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东非国家育龄妇女对现代避孕方法的知情选择及决定因素:人口与健康调查的多层次分析

Informed choice of modern Contraceptive Methods and determinant factors among reproductive age women in Eastern Africa countries: A multilevel analysis of demographic and health survey.

作者信息

Zeleke Gebreeyesus Abera, Negash Birtukan Atena, Shiferaw Kassaw Belay, Tekeba Berhan, Tamir Tadesse Tarik, Worku Workie Zemene, Zegeye Alebachew Ferede

机构信息

Department of Surgical Nursing, School of Nursing, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.

Department of physiotherapy, School of medicine College of Medicine and Health Sciences University of Gondar, Gondar, Ethiopia.

出版信息

PLoS One. 2025 May 19;20(5):e0323797. doi: 10.1371/journal.pone.0323797. eCollection 2025.

Abstract

BACKGROUND

Unwanted pregnancies arise from the discontinuation of many contraceptive methods or the failure to use current contraceptive services; this has been a public health concern in Sub-Saharan Africa, particularly in the eastern African countries. Informed choice of modern contraceptive method is an important indicator of family planning quality services. Evidence shows that informed choice of contraceptive methods lowers the potential risk of family planning discontinuation rate, misunderstanding of contraceptive method and unintended pregnancies finally lead to induced abortions. Therefore, the aim of this study was to ascertain the magnitude of informed choice of modern contraceptive methods user and its determinant factors among reproductive age women who are currently using modern contraceptive in Easter African countries.

METHODS

Secondary data analysis was conducted using data from the DHS eight Eastern Africa nations between 2012 and 2020. The total weighted sample was 6154 reproductive age women who used were modern contraceptive method. Stata version 14 was used to analysis secondary data. Determinants of informed choice were determined by using multilevel mixed-effects logistic regression model. Significant factors related with informed choice in multilevel mixed effect logistic regression model were decided when the p value of <0.05. The adjusted odds ratio (AOR) and confidence interval (CI) were used to interpret the outcome.

RESULT

In East Africa, the magnitude of informed choice found to be 20.70. determinant factors such maternal age (20-35) years (AOR = 2.02 CI: 1.39, 2.93), (36-49) years (AOR = 2.44, 95% CI: 1.66, 3.61), attending secondary & higher education (AOR = 1.37 95% CI 1.02, 1.84), Media exposure (AOR = 1.25 95% CI 1.05, 1.49), visit health facility within 12 months were (AOR = 1.31 95% CI: 1.11, 1.54) were significantly associated with an informed choice among reproductive age women modern contraceptive method user.

CONCLUSIONS AND RECOMMENDATION

This study concluded that only 20.7% reproductive age women using modern contraceptive method were an informed choice in Eastern Africa. The following factors were strongly linked to informed choice: maternal age, attending secondary and higher education, media exposure, and visiting a health facility within a year. Therefore, policies and initiatives targeting informed choice modern contraceptive methods and above critical determinants among reproductive age women in Eastern Africa (ages 15-49) will be designed by the government, ministry of health, and other relevant parties.

摘要

背景

意外怀孕源于多种避孕方法的停用或未能利用现有的避孕服务;这一直是撒哈拉以南非洲地区,尤其是东非国家的一个公共卫生问题。对现代避孕方法的知情选择是计划生育优质服务的一项重要指标。有证据表明,对避孕方法的知情选择可降低计划生育停用率的潜在风险,对避孕方法的误解以及意外怀孕最终导致人工流产。因此,本研究的目的是确定东非国家目前正在使用现代避孕方法的育龄妇女中,对现代避孕方法的知情选择程度及其决定因素。

方法

使用2012年至2020年期间来自八个东非国家的 DHS 数据进行二次数据分析。总加权样本为6154名使用现代避孕方法的育龄妇女。使用 Stata 14 版分析二次数据。通过多级混合效应逻辑回归模型确定知情选择的决定因素。当 p 值<0.05 时,确定多级混合效应逻辑回归模型中与知情选择相关的显著因素。调整后的优势比(AOR)和置信区间(CI)用于解释结果。

结果

在东非,发现知情选择的程度为20.70。决定因素包括产妇年龄(20 - 35)岁(AOR = 2.02,CI:1.39,2.93),(36 - 49)岁(AOR = 2.44,95% CI:1.66,3.61),接受中等及高等教育(AOR = 1.37,95% CI 1.02,1.84),接触媒体(AOR = 1.25,95% CI 1.05,1.49),在12个月内就诊于医疗机构(AOR = 1.31,95% CI:1.11,1.54),这些因素与育龄妇女现代避孕方法使用者的知情选择显著相关。

结论与建议

本研究得出结论,在东非,只有20.7%使用现代避孕方法的育龄妇女做出了知情选择。以下因素与知情选择密切相关:产妇年龄、接受中等及高等教育、接触媒体以及一年内就诊于医疗机构。因此,政府、卫生部和其他相关方将针对东非(15 - 49岁)育龄妇女的现代避孕方法知情选择及上述关键决定因素制定政策和举措。

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