Mboane Ramos, Bhatta Madhav P
Department of Biostatistics, Environmental Health Sciences, and Epidemiology, College of Public Health, Kent State University, 750 Hilltop Drive, 319 Lowry Hall, P. O. Box 5190, Kent, OH, 44242, USA.
Reprod Health. 2015 Apr 23;12:36. doi: 10.1186/s12978-015-0010-2.
Previous studies in developing countries suggest that a husband plays an influential role in a woman's contraceptive use. The influence of a husband/partner's healthcare decision making power on a woman's intention to use contraceptives in Mozambique has not been studied. The present study examined this relationship using data from the 2011 Mozambique Demographic and Health Survey (DHS), which included a nationally representative sample of 7,022 women aged 15-49 years.
The primary outcome of interest in the study was a woman's intention to use contraceptives. The primary exposure of interest was the person making decisions about a woman's healthcare, dichotomized as the husband/partner alone vs. the woman herself or jointly with her husband/partner. Several potential socio-demographic confounders were adjusted for in overall and stratified multivariable logistic regression models. Adjusted odds ratio (AOR) and the associated 95% confidence interval (CI) are reported.
The mean age of the sample was 30.4 (95% CI: 30.1 - 30.7) years. Overall, a woman who reported her husband/partner usually made the decision about her healthcare was 19% less likely to report an intention to use contraceptives than a woman who reported that she herself or jointly with her husband/partner made the decision (AOR = 0.81, 95% CI 0.71- 0.92). In stratified analyses, the association remained statistically significant among rural women (AOR = 0.75, 95% CI: 0.65 - 0.87); among women with knowledge of modern contraceptive methods (AOR = 0.83, 95% CI: 0.73 - 0.95); and among women with three or more (AOR = 0.81, 95% CI: 0.68 - 0.97) and two or fewer (AOR = 0.79, 95% CI: 0.65 - 0.96) living children.
A husband/partner's healthcare decision making power in the relationship had a significant negative effect on a Mozambican woman's intention to use contraceptives. These findings have implications for addressing the role of men in the design and implementation of successful family planning programs to improve the contraceptive uptake rate among women in Mozambique.
以往在发展中国家开展的研究表明,丈夫在女性避孕措施的使用方面发挥着重要作用。在莫桑比克,丈夫/伴侣的医疗保健决策权对女性使用避孕药具意愿的影响尚未得到研究。本研究利用2011年莫桑比克人口与健康调查(DHS)的数据对这种关系进行了研究,该调查涵盖了7022名年龄在15 - 49岁之间具有全国代表性的女性样本。
本研究关注的主要结果是女性使用避孕药具的意愿。主要的暴露因素是决定女性医疗保健事宜的人,分为仅由丈夫/伴侣决定与由女性自己或与丈夫/伴侣共同决定。在总体和分层多变量逻辑回归模型中对几个潜在的社会人口学混杂因素进行了调整。报告了调整后的比值比(AOR)及相关的95%置信区间(CI)。
样本的平均年龄为30.4岁(95%CI:30.1 - 30.7)。总体而言,报告其丈夫/伴侣通常为其做出医疗保健决定的女性,表示有使用避孕药具意愿的可能性比报告由自己或与丈夫/伴侣共同做出决定的女性低19%(AOR = 0.81,95%CI 0.71 - 0.92)。在分层分析中,这种关联在农村女性中(AOR = 0.75,95%CI:0.65 - 0.87)、了解现代避孕方法的女性中(AOR = 0.83,95%CI:0.73 - 0.95)以及有三个或更多存活子女的女性中(AOR = 0.81,95%CI:0.68 - 0.97)和有两个或更少存活子女的女性中(AOR = 0.79,95%CI:0.65 - 0.96)仍具有统计学意义。
在这种关系中,丈夫/伴侣的医疗保健决策权对莫桑比克女性使用避孕药具的意愿产生了显著的负面影响。这些发现对于在设计和实施成功的计划生育项目以提高莫桑比克女性的避孕药具使用率方面解决男性的作用具有启示意义。