Negash Wubshet Debebe, Belachew Tadele Biresaw, Asmamaw Desale Bihonegn
Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Arch Public Health. 2022 Oct 24;80(1):224. doi: 10.1186/s13690-022-00977-1.
Long-acting reversible contraceptives (LARC) have been hailed as one of the safest and most effective methods of contraception. However, the use of LARC is low in the world, including Sub Saharan Africa; therefore, the aim of this study was to assess LARC utilization and associated factors among modern contraceptive users in high fertility SSA countries.
Data for this study was obtained from the most recent Demographic and Health Surveys. A total weighted sample of 14,828 reproductive age women was included. A multilevel mixed-effect binary logistic regression model was fitted to identify the significant associated factors of long acting reversible contraception utilization. Finally, the Adjusted Odds Ratio (AOR) with 95% confidence interval was used to declare as statistical significance.
Overall prevalence of LARC utilization was observed to be 20.1% (19.45, 20.74). The factors significantly associated with the utilization were women's age ≥ 35 years (AOR = 1.42; 95% CI: 1.19,1.68), having media exposure (AOR = 1.13; 95% CI: 1.05, 1.28), number of alive children: 1-2 (AOR = 2.35; 95% CI: 1.38, 4.01), 3-4 (AOR = 2.98; 95% CI: 1.74, 5.10), [Formula: see text] 5 (AOR = 2.82; 95% CI:1.63, 4.86), have no history of abortion (AOR = 1.33; 95% CI: 1.17,1.51) and who have no big problem with distance to the health facility (AOR = 1.29; 95% CI: 1.16, 1.43).
The use of long acting reversible contraception in this study was relatively low. To improve the utilization of long acting reversible contraceptives governments, policymakers, and stakeholders should implement health promotion strategies through media and improve accessibilities of health facilities.
长效可逆避孕法(LARC)被誉为最安全、最有效的避孕方法之一。然而,在全球范围内,包括撒哈拉以南非洲地区,LARC的使用率较低;因此,本研究旨在评估撒哈拉以南非洲高生育率国家现代避孕方法使用者中LARC的使用情况及相关因素。
本研究的数据来自最新的人口与健康调查。纳入了总共14828名育龄妇女的加权样本。采用多级混合效应二元逻辑回归模型来确定长效可逆避孕法使用的显著相关因素。最后,使用95%置信区间的调整优势比(AOR)来判定具有统计学意义。
观察到LARC的总体使用率为20.1%(19.45,20.74)。与使用率显著相关的因素包括:女性年龄≥35岁(AOR = 1.42;95%置信区间:1.19,1.68)、有媒体接触(AOR = 1.13;95%置信区间:1.05,1.28)、存活子女数为1 - 2个(AOR = 2.35;95%置信区间:1.38,4.01)、3 - 4个(AOR = 2.98;95%置信区间:1.74,5.10)、≥5个(AOR = 2.82;95%置信区间:1.63,4.86)、无流产史(AOR = 1.33;95%置信区间:1.17,1.51)以及到医疗机构的距离没有大问题(AOR = 1.29;95%置信区间:1.16,1.43)。
本研究中长效可逆避孕法的使用率相对较低。为提高长效可逆避孕法的使用率,政府、政策制定者和利益相关者应通过媒体实施健康促进策略,并改善医疗机构的可及性。