Abebe Haftom Temesgen, Belachew Abate Bekelle, Gebretsadik Letekirstos Gebreegziabher, Berhe Yodit Zewdie, Gebru Haftu Berhe, Kahsay Alemayohu Bayray, Gebrekidan Atkilt Girma
Mekelle University, Mekelle, Tigray, Ethiopia.
Int J Adolesc Med Health. 2020 Sep 2;34(5):327-336. doi: 10.1515/ijamh-2020-0107. eCollection 2022 Oct 1.
Adolescent women are central for intergenerational health of human populations. Adolescent women are the most vulnerable to a range of reproductive health problems. One of the leading causes of death for adolescent women is complications from childbirth and pregnancy. Contraceptive prevents the occurrence of unwanted pregnancies and its complications, thus potentially lower the death rate for adolescent women. However, contraceptive use assumed to be affected by multilevel factors thus needs statistical modeling that account the effect of these factors. Understanding multilevel factors affecting contraceptive use among adolescent women is important for improving the access to and quality of health services.
The aim of this study was to assess the contraceptive use and its multilevel determinants among adolescent women in Tigray region.
A community based cross-sectional study was conducted. Women who were 15-19 years of age residing in the selected households at the time of data collection were included in the survey. Multi-stage cluster sampling was used to select study units. A multivariable two-level mixed effect binary logistic regression model was fitted to assess the effect of the explanatory variables on contraceptive use.
A total of 1,755 adolescent women were participated. Of these 12.3% were contraceptive users. Pills (40%) and intrauterine device (30%) were commonly used contraceptive methods. Educational level, schooling, marital status, age, being informed about contraceptive, health facility visit, duration of stay at their residence, having partner and hearing of contraceptive use message through media were the most important determinants for use of contraceptive among adolescent women. Study participants who were not at school currently had more likely to use contraceptive methods compared to those who were at school (Adjusted odds ratio [AOR]=2.05; 95% confidence interval [CI]: 1.502, 4.183). Similarly, adolescent women who had no history of health facility visit had less likely to use contraceptive methods than those have history of health facility visit (AOR=0.057; 95% CI: 0.034, 0.096). Adolescent women who heard of contraceptive through median had two times (AOR=2.103; 95% CI: 1.207, 3.664) more likely to use contraceptive methods than those not heard contraceptive through media.
The factors affecting use of contraceptive method among adolescent women were educational level, schooling, marital status, age, being informed about contraceptive, health facility visit, duration of stay at their residence, having partner and hearing of contraceptive use message through media. This study recommends that in order to increase use of contraceptive method among adolescent women, interventions should continue like the promotion of contraceptive methods through media.
青春期女性对于人类种群的代际健康至关重要。青春期女性最易遭受一系列生殖健康问题。青春期女性死亡的主要原因之一是分娩和怀孕并发症。避孕可预防意外怀孕及其并发症的发生，从而有可能降低青春期女性的死亡率。然而，避孕措施的使用被认为受到多层次因素的影响，因此需要考虑这些因素影响的统计模型。了解影响青春期女性避孕措施使用的多层次因素对于改善卫生服务的可及性和质量很重要。
本研究旨在评估提格雷地区青春期女性的避孕措施使用情况及其多层次决定因素。
开展了一项基于社区的横断面研究。调查纳入了在数据收集时居住在选定家庭中的15至19岁女性。采用多阶段整群抽样来选择研究单位。拟合多变量两级混合效应二元逻辑回归模型以评估解释变量对避孕措施使用的影响。
共有1755名青春期女性参与。其中，12.3%为避孕措施使用者。避孕药（40%）和宫内节育器（30%）是常用的避孕方法。教育水平、上学情况、婚姻状况、年龄、了解避孕知识、就医、在居住地的停留时间、有伴侣以及通过媒体听到避孕措施使用信息是青春期女性使用避孕措施的最重要决定因素。目前未上学的研究参与者比在校者更有可能使用避孕方法（调整后的优势比[AOR]=2.05；95%置信区间[CI]：1.502，4.183）。同样，没有就医史的青春期女性比有就医史的女性使用避孕方法的可能性更小（AOR=0.057；95%CI：0.034，0.096）。通过媒体听说过避孕知识的青春期女性使用避孕方法的可能性是未通过媒体听说过的女性的两倍（AOR=2.103；95%CI：1.207，3.664）。
影响青春期女性避孕措施使用的因素包括教育水平、上学情况、婚姻状况、年龄、了解避孕知识、就医、在居住地的停留时间、有伴侣以及通过媒体听到避孕措施使用信息。本研究建议，为了增加青春期女性避孕措施的使用，应继续开展干预措施，如通过媒体推广避孕方法。
