Ajong Atem Bethel, Njotang Philip Nana, Yakum Martin Ndinakie, Essi Marie José, Essiben Felix, Eko Filbert Eko, Kenfack Bruno, Mbu Enow Robinson
Department of Obstetrics and Gynaecology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon.
Obstetrics and Gynaecology unit, Yaoundé Central Hospital, Higher Institute of Health Technologies, Yaoundé, Cameroon.
BMC Womens Health. 2016 Jan 20;16:4. doi: 10.1186/s12905-016-0283-9.
BACKGROUND: With the unacceptably high level of unmet need for family planning in Sub-Saharan Africa, reducing unmet need is paramount in the fight against the high levels of induced abortions, maternal and neonatal morbi-mortality. A clear understanding of the determinants of unmet need for family planning is indispensable in this light. The objective of this study was to determine the prevalence of unmet need for family planning in Urban Cameroon while identifying major determinants of unmet need among women in a union in Urban Cameroon. METHODS: A community based cross sectional study was conducted from March 2015 to April 2015 during which 370 women in a union were recruited using cluster multistep sampling in the Biyem-Assi Health District, Yaounde. Data were collected using a pretested and validated questionnaire. Proportions and their 95% confidence intervals were calculated with the Westoff/DHS method used to estimate unmet need for family planning and the odds ratio used as measure of association with statistical significant threshold set at p-value ≤ 0.05. RESULTS: Of the 370 eligible women included, the mean age was 29.9 ± 6.8 years, and 61.1% were married. The prevalence of unmet need for family planning was 20.4 (16.4-24.8)% with 14.2 (11.2-18.7)% having an unmet need for spacing and 6.2 (3.6-8.7)% an unmet need for limiting. Husband's approval of contraception had a statistically significant protective association with unmet need (AOR = 0.52 [0.30-0.92], p = 0.023), and discussion about family planning within the couple had a highly statistically significant protective association with unmet need (AOR = 0.39 [0.21-0.69], p = 0.001). The major reason for non-use of contraception among women with unmet need was the fear of side effects. CONCLUSION: The prevalence of unmet need of family planning among women in the Biyem-Assi Health District remains high. Husband's approval of contraception and couples' discussion about family planning are two major factors to be considered when planning interventions to reduce unmet need for family planning. Family planning activities focused on couples or including men could be useful in reducing the rate of unmet need in Cameroon.
背景：由于撒哈拉以南非洲地区计划生育需求未得到满足的比例高得令人无法接受，在应对高比例的人工流产、孕产妇和新生儿发病及死亡问题时，降低需求未得到满足的情况至关重要。有鉴于此，清楚了解计划生育需求未得到满足的决定因素必不可少。本研究的目的是确定喀麦隆城市地区计划生育需求未得到满足的患病率，同时确定喀麦隆城市地区处于婚姻关系中的女性需求未得到满足的主要决定因素。 方法：于2015年3月至2015年4月开展了一项基于社区的横断面研究，在此期间，采用整群多阶段抽样方法，在雅温得的Biyem-Assi卫生区招募了370名处于婚姻关系中的女性。使用经过预测试和验证的问卷收集数据。采用韦斯托夫/人口与健康调查（DHS）方法计算比例及其95%置信区间，以估计计划生育需求未得到满足的情况，并将比值比用作关联度量，设定统计学显著性阈值为p值≤0.05。 结果：在纳入的370名符合条件的女性中，平均年龄为29.9±6.8岁，61.1%已婚。计划生育需求未得到满足的患病率为20.4（16.4 - 24.8）%，其中间隔需求未得到满足的比例为14.2（11.2 - 18.7）%，生育限制需求未得到满足的比例为6.2（3.6 - 8.7）%。丈夫对避孕措施的认可与需求未得到满足之间存在具有统计学显著性的保护关联（调整后的比值比[AOR]=0.52[0.30 - 0.92]，p = 0.023），夫妻间关于计划生育的讨论与需求未得到满足之间存在高度统计学显著性的保护关联（AOR = 0.39[0.21 - 0.69]，p = 0.001）。需求未得到满足的女性中不使用避孕措施的主要原因是担心副作用。 结论：Biyem-Assi卫生区女性计划生育需求未得到满足的患病率仍然很高。在规划减少计划生育需求未得到满足情况的干预措施时，丈夫对避孕措施的认可和夫妻间关于计划生育的讨论是两个需要考虑的主要因素。针对夫妻或包括男性的计划生育活动可能有助于降低喀麦隆需求未得到满足的比例。
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