University of California San Francisco, San Francisco, CA, United States; Opportunity Solutions International, San Francisco, CA, United States.
University of California San Francisco, San Francisco, CA, United States.
Contraception. 2021 Aug;104(2):147-154. doi: 10.1016/j.contraception.2021.04.013. Epub 2021 Apr 24.
Women may differ by whether they rely on health providers and/or social ties for seeking information and advice about family planning. It is unknown whether these differences matter for contraceptive outcomes. This study assessed the association between women's family planning (FP) network (social and/or provider ties) and contraceptive use.
This cross-sectional, egocentric network study was conducted among reproductive-age women (n = 193) in rural Madagascar. Data included socio-demographics and contraceptive use. Respondents listed who they relied on for contraceptive information, advice or guidance and provided ties' gender, age, relationship, and perceived support of contraceptive use. The primary outcome was current contraceptive use. Predictors included having a FP network (0/1) and FP network composition (no network, social ties only, provider ties only, both provider and social ties), respectively. Analyses were conducted using a generalized linear model specifying a Poisson distribution, with covariate adjustment and cluster robust standard errors.
Having a network of individuals to turn to for contraceptive information compared to having no FP network was positively associated with contraceptive use (adjusted relative risk [aRR] 4.4, 95% confidence interval [CI] 2.00-9.87). Having a social network, a provider network, or a combination of social and provider network were all positively associated with contraceptive use (aRR 4.30 [CI 1.92-9.66], aRR 4.46 [CI 2.04-9.75], aRR 4.72 [CI 1.93-11.50], respectively), compared to having no FP network.
Contraceptive use was higher among women who relied on social ties, provider ties or both for contraceptive information and advice, compared to women with no FP network. These findings suggest that FP interventions should use a multicomponent approach taking into account both social and provider networks.
It is unknown whether differences in whether women rely on social ties (friends, partner, family members) vs. providers for contraceptive information and advice affect contraceptive outcomes. Women are just as likely to use contraception whether they rely on social ties, provider ties, or both for contraceptive information and advice.
女性在寻求计划生育信息和建议时，可能依赖于医疗服务提供者和/或社会关系。目前尚不清楚这些差异是否会影响避孕效果。本研究评估了女性计划生育（FP）网络（社会和/或提供者关系）与避孕使用之间的关系。
这是一项在马达加斯加农村地区进行的、以生育年龄女性为对象的、横断式、自我中心网络研究。数据包括社会人口统计学和避孕使用情况。受访者列出了他们在避孕信息、建议或指导方面依赖的人，并提供了关系人的性别、年龄、关系以及对避孕使用的支持程度。主要结局是当前的避孕使用情况。预测因素包括是否有 FP 网络（0/1）和 FP 网络组成（无网络、仅社会关系、仅提供者关系、提供者和社会关系都有）。分析采用指定泊松分布的广义线性模型进行，包括协变量调整和聚类稳健标准误差。
与没有 FP 网络相比，有一个可以寻求避孕信息的个人网络与避孕使用呈正相关（调整后的相对风险 [aRR] 4.4，95%置信区间 [CI] 2.00-9.87）。有社会网络、提供者网络或社会和提供者网络的组合，与避孕使用均呈正相关（aRR 4.30 [CI 1.92-9.66]、aRR 4.46 [CI 2.04-9.75]、aRR 4.72 [CI 1.93-11.50]，分别），而与没有 FP 网络相比。
与没有 FP 网络的女性相比，依赖社会关系、提供者关系或两者都依赖于避孕信息和建议的女性，避孕使用率更高。这些发现表明，FP 干预措施应采用多组分方法，同时考虑社会和提供者网络。
目前尚不清楚女性在避孕信息和建议方面依赖社会关系（朋友、伴侣、家庭成员）与提供者的差异是否会影响避孕效果。无论女性是依赖社会关系、提供者关系还是两者都依赖于避孕信息和建议，她们使用避孕的可能性都一样大。
