Dataset Information

Disparities in Long-Acting Reversible Contraceptive Utilization among Married Women in Ethiopia: Findings of the Ethiopian Demographic and Health Survey.

ABSTRACT: Background:Long-acting contraceptive methods, subdermal implants, and intrauterine devices are reliable, safe, and cost-effective family planning methods. However, these methods are not widely used in Ethiopia despite government effort to increase access. The study is aimed at assessing the rate of utilization of long-acting contraceptive methods among married women and associated factors. Method:We analyzed the 2016 Ethiopian Demographic and Health Survey dataset. A total of 2045 married women of reproductive age group, who were using any modern contraceptive method at the time of the survey, were included in the study. Descriptive statistics were computed to characterize the study participants. Bivariate and multivariable logistic regression analyses were performed to identify associated factors, reporting odds ratios (ORs) and 95% confidence intervals (95% CIs). Result:The multivariable analyses showed that women educational status, parity, religion, previous history of abortion, desire for more child, and region where the respondents reside were significantly the factors that determine the utilization of long-acting contraceptive. There is a significant regional disparity in long-acting contraceptive utilization. Compared to women residing in Tigray region, those who live in other regions (Afar-Somali, Oromia, Amhara, Benishangul Gumz-Gambela, and Southern Nations Nationalities and People) have low likelihood of using long-acting contraceptive methods. Conclusion:Utilization of long-acting family planning method is low in Ethiopia. There is a significant regional disparity in utilizing these methods. Policy makers should promote culture-sensitive and tailored interventions to improve the utilization of long-acting family planning methods.

SUBMITTER: Haile BT

PROVIDER: S-EPMC7079244 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Disparities in Long-Acting Reversible Contraceptive Utilization among Married Women in Ethiopia: Findings of the Ethiopian Demographic and Health Survey.

Haile Biniyam Tadesse BT Tsehay Yohannes Ejigu YE

International journal of reproductive medicine 20200305

<h4>Background</h4>Long-acting contraceptive methods, subdermal implants, and intrauterine devices are reliable, safe, and cost-effective family planning methods. However, these methods are not widely used in Ethiopia despite government effort to increase access. The study is aimed at assessing the rate of utilization of long-acting contraceptive methods among married women and associated factors.<h4>Method</h4>We analyzed the 2016 Ethiopian Demographic and Health Survey dataset. A total of 2045 ...[more]

PMID: 32206670

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Project description:BackgroundSame-day placement of long-acting reversible contraceptives, occurring when the device is requested and placed within a single visit, reduces barriers to the patient and reduces unintended pregnancies. Despite the safety and efficacy of same-day placement, access to same-day services remains low.ObjectiveThis study aimed to evaluate the effects of the Delaware Contraceptive Access Now initiative, a statewide initiative in Delaware focused on increasing same-day access to effective contraception on same-day receipt of long-acting reversible contraceptives.Study designWe used Medicaid claims and encounter data to identify instances of same-day and multivisit receipts of long-acting reversible contraceptives among Medicaid-enrolled individuals in Delaware and Maryland aged 15-44 years who were covered in a full-benefits or family planning Medicaid aid category during the month of the placement and the 2 previous months. We used a difference-in-differences design that compared changes in the outcome from before to after implementation of the initiative among placements at agencies that participated in the initiative (n=6676) vs 2 alternative comparison groups: placements at Delaware agencies that did not participate (n=688) and placements in Maryland (n=35,847).ResultsWe found that the intervention was associated with a 13.3 percentage point increase (95% confidence interval, 1.9%-24.7%) in receipt of same-day long-acting reversible contraceptives using a nonparticipating Delaware comparison group, a 21.1 percentage point increase (95% confidence interval, 13.7%-28.6%) using a Maryland comparison group, and a 21.0 percentage point increase (95% confidence interval, 14.1%-27.9%) using a pooled comparison group. The effects were larger for implants than intrauterine devices.ConclusionThe Delaware Contraceptive Access Now initiative substantially increased the number of patients receiving long-acting reversible contraceptives through a single-visit encounter. Our findings suggested that coordinated interventions involving provider and staff training and capital investments that seed device stocking can increase the number of patients receiving same-day long-acting reversible contraceptives.

