Teshale Achamyeleh Birhanu, Wang Vicky Qi, Biney Godness Kye, Ameyaw Edward Kwabena, Adjei Nicholas Kofi, Yaya Sanni
Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Contracept Reprod Med. 2023 Jul 24;8(1):39. doi: 10.1186/s40834-023-00240-0.
The relationship between composition of children and contraception use has received limited scholarly attention in sub-Saharan Africa. In this study, we examined the relationship between contraceptive methods, the number and composition of children in SSA.
Data on 21 countries in sub-Saharan Africa (SSA) countries that had a Demographic and Health Survey on or before 2015 were analysed. We applied a multilevel multinomial logistic regression model to assess the influence of family composition on contraceptive use. Adjusted relative risk ratio (aRRR) and 95% CI were estimated. The significant level was set at p < 0.05. All the analyses were conducted using weighted data.
Women who had one son and two daughters (aRRR = 0.85, CI = 0.75, 0.95), two sons and one daughter (aRRR = 0.81 CI = 0.72, 0.92), one son and three daughters (aRRR = 0.66, CI = 0.54, 0.80), two sons and two daughters (aRRR = 0.59, CI = 0.50, 0.69), and three or more sons (aRRR = 0.75, CI = 0.63, 0.91) were less likely to use temporary modern contraceptive methods. Those with two sons and two daughters were less likely to use traditional methods (aRRR = 0.52, CI = 0.35, 0.78). Women in the older age group (35-49 years) were less likely to use temporary modern methods (aRRR = 0.60; 95%CI; 0.57, 0.63). However, this group of women were more likely to use permanent (sterilization) (aRRR = 1.71; 95%CI; 1.50, 1.91) and traditional methods (aRRR = 1.28; 95%CI; 1.14, 1.43).
These findings suggest that contraception needs of women vary based on the composition of their children, hence a common approach or intervention will not fit. As a result, contraception interventions ought to be streamlined to meet the needs of different categories of women. The findings can inform policymakers and public health professionals in developing effective strategies to improve contraceptive use in SSA.
在撒哈拉以南非洲地区，子女构成与避孕措施使用之间的关系在学术上受到的关注有限。在本研究中，我们考察了撒哈拉以南非洲地区避孕方法、子女数量及构成之间的关系。
对撒哈拉以南非洲地区21个在2015年及之前进行过人口与健康调查的国家的数据进行了分析。我们应用了多层次多项逻辑回归模型来评估家庭构成对避孕措施使用的影响。估计了调整后的相对风险比（aRRR）和95%置信区间（CI）。显著性水平设定为p < 0.05。所有分析均使用加权数据进行。
有一个儿子和两个女儿（aRRR = 0.85，CI = 0.75，0.95）、两个儿子和一个女儿（aRRR = 0.81，CI = 0.72，0.92）、一个儿子和三个女儿（aRRR = 0.66，CI = 0.54，0.80）、两个儿子和两个女儿（aRRR = 0.59，CI = 0.50，0.69）以及三个或更多儿子的女性使用现代短效避孕方法的可能性较小。有两个儿子和两个女儿的女性使用传统避孕方法的可能性较小（aRRR = 0.52，CI = 0.35，0.78）。年龄较大组（35 - 49岁）的女性使用现代短效避孕方法的可能性较小（aRRR = 0.60；95%CI；0.57，0.63）。然而，这组女性使用永久性（绝育）避孕方法（aRRR = 1.71；95%CI；1.50，1.91）和传统避孕方法（aRRR = 1.28；95%CI；1.14，1.43）的可能性较大。
这些研究结果表明，女性的避孕需求因子女构成而异，因此通用的方法或干预措施并不适用。因此，避孕干预措施应进行简化，以满足不同类别女性的需求。这些研究结果可为政策制定者和公共卫生专业人员制定有效策略以提高撒哈拉以南非洲地区的避孕措施使用率提供参考。
