Kibria Gulam Muhammed Al, Burrowes Vanessa, Majumder Sharmin, Sharmeen Atia, Barsha Rifath Ara Alam, Hossen Shakir
Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA.
Faculty of Public Health, Mahidol University, Salaya, Thailand.
Matern Health Neonatol Perinatol. 2017 Jun 6;3:10. doi: 10.1186/s40748-017-0049-x. eCollection 2017.
Total fertility rate (TFR) is high and at a static level for the last two decades in Bangladesh. Reduction of fertility by increasing contraceptives use could reduce maternal and neonatal mortality. To achieve the targeted contraceptive prevalence rate (CPR) of Family Planning 2020 (FP2020) Initiative, it is important to increase CPR in all regions of the country. However, it is lower in Sylhet Division compared to other divisions in Bangladesh. This study looked into the methods, source and determinants of contraceptives use in this division.
Data from the Bangladesh Demographic and Health Survey 2014 (BDHS 2014) were analyzed. After reporting the sources of obtaining contraceptives and choice of methods, distributions of contraceptives use were reported by selected characteristics. Logistic regression was applied to calculate the odds ratios.
A total of 599 women were analyzed. CPR was lower in rural areas compared to urban areas, 45.4% and 58.5%, respectively. The majority of the women received services from governmental sectors. The birth control pill was the most common contraceptive method. The proportion of women using long-acting permanent methods was low (<10%) in both urban and rural areas. In the multivariate analyses, number of alive children (adjusted odds ratio (AOR) of ≥5 children: 1.6, 95% confidence interval (CI): 1.1-2.2), presence of a male child (AOR: 1.7; 95% CI: 1.1-2.6), higher education level of the husband (AOR: 1.7; 95% CI: 1.1-2.6), receiving a visit from a family planning worker (AOR: 2.4; 95% CI: 1.6-3.4) and membership in a non-governmental organization (AOR:1.4, 95% CI: 1.1-1.8) were positively associated with contraceptives use in Sylhet after controlling for age, education level and other contextual factors. Conversely, rural women had the lower likelihood of using contraceptives (AOR: 0.6; 95% CI: 0.4-0.8) than urban women. Women's education level and religion were not statistically significant.
A comprehensive strategy is required for this division to address multiple factors which simultaneously influence contraceptives use. In addition to more awareness programs to increase contraceptives use, providing contraceptive distribution services through family planning workers, involving women with non-governmental organizations and prioritizing rural areas could increase contraceptives use in Sylhet Division.
在孟加拉国，总和生育率（TFR）一直处于高位，且在过去二十年中保持稳定。通过增加避孕药具的使用来降低生育率，可以减少孕产妇和新生儿死亡率。为实现计划生育2020（FP2020）倡议的目标避孕普及率（CPR），提高该国所有地区的CPR非常重要。然而，与孟加拉国的其他地区相比，锡尔赫特专区的CPR较低。本研究调查了该专区避孕药具使用的方法、来源和决定因素。
分析了2014年孟加拉国人口与健康调查（BDHS 2014）的数据。在报告获得避孕药具的来源和方法选择后，按选定特征报告避孕药具使用的分布情况。应用逻辑回归计算比值比。
共分析了599名妇女。农村地区的CPR低于城市地区，分别为45.4%和58.5%。大多数妇女从政府部门获得服务。避孕药片是最常用的避孕方法。在城市和农村地区，使用长效永久避孕方法的妇女比例都很低（<10%）。在多变量分析中，在控制年龄、教育水平和其他背景因素后，存活子女数（≥5个孩子的调整比值比（AOR）：1.6，95%置信区间（CI）：1.1 - 2.2）、有男孩（AOR：1.7；95% CI：1.1 - 2.6）、丈夫的教育水平较高（AOR：1.7；95% CI：1.1 - 2.6）、接受计划生育工作者的访问（AOR：2.4；95% CI：1.6 - 3.4）以及加入非政府组织（AOR：1.4，95% CI：1.1 - 1.8）与锡尔赫特地区的避孕药具使用呈正相关。相反，农村妇女使用避孕药具的可能性低于城市妇女（AOR：0.6；95% CI：0.4 - 0.8）。妇女的教育水平和宗教信仰在统计学上不显著。
该专区需要一项综合战略来解决同时影响避孕药具使用的多个因素。除了开展更多提高避孕药具使用意识的项目外，通过计划生育工作者提供避孕药具分发服务、让妇女参与非政府组织以及优先考虑农村地区，可以提高锡尔赫特专区的避孕药具使用率。
