喀麦隆雅温得现代避孕措施的影响因素：一项基于社区的横断面研究。
Determinants of modern contraceptive practice in Yaoundé-Cameroon: a community based cross sectional study.
作者信息
Njotang Philip Nana, Yakum Martin Ndinakie, Ajong Atem Bethel, Essi Marie José, Akoh Ebile Walter, Mesumbe Nzene Edmond, Ako Simon, Mbu Enow Robinson
机构信息
Department of Obstetrics and Gynaecology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon.
Obstetrics and Gynaecology Unit, Yaoundé Central Hospital, Yaoundé, Cameroon.
出版信息
BMC Res Notes. 2017 Jun 24;10(1):219. doi: 10.1186/s13104-017-2543-7.
BACKGROUND
Despite numerous efforts put in place to increase modern contraceptive use in Cameroon as a means to fight maternal and infant mortality, the prevalence of modern contraception has shown only a slow increase and maternal mortality is constantly rising. This paper attempts to identify barriers to contraceptive use in Biyem-Assi, Yaoundé-Cameroon so as to clearly define in which domain and how to intervene concerning contraceptive use in Cameroon.
METHODS
It was a community-based cross sectional study involving a two-steps cluster sampling. Data were collected from November 2014 to April 2015 and analysis done with Epi-Info version 3.5.4. Association between contraceptive use and independent factors was estimated by calculating odds ratio (OR) and confidence interval at 95%. Significance of association in univariate analysis was estimated by calculating the p value with chi2 test. Potential confounder (pregnancy intention) controlled in a multiple logistic regression.
RESULTS
A total of 613 sexually active women were enrolled into the study with a mean age of 27.2 (δ ± 6.2) years. Among the women, 293 (47.8%) were in a union and 530 (86.8%) of them had attended at least a secondary education. Also, 107 (17.5%) responded that their beliefs do not approve contraceptive use and 101 (16.6%) said their partners do not approve contraception. At the moment of data collection, 361 (58.9 [54.9-62.8] %) were currently using a modern contraceptive method. The rate of use of modern contraception was significantly lower in women in a union (OR 0.57, p = 0.0002) and in those with age greater than 30 years (OR 0.45, p = 0.0004). Conversely, the rate of use was significantly higher in women whose partners approved contraception (OR 4.14, p = 0.0000) or when family planning was discussed within the couple (OR 1.93, p = 0.0028).
CONCLUSION
The rate of use of modern contraception in Biyem-Assi Health District is relatively high. Women in a union and those aged greater than 30 years turn to be less likely to use a contraceptive method than the rest of the population meanwhile women whose partner approve contraceptive-use or who discuss about family planning with their partners, are most likely to use a contraceptive method than others. To increase the rate of use of modern contraception in Yaoundé-Cameroon, interventions should target more of couples and not women alone.
背景
尽管喀麦隆为增加现代避孕方法的使用付出了诸多努力，以此作为降低母婴死亡率的手段，但现代避孕方法的普及率增长缓慢，而孕产妇死亡率却持续上升。本文旨在确定喀麦隆雅温得市比耶姆 - 阿西地区避孕措施使用的障碍，以便明确在哪些领域以及如何针对喀麦隆的避孕措施使用进行干预。
方法
这是一项基于社区的横断面研究，采用两步整群抽样法。数据收集时间为2014年11月至2015年4月，并使用Epi-Info 3.5.4版本进行分析。通过计算比值比（OR）和95%置信区间来估计避孕措施使用与独立因素之间的关联。单因素分析中关联的显著性通过卡方检验计算p值来估计。在多元逻辑回归中对潜在混杂因素（妊娠意愿）进行控制。
结果
共有613名性活跃女性纳入研究，平均年龄为27.（标准差±6.2）岁。其中，293名（47.8%）处于婚姻关系中，530名（86.8%）至少接受过中等教育。此外，107名（17.5%）表示其信仰不赞成使用避孕措施，101名（16.6%）称其伴侣不赞成避孕。在数据收集时，361名（58.9 [54.9 - 62.8]%）正在使用现代避孕方法。婚姻关系中的女性（OR 0.57，p = 0.0002）以及年龄大于30岁的女性（OR 0.45，p = 0.0004）现代避孕方法的使用率显著较低。相反，伴侣赞成避孕的女性（OR 4.14，p = 0.0000）或夫妻间讨论过计划生育的女性（OR 1.93，p = 0.0028）使用率显著较高。
结论
比耶姆 - 阿西卫生区现代避孕方法的使用率相对较高。婚姻关系中的女性以及年龄大于30岁的女性比其他人群使用避孕方法的可能性更低，而伴侣赞成使用避孕措施或与伴侣讨论过计划生育的女性比其他人更有可能使用避孕方法。为提高喀麦隆雅温得市现代避孕方法的使用率，干预措施应更多地针对夫妻双方，而非仅针对女性。
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