Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
Research Triangle Institute International, Health Care Financing and Payment, Research Triangle Park, North Carolina, United States of America.
PLoS One. 2021 Aug 17;16(8):e0254775. doi: 10.1371/journal.pone.0254775. eCollection 2021.
Women who start using contraception ("adopters") are a key population for family planning goals, but little is known about characteristics that predict the adoption of contraception as opposed to current use. We used prospective data from women and facilities for five countries, (Democratic Republic of Congo, India, Kenya, Nigeria, and Burkina Faso) and identified baseline characteristics that predicted adoption of modern contraception in the short term.
We used data from the Performance Monitoring for Action (PMA) Agile Project. PMA Agile administered service delivery point (SDP) client exit interview (CEI) surveys in urban sites of these five countries. Female clients responding to the CEI were asked for phone numbers that were used for a phone follow-up survey approximately four months later. For our analysis, we used data from the SDP and CEI baseline surveys, and the phone follow up to compare women who start using contraception during this period with those who remain non-users. We used characteristics of the facility and the woman at baseline to predict her contraception adoption in the future.
Discussing FP with a partner at baseline was associated with greater odds of adoption in DRC (OR 2.34; 95% CI 0.97-5.66), India (OR 2.27; 95% CI 1.05-4.93), and Kenya (OR 1.65; 95% CI 1.16-2.35). Women who discussed family planning with any staff member at the health facility had 1.72 greater odds (95% CI 1.13-2.67) of becoming an adopter in Nigeria. The odds of adoption were lower in Nigerian facilities that had a stockout (OR 0.66 95% CI 0.44-1.00) at baseline. Other characteristics associated with contraception adoption across settings were education, age, wealth, parity, and marital status.
Characteristics of both the woman and the health facility were associated with adoption of modern contraception in the future. Some characteristics, like discussing family planning with a spouse, education, and parity, were associated with contraceptive adoption across settings. Other characteristics that predict contraceptive use, such as health facility measures, varied across countries.
开始使用避孕措施的女性（使用者）是计划生育目标的关键人群，但对于哪些特征可预测她们会采用避孕措施而不是继续使用现有避孕方法，人们知之甚少。我们使用来自五个国家（刚果民主共和国、印度、肯尼亚、尼日利亚和布基纳法索）的妇女和医疗机构的前瞻性数据，确定了短期内在哪些方面的特征可以预测她们采用现代避孕方法。
我们使用了绩效管理行动（PMA）敏捷项目的数据。PMA 敏捷在这五个国家的城市地点开展服务提供点（SDP）客户出口调查（CEI）。在 CEI 中对女性客户进行了回复，她们被要求提供电话号码，以便大约四个月后进行电话随访调查。在我们的分析中，我们使用了 SDP 和 CEI 基线调查以及电话随访的数据，将在此期间开始使用避孕措施的女性与继续未使用者进行比较。我们使用了基本情况中设施和女性的特征来预测她们未来的避孕措施采用情况。
在刚果民主共和国（OR 2.34；95%CI 0.97-5.66）、印度（OR 2.27；95%CI 1.05-4.93）和肯尼亚（OR 1.65；95%CI 1.16-2.35），与伴侣在基线时讨论计划生育的女性更有可能采用避孕措施。在尼日利亚，与任何卫生机构工作人员讨论计划生育的女性成为使用者的可能性增加 1.72 倍（95%CI 1.13-2.67）。在尼日利亚，在基线时库存不足的设施中，采用避孕措施的可能性较低（OR 0.66；95%CI 0.44-1.00）。在其他环境中，与避孕措施采用相关的特征还有教育程度、年龄、财富、胎次和婚姻状况。
女性和医疗机构的特征都与未来采用现代避孕方法有关。一些特征，如与配偶讨论计划生育、教育程度和胎次，在不同环境中与避孕措施的采用有关。其他预测避孕措施使用的特征，如卫生机构措施，在不同国家有所不同。
