Department of Statistical Methods and Actuarial Science, School of Statistics & Planning, College of Business and Management Sciences, Makerere University, P.O. Box 7062, Kampala, Uganda.
Department of Population Studies, School of Statistics & Planning, College of Business and Management Sciences, Makerere University, P.O. Box 7062, Kampala, Uganda.
BMC Public Health. 2021 Jul 27;21(1):1457. doi: 10.1186/s12889-021-11069-0.
In spite of the universal right for women to decide freely for themselves when, and how many children they want to have in life, married women in Uganda are less likely to use modern contraceptives as compared to other marital categories. This study examines the individual and community factors associated with modern contraceptive use among married women in Uganda.
The study used data from the 2016 Uganda Demographic and Health Survey which comprised of 8671 married women aged 15-49 years who were fecund and non-pregnant at the time of the survey. Analysis was done using a multilevel mixed-effects logistic regression model.
Findings showed that married women who were; Muslims (AOR = 0.78, CI = 0.66-0.91), had more than five children (AOR = 0.76, CI = 0.61-0.98), staying in communities with high poverty (AOR = 0.78, CI = 0.65-0.93), with older age at first birth (AOR = 0.94, CI = 0.92-0.96) as well as having spousal age difference of more than 9 years (AOR = 0.86, CI = 0.76-0.98) were associated with low modern contraceptive use. Women living in communities with higher age at first marriage (AOR = 0.93, CI = 0.88-0.98) or higher sexual debut (AOR = 0.91, CI = 0.85-0.98) were also associated with reduced odds of modern contraception. In addition, older women (AOR = 1.03, CI = 1.01-1.04), having secondary/higher education (AOR = 1.93, CI = 1.58-2.37), living in a rich household (AOR = 1.32, CI = 1.14-1.53), short distance to health facility (AOR = 1.18, CI = 1.06-1.31), high community education (AOR = 1.38, CI = 1.17-1.62), high community exposure to family planning messages (AOR = 1.24, CI = 1.08-1.42), and communities with high proportion of women working (AOR = 1.22, CI = 1.06-1.39) were more likely to use modern contraceptives.
The study revealed that both individual and community factors were important in explaining the factors associated with modern contraceptive use among married women in Uganda. Therefore, there is need to invest in community based programs like: family planning outreach services, mass media campaigns and community mobilization activities to help in dissemination of family planning information, increase awareness and promotion in use of modern contraceptives. Also, expansion of higher education and the need to make family planning services available and accessible to areas with limited physical access to health facilities will lead to sustained increase in uptake of modern contraceptives.
尽管女性拥有自由决定何时生育以及生育数量的普遍权利，但与其他婚姻群体相比，乌干达已婚女性使用现代避孕药具的可能性较低。本研究旨在探讨与乌干达已婚女性使用现代避孕药具相关的个体和社区因素。
本研究使用了 2016 年乌干达人口与健康调查的数据，该调查涵盖了 8671 名年龄在 15-49 岁之间、有生育能力且在调查时未怀孕的已婚女性。分析采用多水平混合效应逻辑回归模型进行。
研究结果表明，以下因素与已婚女性低现代避孕药具使用率相关：信仰伊斯兰教（AOR=0.78，CI=0.66-0.91）、子女数量超过五个（AOR=0.76，CI=0.61-0.98）、居住在贫困程度较高的社区（AOR=0.78，CI=0.65-0.93）、首次生育年龄较大（AOR=0.94，CI=0.92-0.96）以及配偶年龄相差超过 9 岁（AOR=0.86，CI=0.76-0.98）。此外，居住在首次结婚年龄较高的社区（AOR=0.93，CI=0.88-0.98）或首次性行为较早的社区（AOR=0.91，CI=0.85-0.98）的女性也与现代避孕药具使用减少有关。此外，年龄较大的女性（AOR=1.03，CI=1.01-1.04）、接受过中等/高等教育（AOR=1.93，CI=1.58-2.37）、生活在富裕家庭（AOR=1.32，CI=1.14-1.53）、距离卫生机构较近（AOR=1.18，CI=1.06-1.31）、社区教育程度较高（AOR=1.38，CI=1.17-1.62）、社区接受计划生育信息较多（AOR=1.24，CI=1.08-1.42）以及女性就业比例较高的社区（AOR=1.22，CI=1.06-1.39）更有可能使用现代避孕药具。
本研究表明，个体和社区因素在解释乌干达已婚女性使用现代避孕药具的相关因素方面都很重要。因此，有必要投资于以社区为基础的项目，如计划生育外展服务、大众媒体宣传和社区动员活动，以帮助传播计划生育信息、提高认识并促进现代避孕药具的使用。此外，扩大中等教育并使计划生育服务在设施物理条件有限的地区能够获得和使用，将导致现代避孕药具的使用率持续增加。