Project description:Background:Globally, unintended pregnancy has been very high accounting for 27% of maternal deaths. Different studies noted that nearly half of HIV positive women who gave unintended birth were using contraceptive methods prior to their unintended pregnancy. This implies that contraceptive failure contributes to unintended pregnancy. Long-term and permanent contraceptive methods are safe and effective contraceptive options. In women who are using long acting and permanent methods, the unintended pregnancy rate is very low and it is almost the same both in typical and perfect users. However, there is limited information on factors that affect long acting and permanent contraceptive methods utilization among Human Immuno-deficiency Virus (HIV) positive women in Ethiopia. Therefore, the purpose of this study was to assess long acting and permanent contraceptive utilization and its associated factors. Methods:An institution-based cross-sectional study was conducted among 505 married women attending care at Anti Retroviral Therapy (ART) clinics in Bahir Dar from March 16, 2014 to April 15, 2014. The data were collected using a structured and interviewer administered questionnaire. Both bivariate and multivariate logistic regressions were used to identify associated factors. Results:A total of 505 married women participated in the study with a response rate of 99.6%. The utilization of long acting and permanent contraceptive methods (LAPMs) was 27.5% [95% CI, 23.8-31.5]. The multivariate analyses showed that women who were getting pre- anti retroviral therapy (Pre-ART) services [Adjusted Odds Ratio?=?2.65, 95% confidence interval: 1.44, 4.86], had spousal discussion on family planning sometimes [Adjusted Odds Ratio?=?6.03, 95% CI:2.42-15.01] and frequently [Adjusted Odds Ratio?=?6.61, 95% confidence interval: 2.49-17.47], had previous experience on long acting contraceptive methods [Adjusted Odds Ratio?=?9.06, 95% confidence interval: 5.38-15.26], no exposure to myths about LAPMs [Adjusted Odds Ratio?=?2.07, 95% confidence interval: 1.24-3.45], had birth intention after 2 years [Adjusted Odds Ratio?=?6.95, 95% confidence interval: 3.35-14.42], and no such intention [Adjusted Odds Ratio?=?7.60, 95% confidence interval: 3.77-15.34] were factors significantly associated with utilization of long acting and permanent contraceptive methods. Conclusion:The utilization of long acting and permanent contraceptive methods was relatively high. Discussion with partners on family planning, previous experiences of LAPMs, not hearing myths about LAPMs, women not started ART, and no birth intention were positively associated with LAPMs utilization. It is therefore recommended that health service providers need to make couples counseling on FP, undergo behavioral change communication (BCC) to avoid misconceptions/myths regarding LAPMs. Further research is also recommended to address the gaps mentioned in the limitation section and to explore the reason/s for not using LAPMs (qualitative study).

Project description:Background. Modern contraceptives are a key intervention to improve the health of both the mother and children by preventing unintended pregnancy. However, significant numbers of women were facing abortion-related morbidity and mortality globally including Ethiopia due to the nonuse or failure of contraceptive uses. Therefore, the aim of this study was to assess the utilization of modern contraceptive methods and associated factors among married Gumuz women in Metekel Zone North West Ethiopia. A community-based cross-sectional study was conducted among 580 women from March 1 to 30/2019. Pretested structured interview administer questionnaires was used to collect the data. Data were cleaned, coded, and entered into Epi-info version 7.1 and export to SPSS for farther analysis. Both bivariate and multivariate analyses were used. On bivariate analysis P value, less than 0.2 were used to select the candidate variable for multivariate analysis. P value and 95% confidence interval were used to measure the level of significance on multivariate analysis and those variables whose P value < 0.05 were considered as statically significant. The prevalence of modern contraceptive method was 18.6% [95% CI: 15.00-22.00]. Age ? 35 year AOR 4.67; 95% CI (1.34 -16.18), able to read and write AOR 6.45 95% CI(2.98-13.97), primary school AOR 6.56; 95% CI (2.22-19.38), secondary school AOR 7.27; 95% CI (3.00 -17.61), counseled on contraceptive methods AOR 3.72 95% CI (2.11-6.56), moderate knowledge on modern contraceptive method AOR 2.31; 95% CI (1.15-4.64), and good knowledge on modern contraceptive method AOR 4.37; 95% CI (2.38-8.02) were identified as statistically significant with modern contraceptive methods utilization. The prevalence of contraceptive utilization was low when compared to the national and the regional figure. Maternal age, maternal educational status, counseling about modern contraceptive methods, and knowledge on modern contraceptive methods were found as statistically significant with modern contraceptive utilization.

