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印度城市贫民窟中年轻已婚妇女(15-24 岁)对计划生育服务的需求未得到满足。

Unmet need for family planning services among young married women (15-24 years) living in urban slums of India.

机构信息

Assistant Professor, Vir Chandra Singh Garhwali Government Institute of Medical Science and Research, Srinagar, Pauri Garhwal, Uttarakhand, India.

Department of Community Medicine & Public Health, K.G. Medical University, Lucknow, UP, India.

出版信息

BMC Womens Health. 2020 Sep 3;20(1):187. doi: 10.1186/s12905-020-01010-9.

Abstract

BACKGROUND

NFHS-4 stated high unmet need for family planning (FP) among married women in Uttar Pradesh. Unmet need is highest among age groups: 15-19 and 20-24 years. Currently few data is available about unmet need for FP among vulnerable section of the community, i.e.15-24 year's age group living in the urban slums. Therefore this study was conducted to assess the unmet need for FP services and its determinants among this under-privileged and under-served section of society residing in urban slums of Uttar Pradesh, India.

METHODS

Cross sectional study was conducted in the slums of Lucknow, India. One Urban-Primary Health Centre (U-PHC) was randomly selected from each of the eight Municipal Corporation zones in Lucknow and two notified slums were randomly selected from each U-PHC. All the households in the selected slums were visited for interviewing 33 young married women (YMW) in each slum, with a pre-structured and pre tested questionnaire, to achieve the sample size of 535. Analysis of the data was done using logistic regression.

RESULTS

The unmet need for family planning services among YMW was 55.3%. About 40.9% of the unmet need was for spacing methods and 14.4% for limiting methods. Important reasons cited for unmet need for family planning services were negligent attitude of the women towards family planning, opposition by husband or others, embarrassment / hesitation / shyness for contraceptive use, poor knowledge of the FP method or availability of family planning services. Among method related reasons health concerns and fear of side effects were frequently cited reasons. On multiple logistic regression: age, educational status, duration of marriage, number of pregnancies, knowledge of contraceptive methods, opposition to contraceptive use and contact with Auxiliary Nurse Midwife (ANM) showed independently significant association with unmet need for family planning services.

CONCLUSIONS

Unmet need for family planning services is very high among the YMW of urban slums. The findings stress that program managers should take into cognizance these determinants of high level of unmet need for family planning among YMW and make intense efforts for addressing these issues in a holistic manner.

摘要

背景

NFHS-4 指出,北方邦已婚女性对计划生育(FP)的需求未得到满足。未满足的需求在年龄组中最高:15-19 岁和 20-24 岁。目前,关于社区弱势群体(即 15-24 岁年龄组居住在城市贫民窟的人群)对 FP 的未满足需求的数据很少。因此,本研究旨在评估印度北方邦城市贫民窟中这一贫困和服务不足的社会群体对 FP 服务的未满足需求及其决定因素。

方法

在印度勒克瑙的贫民窟进行了横断面研究。从勒克瑙的八个市政公司区中随机选择了一个城市初级保健中心(U-PHC),并从每个 U-PHC 中随机选择了两个通知的贫民窟。在选定的贫民窟中,每个贫民窟都访问了所有家庭,对 33 名年轻已婚妇女(YMW)进行了访谈,使用了预先制定和预先测试的问卷,以达到 535 人的样本量。使用逻辑回归分析数据。

结果

YMW 的计划生育服务未满足需求为 55.3%。未满足需求的约 40.9%是为了间隔方法,14.4%是为了限制方法。未满足计划生育服务需求的重要原因是妇女对计划生育的漠不关心态度、丈夫或其他人的反对、对避孕使用的尴尬/犹豫/害羞、对 FP 方法的知识不足或计划生育服务的可用性。在与方法相关的原因中,健康问题和对副作用的恐惧经常被提及。在多变量逻辑回归中:年龄、教育程度、婚姻持续时间、怀孕次数、避孕方法知识、对避孕使用的反对以及与辅助护士助产士(ANM)的接触均与计划生育服务的未满足需求呈独立显著相关。

结论

城市贫民窟中 YMW 的计划生育服务未满足需求非常高。调查结果强调,项目管理人员应注意到这些导致 YMW 对计划生育的未满足需求高的决定因素,并以整体的方式努力解决这些问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f898/7469334/f9e8ac4f7299/12905_2020_1010_Fig1_HTML.jpg

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