Sifora Kutlwano Kimberly, De Wet-Billings Nicole, Frade-Bekker Sasha, Phiri Million
Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Department of Demography, Population Sciences and Monitoring and Evaluation, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia.
Contracept Reprod Med. 2025 Aug 25;10(1):53. doi: 10.1186/s40834-025-00392-1.
Contraceptive use is a major global public health priority, contributing to improved maternal and child health, gender equality, and sustainable development. Despite advancements, women with sensory disabilities in low- and middle-income countries continue to face challenges in accessing modern contraceptives, leading to low utilisation. Despite this, no research has examined the influence of sensory disability status on modern contraceptive use among women of reproductive age in South Africa. Thus, this study explored the association between sensory disability status and other individual and community-level factors and modern contraceptive utilisation in South Africa.
Data were drawn from the 2016 South Africa Demographic and Health Survey (SADHS). A sample of 7,040 sexually active women aged 15-49 years was used in the analysis. A two-level multilevel binary logistic regression model was used to examine the association between sensory disability status and other individual and community-level factors and modern contraceptive use.
The prevalence of modern contraception among sexually active women in South Africa was 57.32% [95% CI = 55.59-59.03]. Women with sensory disabilities [aOR = 0.81, CI = 0.67-0.98] were less likely to use contraceptives. Other factors negatively associated with use included desiring five or more children [aOR = 0.67, 95% CI = 0.47-0.97] and living in communities with a high ideal number of children [aOR = 0.75, 95% CI = 0.63-0.90]. Factors positively associated with contraceptive use included mobile phone ownership [aOR = 1.45, 95% CI = 1.15-1.82] and living in communities with high employment [aOR = 1.32, 95% CI = 1.06-1.64].
Sensory disability status influenced women's contraceptive behaviour in South Africa. Current family planning interventions should target women with sensory disabilities by prioritising accessible communication methods (e.g., braille, sign language), disability awareness training for healthcare workers, and integration of reproductive health services into disability support programmes.
避孕措施的使用是一项重大的全球公共卫生优先事项，有助于改善母婴健康、性别平等和可持续发展。尽管取得了进展，但低收入和中等收入国家的感官残疾女性在获取现代避孕方法方面仍然面临挑战，导致使用率较低。尽管如此，尚无研究考察感官残疾状况对南非育龄妇女现代避孕措施使用情况的影响。因此，本研究探讨了南非感官残疾状况与其他个人及社区层面因素与现代避孕措施使用率之间的关联。
数据取自2016年南非人口与健康调查（SADHS）。分析中使用了7040名年龄在15 - 49岁的性活跃女性样本。采用两级多水平二元逻辑回归模型来考察感官残疾状况与其他个人及社区层面因素与现代避孕措施使用之间的关联。
南非性活跃女性中现代避孕措施的使用率为57.32%[95%置信区间 = 55.59 - 59.03]。有感官残疾的女性[调整后比值比 = 0.81，置信区间 = 0.67 - 0.98]使用避孕措施的可能性较小。与使用避孕措施呈负相关的其他因素包括期望生育五个或更多孩子[调整后比值比 = 0.67，95%置信区间 = 0.47 - 0.97]以及生活在理想子女数量较多的社区[调整后比值比 = 0.75，95%置信区间 = 第1页共2页0.63 - 0.90]。与避孕措施使用呈正相关的因素包括拥有手机[调整后比值比 = 1.45，95%置信区间 = 1.15 - 1.82]以及生活在就业水平高的社区[调整后比值比 = 1.32，95%置信区间 = 1.06 - 1.64]。
感官残疾状况影响了南非女性的避孕行为。当前的计划生育干预措施应针对有感官残疾的女性，优先采用无障碍沟通方式（如盲文、手语），对医护人员进行残疾意识培训，并将生殖健康服务纳入残疾支持项目。
