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埃塞俄比亚奥罗米亚州西阿尔西地区比山古拉查镇处于生育年龄的流离失所已婚妇女对现代避孕方法的未满足需求

Unmet Need for Modern Contraceptive Methods Among Displaced Married Women in Their Reproductive Years in Bishan Guracha Town, West Arsi Zone, Oromia Region, Ethiopia.

作者信息

Million Sisay, Gebru Zeleke, Hassen Sultan, Tesfaye Selamnesh

机构信息

School of Public Health Hawassa University Comprehensive Specialized Hospital, Hawassa, Ethiopia.

School of Public Health College of Medicine & Health Sciences Arba Minch University, Arba Minch, Ethiopia.

出版信息

Int J Reprod Med. 2024 Sep 18;2024:6662117. doi: 10.1155/2024/6662117. eCollection 2024.

DOI:10.1155/2024/6662117
PMID:39328983
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11424867/
Abstract

Refugees and conflict-affected areas are often unreached by national strategies and programs. As a result, high unmet needs are more likely because of their social interruption with their traditional information sources, support, protection, and lack of income which limits refugees' ability to make a free choice that would allow them to plan and space the number of children they desire. Information on the unmet needs of internally displaced persons (IDPs) women is scarce. This study is aimed at assessing the magnitude of the unmet need for modern contraceptive methods and associated factors among IDPs currently married reproductive-age women. A community-based cross-sectional study was conducted among 393 internally displaced women currently married reproductive-age women using a simple random sampling method using a structured, pretested, and interview-administered questionnaire. A logistic regression model was used to identify associated factors. Statistically significant variables at value < 0.25 in the bivariate analysis were entered into multivariable analysis, and statistical significance was declared at value ≤ 0.05. About 160 (40.7%) (95% CI: 35.94%-45.67%) of women had an unmet need for modern contraceptive methods, 139 (35.4%) for spacing, and 21 (5.3%) for limiting. Less than 18 years of age at first marriage, lack of access to modern contraception, lack of discussion with healthcare providers, and travel time of 30 min or more to obtain family planning were found to be risk factors for unmet contraceptive needs. The risk of unmet need for modern contraceptives was high among women who were married at age of less than 18 years of age in comparison with women who were married at 18 and above (AOR = 1.559; 95%CI = 1.019-2.385). Unmet needs were higher among participants who had no adequate availability of modern contraceptive methods than those who had adequate availability of modern contraceptive methods (AOR = 1.738; 95%CI = 1.125-2.684). Similarly, the odds of unmet needs were 1.673 times higher among participants who did not discuss FP with healthcare providers than those who discussed FP with healthcare providers (AOR = 1.673; 95%CI = 1.085-2.581). Moreover, the odds of unmet needs were 1.551 times higher among participants who traveled 30 min and above to access family planning services as compared to those respondents who traveled below 30 min (AOR = 1.551; 95%CI = 1.002-2.401). The magnitude of the unmet need for modern contraceptive methods was higher than both the Ethiopian national and Oromia regional state total unmet need for the general population. Governmental and nongovernmental organizations should increase their efforts to reduce this high magnitude of unmet needs by emphasizing those factors that have a great contribution to unmet needs.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/22a5/11424867/38e2bca6c1cd/IJRMED2024-6662117.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/22a5/11424867/38e2bca6c1cd/IJRMED2024-6662117.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/22a5/11424867/38e2bca6c1cd/IJRMED2024-6662117.001.jpg

难民和受冲突影响地区往往无法受益于国家战略和计划。因此,由于他们与传统信息来源、支持、保护相脱节,且缺乏收入,未得到满足的需求很可能居高不下,而这限制了难民自由选择的能力,使其无法规划并控制自己想要生育的子女数量。关于境内流离失所者(IDP)妇女未得到满足的需求的信息很少。本研究旨在评估已婚育龄境内流离失所妇女未满足的现代避孕方法需求的规模及相关因素。采用简单随机抽样方法,对393名已婚育龄境内流离失所妇女进行了一项基于社区的横断面研究,使用的是一份经过结构化、预测试和访谈管理的问卷。采用逻辑回归模型来确定相关因素。在双变量分析中p值<0.25的具有统计学意义的变量被纳入多变量分析,并在p值≤0.05时宣布具有统计学意义。约160名(40.7%)(95%置信区间:35.94%-45.67%)妇女有未满足的现代避孕方法需求,139名(35.4%)有生育间隔需求,21名(5.3%)有生育限制需求。初婚年龄小于18岁、无法获得现代避孕方法、未与医疗保健提供者进行讨论以及前往获取计划生育服务的行程时间为30分钟或更长时间被发现是未满足避孕需求的风险因素。与18岁及以上结婚的妇女相比,初婚年龄小于18岁的妇女未满足现代避孕需求的风险更高(调整后比值比[AOR]=1.559;95%置信区间=1.019-2.385)。现代避孕方法供应不足的参与者中未满足的需求高于供应充足的参与者(AOR=1.738;95%置信区间=1.125-2.684)。同样,未与医疗保健提供者讨论计划生育的参与者未满足需求的几率比与医疗保健提供者讨论过计划生育的参与者高1.673倍(AOR=1.673;95%置信区间=1.085-2.581)。此外,与行程时间低于30分钟的受访者相比,前往获取计划生育服务的行程时间为30分钟及以上的参与者未满足需求的几率高1.551倍(AOR=1.551;95%置信区间=1.002-2.401)。现代避孕方法未满足需求的规模高于埃塞俄比亚全国以及奥罗米亚地区州总体人口未满足需求的总和。政府和非政府组织应加大努力,通过强调那些对未满足需求有重大影响的因素来降低这种高规模的未满足需求。

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