Bansal Anjali, Dwivedi Laxmi Kant
International Institute for Population Sciences, Mumbai, 400088 India.
Department of Mathematical Demography and Statistics, International Institute for Population Sciences, Mumbai, 400088 India.
Contracept Reprod Med. 2020 Sep 8;5:13. doi: 10.1186/s40834-020-00115-8. eCollection 2020.
According to United Nations, 19% of females in the world relied only on the permanent method of family planning, with 37% in India according to NFHS-4. Limited studies tried to measure the sterilization regret, and its correlated factors. The study tried to explore the trend of sterilization regret in India from 1992 to 2015 and to elicit the determining effects of various factors on sterilization regret, especially in context to perceived quality of care in the sterilization operations and type of providers.
The pooled data from NFHS-1, NFHS-3 and NFHS-4 was used to explore the regret by creating interaction between time and all the predictors. Predicted probabilities were calculated to show the trend of sterilization regret amounting to quality of care, type of health provider at the three time periods.
The sterilization regret was increased from 5 % in NFHS-1 to 7 % in NFHS-4. According to NFHS-4, for those whose sterilization was performed in private health facility the regret was found to be less (OR-0.937; 95% CI- (0.882-0.996)) compared to public health facility. Also, the results show a two-fold increase in regret when women reported bad quality of care. The results from predicted probabilities provide enough evidence that the regret due to bad quality of care in sterilization operation had increased with each subsequent round of NFHS.
Many socio-economic and demographic factors have influenced the regret, but the poor quality of care contributed maximum to the regret from 1992 to 2015. The health facilities have seriously strayed from improving the health and well-being of women in providing the family planning methods. In addition, to public facilities, the regret amounting to private facilities have also increased from NFHS-1 to 4. The quality of care provided in the family planning operation should be standardized in every hospital to strengthen the health systems in the country. The couple should be motivated to adopt more of spacing methods.
根据联合国数据，全球19%的女性仅依赖永久性计划生育方法，而根据第四次全国家庭健康调查（NFHS - 4），印度这一比例为37%。仅有有限的研究尝试衡量绝育后悔情况及其相关因素。本研究试图探究1992年至2015年印度绝育后悔的趋势，并找出各种因素对绝育后悔的决定性影响，特别是在绝育手术中感知到的护理质量和提供者类型方面。
使用来自第一次全国家庭健康调查（NFHS - 1）、第三次全国家庭健康调查（NFHS - 3）和第四次全国家庭健康调查（NFHS - 4）的汇总数据，通过在时间与所有预测因素之间创建交互作用来探究后悔情况。计算预测概率以显示在三个时间段内，绝育后悔与护理质量、健康提供者类型之间的趋势。
绝育后悔率从NFHS - 1的5%上升至NFHS - 4的7%。根据NFHS - 4，与在公共卫生机构进行绝育手术的女性相比，在私立卫生机构进行绝育手术的女性后悔率更低（比值比 - 0.937；95%置信区间 - （0.882 - 0.996））。此外，结果显示当女性报告护理质量差时，后悔率会增加两倍。预测概率的结果提供了充分证据，表明在绝育手术中因护理质量差导致的后悔率在随后的每一轮NFHS中都有所增加。
许多社会经济和人口因素影响了后悔情况，但在1992年至2015年期间，护理质量差对后悔情况的影响最大。卫生机构在提供计划生育方法时严重偏离了改善女性健康和福祉的目标。此外，与公共机构一样，从NFHS - 1到NFHS - 4，私立机构的后悔率也有所增加。每家医院都应规范计划生育手术中的护理质量，以加强该国的卫生系统。应鼓励夫妻更多地采用间隔生育方法。
