Geremew Alehegn Bishaw, Gelagay Abebaw Addis
Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Science, University of Gondar, 196 Gondar, Ethiopia.
Womens Midlife Health. 2018 Oct 19;4:13. doi: 10.1186/s40695-018-0044-z. eCollection 2018.
A modern contraceptive method is a product or medical procedure that interferes with reproduction following sexual intercourse; however, contraceptive services remain out of reach for many women of reproductive age worldwide, resulting in millions of unwanted pregnancies and unsafe abortions each year. In addition to limiting the number of children, family planning is essential to promoting the well-being and autonomy of women, their families, and their communities. Factors influencing modern contraceptive utilization are multifaceted and challenging, therefore; this study aimed to assess modern contraceptive utilization and associated factors among mid to late reproductive age, married women in Finote Selam town, northwest Ethiopia.
A community based cross-sectional study was conducted from June 30 to July 15, 2017 among married women aged 30-49. A cluster sampling technique was used to select 1146 eligible participants from three randomly selected kebeles. A face-to-face interviewer administered a structured and pretested questionnaire. Binary logistic regression models, in bivariate and multivariable analyses, were fitted to identify factors associated with the outcome variable. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) was calculated to determine the presence, direction, and strength of associations.
A total of 1134 women aged 30-49 participated in this study representing a response rate of 98.9%.The overall modern contraceptive utilization was 37% (95% CI 35.43-40.21). An injectable contraceptive was the most commonly used method, followed by an implant contraceptive method. Factors independently associated with modern contraceptive use were: educational status -secondary school (AOR = 1.5,95%CI 1.01-2.2) and college and above (AOR = 1.5,95%CI 1.02-2) compared to no education, number of previous pregnancy: nulligravid (AOR = 4.6,95%CI 3.2-5.5),1-2 previous pregnancies (AOR = 3.2,95%CI 2.03-5.44), 3-4 previous pregnancies(AOR = 2.3,95% CI1.4-3.7) compared to > 4 pregnancies and postnatal care utilization (AOR = 1.5,95% CI 1.1-2.1)compared to no postnatal service utilized.
Our findings show that modern contraceptive utilization among women age 30-49 is low in Finote Selam town Northwest Ethiopia. Women's educational status, low number of previous pregnancies and postnatal care service utilization during the last birth were independently associated with modern contraceptive method used. Providing modern contraceptives targeting grand multiparous women and women having no formal education is important. Improving postnatal care utilization is one potential strategy to enhance modern contraceptive utilization.
现代避孕方法是一种在性交后干扰生殖的产品或医疗程序;然而,全球许多育龄妇女仍无法获得避孕服务,导致每年有数百万意外怀孕和不安全堕胎。除了限制子女数量外,计划生育对于促进妇女、其家庭和社区的福祉与自主权至关重要。因此,影响现代避孕方法使用的因素是多方面且具有挑战性的;本研究旨在评估埃塞俄比亚西北部菲诺特塞拉姆镇中晚期育龄已婚妇女的现代避孕方法使用情况及相关因素。
2017年6月30日至7月15日,对30 - 49岁的已婚妇女进行了一项基于社区的横断面研究。采用整群抽样技术从三个随机选择的社区中选取1146名符合条件的参与者。由面对面的访谈员发放一份经过结构化和预测试的问卷。在双变量和多变量分析中,采用二元逻辑回归模型来确定与结果变量相关的因素。计算调整后的比值比(AOR)及95%置信区间(CI),以确定关联的存在、方向和强度。
共有1134名30 - 49岁的妇女参与了本研究,应答率为98.9%。现代避孕方法的总体使用率为37%(95%CI 35.43 - 40.21)。注射用避孕药是最常用的方法,其次是植入式避孕方法。与现代避孕方法使用独立相关的因素有:教育程度——与未受过教育相比,中学学历(AOR = 1.5,95%CI 1.01 - 2.2)和大专及以上学历(AOR = 1.5,95%CI 1.02 - 2);既往怀孕次数:未孕(AOR = 4.6,95%CI 3.2 - 5.5)、既往怀孕1 - 2次(AOR = 3.2,95%CI 2.03 - 5.44)、既往怀孕3 - 4次(AOR = 2.3,95%CI 1.4 - 3.7)与既往怀孕超过4次相比;以及产后护理利用情况(AOR = 1.5,95%CI 1.1 - 2.1)与未使用产后服务相比。
我们的研究结果表明,埃塞俄比亚西北部菲诺特塞拉姆镇30 - 49岁妇女的现代避孕方法使用率较低。妇女的教育程度、既往怀孕次数少以及上次分娩时的产后护理服务利用情况与所使用的现代避孕方法独立相关。为多产妇女和未受过正规教育的妇女提供现代避孕药具很重要。提高产后护理利用率是提高现代避孕方法使用率的一种潜在策略。