与巴基斯坦避孕方法使用相关的需求侧和供给侧因素：1990-2018 年人口与健康调查的比较研究。
Demand- and supply-side factors associated with the use of contraceptive methods in Pakistan: a comparative study of demographic and health surveys, 1990-2018.
机构信息
Virtual University Lahore, Lahore, Pakistan.
Institute of Social and Cultural Studies, University of the Punjab, Lahore, Pakistan.
出版信息
BMC Womens Health. 2020 Nov 30;20(1):265. doi: 10.1186/s12905-020-01112-4.
BACKGROUND
A remarkable decline in fertility rates has been observed in many countries, with a primary determinant being an increase in the use of contraceptives. However, the birth rate in Pakistan is still higher compared to the other countries of the region. Therefore, this study aims to assess the effect of demand- and supply-side factors associated with the use of contraceptive measures in Pakistan.
METHODS
Secondary data analysis of four data series of the Pakistan Demographic and Health Surveys (PDHS 1990-1991, 2006-2007, 2012-2013 and 2017-2018) were used. The data includes ever-married women aged 15-49 years who had given birth in the previous five years and participated in the family planning module of the PDHS. A total of 25,318 women were included in the analysis. Data were analysed by investigating the associations between independent variables (demand- and supply-side factors) and the use of contraceptive measures through unadjusted odds ratios (OR) and adjusted OR (AOR).
RESULTS
The results among demand-side factors indicated that in 2012-2013, women without media exposure were less likely to use contraceptives and the trend remains almost constant for 2017-2018 (AOR = 0.664, 95% CI 0.562-0.784) in 2012-2013 and (AOR = 0.654, 95% CI 0.483-0.885) in 2017-2018. However, they still show a lower likelihood of using contraceptives without media exposure. The results among supply-side factors indicated that absence of transport (2012-2013) and limited visits by family planning workers over the previous 12 months (2006-2007, 2012-2013 and 2017-2018) remained significant factors for not using contraceptive methods.
CONCLUSIONS
The results of the study indicate that certain demand- and supply-side factors are associated with the use of contraceptive measures in Pakistan. It highlights the need for the provision of family planning resources and further structural factors, particularly in remote areas.
背景
许多国家的生育率显著下降，主要决定因素是避孕措施使用率的增加。然而，与该地区其他国家相比，巴基斯坦的出生率仍然较高。因此，本研究旨在评估与巴基斯坦使用避孕措施相关的需求方和供应方因素的影响。
方法
使用四次巴基斯坦人口与健康调查（PDHS）数据系列（1990-1991 年、2006-2007 年、2012-2013 年和 2017-2018 年）的二次数据分析。数据包括过去五年内生育过且参与 PDHS 计划生育模块的 15-49 岁已婚妇女。共纳入 25318 名妇女进行分析。通过未调整比值比（OR）和调整比值比（AOR）调查独立变量（需求方和供应方因素）与避孕措施使用之间的关联，对数据进行分析。
结果
需求方因素的结果表明，在 2012-2013 年，没有媒体接触的妇女使用避孕药具的可能性较小，这一趋势在 2017-2018 年几乎保持不变（AOR=0.664，95%CI 0.562-0.784）在 2012-2013 年和（AOR=0.654，95%CI 0.483-0.885）在 2017-2018 年。然而，她们仍然显示出较低的使用避孕药具的可能性，没有媒体接触。供应方因素的结果表明，2012-2013 年没有交通工具以及过去 12 个月家庭计划工作人员的访问次数有限仍然是不使用避孕方法的重要因素（2006-2007 年、2012-2013 年和 2017-2018 年）。
结论
研究结果表明，某些需求方和供应方因素与巴基斯坦避孕措施的使用相关。它强调了提供计划生育资源和进一步的结构性因素的必要性，特别是在偏远地区。
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