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撒哈拉以南非洲地区妇女使用长效可逆避孕方法的趋势、模式和决定因素。

Trends, patterns and determinants of long-acting reversible methods of contraception among women in sub-Saharan Africa.

机构信息

Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand, Johannesburg, South Africa.

Programme in Demography and Population Studies, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa.

出版信息

PLoS One. 2019 Jun 4;14(6):e0217574. doi: 10.1371/journal.pone.0217574. eCollection 2019.

Abstract

BACKGROUND

Method-specific contraceptive prevalence varies widely globally, as huge variations exist in the use of different types of contraception, with short-term methods being the most common methods in sub-Saharan Africa (SSA). Evidence is scanty on the trends, patterns and determinants of long-acting reversible contraceptive (LARC) methods in SSA. This study aimed to address this knowledge gap.

METHODS

Using a pseudo longitudinal research design and descriptive and inferential statistics, we analysed Demographic and Health Survey data of eight countries selected on the basis of contraceptive prevalence rates across SSA. Multinomial logistic regression modelling was used to tease out the predictors of the uptake of LARC methods in the selected countries.

RESULTS

Findings exhibit a steady but slow upward trend in LARC methods across selected countries, as a marginal increase was recorded in LARC uptake over a 10-year period in many of the selected countries. Results established significant predictors of LARC methods uptake, including fertility-related characteristics, age, level of education, work status, wealth index and exposure to mass media. This study underscored the need to address various barriers to the uptake of LARC methods in SSA. It is recommended that governments at different levels undertake to cover the costs of LARC methods in order to increase access and uptake.

摘要

背景

全球范围内,特定方法的避孕普及率差异很大,不同类型的避孕方法的使用存在巨大差异,短期方法在撒哈拉以南非洲(SSA)最为常见。关于 SSA 中长效可逆避孕(LARC)方法的趋势、模式和决定因素的证据很少。本研究旨在填补这一知识空白。

方法

本研究采用伪纵向研究设计和描述性及推断性统计方法,分析了根据 SSA 避孕普及率选择的八个国家的人口与健康调查数据。使用多项逻辑回归模型来梳理出选定国家中 LARC 方法采用的预测因素。

结果

研究结果显示,选定国家的 LARC 方法呈稳步但缓慢上升趋势,因为在许多选定国家中,LARC 采用率在 10 年内略有增加。研究结果确定了 LARC 方法采用的重要预测因素,包括与生育相关的特征、年龄、教育水平、工作状况、财富指数和大众媒体接触。本研究强调了需要解决 SSA 中采用 LARC 方法的各种障碍。建议各级政府承担 LARC 方法的费用,以增加获得和采用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5284/6548375/6df2a386cb8f/pone.0217574.g001.jpg

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