也能够做出与生育相关的决策。尼日利亚旨在提高现代避孕方法使用率的项目应包括一些策略，通过鼓励女性更明显地参与生活不同领域的决策来提高女性地位。
