Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban 4041, South Africa.
Department of Population and Health, University of Cape Coast, Cape Coast,PMB, Ghana.
Int Health. 2022 Sep 7;14(5):492-500. doi: 10.1093/inthealth/ihab053.
Long-acting reversible contraceptives (LARCs) are associated with high efficacy rates and continuity of use. Based on the foregoing, we sought to examine the prevalence and factors associated with LARC use among sexually active women in 26 countries in sub-Saharan Africa(SSA).
Secondary data from Demographic and Health Surveys conducted in 26 countries in SSA between January 2010 and December 2019 were pooled and analysed. A total of 56 067 sexually active women 15-49 y of age met the inclusion criteria. Bivariate and multivariate regression analyses were performed to examine the association between selected factors and the use of LARCs in SSA. Results were presented as crude odds ratios and adjusted odds ratios (aORs) with statistical precision at <0.05.
The prevalence of LARC use was 21.73%, ranging from 1.94% in Namibia to 54.96% in Benin. Sexually active women with secondary or higher education (aOR 1.19 [95% confidence interval {CI} 1.08 to 1.32]), those cohabiting (aOR 1.25 [95% CI 1.06 to 1.47]) and those with four or more children (aOR 2.22 [95% CI 1.78 to 2.78]) were more likely to use LARCs compared with those without education, never married and with no biological child.
The use of LARCs in the 26 countries in SSA was relatively low. Hence, the identified contributory factors of LARC use should be tackled with appropriate interventions. These include continuous campaigns on the efficacy of LARCs in reducing unintended pregnancy, maternal mortality and morbidity.
长效可逆避孕措施（LARC）具有高效和持续使用的特点。基于这一点，我们试图研究在撒哈拉以南非洲（SSA）的 26 个国家中，活跃性性行为女性中 LARC 使用的流行率和相关因素。
对 2010 年 1 月至 2019 年 12 月期间在 SSA 进行的 26 个国家的人口与健康调查的二级数据进行汇总和分析。共有 56067 名年龄在 15-49 岁之间的活跃性性行为女性符合纳入标准。采用二变量和多变量回归分析，研究了选定因素与 SSA 中 LARC 使用之间的关系。结果以粗比值比和调整比值比（aOR）表示，统计学精度为<0.05。
LARC 的使用率为 21.73%，范围从纳米比亚的 1.94%到贝宁的 54.96%。具有中等或高等教育（aOR 1.19[95%置信区间（CI）1.08-1.32]）、同居（aOR 1.25[95%CI 1.06-1.47]）和有四个或更多孩子的（aOR 2.22[95%CI 1.78-2.78]）活跃性性行为女性比没有教育、从未结婚和没有生物学孩子的女性更有可能使用 LARC。
SSA 26 个国家中 LARC 的使用率相对较低。因此，应针对 LARC 使用的这些确定的促成因素，采取适当的干预措施。这些措施包括对 LARC 在降低非意愿妊娠、孕产妇死亡率和发病率方面的功效进行持续宣传。
