Rutaremwa Gideon, Kabagenyi Allen, Wandera Stephen Ojiambo, Jhamba Tapiwa, Akiror Edith, Nviiri Hellen Laetitia
Centre for Population and Applied Statistics (CPAS), Makerere University, Kampala, Uganda.
United Nations Population Fund (UNFPA), Uganda Country Office, Kampala, Uganda.
BMC Public Health. 2015 Mar 18;15:262. doi: 10.1186/s12889-015-1611-y.
The rationale for promotion of family planning (FP) to delay conception after a recent birth is a best practice that can lead to optimal maternal and child health outcomes. Uptake of postpartum family planning (PPFP) remains low in sub-Saharan Africa. However, little is known about how pregnant women arrive at their decisions to adopt PPFP.
We used 3298 women of reproductive ages 15-49 from the 2011 UDHS dataset, who had a birth in the 5 years preceding the survey. We then applied both descriptive analyses comprising Pearson's chi-square test and later a binary logistic regression model to analyze the relative contribution of the various predictors of uptake of modern contraceptives during the postpartum period.
More than a quarter (28%) of the women used modern family planning during the postpartum period in Uganda. PPFP was significantly associated with primary or higher education (OR=1.96; 95% CI=1.43-2.68; OR=2.73; 95% CI=1.88-3.97 respectively); richest wealth status (OR=2.64; 95% CI=1.81-3.86); protestant religion (OR=1.27; 95% CI=1.05-1.54) and age of woman (OR=0.97, 95% CI=0.95-0.99). In addition, PPFP was associated with number of surviving children (OR=1.09; 95 % CI=1.03-1.16); exposure to media (OR=1.30; 95% CI=1.05-1.61); skilled birth attendance (OR=1.39; 95% CI=1.12-1.17); and 1-2 days timing of post-delivery care (OR=1.68; 95% CI=1.14-2.47).
Increasing reproductive health education and information among postpartum women especially those who are disadvantaged, those with no education and the poor would significantly improve PPFP in Uganda.
提倡计划生育以在近期生育后推迟受孕是一种最佳做法,可带来最佳的母婴健康结果。撒哈拉以南非洲地区产后计划生育(PPFP)的采用率仍然很低。然而,对于孕妇如何做出采用PPFP的决定知之甚少。
我们使用了2011年乌干达人口与健康调查(UDHS)数据集中3298名年龄在15 - 49岁的育龄妇女,她们在调查前5年内生育过。然后我们应用了包括Pearson卡方检验的描述性分析以及二元逻辑回归模型,以分析产后期间采用现代避孕方法的各种预测因素的相对贡献。
在乌干达,超过四分之一(28%)的妇女在产后期间使用现代计划生育方法。PPFP与小学及以上教育程度(OR = 1.96;95%置信区间 = 1.43 - 2.68;OR = 2.73;95%置信区间分别为1.88 - 3.97)、最富裕的财富状况(OR = 2.64;95%置信区间 = 1.81 - 3.86)、新教信仰(OR = 1.27;95%置信区间 = 1.05 - 1.54)以及妇女年龄(OR = 0.97,95%置信区间 = 0.95 - 0.99)显著相关。此外,PPFP与存活子女数量(OR = 1.09;95%置信区间 = 1.03 - 1.16)、接触媒体(OR = 1.30;95%置信区间 = 1.05 - 1.61)、熟练助产服务(OR = 1.39;95%置信区间 = 1.12 - 1.17)以及产后护理时间为1 - 2天(OR = 1.68;95%置信区间 = 1.14 - 2.47)相关。
在产后妇女中,特别是那些处于不利地位、未受过教育的人和穷人中增加生殖健康教育和信息,将显著改善乌干达的PPFP。