Population Council, New York, NY, United States of America.
McGill University, Montreal, Canada.
PLoS One. 2024 Jul 23;19(7):e0307141. doi: 10.1371/journal.pone.0307141. eCollection 2024.
Internal migration is an important part of the transition to adulthood for many young people in sub-Saharan Africa. This study examines how migration, in relation to marriage and parenthood, impacts modern contraceptive use and health facility visits amongst young urban women.
We draw on Performance Monitoring for Action (PMA) surveys conducted in Burkina Faso, Côte d'Ivoire, Democratic Republic of Congo, Kenya, Nigeria, and Uganda (2019-2022). Our analysis is unique in being able to adjust for whether women wanted to get pregnant soon. Our sample includes women ages 15-24 years currently residing in urban areas (n = 6,225). We conducted logistic regression models clustered by village level identifier to explore the sequence of life events and the timing of migration in relation to current modern contraceptive use and recent health facility visit, a proxy for engagement with formal health services.
The timing of migration matters more than the sequence of these life events. Young urban women who experienced both migration and a birth, regardless of the order, had increased contraceptive use and recent health facility visit, compared to women who had only experienced one event or neither. Young women who migrated in the past year had 24% lower odds of using a modern method (Odds Ratio = 0.76; 95% confidence interval 0.63, 0.91), adjusting for demographic factors and adjusting for fertility preference (Wanting to get pregnant soon). Having had a birth was highly significant for health facility visit and among women who had had a birth, those who migrated in the last year had lower odds of a recent visit (OR = 0.68, 95% CI 0.41, 0.89). Results suggest an initially disruptive effect of migration.
Our results suggest young women who recently migrated to urban areas may need additional support in accessing contraception and formal health services for themselves or their children.
对于撒哈拉以南非洲的许多年轻人来说，国内迁移是向成年期过渡的重要组成部分。本研究考察了迁移与婚姻和生育的关系，如何影响城市青年女性现代避孕措施的使用和对卫生机构的使用。
我们利用在布基纳法索、科特迪瓦、刚果民主共和国、肯尼亚、尼日利亚和乌干达进行的绩效监测行动（PMA）调查（2019-2022 年）。我们的分析具有独特性，因为它能够根据女性是否希望尽快怀孕进行调整。我们的样本包括目前居住在城市地区的 15-24 岁的女性（n=6225）。我们通过村庄级标识符进行逻辑回归模型分析，以探讨生活事件的顺序以及迁移的时间与当前现代避孕措施的使用和最近一次卫生机构就诊之间的关系，这是与正规卫生服务接触的代理指标。
迁移的时间比这些生活事件的顺序更为重要。经历过迁移和生育的年轻城市女性，无论顺序如何，与仅经历过一次事件或两者都没有的女性相比，更有可能使用现代避孕方法和最近一次去卫生机构就诊。过去一年中迁移的年轻女性使用现代方法的可能性降低了 24%（优势比=0.76；95%置信区间 0.63，0.91），调整了人口统计因素和生育意愿（希望尽快怀孕）。生育对卫生机构就诊具有高度显著意义，在生育过的女性中，过去一年中迁移的女性最近就诊的可能性较低（OR=0.68，95%CI 0.41，0.89）。结果表明迁移最初具有破坏性影响。
我们的研究结果表明，最近迁移到城市地区的年轻女性可能需要额外的支持，以获得自己或子女的避孕措施和正规卫生服务。
