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避孕方法组合与偏好:以喀麦隆城市地区的长效可逆避孕法为例。

Contraceptive method mix and preference: A focus on long acting reversible contraception in Urban Cameroon.

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

PLoS One. 2018 Aug 23;13(8):e0202967. doi: 10.1371/journal.pone.0202967. eCollection 2018.

Abstract

INTRODUCTION

Meeting targets of the Sustainable Development Goals in the domain of maternal health and the Family Planning 2020 commitments for Cameroon requires an increased use of modern contraception. Long acting reversible contraceptives (LARCs) are methods which have been proven highly efficient with contraceptive failure rates of less than 1%. The objective of this survey was to determine the contraceptive method mix in the Biyem-Assi Health District and identify factors associated to the use of LARCs.

METHODOLOGY

A cross-sectional community-based study was conducted from March 2015 to April 2015 targeting current female contraceptive users of childbearing age in the Biyem-Assi Health District. A multistep cluster sampling was used and data collected by trained surveyors using a pretested and validated questionnaire. Data were analysed using the statistical software Epi-Info version 3.5.4. Logistic regressions were used to identify associations between the use of LARCs and selected covariates and the strength of association measured with the odds ratio.

RESULTS

A total of 437 eligible women were included in the survey. Their mean age was 26.7±5.8 years and 45.8% were in a union. The contraceptive method mix decreased in this order; male condoms (76.0%), female condoms (7.6%), oral contraceptive pills (5.0%), implants (4.6%), and intrauterine devices (3.4%) giving us a LARC rate of 8%. Only 54.0% and 46.9% of the participants reported to be knowledgeable of the implant and intrauterine device respectively. Their contraceptive choices were determined principally by perceived efficiency and accessibility. The major factor significantly associated to LARC use was the number of living children above 2 (AOR = 3.90[1.53-9.94], p-value = 0.004). Though not statistically significant, associations were found between LARC use and other factors like marital status, level of education, religion and future fertility desire.

CONCLUSION

The rate of use of LARCs is still very low among these women. The number of living children is significantly associated with the use of LARCs. The local family planning policy makers should intensify sensitization on the benefits and side effects of modern contraception and LARCs in order to create more awareness and improve contraceptive uptake.

摘要

简介

为了实现孕产妇健康和计划生育 2020 年目标,喀麦隆需要增加现代避孕方法的使用。长效可逆避孕方法(LARC)的避孕失败率低于 1%,已被证明非常有效。本调查的目的是确定比耶姆-阿西卫生区的避孕方法组合,并确定与 LARC 使用相关的因素。

方法

2015 年 3 月至 2015 年 4 月,我们在比耶姆-阿西卫生区进行了一项基于社区的横断面研究,目标是当前有生育能力的女性避孕使用者。采用多阶段聚类抽样,由经过培训的调查员使用预测试和验证的问卷收集数据。使用统计软件 Epi-Info 版本 3.5.4 进行数据分析。使用逻辑回归确定 LARC 使用与选定协变量之间的关联,并使用优势比测量关联的强度。

结果

共有 437 名符合条件的妇女参加了调查。她们的平均年龄为 26.7±5.8 岁,45.8%处于婚姻状态。避孕方法的组合依次减少;男用避孕套(76.0%)、女用避孕套(7.6%)、口服避孕药(5.0%)、皮下埋植剂(4.6%)和宫内节育器(3.4%),我们的 LARC 使用率为 8%。只有 54.0%和 46.9%的参与者分别表示了解皮下埋植剂和宫内节育器。他们的避孕选择主要取决于感知效率和可及性。与 LARC 使用显著相关的主要因素是 2 个以上活产子女的数量(AOR = 3.90[1.53-9.94],p 值=0.004)。虽然没有统计学意义,但 LARC 使用与婚姻状况、教育程度、宗教和未来生育愿望等其他因素之间存在关联。

结论

这些妇女中 LARC 的使用率仍然很低。活产子女的数量与 LARC 的使用显著相关。当地计划生育政策制定者应加强对现代避孕方法和 LARC 的益处和副作用的宣传,以提高认识并提高避孕方法的使用率。

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