School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.
Department of Population and Health, College of Humanities and Legal Studies, University of Cape Coast, Cape Coast, Ghana.
Reprod Health. 2020 Oct 23;17(1):163. doi: 10.1186/s12978-020-01018-2.
Globally, sub-Saharan Africa (SSA) bears the highest proportion of women with unmet need for contraception as nearly 25% of women of reproductive age in the sub-region have unmet need for contraception. Unmet need for contraception is predominant among young women. We examined the association between socio-economic and demographic factors and unmet need for contraception among young women in SSA.
Data for this study obtained from current Demographic and Health Surveys (DHS) conducted between January 1, 2010 and December 31, 2018 in 30 sub-Saharan African countries. The sample size consisted of young women (aged 15-24), who were either married or cohabiting and had complete cases on all the variables of interest (N = 59,864). Both bivariate and multivariable binary logistic regression analyses were performed using STATA version 14.0.
The overall prevalence of unmet need for contraception among young women was 26.90% [95% CI: 23.82-29.921], ranging from 11.30% [95% CI: 5.1-17.49] in Zimbabwe to 46.7% [95% CI: 36.92-56.48] in Comoros. Results on socio-economic status and unmet need for contraception showed that young women who had primary [aOR = 1.18; CI = 1.12-1.25, p < 0.001] and secondary/higher levels of formal education [aOR = 1.27; CI = 1.20-1.35, p < 0.001] had higher odds of unmet need for contraception compared to those with no formal education. With wealth status, young women in the richest wealth quintile had lower odds of unmet need for contraception compared with those in the poorest wealth quintile [aOR = 0.89; CI = 0.81-0.97, p < 0.01]. With the demographic factors, the odds of unmet need for contraception was lower among young women aged 20-24 [aOR = 0.74; CI = 0.70-0.77, p < 0.001], compared with 15-19 aged young women. Also, young women who were cohabiting had higher odds of unmet need for contraception compared to those who were married [aOR = 1.35; CI = 1.28-1.43, p < 0.001].
Our study has demonstrated that unmet need for contraception is relatively high among young women in SSA and this is associated with socio-economic status. Age, marital status, parity, occupation, sex of household head, and access to mass media (newspaper) are also associated with unmet need for contraception. It is therefore, prudent that organisations such as UNICEF and UNFPA and the Bill & Melinda Gates Foundation who have implemented policies and programmes on contraception meant towards reducing unmet need for contraception among women take these factors into consideration when designing interventions in sub-Saharan African countries to address the problem of high unmet need for contraception among young women.
在全球范围内，撒哈拉以南非洲（SSA）的避孕需求未得到满足的女性比例最高，该地区近 25%的育龄女性避孕需求未得到满足。避孕需求未得到满足主要集中在年轻女性群体中。我们研究了社会经济和人口因素与撒哈拉以南非洲年轻女性避孕需求未得到满足之间的关联。
本研究的数据来自于 2010 年 1 月 1 日至 2018 年 12 月 31 日期间在 30 个撒哈拉以南非洲国家进行的当前人口与健康调查（DHS）。样本量包括 15-24 岁的年轻女性（已婚或同居，且所有感兴趣的变量均有完整案例）（N=59864）。使用 STATA 版本 14.0 进行了单变量和多变量二元逻辑回归分析。
年轻女性避孕需求未得到满足的总体流行率为 26.90%[95%CI：23.82-29.921]，范围从津巴布韦的 11.30%[95%CI：5.1-17.49]到科摩罗的 46.7%[95%CI：36.92-56.48]。关于社会经济地位和避孕需求未得到满足的结果表明，与没有正规教育的女性相比，具有小学[优势比（aOR）=1.18；置信区间（CI）=1.12-1.25，p<0.001]和中学/高等正规教育[aOR=1.27；CI=1.20-1.35，p<0.001]的年轻女性更有可能避孕需求未得到满足。就财富状况而言，与最贫穷的财富五分位数相比，最富有的财富五分位数的年轻女性避孕需求未得到满足的可能性更低[aOR=0.89；CI=0.81-0.97，p<0.01]。在人口因素方面，与 15-19 岁的年轻女性相比，20-24 岁的年轻女性避孕需求未得到满足的可能性更低[aOR=0.74；CI=0.70-0.77，p<0.001]。此外，与已婚女性相比，同居的年轻女性避孕需求未得到满足的可能性更高[aOR=1.35；CI=1.28-1.43，p<0.001]。
我们的研究表明，撒哈拉以南非洲年轻女性的避孕需求未得到满足的情况相对较高，这与社会经济地位有关。年龄、婚姻状况、生育子女数、职业、家庭户主性别和大众媒体（报纸）的获取情况也与避孕需求未得到满足有关。因此，联合国儿童基金会、联合国人口基金会和比尔及梅琳达·盖茨基金会等组织在实施旨在减少女性避孕需求未得到满足的政策和方案时，在设计撒哈拉以南非洲国家的干预措施以解决年轻女性避孕需求未得到满足的问题时，应考虑这些因素。
