Ifakara Health Institute, Dar Es Salaam 14112, Tanzania.
Medical Team International, 4th Floor Plot No.96. Mikocheni Light Industrial Area, New Bagamoyo Road, Dar Es Salaam 14112, Tanzania.
Int J Environ Res Public Health. 2023 Jan 27;20(3):2262. doi: 10.3390/ijerph20032262.
The current study investigated the trends and factors associated with the unmet need for family planning (FP) for limiting and spacing births among married Tanzanian women between 1999 and 2016. The study used Tanzania Demographic and Health Survey (TDHS) data for the years 1999 ( = 2653), 2004-2005 ( = 2950), 2010 ( = 6412), and 2015-2016 ( = 8210). Trends in the unmet need for FP were estimated over the study period. Multivariable multinomial logistic regression models were used to investigate the association between community-level, predisposing, enabling, and need factors with the unmet need for FP in Tanzania. The results showed no significant change in percentage of married women with an unmet need for birth spacing between 1999 and 2016. The proportion of married women with an unmet need for limiting births decreased from 9.5% (95% confidence interval (CI): 7.9%, 10.6%) in 1999 to 6.6% (95% CI: 5.9%, 7.3%) in 2016. Residing in a rural area, parity between 1-4 and 5+, visiting a health facility for any health services within twelve months, and planning to have more children (after two years and/or undecided) were factors positively associated with the unmet need for FP-spacing. Women with parity of 5+ were more likely to experience an unmet need for FP-limiting. Women's age between 25-34 and 35-49 years, women's employment status, watching television, women's autonomy of not being involved in household decisions, and planning to have more children were factors associated with lower odds of having an unmet need for FP-spacing. Women's age between 25-34 years, watching television, autonomy, and planning to have more children were factors with lower odds of having an unmet need for FP-limiting. Improving FP uptake among married Tanzanian women can reduce the unmet need for FP. Therefore, reducing unmet needs for FP is attainable if government policies and interventions can target women residing in rural areas and other modifiable risk factors, such as parity, health facility visits, planning to having more children, employment, watching television, and women's autonomy.
本研究旨在调查 1999 年至 2016 年期间坦桑尼亚已婚女性在生育间隔和生育限制方面计划生育未满足需求的趋势和相关因素。本研究使用了坦桑尼亚人口与健康调查（TDHS）1999 年（=2653）、2004-2005 年（=2950）、2010 年（=6412）和 2015-2016 年（=8210）的数据。研究期间，对计划生育未满足需求的趋势进行了估计。采用多变量多项逻辑回归模型，研究了社区层面、倾向因素、促成因素和需求因素与坦桑尼亚计划生育未满足需求之间的关系。结果显示，1999 年至 2016 年期间，生育间隔未满足需求的已婚女性比例没有显著变化。生育限制未满足需求的已婚女性比例从 1999 年的 9.5%（95%置信区间（CI）：7.9%，10.6%）下降到 2016 年的 6.6%（95% CI：5.9%，7.3%）。居住在农村地区、产次为 1-4 次和 5 次及以上、在过去 12 个月内因任何健康问题就诊于卫生机构、计划在两年后或不确定时间内生育更多子女是与生育间隔未满足需求呈正相关的因素。产次为 5 次及以上的妇女更有可能经历生育限制未满足需求。25-34 岁和 35-49 岁的妇女年龄、妇女就业状况、看电视、妇女在家庭决策中不参与的自主权以及计划生育更多子女是与生育间隔未满足需求的可能性较低相关的因素。25-34 岁的妇女年龄、看电视、自主权和计划生育更多子女是生育限制未满足需求可能性较低的因素。提高坦桑尼亚已婚女性的计划生育使用率可以降低计划生育未满足需求。因此，如果政府政策和干预措施能够针对居住在农村地区的妇女以及其他可改变的风险因素，如产次、卫生机构就诊、计划生育更多子女、就业、看电视和妇女自主权，那么降低计划生育未满足需求是可以实现的。
