Division of Reproductive Health, United States Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Programs Team, EngenderHealth, Dar es Salaam, Tanzania.
J Womens Health (Larchmt). 2022 Mar;31(3):447-457. doi: 10.1089/jwh.2020.8984. Epub 2021 Jun 14.
Globally 10% of women have an unmet need for contraception, with higher rates in sub-Saharan Africa. Programs to improve family planning (FP) outcomes require data on how service characteristics (, geographic access, quality) and women's characteristics are associated with contraceptive use. We combined data from health facility assessments (2018 and 2019) and a population-based regional household survey (2018) of married and in-union women ages 15-49 in the Kigoma Region of Tanzania. We assessed the associations between contraceptive use and service (, distance, methods available, personnel) and women's (, demographic characteristics, fertility experiences and intentions, attitudes toward FP) characteristics. In this largely rural sample ( = 4,372), 21.7% of women used modern reversible contraceptive methods. Most variables were associated with contraceptive use in bivariate analyses. In multivariate analyses, access to services located <2 km of one's home that offered five methods (adjusted odds ratio [aOR] = 1.57, confidence interval [CI] = 1.18-2.10) and had basic amenities (aOR = 1.66, CI = 1.24-2.2) increased the odds of contraceptive use. Among individual variables, believing that FP benefits the family (aOR = 3.65, CI = 2.18-6.11) and believing that contraception is safe (aOR = 2.48, CI = 1.92-3.20) and effective (aOR = 3.59, CI = 2.63-4.90) had strong associations with contraceptive use. Both service and individual characteristics were associated with contraceptive use, suggesting the importance of coordination between efforts to improve access to services and social and behavior change interventions that address motivations, knowledge, and attitudes toward FP.
全球有 10%的女性对避孕措施有未满足的需求，撒哈拉以南非洲地区的这一比例更高。改善计划生育（FP）结果的项目需要了解服务特征（地理位置、可及性、质量）和妇女特征如何与避孕措施使用相关的数据。我们结合了坦桑尼亚基戈马地区 2018 年和 2019 年的卫生机构评估数据和 2018 年基于人群的区域家庭调查数据，调查了已婚和同居的 15-49 岁妇女的避孕措施使用情况与服务（地理位置、方法、人员）和妇女（人口统计学特征、生育经历和意图、对 FP 的态度）特征之间的关联。在这个以农村为主的样本（ = 4372）中，有 21.7%的妇女使用现代可逆避孕方法。大多数变量在单变量分析中与避孕措施使用相关。在多变量分析中，获得距离家庭住址 <2 公里的提供五种方法的服务（调整后的优势比 [aOR] = 1.57，置信区间 [CI] = 1.18-2.10）和拥有基本便利设施（aOR = 1.66，CI = 1.24-2.2）增加了避孕措施使用的几率。在个体变量中，认为 FP 使家庭受益（aOR = 3.65，CI = 2.18-6.11）和认为避孕安全（aOR = 2.48，CI = 1.92-3.20）和有效（aOR = 3.59，CI = 2.63-4.90）与避孕措施使用有很强的关联。服务和个体特征都与避孕措施使用相关，这表明改善服务可及性的努力与针对 FP 的动机、知识和态度的社会和行为改变干预措施之间需要协调。
