Bhusal Chet Kant, Bhattarai Sigma
Department of Community Medicine, Universal College of Medical Science and Teaching Hospital, Tribhuvan University, Bhairahawa, Rupandehi, Nepal.
Nursing Department, Universal College of Medical Science and Teaching Hospital, Tribhuvan University, Bhairahawa, Rupandehi, Nepal.
Int J Reprod Med. 2018 Sep 23;2018:9312687. doi: 10.1155/2018/9312687. eCollection 2018.
Increase in population plays a decisive role in providing universal access to reproductive health; however, there is very limited evidence about the reason of unmet need among marginalized and tribal communities such as Tharus. This study aimed to determine the factors affecting unmet need of family planning among married Tharu women of Dang, Nepal.
Community-based cross-sectional household survey among 650 married Tharu women of age group 15-49 in October 2015 to April 2016 was conducted in Dang district, Nepal. Randomly 3 wards were selected from each Tulsipur municipality, Hekuli Village Development Committee, and Pawan Nagar VDC.
The mean age and parity were 30±7.31 and 2±0.69, respectively. Out of 650 women, 47% were using contraceptives. Westoff model was used for calculating total unmet need which is 49%, where unmet need for limiting and spacing was 27% and 22%, respectively. Hence after combining the current users and total unmet need, total demand for family planning was 96%. After adjustment, significant relation was observed between number of living sons ≥ 1 and unmet need of family planning (OR= 0.4; CI=0.2-0.8, =0.01 ), similarly for women education; lower secondary level (OR=0.3; CI=0.1-0.6, =0.01) and secondary (OR=0.1; CI=0.03-0.4, =0.01); husband education, lower secondary level (OR=0.3; CI=0.1-0.6, =0.01) and secondary (OR=0.4; CI= 0.2-0.9, =0.04); and husband occupation, wage labor (OR=0.6; CI=0.4-0.99, =0.05). In addition, having very good knowledge about method was also significantly associated (OR=0.49; CI= 0.2-0.97, = 0.04).
Unmet need of family planning was significantly higher among less than secondary educated women. It is also predisposed by spouse education, partner's occupation, and number of living sons. This study concerns the need for all stake holders to focus on strategic behavior communication program regarding reproductive health.
人口增长在普及生殖健康服务方面起着决定性作用;然而,关于像塔鲁族这样的边缘化和部落社区未满足需求的原因,证据非常有限。本研究旨在确定影响尼泊尔当地区已婚塔鲁族妇女计划生育未满足需求的因素。
2015年10月至2016年4月,在尼泊尔当地区对650名年龄在15 - 49岁的已婚塔鲁族妇女进行了基于社区的横断面家庭调查。从图尔西布尔市、赫库利村发展委员会和帕万纳加尔乡村发展委员会中各随机选取3个选区。
平均年龄和胎次分别为30±7.31岁和2±0.69次。在650名妇女中,47%使用避孕措施。采用韦斯托夫模型计算出总的未满足需求为49%,其中生育间隔和限制生育的未满足需求分别为27%和22%。因此,将当前使用者和总的未满足需求相加后,计划生育的总需求为96%。调整后,观察到存活儿子数≥1与计划生育未满足需求之间存在显著关联(比值比=0.4;可信区间=0.2 - 0.8,P = 0.01),同样,对于女性教育程度,初中以下水平(比值比=0.3;可信区间=0.1 - 0.6,P = 0.01)和高中水平(比值比=0.1;可信区间=0.03 - 0.4,P = 0.01);丈夫教育程度,初中以下水平(比值比=0.3;可信区间=0.1 - 0.6,P = 0.01)和高中水平(比值比=0.4;可信区间=0.2 - 0.9,P = 0.04);以及丈夫职业,受雇劳动者(比值比=0.6;可信区间=0.4 - 0.99,P = 0.05)。此外,对避孕方法有很好的了解也有显著关联(比值比=0.49;可信区间=0.2 - 0.97,P = 0.04)。
初中以下文化程度妇女计划生育未满足需求显著更高。这也受到配偶教育程度、伴侣职业和存活儿子数的影响。本研究表明所有利益相关者需要关注关于生殖健康的战略行为沟通项目。