Project description:Background:Long acting reversible contraceptive methods are highly effective, safe and provide uninterrupted protection to women for 3 to 12?years, yet are little used in the Ethiopia. Assessment of the utilization and predictors of long acting reversible contraceptive methods assist health planners to prioritize promotion strategies, and is a fundamental step for intervention. Therefore, this study aimed to assess the utilization and predictors of long acting reversible contraceptives among reproductive age women in Hawassa city, South Ethiopia; 2019. Methods:A community-based cross-sectional study was conducted using a mixed method among the sample of 660 reproductive age women in Hawassa city, South Ethiopia from January 1-30, 2019. We have used a systematic and purposive sampling technique to select the study participants. A structured interview-administrated questionnaire and focus group discussion were used to collect the data. The data were entered using Epi data version 3.1 and analyzed using SPSS version 20. Chi-square (X2) test was used to determine the overall association between explanatory and outcome variables. The variables were entered into the multivariable model using the backward stepwise regression approach. Bi-variable and multivariable logistic regression analyses were conducted. The qualitative data were analyzed using a manual thematic analysis technique. Results:The overall utilization of long acting reversible contraceptive methods was 22% (95% CI?=?19.50-25.50%). Among this, 17.5 and 4.5% of women utilized the implants and IUCD, respectively. Good knowledge (AOR?=?4.0; 95% CI?=?1.66-9.60; P =?0.001) and positive attitude (AOR?=?7.9; 95% CI?=?3.84-16.10; P =?0.001) of women about LARC methods were positively associated with utilization of LARC methods. The odds of utilizing LARC methods increased 8.2 times for women who have no desire to have a child (AOR?=?8.2, 95% CI?=?3.13-21.30) as compared to those who have the desire to have a child. The discussion of women about LARC methods with providers (AOR?=?4.1; 95% CI?=?1.24-5.24) and husbands (AOR?=?2.7; 95% CI =1.02-7.20) were positively associated with utilization of LARC methods. These findings were supported by the individual, institutional and socio-cultural qualitative findings. Conclusions:The utilization of LARC methods far below the national target (22?V 40%) in the study area. Good knowledge and positive attitude about LARC methods, no desire to have a child, discussion with husbands and providers were major predictors of the LARC methods utilization. Increasing knowledge and positive attitude of the women about LARC methods using various methods of health education should be considered.

