Solanke Bola Lukman, Adetutu Olufemi Mayowa, Rahman Semiu Adebayo, Soladoye Daniel Alabi, Owoeye Michael Olumide
Department of Demography and Social Statistics, Obafemi Awolowo University, Ile-Ife, Nigeria.
Department of Sociology, Bowen University, Iwo, Nigeria.
Arch Public Health. 2022 Nov 21;80(1):239. doi: 10.1186/s13690-022-00997-x.
Studies have identified various determinants of unmet need for contraception. These determinants cut across individual, household, community, and health facility levels. Despite this evidence, there remains a lack of information regarding differentials in the prevalence and determinants of unmet need for contraception among women in the low-priority segments (such as women of advanced reproductive age and women living with disabilities) and high-priority segments (such as adolescents, young adults, and unmarried women) for family planning demand generation, hence this study.
The study design is cross-sectional. The study analyzed merged data from the individual, and persons recode of the 2018 Nigeria Demographic and Health Survey (NDHS). The samples analyzed are 5,147 women in the high-priority segment and 7,536 women in the low-priority segment. The outcome variable in the study was unmet need for contraception. The explanatory variables were selected at the individual, household, community, and facility levels. Statistical analyzes were performed using Stata 14. Three multilevel mixed-effects regression models were fitted. Model 1 was the empty model, while Model 2 included the sets of individual, household, and community variables. Model 3 controlled for the facility-level variables.
Findings show a higher prevalence of unmet need for contraception among women in the family planning low-priority segment compared to women in the family planning high-priority segment. Religion and desired family size were the two individual characteristics that significantly predicted the unmet need for contraception among women in the two segments. Sexual autonomy was the only household characteristic that predicted unmet need for contraception in both segments. There were differences in the community characteristics that predicted unmet need for contraception among women in the two segments.
The prevalence of unmet need for contraception is not the same among women in low and high family planning priority segments. The determinants also differ among women in the two segments. Though, women in different family planning segments have the same contraceptive needs of avoiding pregnancy when not needed, however, getting the needs satisfied requires that existing programs be further examined to develop initiatives that will resonate with each segment of reproductive-age women.
研究已经确定了未满足的避孕需求的各种决定因素。这些决定因素跨越个人、家庭、社区和卫生机构层面。尽管有这些证据，但对于计划生育需求产生的低优先级群体（如高龄育龄妇女和残疾妇女）和高优先级群体（如青少年、青年和未婚妇女）中未满足的避孕需求的患病率及决定因素的差异，仍然缺乏相关信息，因此开展了本研究。
本研究设计为横断面研究。研究分析了2018年尼日利亚人口与健康调查（NDHS）中个人及住户重新编码的合并数据。分析的样本包括高优先级群体中的5147名妇女和低优先级群体中的7536名妇女。研究中的结果变量是未满足的避孕需求。解释变量是在个人、家庭、社区和机构层面选取的。使用Stata 14进行统计分析。拟合了三个多层次混合效应回归模型。模型1为空模型，模型2纳入了个人、家庭和社区变量集。模型3控制了机构层面的变量。
研究结果显示，与计划生育高优先级群体中的妇女相比，计划生育低优先级群体中的妇女未满足的避孕需求患病率更高。宗教信仰和理想家庭规模是显著预测这两个群体中妇女未满足的避孕需求的两个个人特征。性自主权是在两个群体中都能预测未满足的避孕需求的唯一家庭特征。在预测两个群体中妇女未满足的避孕需求的社区特征方面存在差异。
计划生育低优先级和高优先级群体中妇女未满足的避孕需求患病率并不相同。这两个群体中妇女的决定因素也有所不同。尽管不同计划生育群体中的妇女都有在不需要时避免怀孕的相同避孕需求，然而，要满足这些需求，需要进一步审视现有项目，以制定能与各育龄妇女群体产生共鸣的举措。
