Mruts Kalayu Brhane, Tessema Gizachew A, Kassaw Nigussie Assefa, Gebremedhin Amanuel Tesfay, Scott Jane A, Pereira Gavin
School of Public Health, Debre Berhan University, P.O. Box 445, Debre Berhan, Ethiopia.
Curtin School of Population Health, Curtin University, Perth, Australia.
Arch Public Health. 2023 May 1;81(1):79. doi: 10.1186/s13690-023-01096-1.
An unmet need for contraception is associated with unintended pregnancy and adverse maternal and childhood outcomes. Family planning counselling is linked with reduced unmet need for contraception. However, evidence is lacking in Ethiopia on the impact of integrated family planning counselling on the unmet need for contraception. This study aimed to examine the association between family planning counselling and the unmet need for contraception in Ethiopia.
We used community-based prospective cohort study data from a nationally representative survey conducted by Performance Monitoring for Action Ethiopia between 2019 and 2020. Women who had received three maternal and child health (MCH) services (n = 769) - antenatal care (ANC), facility delivery and child immunisation - were included in this study. The primary exposure variable was family planning counselling provided during the different MCH services. A weighted modified Poisson regression model was used to estimate the adjusted relative risk (aRR) of the unmet need for contraception.
The prevalence of family planning counselling during ANC, prior to discharge, and child immunisation was 22%, 28%, and 28%, respectively. Approximately one-third (34%) of the women had an unmet need for contraception. Family planning counselling prior to discharge from the facility was associated with reductions in the unmet need for contraception (aRR 0.88; 95% CI 0.67, 1.16). The risk of unmet need for contraception was 31% (aRR 0.69; 95% CI 0.48, 0.98) less likely among women who had received family planning counselling during child immunisation services. However, family planning counselling during ANC was associated with an increased unmet need for contraception (aRR 1.24; 95% CI 0.93, 1.64).
Strongest evidence was observed for moderate associations between reductions in the unmet need for contraception and family planning counselling during the provision of child immunisation services in Ethiopia.
避孕需求未得到满足与意外怀孕以及孕产妇和儿童不良结局相关。计划生育咨询与降低未满足的避孕需求有关。然而，埃塞俄比亚缺乏关于综合计划生育咨询对未满足的避孕需求影响的证据。本研究旨在探讨埃塞俄比亚计划生育咨询与未满足的避孕需求之间的关联。
我们使用了埃塞俄比亚行动绩效监测组织在2019年至2020年期间进行的一项具有全国代表性调查的基于社区的前瞻性队列研究数据。本研究纳入了接受过三项母婴健康（MCH）服务（n = 769）——产前护理（ANC）、机构分娩和儿童免疫接种——的妇女。主要暴露变量是在不同的母婴健康服务期间提供的计划生育咨询。采用加权修正泊松回归模型来估计未满足的避孕需求的调整相对风险（aRR）。
产前护理、出院前和儿童免疫接种期间计划生育咨询的患病率分别为22%、28%和28%。约三分之一（34%）的妇女有未满足的避孕需求。机构出院前的计划生育咨询与未满足的避孕需求减少相关（aRR 0.88；95% CI 0.67，1.16）。在儿童免疫接种服务期间接受过计划生育咨询的妇女中，未满足的避孕需求风险降低了31%（aRR 0.69；95% CI 0.48，0.98）。然而，产前护理期间的计划生育咨询与未满足的避孕需求增加相关（aRR 1.24；95% CI 0.93，1.64）。
在埃塞俄比亚，提供儿童免疫接种服务期间，未满足的避孕需求减少与计划生育咨询之间存在中度关联，这一关联有最有力的证据支持。
