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乌干达年轻女性和年长女性现代避孕方法使用的相关因素;一项比较分析

Factors associated with modern contraceptive use among young and older women in Uganda; a comparative analysis.

作者信息

Asiimwe John Bosco, Ndugga Patricia, Mushomi John, Manyenye Ntozi James Patrick

机构信息

Department of Planning and Applied Statistics, School of Statistics and Planning, College of Business and Management Sciences, Makerere University, Kampala, Uganda.

出版信息

BMC Public Health. 2014 Sep 8;14:926. doi: 10.1186/1471-2458-14-926.

Abstract

BACKGROUND

Much of the research literature about the use of family planning generalizes contraceptive use among all women, using age as a covariate. In Uganda, a country with divergent trends in modern family planning use, this study was set to explore whether or not the predictors of contraceptive use differ by age. This was assessed by using data from the 2011 Uganda Demographic and Health Survey (UDHS).

METHODS

We restricted the sample from each round to fecund, non-pregnant married women age 15-34 who were sexually active within one year prior to the survey, resulting in a sample of 2,814 women. We used logistic regression with age variable used as an interaction term to model the relationship between selected independent variables and the outcome variable (modern contraception use) for each group of women.

RESULTS

We found that the key factors associated with use of modern contraceptives varied among young and older married women age 15-24 and 25-34 respectively. Results showed that perception on distance to health facility, listening to radio and geographical differences exhibited significant variability in contraceptive use among the young and the older women. Other key factors that were important for both age groups in explaining contraceptive use were; desire to have children after two years and education level.

CONCLUSIONS

Addressing contraceptive use among old and young women in Uganda requires concerted efforts that target such women to address the socio economic barriers that exist. There is need for increased access of family planning service to the population through strengthening the use of Village Health Teams (VHTs) whose service is currently limited in coverage (MoH, 2009). Given the variation in contraceptive use between the two age groups, our findings further suggest that there is need for variability in media targeting among the young and the older women categories for improved use of modern contraceptives, for instance using alternative media strategies to reach the young women. Family planning policies should also be tailored to address the specific needs of different age groups of women with varied geographical locations.

摘要

背景

许多关于计划生育使用情况的研究文献将所有女性的避孕使用情况进行了概括,并将年龄作为协变量。在乌干达这个现代计划生育使用趋势存在差异的国家,本研究旨在探讨避孕使用的预测因素是否因年龄而异。这是通过使用2011年乌干达人口与健康调查(UDHS)的数据进行评估的。

方法

我们将每一轮的样本限制为15 - 34岁、生育能力正常、未怀孕且在调查前一年内有性行为的已婚女性,最终得到2814名女性的样本。我们使用逻辑回归,将年龄变量用作交互项,以模拟每组女性中选定自变量与结果变量(现代避孕方法的使用)之间的关系。

结果

我们发现,与现代避孕药具使用相关的关键因素在15 - 24岁和25 - 34岁的年轻和年长已婚女性中有所不同。结果表明,对到医疗机构距离的认知、收听广播以及地理差异在年轻和年长女性的避孕使用方面表现出显著差异。在解释避孕使用情况时,对两个年龄组都很重要的其他关键因素包括:两年后生育子女的意愿和教育水平。

结论

解决乌干达年轻和年长女性的避孕使用问题需要共同努力,针对这些女性解决存在的社会经济障碍。有必要通过加强村卫生队(VHTs)的使用来增加计划生育服务对人群的可及性,目前村卫生队的服务覆盖范围有限(卫生部,2009年)。鉴于两个年龄组在避孕使用上的差异,我们的研究结果进一步表明,为了提高现代避孕药具的使用率,针对年轻和年长女性群体的媒体宣传需要有所不同,例如使用替代媒体策略来接触年轻女性。计划生育政策也应量身定制,以满足不同地理位置、不同年龄组女性的特定需求。

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