International Institute for Population Sciences (IIPS), Mumbai, India.
J Biosoc Sci. 2020 Nov;52(6):846-859. doi: 10.1017/S0021932019000828. Epub 2019 Dec 19.
Research on informed choice in modern contraceptive method acceptance by young married women is pertinent in the broader context of individual freedom and reproductive rights, especially in countries where women continue to have limited control over their reproductive and contraceptive choices. This study in India asked: (1) is young married women's acceptance of specific modern contraceptive methods an informed choice? and (2) what are the enablers and barriers to informed choice? The study used data for currently married women aged 15-24 (N = 20,752) from the fourth round of the National Family Health Survey (NFHS-4) conducted in 2015-16. A Method Information Index (MII) was calculated as a measure of informed choice from the percentage of users who responded 'yes' to all three questions on: whether they were informed about methods other than the one they received, told about the method-specific side-effects, and advised what to do if they experienced side-effects. Binary logistic regression analysis was carried out to examine the adjusted effect of factors associated with the MII separately for female sterilization, the intrauterine device and the oral contraceptive pill, and a combined MII including all three methods plus injectables. One-fifth of the study women used any modern contraceptive method at the time of survey, of which only 36% had fully informed choice. The likelihood of being informed about the methods was significantly higher among those using the oral contraceptive pill (OR: 1.75, CI 1.58-1.94), IUD (OR: 2.23, CI 1.97-2.52) and injectables (OR: 1.37, CI 0.97-1.94) compared with those who were sterilized. Informed choice varied by region and the socioeconomic profile of the users. Inadequately informed choice violates the reproductive rights of young women and might result in higher post-use health problems, discontinuation of and unmet need for contraceptives, unintended pregnancies, induced abortions and regret, adversely affecting women's health. Training of health/family planning workers in India about the importance of reproductive rights is urgently required to enhance informed contraceptive choice and improve the health of young married women.
现代避孕方法接受中的知情选择研究对于个体自由和生殖权利的更广泛背景具有相关性，特别是在那些女性对其生殖和避孕选择继续缺乏控制的国家。这项在印度进行的研究提出了以下两个问题：（1）年轻已婚女性对特定现代避孕方法的接受是否是知情选择？（2）知情选择的促成因素和障碍是什么？该研究使用了 2015-2016 年进行的第四次国家家庭健康调查（NFHS-4）中年龄在 15-24 岁的目前已婚女性的数据（N=20752）。通过计算方法信息指数（MII）来衡量知情选择程度，该指数是对所有三个问题回答“是”的用户比例的衡量，这三个问题分别是：是否了解除所接受方法以外的其他方法、是否告知方法的具体副作用以及是否告知如果出现副作用该怎么做。采用二元逻辑回归分析，分别针对女性绝育、宫内节育器和口服避孕药以及包括所有三种方法加注射剂的综合 MII，对与 MII 相关的因素进行调整后的效应进行了检验。研究中有五分之一的女性在调查时使用了任何现代避孕方法，其中只有 36%的女性有完全的知情选择。使用口服避孕药（OR：1.75，CI 1.58-1.94）、宫内节育器（OR：2.23，CI 1.97-2.52）和注射剂（OR：1.37，CI 0.97-1.94）的女性，比接受绝育的女性更有可能了解这些方法。知情选择因地区和使用者的社会经济状况而异。知情选择不足侵犯了年轻女性的生殖权利，可能导致更高的使用后健康问题、避孕措施的停用和未满足的需求、意外怀孕、人工流产和后悔，从而对女性健康产生不利影响。印度迫切需要对卫生/计划生育工作者进行有关生殖权利重要性的培训，以增强知情避孕选择并改善年轻已婚女性的健康。
