Lahole Begetayinoral Kussia, Banga Debora, Mare Kusse Urmale
Department of Midwifery, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia.
School of Nursing, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia.
Contracept Reprod Med. 2024 Sep 27;9(1):46. doi: 10.1186/s40834-024-00310-x.
Worldwide, sexual and reproductive health remains a prominent public health concern for women of reproductive age. Modern contraceptive methods play a crucial role in enabling individuals and families to regulate fertility, thereby reducing unintended pregnancies, abortions, pregnancy-related complications, and mortality. Due to the scarcity of reliable and current data regarding the factors affecting the adoption of modern contraceptives among women of reproductive age at the national level in Ghana, this research aimed to explore the determinants of modern contraceptive usage among reproductive age women.
The study analyzed data from the 2022 Ghana Demographic and Health Survey, including a weighted sample of 6,839 reproductive-age women. By employing a multilevel logistic regression model, the study sought to determine factors associated with the utilization of modern contraceptives. Associations between explanatory variables and the outcome were evaluated using adjusted odds ratios (AORs) along with 95% confidence intervals (CIs). Statistical significance was established using a p-value threshold of less than 0.05. All statistical analyses were conducted using STATA version 17 software.
The study found that 26.36% (95% CI: 25.33-27.34%) of women of reproductive age in Ghana used modern contraceptives. Secondary education (AOR = 1.26, 95% CI = 1.03-1.53), poorer household (AOR = 1.30, 95% CI = 1.05-1.61), women's marital status, i.e. married (AOR = 1.46, 95% CI = 1.16-1.83), living with a partner (AOR = 1.65, 95% CI = 1.32-2.06), divorced (AOR = 2.53, 95% CI = 1.48-4.31), and separated (AOR = 1.70, 95% CI = 1.21-2.37), multipara (AOR = 1.39, 95% CI = 1.04-1.87), were the factors that promote modern contraceptive utilization. Women's age in years, i.e. 35-39 (AOR = 0.71, 95% CI = 0.52-0.97), 40-44 (AOR = 0.63, 95% CI = 0.44-0.90), and 45-49 (AOR = 0.45, 95% CI = 0.25-0.79), history of pregnancy loss (AOR = 0.86, 95% CI = 0.76-0.98), region, i.e. Greater Accra (95% CI = 0.42-0.92), Bono East (95% CI = 0.32-0.81), Northern (95% CI = 0.28-0.67), Savannah (95% CI = 0.28-0.81), and North East (95% CI = 0.20-0.63), were all associated with a lower use of modern contraceptives.
Modern contraceptive utilization was low in this study. Factors such as women's education, socioeconomic status, and marital status were associated with increased modern contraceptive utilization, whereas women's age and regional disparities were linked to lower usage rates. These findings emphasize the need for targeted interventions to address socioeconomic barriers and regional disparities in access to family planning services across Ghana.
在全球范围内，性与生殖健康仍然是育龄妇女一项突出的公共卫生问题。现代避孕方法在使个人和家庭能够调节生育方面发挥着关键作用，从而减少意外怀孕、堕胎、与怀孕相关的并发症及死亡率。由于在加纳国家层面缺乏关于影响育龄妇女采用现代避孕方法的因素的可靠和最新数据，本研究旨在探讨育龄妇女使用现代避孕方法的决定因素。
该研究分析了2022年加纳人口与健康调查的数据，包括6839名育龄妇女的加权样本。通过采用多水平逻辑回归模型，该研究试图确定与现代避孕方法使用相关的因素。使用调整后的优势比（AOR）以及95%置信区间（CI）评估解释变量与结果之间的关联。使用小于0.05的p值阈值确定统计学显著性。所有统计分析均使用STATA 17版软件进行。
该研究发现，加纳26.36%（95%CI：25.33 - 27.34%）的育龄妇女使用现代避孕方法。中等教育程度（AOR = 1.26，95%CI = 1.03 - 1.53）、较贫困家庭（AOR = 1.30，95%CI = 1.05 - 1.61）、妇女的婚姻状况，即已婚（AOR = 1.46，95%CI = 1.16 - 1.83）、与伴侣同居（AOR = 1.65，95%CI = 1.32 - 2.06）、离婚（AOR = 2.53，95%CI = 1.48 - 4.31）和分居（AOR = 1.70，95%CI = 1.21 - 2.37）、多产妇（AOR = 1.39，95%CI = 1.04 - 1.87），是促进现代避孕方法使用的因素。妇女的年龄（岁），即35 - 39岁（AOR = 0.71，95%CI = 0.52 - 0.97）、40 - 44岁（AOR = 0.63，95%CI = 0.44 - 0.90）和45 - 49岁（AOR = 0.45，95%CI = 0.25 - 0.79）、流产史（AOR = 0.86，95%CI = 0.76 - 0.98）、地区，即大阿克拉（95%CI = 0.42 - 0.92）、博诺东部（95%CI = 0.32 - 0.81）、北部（95%CI = 0.28 - 0.67）、萨凡纳（95%CI = 0.28 - 0.81）和东北部（95%CI = 0.20 - 0.63），均与现代避孕方法的较低使用相关。
本研究中现代避孕方法的使用率较低。妇女的教育程度、社会经济地位和婚姻状况等因素与现代避孕方法使用的增加相关，而妇女的年龄和地区差异与较低的使用率相关。这些发现强调了有针对性地进行干预以解决加纳全国计划生育服务获取方面的社会经济障碍和地区差异的必要性。
