Austin Anne
Maternal Health Task Force and Woman and Health Initiative, Department of Global Health and Population, Harvard School of Public Health, Boston, MA, USA.
Contraception. 2015 Jan;91(1):31-8. doi: 10.1016/j.contraception.2014.10.002. Epub 2014 Oct 13.
The aim of this study is to examine trends in and drivers of unmet need for contraceptives among married Nigerian women between 2003 and 2013.
This analysis utilized combined data from the 2003, 2008 and 2013 cross-sectional Nigerian Demographic Health Surveys, resulting in a sample size of 54,873 currently married women. Multinomial logistic regression examined associations between trends in unmet need for spacing and limiting, and the demographic, socioeconomic, and reproductive profiles of the respondents.
Women in 2008 were 30% more likely to have an unmet need for spacing, relative to women in 2013. Despite these significant declines in unmet need to space fertility between 2008 and 2013, the adjusted results show that between 2003 and 2013, there was no significant change in the trends in unmet need to space fertility. Unmet need to limit fertility was significantly higher in 2003, adjusted, and 2008 relative to 2013. Younger, low-parity, Muslim women were significantly less likely than older, high-parity, non-Muslim women to have an unmet need to limit fertility. Women residing in the northeast and northwest of the country were significantly less likely than women residing in the south of the country to have an unmet need to limit fertility. Women whose most recent child had died were significantly less likely to have an unmet need to space and limit fertility.
These data suggest that interventions to increase the knowledge of modern contraceptives, to reduce child mortality, and to improve women's decision-making power would all serve to increase demand for contraceptives, even in areas with high-fertility preferences.
Nigeria has set a goal of a 36% contraceptive prevalence rate by 2018. With a current contraceptive prevalence rate of 15% reaching the additional 16% of women, who have articulated a demand for contraception, will almost reach that goal. Contraceptive use directly reduces maternal risk; implementing interventions to increase demand for contraception and meeting articulated demands for contraception would not only support women's (and men's) ability to realize their reproductive rights but also, ultimately, may reduce the burden of maternal deaths in Nigeria.
本研究旨在探讨2003年至2013年间尼日利亚已婚女性未满足的避孕需求的趋势及其驱动因素。
本分析使用了2003年、2008年和2013年尼日利亚人口与健康横断面调查的合并数据，最终样本为54,873名当前已婚女性。多项逻辑回归分析了间隔生育和限制生育的未满足需求趋势与受访者的人口统计学、社会经济和生殖特征之间的关联。
相对于2013年的女性，2008年的女性有间隔生育未满足需求的可能性高出30%。尽管2008年至2013年间生育间隔未满足需求有显著下降，但调整后的结果显示，2003年至2013年间，生育间隔未满足需求的趋势没有显著变化。相对于2013年，2003年经调整后以及2008年限制生育的未满足需求显著更高。年轻、低生育次数、穆斯林女性比年长、高生育次数、非穆斯林女性有限制生育未满足需求的可能性显著更低。居住在该国东北部和西北部的女性比居住在该国南部的女性有限制生育未满足需求的可能性显著更低。最近一个孩子死亡的女性有间隔生育和限制生育未满足需求的可能性显著更低。
这些数据表明，增加现代避孕知识、降低儿童死亡率以及提高女性决策权的干预措施，都将有助于增加对避孕措施的需求，即使在生育意愿较高的地区也是如此。
尼日利亚设定了到2018年避孕普及率达到36%的目标。目前避孕普及率为15%，让另外16%已表明有避孕需求的女性使用避孕措施，几乎就能实现这一目标。使用避孕措施能直接降低孕产妇风险；实施增加避孕需求的干预措施并满足已表明的避孕需求，不仅将支持女性（和男性）实现其生殖权利的能力，而且最终可能减轻尼日利亚孕产妇死亡的负担。
