School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.
Centre for Gender and Advocacy, Takoradi Technical University, Takoradi, Ghana.
Reprod Health. 2022 Aug 20;19(1):183. doi: 10.1186/s12978-022-01484-w.
Contraception plays a significant role in fertility regulation. Evidence suggests that reproductive health rights influence contraception use. Women of Mali are noted to have limited control over their healthcare decisions. As a result, this study aimed at investigating the association between women's healthcare decision-making capacity and unmet need for contraception in Mali.
This study comprised 6593 women who participated in the 2018 Mali Demographic and Health Survey. Two binary logistic regression models were built. Whilst the first model (crude) involved healthcare decision-making capacity and unmet need for contraception, the second one was a complete model which controlled for all the socio-demographic characteristics. Sample weight was applied and Stata version 13.0 was used for all analyses.
Most of the women were not taking their healthcare decisions alone (92.8%). Nearly four out of ten of them indicated that they had unmet need for contraception (35.7%). Unmet need for contraception was high among women aged 45-49 (50.9%) and low among those aged 15-19 (19.2%). Unmet need for contraception was more probable among women who took their healthcare decisions alone compared to those who did not take their healthcare decisions alone [AOR = 1.35; CI = 1.08-1.70]. Compared with women aged 15-19, unmet need was higher among women aged 45-49 [AOR = 4.58, CI = 3.05-6.86]. Richer women had lower odds of unmet need for contraception compared with poorest women [AOR = 0.77, CI = 0.61-0.97].
Women who took their healthcare decisions alone had higher odds of unmet need for contraception. To increase contraceptive use in Mali, it is imperative to take women's healthcare decisions into consideration to strengthen existing policies geared towards fertility control and improvement in maternal health to achieve Sustainable Development Goals 3 and 5. Sustainable Development Goal 3 seeks to ensure healthy lives and promote well-being for all at all ages whilst Goal 5 aims at achieving gender equality and empower all women and girls.
避孕在生育调节中起着重要作用。有证据表明，生殖健康权利会影响避孕措施的使用。马里的妇女在医疗保健决策方面的控制能力有限。因此，本研究旨在探讨马里妇女的医疗保健决策能力与避孕未满足需求之间的关联。
本研究纳入了参加 2018 年马里人口与健康调查的 6593 名妇女。建立了两个二元逻辑回归模型。第一个模型（原始模型）涉及医疗保健决策能力和避孕未满足需求，第二个模型是一个完整模型，控制了所有社会人口统计学特征。应用样本权重，所有分析均使用 Stata 版本 13.0。
大多数妇女并非独自做出医疗保健决策（92.8%）。近十分之四的妇女表示她们有避孕未满足需求（35.7%）。45-49 岁的妇女避孕未满足需求较高（50.9%），15-19 岁的妇女较低（19.2%）。与未独自做出医疗保健决策的妇女相比，独自做出医疗保健决策的妇女避孕未满足需求的可能性更高[优势比（AOR）=1.35；95%置信区间（CI）=1.08-1.70]。与 15-19 岁的妇女相比，45-49 岁的妇女避孕未满足需求更高[AOR=4.58，95%CI=3.05-6.86]。与最贫穷的妇女相比，较富裕的妇女避孕未满足需求的可能性较低[AOR=0.77，95%CI=0.61-0.97]。
独自做出医疗保健决策的妇女避孕未满足需求的可能性更高。为了提高马里的避孕使用率，必须考虑妇女的医疗保健决策，以加强现有的生育控制政策和改善产妇保健，以实现可持续发展目标 3 和 5。可持续发展目标 3 旨在确保所有年龄段的所有人享有健康的生活并促进福祉，目标 5 旨在实现性别平等，赋予所有妇女和女孩权力。