Project description:The notion of unmet need for family planning indicates the gap between women's contraceptive practice and their reproductive intention. Although universal access to sexual and reproductive health services including contraceptive methods is a bedrock for sustainable development goals, the unmet need for contraception is high among young women in low-income countries including Ethiopia. The unmet need for contraception is associated with unintended pregnancy which most of the time end in unsafe abortion. Hence, this study aimed to assess the determinants of unmet need for family planning among young married women in Ethiopia using nationally representative data. This study utilized secondary data collected in the 2016 Ethiopia Demographic and Health Survey (EDHS). A two-stage cluster sampling method was used. The analysis included a total of 2444 sexually active married young women (15-24 years). Multilevel logistic regression analysis was conducted to identify individual and community level factors associated with unmet need for contraceptives and the results were presented as adjusted odds ratio (AOR) at 95% confidence interval (CI), declaring statistical significance at a p-value <0.05 in all analyses. In this study, the prevalence of unmet need for contraceptive method among married young women was 18.4% [95% CI: (16.9, 20.0)]. Female head of the household [AOR: 1.62, CI (1.25, 2.11)], primary level of education [AOR: 1.53, CI: (1.16, 2.03)], family size ≥5 [AOR: 1.53, 95%CI: (1.22, 1.93)], undecided to have child [AOR: 2.86, 95%CI: (1.58, 5.20)] and infecund [AOR: 1.54, 95%CI: (1.08, 2.20)] were factors positively associated with unmet need for family planning. Whereas the odds of unmet need for contraceptive method was lower among women-initiated sex between 15-17 years and >17 years [AOR:0.72, 95%CI (0.53, 0.98)] and [AOR: 0.58, 95%CI: (0.40, 0.85)] respectively and community with high proportion of poverty [AOR: 0.68, 95%CI: (0.46, 0.99)]. The prevalence of unmet need for contraceptive methods among young married women was relatively high. Being female household head, age at first sexual intercourse, educational status of the woman, family size, desire for more children, and community poverty were significantly associated with unmet need for family planning. Hence, interventions targeting these special populations at the individual and community level would play a paramount role in meeting the unmet need for contraception among young married women in Ethiopia.

Project description:BACKGROUND:Contraceptive discontinuations for reasons other than the desire for pregnancy are a public health concern because of their negative effect on reproductive health outcomes. In Ethiopia, the contraceptive discontinuation rate is increasing; however the factors associated are poorly understood. So this study was aimed at assessing reasons and multilevel factors for unscheduled contraceptive use discontinuation. METHODS:This is a cross-sectional study of Ethiopian women who participated in the Ethiopian demographic health survey from January 18, 2016, to June 27, 2016. Ever using any contraceptive with in the calendar of the survey were an inclusion criteria for which 3835 women were found eligible. The data were analyzed using multilevel binary logistic regression in STATA version 14. Variables with p-value less than 0.05 were considered as statistically significant, and reported using adjusted odds ratio and 95% confidence interval. Median odds ratio and interval odds ratio, to quantify the magnitude of the general and specific contextual effect respectively, were used. Receiver operating characteristics curve and akaike's information criterion were used for model comparison. RESULT:The prevalence of unscheduled contraceptive use discontinuation was 46.18% for the principal reason of method related problems (Side effects-45.3%, needing better method-33.6%, and inconvenience-21.1%,). Women heading a household (AOR?=?1.281, 95%CI 1.079-1.520), women who had no work (AOR?=?0.812, 95%CI 0.673, 0.979) compared to professionals, living in poorest house hold income (AOR?=?0.753, 95%CI 0.567, 0.997) compared to middle, residing in community with low contraceptive utilization rate (AOR?=?1.945, 95%CI 1.618, 2.339), residing in poor community (AOR?=?0.763, 95%CI 0.596-0.997), and having more children, and region were found to be significant predictors of unscheduled contraceptive use discontinuation. CONCLUSION:Method related problems were found to contribute for more than half of the contraceptive use discontinuation. Both individual and community level factors were found to significantly influence the Unscheduled contraceptive use discontinuation. The outcome was common in groups who could have more social interactions and knowledge on which myths and rumors are common. So strengthening the efforts to reduce contraceptive use discontinuation and quality of contraceptive service provision could be important.

Dataset Information

Disparities in Long-Acting Reversible Contraceptive Utilization among Married Women in Ethiopia: Findings of the Ethiopian Demographic and Health Survey.

Publications

Disparities in Long-Acting Reversible Contraceptive Utilization among Married Women in Ethiopia: Findings of the Ethiopian Demographic and Health Survey.

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