Department of Epidemiology & Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania.
Bukoba Regional Referral Hospital, Bukoba, Tanzania.
PLoS One. 2021 Mar 25;16(3):e0249017. doi: 10.1371/journal.pone.0249017. eCollection 2021.
Postpartum contraceptive use is vital to improve maternal and child survival. It helps to have optimal child spacing, prevent unplanned pregnancies and associated adverse birth outcomes. However, postpartum contraceptive use in Tanzania remains low. Short median interval for resumption to sex after birth among African women has been associated with adverse maternal and child health wellbeing. This study aimed to assess optimal time to contraceptive use and predictors of time to contraceptive use after birth among women of reproductive age in Tanzania.
A cross section study using the TDHS 2015-16 data was used. A total of 3775 postpartum women were analyzed. Information on pregnancy, births and contraceptive use were recorded over the previous 5 years with the focus on most recent birth from the contraceptive calendar. Data analysis was performed using Stata 14.0. Analysis accounted for complex survey design. Time to modern contraceptive use after birth was computed using Kaplan Meier estimate. Adjusted time ratios with 95% CI were estimated using Weibull accelerated failure time models.
A total weighted sample of 3775 women was analyzed. The median time to contraceptive use after birth was 7(IQR: 4-13) months, while for resumption to sex afterbirth was 2(IQR: 1-5) months. Factors such as never been married (TR: 1.63; 95%CI: 1.26-2.11) and breastfeeding (TR: 5.50; 95%CI: 4.12-7.35) were associated with longer time to postpartum contraceptive use. Belonging to richest wealth quintile (TR: 0.73; 95%CI: 0.54-0.99) and adopting long acting methods (TR: 0.70; 95%CI: 0.60-0.82) increased women's likelihood of having shorter time to postpartum contraceptive use.
There was a time lag of five months from resumption of sex and initiation of postpartum contraception use. The interceptive measures to facilitate timely availing methods of women's choice and promotion of utilization of maternal health care services may reduce delays in postpartum contraceptive use.
产后避孕对于改善母婴生存至关重要。它有助于实现最佳的生育间隔，防止意外怀孕和相关的不良生育结局。然而，坦桑尼亚的产后避孕使用率仍然很低。非洲妇女产后恢复性生活的中位时间较短，与母婴健康不良有关。本研究旨在评估坦桑尼亚育龄妇女产后避孕的最佳时间以及产后避孕时间的预测因素。
本研究采用 2015-16 年坦桑尼亚人口与健康调查（TDHS）的横断面数据。共分析了 3775 名产后妇女。在过去 5 年中，记录了与妊娠、分娩和避孕相关的信息，重点是避孕日历上最近的分娩。使用 Stata 14.0 进行数据分析。分析考虑了复杂的调查设计。使用 Kaplan-Meier 估计计算产后使用现代避孕药具的时间。使用 Weibull 加速失效时间模型估计调整后的时间比及其 95%CI。
共分析了 3775 名加权总样本妇女。产后避孕的中位时间为 7（IQR：4-13）个月，而产后恢复性生活的中位时间为 2（IQR：1-5）个月。从未结婚（TR：1.63；95%CI：1.26-2.11）和母乳喂养（TR：5.50；95%CI：4.12-7.35）等因素与产后避孕时间延长有关。属于最富有财富五分位数（TR：0.73；95%CI：0.54-0.99）和采用长效避孕方法（TR：0.70；95%CI：0.60-0.82）增加了妇女产后避孕的可能性，缩短了时间。
从恢复性生活到开始产后避孕使用之间存在五个月的时间滞后。采取干预措施，促进妇女及时获得她们选择的方法，并促进利用孕产妇保健服务，可能会减少产后避孕的延迟。
