Negash Habtu Kifle, Gelaw Destaye Tirite, Getnet Mihret, Endale Hiwot Tezera, Asefa Tseganesh, Hasen Fethiya Seid, Ayenew Yihun Tefera, Baykemagn Nebebe Demis, Yehuala Trualem Zeleke, Tesfaye Winta
Department of Anatomy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Contracept Reprod Med. 2024 Dec 30;9(1):68. doi: 10.1186/s40834-024-00332-5.
Modern contraceptives are crucial for reducing maternal and child mortality, yet Mozambique's contraceptive prevalence rate is very low, with significant regional disparities. This study investigates geographic variation in contraceptive use and the individual, community, and regional factors influencing it to guide equitable family planning interventions.
This study utilized data from the 2022/23 Mozambique Demographic and Health Survey, analyzing a weighted sample of 9,316 women aged 15-49. The outcome variable was modern contraceptive use, with predictors including individual factors such as age, education, wealth, and marital status, as well as community-level factors like residence and region. Data analysis was conducted using Stata 17 and ArcGIS 10.7, employing multilevel logistic regression and spatial techniques (Global Moran's I, Getis-Ord Gi*, interpolation, and SaTScan) to identify patterns and geographic clusters of contraceptive use.
The study found a modern contraceptive prevalence of 34.8% (95% CI: 33.84-35.78). Key factors influencing usage included age, education, wealth, and healthcare access. Women aged 25-34 were 31% more likely to use contraceptives than those aged 15-24 (AOR: 1.31, 95% CI: 1.13-1.53). Secondary education more than doubled the likelihood (AOR: 2.25, 95% CI: 1.82-2.78), and wealthier women had a 74% higher likelihood (AOR: 1.74, 95% CI: 1.39-2.17). Fieldworker visits increased usage by 38% (AOR: 1.38, 95% CI: 1.15-1.64). Regional disparities were significant, with women in Cabo Delgado 81% (AOR: 0.19 95% CI: 0.14, 0.27) less likely to use contraceptives compared to Maputo. Higher usage was concentrated in Maputo and Southeastern Gaza. Spatial analysis revealed significant regional disparities, with hotspots in Maputo and Gaza, where women are 2.52 times more likely to use contraceptives, while rural areas like Cabo Delgado lag behind.
Modern contraceptive use in Mozambique remains low, with regional disparities. Key factors influencing use include age, education, wealth, and healthcare access. Older, educated, and wealthier women are more likely to use contraception. Media exposure and proximity to healthcare facilities also play a role. Regional differences persist, with lower usage in provinces like Cabo Delgado and higher usage in urban areas like Maputo and Gaza. Targeted interventions are necessary to address these disparities.
现代避孕措施对于降低孕产妇和儿童死亡率至关重要，但莫桑比克的避孕普及率非常低，且存在显著的地区差异。本研究调查了避孕措施使用情况的地理差异以及影响其使用的个人、社区和地区因素，以指导公平的计划生育干预措施。
本研究利用了2022/23年莫桑比克人口与健康调查的数据，分析了9316名15至49岁女性的加权样本。结果变量是现代避孕措施的使用情况，预测因素包括年龄、教育程度、财富和婚姻状况等个人因素，以及居住和地区等社区层面的因素。使用Stata 17和ArcGIS 10.7进行数据分析，采用多层逻辑回归和空间技术（全局莫兰指数、Getis-Ord Gi*、插值法和空间扫描统计）来识别避孕措施使用情况的模式和地理集群。
研究发现现代避孕普及率为34.8%（95%置信区间：33.84 - 35.78）。影响使用的关键因素包括年龄、教育程度、财富和医疗保健服务的可及性。25至34岁的女性使用避孕药具的可能性比15至24岁的女性高31%（调整后比值比：1.31，95%置信区间：1.13 - 1.53）。接受中等教育使使用可能性增加了一倍多（调整后比值比：2.25，95%置信区间：1.82 - 2.78），较富裕的女性使用可能性高74%（调整后比值比：1.74，95%置信区间：1.39 - 2.17）。实地工作人员的探访使使用率提高了38%（调整后比值比：1.38，95%置信区间：1.15 - 1.64）。地区差异显著，与马普托相比，德尔加杜角省的女性使用避孕药具的可能性低81%（调整后比值比：0.19，95%置信区间：0.14，0.27）。较高的使用率集中在马普托和加沙东南部。空间分析显示出显著的地区差异，马普托和加沙存在热点地区，那里的女性使用避孕药具的可能性是其他地区的2.52倍，而德尔加杜角等农村地区则相对落后。
莫桑比克现代避孕措施的使用率仍然较低，且存在地区差异。影响使用的关键因素包括年龄、教育程度、财富和医疗保健服务的可及性。年龄较大、受过教育且较富裕的女性更有可能使用避孕措施。媒体曝光和靠近医疗设施也起到了一定作用。地区差异仍然存在，德尔加杜角等省份的使用率较低，而马普托和加沙等城市地区的使用率较高。需要采取有针对性的干预措施来解决这些差异。
