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与埃塞俄比亚产后第一年现代避孕药具使用相关的因素：系统评价和荟萃分析。

Factors associated with modern contraceptives uptake during the first year after birth in Ethiopia: A systematic review and meta-analysis.

机构信息

Department of Public Health, College of Health Science, Arsi University, Asella, Ethiopia.

Department of Health Sciences, Global health, University of Groningen/University Medical Centre Groningen, Groningen, The Netherlands.

出版信息

PLoS One. 2023 Feb 7;18(2):e0270055. doi: 10.1371/journal.pone.0270055. eCollection 2023.

DOI:10.1371/journal.pone.0270055
PMID:36749759
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9904466/
Abstract

Though postpartum family planning helps women to achieve the recommended birth interval before next pregnancy, its utilization in Ethiopia is low. Understanding drivers and barriers is key to improve postpartum family planning uptake. The aim of this systematic review and meta-analysis is to analyze and summarize predictors of postpartum family planning uptake, during the first year after birth, in Ethiopia. We conducted a systematic review and meta-analysis of observational studies published in English before April 16, 2021. We searched electronic sources like PubMed, MEDLINE, CINHAL Embase, Google and supplemented it with manual search. Two reviewers appraised independently the studies using the Joanna Briggs Institute Quality Assessment Tool for the observational studies. Data synthesis and analysis were conducted using Review Manager Version 5.3. The Cochrane Q test statistic and I2 tests were used to assess the heterogeneity among the included studies. A random-effects and fixed effect model were used to calculate pooled Odds Ratio and its 95% CI. A total of 22 studies were included in the review. Better educational status of women[OR = 2.60; 95% CI: 2.15, 3.14], women's marital status [OR = 4.70; 95% CI: 1.51, 14.60], resumption of sexual intercourse [OR = 6.22; 95% CI: 3.01, 12.86], menses return [OR = 3.72; 95% CI: 1.98, 6.99], PPFP discussion with partner [OR = 2.53; 95% CI: 2.00, 3.20], women's previous PPFP information [OR = 4.93; 95% CI: 2.26, 10.76], PPFP counseling during ANC [OR = 3.95; 95% CI: 2.50, 6.23], having PNC [OR = 4.22; 95% CI: 2.80, 6.34], having experience of modern contraceptive use [OR = 2.90; 95% CI: 1.62, 5.19], facility birth [OR = 6.70; 95% CI: 3.15, 14.25], and longer interval after last delivery [OR = 0.37; 95% CI: 0.32, 0.43] were significantly associated with modern contraceptive uptake during postpartum period. Our systematic review identified modifiable factors and estimated their association with PPFP uptake. Since most of these factors are related to reproductive health characteristics and MNCH services, integrating PPFP into MNCH services particularly at primary health care unit may improve contraceptive uptake during postpartum period. Systematic review registration: PROSPERO: 2020: CRD42020159470.

摘要

尽管产后计划生育有助于女性在下一次怀孕前达到建议的生育间隔，但在埃塞俄比亚，其利用率很低。了解驱动因素和障碍是提高产后计划生育使用率的关键。本系统评价和荟萃分析旨在分析和总结埃塞俄比亚产后一年内使用产后计划生育的预测因素。我们对 2021 年 4 月 16 日之前发表的英文观察性研究进行了系统评价和荟萃分析。我们搜索了电子资源，如 PubMed、MEDLINE、CINHAL Embase、Google，并通过手动搜索进行了补充。两位审查员使用 Joanna Briggs 研究所的观察性研究质量评估工具独立评估了这些研究。使用 Review Manager Version 5.3 进行数据综合和分析。Cochrane Q 检验统计量和 I2 检验用于评估纳入研究之间的异质性。使用随机效应和固定效应模型计算汇总的优势比及其 95%置信区间。共纳入 22 项研究。女性的教育程度更好[OR = 2.60；95%CI：2.15，3.14]，女性的婚姻状况[OR = 4.70；95%CI：1.51，14.60]，恢复性生活[OR = 6.22；95%CI：3.01，12.86]，月经恢复[OR = 3.72；95%CI：1.98，6.99]，与伴侣讨论产后计划生育[OR = 2.53；95%CI：2.00，3.20]，女性之前有过产后计划生育信息[OR = 4.93；95%CI：2.26，10.76]，在 ANC 期间接受产后计划生育咨询[OR = 3.95；95%CI：2.50，6.23]，接受 PNC [OR = 4.22；95%CI：2.80，6.34]，有现代避孕方法使用经验[OR = 2.90；95%CI：1.62，5.19]，机构分娩[OR = 6.70；95%CI：3.15，14.25]，以及上次分娩后间隔时间较长[OR = 0.37；95%CI：0.32，0.43]与产后期间现代避孕药具的使用显著相关。我们的系统评价确定了可改变的因素，并估计了它们与产后计划生育使用的关联。由于这些因素大多与生殖健康特征和母婴健康服务有关，因此将产后计划生育纳入母婴健康服务，特别是在初级保健单位，可能会提高产后期间的避孕措施使用率。系统评价注册：PROSPERO：2020：CRD42020159470。

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