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尼日利亚妇女长效可逆避孕措施采用的医疗服务提供者互动和其他预测因素。

Healthcare provider interaction and other predictors of long-acting reversible contraception adoption among women in Nigeria.

机构信息

Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

Nigerian Urban Reproductive Health Initiative (NURHI2), Ibadan, Nigeria.

出版信息

Int J Gynaecol Obstet. 2019 Feb;144(2):153-160. doi: 10.1002/ijgo.12705. Epub 2018 Nov 28.

DOI:10.1002/ijgo.12705
PMID:30407627
Abstract

OBJECTIVE

To test the association between healthcare provider communication and adoption of long-acting reversible contraception (LARC) among women in Nigeria.

METHODS

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.

RESULTS

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.

CONCLUSION

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.

摘要

目的

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。

方法

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。

结果

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。

结论

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。

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