Faculty, Tulane School of Public Health and Tropical Medicine, New Orleans, LA, USA; Senior Research Advisor, Population Services International, Washington, DC, USA.
Senior Research Manager, Population Services International Myanmar, Yangon, Myanmar.
Sex Reprod Health Matters. 2023 Dec;31(1):2215568. doi: 10.1080/26410397.2023.2215568.
The objective of this paper was to document contraceptive dynamics and associated correlates of contraceptive method switching and discontinuation in Myanmar during the COVID-19 pandemic. We conducted a secondary analysis of panel data collected between August 2020 and March 2021 among married women of reproductive age of households registered for a strategic purchasing project in Yangon. Statistical analysis included descriptive statistics, bivariate tests of association and adjusted log-Poisson models with generalised estimating equations to examine relative risks and 95% confidence intervals. Among the study sample, 28% of women reported method switching and 20% method discontinuation at least once during the study period. Difficulties accessing resupply/removal/insertion of contraception due to COVID-19 and method type at baseline were identified as correlates of method switching and discontinuation. Women who reported difficulty obtaining their method due to COVID-19 had an increased risk of method switching (RR: 1.85, 95%CI: 1.27, 2.71). Women who reported injectables as their initial contraceptive method at baseline had an increased risk of method switching (RR:1.71, 95%CI: 1.06, 2.76) and method discontinuation (RR: 2.16, 95%CI: 1.16, 4.02) compared to non-injectable users. As Myanmar evaluates its public health response to COVID-19, the country should consider innovative service delivery models that allow women to have sustained access to their method of choice during a health emergency. (211).
本文旨在记录 COVID-19 大流行期间缅甸的避孕动态以及与避孕方法转换和停止相关的因素。我们对 2020 年 8 月至 2021 年 3 月期间在仰光参与一项战略采购项目的已婚育龄家庭妇女进行了一项基于面板数据的二次分析。统计分析包括描述性统计、关联的双变量检验以及调整后的对数泊松模型和广义估计方程，以检验相对风险和 95%置信区间。在研究样本中，28%的女性在研究期间至少报告过一次方法转换，20%的女性至少报告过一次方法停止。由于 COVID-19 而难以获得避孕用品的供应/移除/插入以及基线时的方法类型被确定为方法转换和停止的相关因素。由于 COVID-19 而报告难以获得方法的女性发生方法转换的风险增加（RR：1.85，95%CI：1.27，2.71）。与非注射剂使用者相比，基线时报告使用注射剂作为初始避孕方法的女性发生方法转换（RR：1.71，95%CI：1.06，2.76）和方法停止（RR：2.16，95%CI：1.16，4.02）的风险增加。在评估其对 COVID-19 的公共卫生应对措施时，缅甸应考虑创新的服务提供模式，以便在卫生紧急情况下妇女能够持续获得她们选择的方法。（211）。
