Chiles Center, College of Public Health, University of South Florida, Tampa, FL 33612, USA.
Department of Obstetrics and Gynecology, Federal University of Health Sciences, Otukpo 972261, Nigeria.
Int J Environ Res Public Health. 2023 Dec 29;21(1):53. doi: 10.3390/ijerph21010053.
This study examined the associations between pregnancy intention and motivational readiness for postpartum contraceptive use. Data for this cross-sectional analysis were derived from nationally representative surveys of the Performance Monitoring and Accountability 2020 (PMA2020) project conducted in eight sub-Saharan African countries. Participants included 9488 nonpregnant women of reproductive age (15-49 years) who had given birth in the last 2 years. Weighted multinomial logistic regression analyses were performed to estimate the odds ratios (OR) and their corresponding 95% confidence intervals (CIs) of the associations of motivational readiness for contraceptive adoption categorized as precontemplation, contemplation, and post-action with pregnancy intention. After adjusting for confounding factors, the findings revealed that women in Côte d'Ivoire and Nigeria who had mistimed pregnancies had significantly higher odds of being in the contemplation vs. precontemplation stage compared to those who had intended pregnancies. Similarly, women who had unwanted pregnancies in Ethiopia were also more likely to be in the contemplation stage. Furthermore, significant differences were observed for women in Burkina Faso, Côte d'Ivoire, and Nigeria regarding the association between mistimed pregnancies and being in the post-action stage. For women who had unwanted pregnancies, this association was significant only in Nigeria. Additionally, the odds of being in the contemplation stage, compared to the post-action stage, for women who had unwanted pregnancies were significantly higher in Ethiopia and Nigeria. These results indicate that recent unintended pregnancies in specific sub-Saharan African countries may motivate women to take action to prevent future unintended pregnancies. The findings underscore the importance of tailored and context-specific approaches in family-planning programs based on the stage of motivational readiness.
本研究探讨了妊娠意图与产后避孕使用动机准备之间的关联。这项横断面分析的数据来自于在撒哈拉以南非洲的八个国家进行的具有代表性的绩效监测和问责制 2020 年(PMA2020)项目调查。参与者包括 9488 名最近两年内分娩过的育龄期(15-49 岁)非孕妇。采用加权多项逻辑回归分析来估计将避孕采用动机准备分为无意愿、考虑和行动后与妊娠意图相关联的优势比(OR)及其相应的 95%置信区间(CI)。在调整混杂因素后,结果表明,科特迪瓦和尼日利亚的意外怀孕的女性与有计划怀孕的女性相比,处于考虑阶段的可能性显著更高。同样,在埃塞俄比亚意外怀孕的女性也更有可能处于考虑阶段。此外,布基纳法索、科特迪瓦和尼日利亚的女性在意外怀孕与处于行动后阶段之间的关联方面存在显著差异。对于意外怀孕的女性,这种关联仅在尼日利亚显著。此外,与处于行动后阶段相比,埃塞俄比亚和尼日利亚意外怀孕的女性处于考虑阶段的可能性显著更高。这些结果表明,特定撒哈拉以南非洲国家最近发生的意外怀孕可能会促使女性采取行动以防止未来发生意外怀孕。研究结果强调了基于动机准备阶段的计划生育方案中采用量身定制和具体情况的方法的重要性。