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肯尼亚长效可逆避孕的相关趋势与因素

Trends and factors associated with long-acting reversible contraception in Kenya.

作者信息

Kungu Wambui, Khasakhala Anne, Agwanda Alfred

机构信息

Population Studies and Research Institute, University of Nairobi, Nairobi, Kenya.

出版信息

F1000Res. 2020 May 20;9:382. doi: 10.12688/f1000research.23857.1. eCollection 2020.

Abstract

: Kenya has 12 million female adolescents and youths aged 10-34 years whose reproductive behavior will determine the growth and size of its population for the next decade. The anticipated momentum of births can be slowed by the use of long-acting reversible contraception (LARC) methods as they are more effective, need no user adherence, and hence have no risk of incorrect or inconsistent use. However, in spite of the many health and social benefits, LARC is underutilized because of myths and misconceptions. Kenya is in the ultimate decade towards Vision 2030 and investing in LARC can save costs of health care and accelerate the achievement of the development goal. The objective of this study was to establish factors associated with LARC use, with a view of establishing the potential for increasing demand. : The study was national and used secondary data from the three waves of the Kenya Demographic Health Survey from 2003, 2008/09 and 2014 in a sample of all women of reproductive age who reported currently using modern contraceptive methods at the time of interview. Descriptive and logistic regression analysis was employed to profile and examine LARC users. : LARC use was low but picking up rapidly, especially among contraceptive users of higher social economic status in a major shift between 2008/09 and 2014. Consistent factors that influenced its use were age, wealth, and number of living children, while education and residence were of influence some of the time. : There is huge unexploited potential for more LARC uptake based on the identified predictors of its use. Scaling up of LARC uptake is critical to deal with issues of poor user adherence, incorrect and inconsistent use, and method failure that characterize short-acting contraception, resulting in increased unintended pregnancies, incidences of unsafe abortions and maternal and infant mortality.

摘要

肯尼亚有1200万年龄在10至34岁之间的女性青少年和青年,她们的生育行为将决定该国未来十年的人口增长和规模。长效可逆避孕(LARC)方法可以减缓预期的生育增长势头,因为这些方法更有效,无需使用者坚持,因此不存在使用不当或不规律的风险。然而,尽管有诸多健康和社会效益,但由于误解和错误观念,LARC的使用率仍然很低。肯尼亚正处于迈向2030年愿景的最后十年,投资LARC可以节省医疗保健成本并加速实现发展目标。本研究的目的是确定与LARC使用相关的因素,以期确定增加需求的潜力。

该研究是全国性的,使用了来自2003年、2008/09年和2014年三轮肯尼亚人口与健康调查的二手数据,样本为所有在访谈时报告正在使用现代避孕方法的育龄妇女。采用描述性和逻辑回归分析来描述和研究LARC使用者。

LARC的使用率较低,但正在迅速上升,特别是在2008/09年至2014年期间出现重大转变的较高社会经济地位的避孕使用者中。影响其使用的一致因素是年龄、财富和存活子女数量,而教育和居住地有时也有影响。

基于已确定的LARC使用预测因素,更多人采用LARC的潜力巨大。扩大LARC的采用对于解决短效避孕中常见的使用者依从性差、使用不当和不规律以及方法失败等问题至关重要,这些问题会导致意外怀孕增加、不安全堕胎发生率上升以及母婴死亡率上升。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fcca/9152462/4455cc123e86/f1000research-9-26324-g0000.jpg

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