农村哺乳期妇女现代避孕方法的使用情况及影响因素：来自埃塞俄比亚西北部两个地区初级卫生保健项目的结果。
Prevalence and determinants of modern contraceptive utilization among rural lactating mothers: findings from the primary health care project in two northwest Ethiopian districts.
机构信息
Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Dabat Research Centre Health and Demographic Surveillance System, Institute of Public Health College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.
出版信息
BMC Womens Health. 2020 Apr 3;20(1):67. doi: 10.1186/s12905-020-00933-7.
BACKGROUND
Contraceptive utilization is a guarantee to avert unwanted pregnancies. In Ethiopia however, more than half of the rural women have shorter birth intervals. Consequently, 17 and 8% of the births have been either mistimed (wanted at later date) or unwanted, respectively. Therefore, this study investigated modern contraceptive utilization and its predictors among rural lactating women.
METHODS
A community based-cross-sectional study was conducted from May 01 to June 29, 2019, in Dabat and Gondar zuria districts, northwest Ethiopia. Data from 603 lactating mother were collected through face to face interviews using a structured questionnaire. Bivariate and multivariate logistic regression analyses were fitted to identify the independent predictors of modern contraceptive utilization.
RESULTS
The overall prevalence of modern contraceptive (MC) utilization rate was 45.8% [95% CI: 38.01, 53.59]. The contraceptive method mix was dominated by Depo-Provera (39.8%) followed by implants (4.8%). The odds of utilization of contraceptive were 5.58 times higher among mothers of children with fully immunized [AOR = 5.58, 95% CI: 3.45, 9.01] compared to mothers whose children were vaccinated partially or not at all. Mothers who received antenatal [AOR = 1.74, 95% CI: 1.13, 4.43] and postnatal care [AOR = 2.02, 95%CI: 1.24, 2.91) were 1.74 and 2.02 folds more likely to utilize modern contraceptives than mothers who did not receive such care, respectively.
CONCLUSION
The prevalence of modern contraceptive utilization in this study area was lower than the planed national target. In the region, child immunization service is one of the promising platforms for reaching lactating mothers with modern contraceptive utilization. Our findings suggest that antenatal and postnatal care visits are the other key determinants of modern contraceptive utilization. Thus, in low-resource settings like ours, the health system approaches to improved antenatal and, postnatal care and child immunization services should be intensified with more effective advice on modern contraceptive utilization to reduce unwanted pregnancies.
背景
避孕措施的使用是避免意外怀孕的保障。然而，在埃塞俄比亚，超过一半的农村妇女生育间隔较短。因此，分别有 17%和 8%的分娩是计划外的（希望在稍后的日期进行）或非意愿的。因此，本研究调查了农村哺乳期妇女现代避孕措施的使用情况及其预测因素。
方法
这是一项于 2019 年 5 月 1 日至 6 月 29 日在埃塞俄比亚西北部的达巴特和贡德尔祖里亚地区进行的基于社区的横断面研究。通过面对面访谈，使用结构化问卷收集了 603 名哺乳期母亲的数据。采用双变量和多变量逻辑回归分析来确定现代避孕措施使用的独立预测因素。
结果
现代避孕措施（MC）的总体使用率为 45.8%[95%置信区间：38.01，53.59]。避孕方法以 Depo-Provera（39.8%）为主，其次是植入物（4.8%）。与那些孩子部分或根本未接种疫苗的母亲相比，孩子完全免疫接种的母亲使用避孕措施的可能性高 5.58 倍[AOR=5.58，95%CI：3.45，9.01]。接受产前[AOR=1.74，95%CI：1.13，4.43]和产后护理[AOR=2.02，95%CI：1.24，2.91]的母亲使用现代避孕措施的可能性分别是未接受此类护理的母亲的 1.74 倍和 2.02 倍。
结论
在本研究地区，现代避孕措施的使用率低于计划的国家目标。在该地区，儿童免疫服务是向哺乳期妇女提供现代避孕措施的有希望的平台之一。我们的研究结果表明，产前和产后护理访视是现代避孕措施使用的另一个关键决定因素。因此，在我们这样的资源匮乏的环境中，应加强以改善产前和产后护理以及儿童免疫服务为重点的卫生系统方法，并就现代避孕措施的使用提供更有效的建议，以减少非意愿妊娠。
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