Abraha Teklehaymanot Huluf, Teferra Alemayehu Shimeka, Gelagay Abebaw Addis
Department of Public Health, College of Health Sciences, Aksum University, Aksum, Ethiopia.
Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Epidemiol Health. 2017 Mar 20;39:e2017012. doi: 10.4178/epih.e2017012. eCollection 2017.
The postpartum period is a critical period for addressing widespread unmet needs in family planning and for reducing the risks of closely spaced pregnancies. However, contraception during the extended postpartum period has been underemphasized in Ethiopia. Therefore, this study aimed to assess postpartum modern contraceptive use among women in northern Ethiopia and to identify factors associated with modern contraceptive use in the postpartum period.
A community based cross-sectional study was conducted from March to April, 2015. Data were entered using Epi Info version 7 and then exported into Stata version 12 for analysis. Bivariate and multivariate logistic regression models were fitted to identify the determinants of postpartum modern contraceptive use. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were calculated, and p-values <0.05 were considered to indicate statistical significance.
Nearly half (48.0%) of women used modern contraceptives during the extended postpartum period. Postpartum modern contraceptive use was significantly associated with secondary and tertiary education levels (aOR, 4.25; 95% CI, 1.29 to 14.00; aOR, 5.36 ; 95% CI, 1.14 to 25.45, respectively), family planning counseling during prenatal and postnatal care (aOR, 5.72 ; 95% CI, 2.67, 12.28), having postnatal care (aOR, 2.36; 95% CI, 1.15 to 4.87), resuming sexual activity (aOR, 9.53; 95% CI, 3.74 to 24.27), and menses returning after birth (aOR, 6.35; 95% CI, 3.14 to 13.39). In addition, experiencing problems with previous contraceptive use was negatively associated with modern contraceptive use (aOR, 0.34; 95% CI, 0.16 to 0.72).
Low rate of postpartum modern contraceptive use were found in the study area. Therefore, strengthening family planning counseling during antenatal and postnatal care visits, improving utilization of postnatal care services and improving women's educational status are crucial steps for to enhance modern contraceptive use among postpartum women.
产后时期是满足计划生育方面广泛未满足需求以及降低短时间内再次怀孕风险的关键时期。然而，在埃塞俄比亚，产后较长时期的避孕措施一直未得到足够重视。因此，本研究旨在评估埃塞俄比亚北部妇女产后现代避孕方法的使用情况，并确定与产后现代避孕方法使用相关的因素。
2015年3月至4月进行了一项基于社区的横断面研究。数据使用Epi Info 7版本录入，然后导出到Stata 12版本进行分析。采用双变量和多变量逻辑回归模型来确定产后现代避孕方法使用的决定因素。计算调整后的比值比（aOR）及95%置信区间（CI），p值<0.05被认为具有统计学意义。
近一半（48.0%）的妇女在产后较长时期使用现代避孕方法。产后现代避孕方法的使用与中等和高等教育水平显著相关（aOR分别为4.25；95%CI为1.29至14.00；aOR为5.36；95%CI为1.14至25.45），产前和产后护理期间接受计划生育咨询（aOR为5.72；95%CI为2.67至12.28），接受产后护理（aOR为2.36；95%CI为1.15至4.87），恢复性生活（aOR为9.53；95%CI为3.74至24.27），以及产后月经恢复（aOR为6.35；95%CI为3.14至13.39）。此外，之前使用避孕方法出现问题与现代避孕方法的使用呈负相关（aOR为0.34；95%CI为0.16至0.72）。
研究地区产后现代避孕方法的使用率较低。因此，加强产前和产后护理期间的计划生育咨询、提高产后护理服务的利用率以及提高妇女的教育水平是提高产后妇女现代避孕方法使用率的关键步骤。
