Mechal Negalign, Negash Mustefa, Bizuneh Hailemichael, Abubeker Ferid A
Department of Obstetrics and Gynecology, Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
Epidemiology Unit, Department of Public Health, Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
Contracept Reprod Med. 2022 May 11;7(1):6. doi: 10.1186/s40834-022-00173-0.
Unmet need for contraception refers to the proportion of women who want to postpone or stop childbearing but are not using a contraceptive method. Addressing unmet need is especially important for women with medical conditions such as cardiovascular disease (CVD). Preventing unintended pregnancy is crucial to improve pregnancy outcomes and minimize complications of CVD during pregnancy. However, unmet need for contraceptives continues to undermine the potential benefits of contraceptive use. This research aimed to determine the rate of unmet need for contraceptives and associated factors among women with cardiovascular disease having follow-up at Saint Paul's Hospital Millennium Medical College (SPHMMC), Addis Ababa, Ethiopia.
A facility-based cross-sectional study was conducted from February 1 to May 31/2020. A total of 284 reproductive age women with cardiovascular disease having follow-up at the cardiac clinic of SPHMMC were enrolled consecutively until the desired sample size was reached. Data was collected through an exit interview using a structured and pretested questionnaire. Descriptive, bivariate, and multivariable methods were used to analyze the level of unmet need and its associated factors.
The overall unmet need for contraception was 36.0% (95% CI: 30.4-41.5). The majority of the respondents lack counseling on contraception use. The most common reasons for non-use of a contraceptive method were fear of drug side effects and drug interaction. Unmet need for contraception was found to be more likely among those who have not been counseled on contraceptive utilization (AOR 6.7, CI 1.8-24.7) and those who lack partner support on contraception use (AOR = 6.2, CI: 1.91-19.8). Unmet need was also found to be more likely among women who have never used contraception before (AOR = 3.2, CI 1.12-8.92).
Unmet need for contraception was high in this high-risk population group. The cardiac follow-up clinic should implement client-centered counseling by a multidisciplinary team to address the needs of women and prevent consequences of unintended pregnancy. Furthermore, there is a need to initiate interventions that encourage communication between couples and increase male partner involvement through a renewed focus on couples counseling.
未满足的避孕需求是指那些想要推迟或停止生育但未采用避孕方法的女性所占的比例。满足未满足的需求对于患有心血管疾病（CVD）等疾病的女性尤为重要。预防意外怀孕对于改善妊娠结局和最大限度减少孕期心血管疾病并发症至关重要。然而，未满足的避孕需求持续削弱了使用避孕措施的潜在益处。本研究旨在确定埃塞俄比亚亚的斯亚贝巴圣保罗医院千禧医学院（SPHMMC）接受随访的患有心血管疾病的女性中未满足的避孕需求率及相关因素。
于2020年2月1日至5月31日进行了一项基于机构的横断面研究。连续纳入在SPHMMC心脏科门诊接受随访的284名患有心血管疾病的育龄女性，直至达到所需样本量。通过使用结构化且经过预测试的问卷进行出院访谈收集数据。采用描述性、双变量和多变量方法分析未满足需求的水平及其相关因素。
避孕需求未得到满足的总体比例为36.0%（95%置信区间：30.4 - 41.5）。大多数受访者缺乏关于避孕使用的咨询。不采用避孕方法的最常见原因是担心药物副作用和药物相互作用。在未接受过避孕使用咨询的人群中（调整后比值比[AOR]为6.7，置信区间为1.8 - 24.7）以及在避孕使用方面缺乏伴侣支持的人群中（AOR = 6.2，置信区间：1.91 - 19.8），未满足的避孕需求更有可能出现。在从未使用过避孕措施的女性中也发现未满足需求的可能性更高（AOR = 3.2，置信区间1.12 - 8.92）。
在这个高危人群组中，未满足的避孕需求较高。心脏科随访门诊应由多学科团队实施以患者为中心的咨询，以满足女性的需求并预防意外怀孕的后果。此外，有必要开展干预措施，鼓励夫妻之间的沟通，并通过重新关注夫妻咨询来增加男性伴侣的参与度。
