Department of Women's and Family Health, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Human Anatomy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
BMC Public Health. 2024 Aug 12;24(1):2185. doi: 10.1186/s12889-024-19572-w.
Many married women of reproductive age with husbands or partners are less cooperative in using contraceptives, often resulting in unintended pregnancies or secret contraceptive use. This private use of contraceptives causes women to suffer from side effects without proper support, and many women in Ethiopia die due to unintended pregnancies. However, the involvement of husbands or partners in the contraceptive decision-making process in Ethiopia is often neglected. There is also a lack of evidence regarding the determinants of husbands' or partners' decision-making power on contraceptive use in Ethiopia.
This study aimed to assess the determinants of low involvement of husbands/partners in women's contraceptive use decision-making processes in Ethiopia.
This study was based on Ethiopian Demographic and Health Survey data, collected from January 18 to June 27, 2016. Weighted samples of 3,669 reproductive-age women were included. Husbands'/partners' independent decision-making was measured by whether the husband/partner decided independently or alone about contraceptive use, categorized as "Yes" or "No". A multilevel logistic regression model was fitted, and ICC (Intra-class Correlation Coefficient), MOR (Median Odds Ratio), PCV (Proportion Change in Variance), and deviance were used to assess model fitness and comparison. Variables with a p-value of ≤ 0.2 in the bivariate analysis were considered candidates for multivariable multilevel analysis. An adjusted odds ratio with a 95% confidence interval was used to determine both the direction and strength of the association, and a p-value of < 0.05 was used to declare statistical significance.
Husbands'/partners' independent decision-making in women's contraceptive use was found to be 5.41% [4.72-6.19%]. Significant factors associated with this included: Husbands/partners aged 31-59 years (Adjusted Odds Ratio (AOR) = 1.3; Confidence Interval (CI) 2.3-5.4) and over 59 years (AOR = 2.3; CI 1.2-4.3), Educational level of husbands/partners: primary education (AOR = 3.2; CI 2.9-4.3), secondary education (AOR = 3.9; CI 2.7-4.4), and higher education (AOR = 4.3; CI 2.8-5.0), Media exposure (AOR = 4.5; CI 2.2-5.4), History of pregnancy termination (AOR = 3.3; CI 2.6-4.1), Perception that distance to health facilities is not a significant problem (AOR = 3.0; CI 1.7-4.7) and Urban residency (AOR = 3.5; CI 1.6-4.2).
In Ethiopia, the involvement of husbands/partners in the contraceptive use decision-making process is low. To increase their decision-making power, attention should be given to factors such as age, educational level, media exposure, history of pregnancy termination, distance to health facilities, and urban residency.
许多有生育能力的已婚女性与丈夫或伴侣在使用避孕药具方面合作意愿较低，这往往导致意外怀孕或秘密使用避孕药具。这种私下使用避孕药具会导致女性在没有适当支持的情况下遭受副作用，而在埃塞俄比亚，许多女性因意外怀孕而死亡。然而，在埃塞俄比亚，丈夫或伴侣参与避孕决策过程往往被忽视。此外，关于丈夫或伴侣在埃塞俄比亚避孕药具使用决策中的决定能力的决定因素的证据也很缺乏。
本研究旨在评估埃塞俄比亚丈夫/伴侣低度参与女性避孕使用决策过程的决定因素。
本研究基于埃塞俄比亚人口与健康调查数据，于 2016 年 1 月 18 日至 6 月 27 日收集。纳入了 3669 名育龄妇女的加权样本。丈夫/伴侣的独立决策是通过丈夫/伴侣是否独立或单独决定避孕药具的使用来衡量的，分为“是”或“否”。拟合了多水平逻辑回归模型，并使用 ICC（组内相关系数）、MOR（中位数优势比）、PCV（方差变化比例）和偏差来评估模型拟合度和比较。在双变量分析中 p 值≤0.2 的变量被视为多变量多水平分析的候选变量。使用调整后的比值比（95%置信区间）来确定关联的方向和强度，p 值<0.05 用于宣布统计学意义。
发现丈夫/伴侣在女性避孕药具使用方面的独立决策比例为 5.41%[4.72-6.19%]。与这一结果相关的显著因素包括：丈夫/伴侣年龄 31-59 岁（调整后的优势比（AOR）=1.3；2.3-5.4）和 59 岁以上（AOR=2.3；1.2-4.3）、丈夫/伴侣的教育程度：小学教育（AOR=3.2；2.9-4.3）、中学教育（AOR=3.9；2.7-4.4）和高等教育（AOR=4.3；2.8-5.0）、媒体接触（AOR=4.5；2.2-5.4）、妊娠终止史（AOR=3.3；2.6-4.1）、认为距离卫生设施不是一个重大问题（AOR=3.0；1.7-4.7）和城市居住（AOR=3.5；1.6-4.2）。
在埃塞俄比亚，丈夫/伴侣参与避孕决策过程的程度较低。为了增加他们的决策权，应关注年龄、教育程度、媒体接触、妊娠终止史、距离卫生设施的距离以及城市居住等因素。
