Bishwajit Ghose, Yaya Sanni
Faculty of Social Sciences, School of International Development and Global Studies, University of Ottawa, Ottawa, ON, Canada.
Open Access J Contracept. 2018 Jan 25;9:21-28. doi: 10.2147/OAJC.S154733. eCollection 2018.
The nonuse of family planning methods remains a major public health concern in the low-and-middle-income countries, especially due to its impact on unwanted pregnancy, high rate of abortion, and transmission of sexually transmitted diseases. Various demographic and socioeconomic factors have been reported to be associated with the nonuse of family planning methods. In the present study, we aimed at assessing the influence of domestic violence (DV) on contraceptive use among ever married women in Nigeria.
Data on 22,275 women aged between 15 and 49 years were collected from the most recent Nigeria Demographic and Health Survey conducted in 2013. The outcome variable was contraceptive utilization status, and the main exposure variable was DV, which was assessed by the self-reported experience of physical and psychological abuse. Complex survey method was employed to account for the multistage design of the survey. Data analyses were performed by using bivariate and multivariable techniques.
The mean age of the participants was 31.33±8.26. More than four fifths (84%) of the participants reported that they were not using any contraceptive methods at all. Lifetime prevalence of psychological and physical abuse was, respectively, 19.0% (95% CI =18.0-20.1) and 14.1% (95% CI =13.3-14.9). Women who reported physical abuse were 28% (adjusted odds ratio [AOR] =1.275; 95% CI =1.030-1.578), and those reported both physical and psychological abuse had 52% (AOR =1.520; 95% CI =1.132-2.042) higher odds of not using any contraception.
The rate of contraception nonuse was considerably high and was found to be significantly associated with DV. Thus, the high prevalence of DV may compromise the effectiveness of the family planning programs in the long run. Evidence-based intervention strategies should be developed to protect the health and reproductive rights of the vulnerable women and to reduce DV by giving the issue a wider recognition in public policy making.
在低收入和中等收入国家，不使用计划生育方法仍是一个主要的公共卫生问题，尤其是因为其对意外怀孕、高堕胎率和性传播疾病传播的影响。据报道，各种人口和社会经济因素与不使用计划生育方法有关。在本研究中，我们旨在评估家庭暴力（DV）对尼日利亚已婚妇女避孕措施使用情况的影响。
从2013年进行的最新尼日利亚人口与健康调查中收集了22275名年龄在15至49岁之间妇女的数据。结果变量是避孕措施使用状况，主要暴露变量是家庭暴力，通过自我报告的身体和心理虐待经历进行评估。采用复杂抽样调查方法以考虑调查的多阶段设计。使用双变量和多变量技术进行数据分析。
参与者的平均年龄为31.33±8.26岁。超过五分之四（84%）的参与者报告称他们根本没有使用任何避孕方法。心理和身体虐待的终生患病率分别为19.0%（95%置信区间=18.0 - 20.1）和14.1%（95%置信区间=13.3 - 14.9）。报告遭受身体虐待的妇女不使用任何避孕措施的几率高28%（调整优势比[AOR]=1.275；95%置信区间=1.030 - 1.578），而报告同时遭受身体和心理虐待的妇女这一几率高52%（AOR =1.520；95%置信区间=1.132 - 2.042）。
避孕措施不使用率相当高，且发现与家庭暴力显著相关。因此，从长远来看，高家庭暴力患病率可能会损害计划生育项目的有效性。应制定基于证据的干预策略，以保护弱势妇女的健康和生殖权利，并通过在公共政策制定中更广泛地认识这一问题来减少家庭暴力。
