Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Nigerian Urban Reproductive Health Initiative (NURHI2), Ibadan, Nigeria.
Int J Gynaecol Obstet. 2019 Feb;144(2):153-160. doi: 10.1002/ijgo.12705. Epub 2018 Nov 28.
To test the association between healthcare provider communication and adoption of long-acting reversible contraception (LARC) among women in Nigeria.
The present cross-sectional observational secondary analysis included women aged 18-49 who were interviewed between June 1 and July 31, 2014, at selected family planning sites in Ibadan and Kaduna, Nigeria. A multivariate generalized estimating equation was utilized to assess the predictors of LARC adoption.
597 women were interviewed, and the study showed that each unit increase on the GATHER index-a self-reported measure of interaction with the provider-was significantly associated with a 16% increased likelihood (adjusted odds ratio [AOR] 1.16, 95% confidence interval [CI] 1.03-1.32) of adopting LARCs. Joint decision making with a partner (AOR 1.51, 95% CI 1.0-2.20), desire to have children in the next 2 years (AOR 0.36, 95% CI 0.18-0.74), whether or not a pregnancy in the next 6 months would be a problem (AOR 1.69, 95% CI 1.16-2.46), and LARC use in the past (AOR 4.15, 95% CI 1.19-14.50) were associated with LARC uptake.
Improved patient-provider communication involving patient preferences, information about all methods of contraception, and planned follow-up could play a central role in increasing the demand for, and uptake of, LARCs.
检验尼日利亚卫生保健提供者沟通与长效可逆避孕措施(LARC)采用之间的关联。
本横断面观察性二次分析纳入了年龄在 18-49 岁之间的女性,她们于 2014 年 6 月 1 日至 7 月 31 日在尼日利亚伊巴丹和卡杜纳的选定计划生育点接受访谈。采用多元广义估计方程来评估 LARC 采用的预测因素。
对 597 名妇女进行了访谈,研究表明,GATHER 指数(一种自我报告的与提供者互动的衡量指标)每增加一个单位,采用 LARC 的可能性就会显著增加 16%(调整后的优势比 [AOR] 1.16,95%置信区间 [CI] 1.03-1.32)。与伴侣共同决策(AOR 1.51,95%CI 1.0-2.20)、未来 2 年内想要孩子(AOR 0.36,95%CI 0.18-0.74)、未来 6 个月内怀孕是否会成为问题(AOR 1.69,95%CI 1.16-2.46)以及过去是否使用过 LARC(AOR 4.15,95%CI 1.19-14.50)均与 LARC 的采用相关。
改进涉及患者偏好、所有避孕方法信息以及计划随访的医患沟通,可能在增加对 LARC 的需求和采用方面发挥核心作用。