Utilization and its factors of post abortion modern contraceptive in Ethiopia: a systematic review and meta-analysis.
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ABSTRACT: Background
Providing post-abortion care service is a widely accepted to reduce maternal morbidity and mortality by promoting, preventing and treating maternal and neonatal health, identifying the utilization and its factor of post abortion contraceptive is crucial. Therefore we tried to review post abortion contraceptive utilization and its factors in Ethiopia.Methods
A review was performed by using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A systematic and a comprehensive literature searching mechanism were used without any restriction, through Google scholar, PubMed, EMBASE, Scopus, Web of Sciences, and Grey literature databases for reporting utilization of post abortion family planning. Pilo-tested were performed in random sample studies and a standardized data extraction form was used. All statistical analyses were done using STATA version 14 software for windows, and meta-analysis was used with a random-effects method. The results are presented using texts, tables and forest plots with measures of effect and 95% confidence interval.Results
Among 1221 records, 11 studies were taken in the meta-analysis with 4336 Participants that full fill the inclusion criteria. The pooled prevalence of post abortion contraceptive in Ethiopia was 74.56% (95% CI (73.31%, 75.81%)). Married women (OR 2.01 (95% CI (1.52, 2.66), I2: 0.0%)), women who were counseled (OR 5.36 (95% CI (3.10, 9.29), I2: 79.5%)), women whose educational level tertiary and above (OR 2.28 (95% CI (1.66, 3.17), I2: 0.0%)), women who had ever used contraceptive (OR 3.76 (95% CI (2.19, 6.47), I2: 67.8%)) and those women's age 15-24 years old (OR 8.35 (95% CI (2.74, 14.74), I2: 87.4)) were statistically significant.Conclusion
According to World Health Organization (WHO) guideline, "after a miscarriage or induced abortion, the recommended minimum interval to next pregnancy is at least 6 months in order to reduce risks of adverse maternal and perinatal outcomes".. According to this post abortion contraceptive utilization in Ethiopia is not optimal. Marital status, education, Counsel, previously exposed and age were significantly associated. Therefore, the Ministry of Health should work target fully to address those problems to maintain maternal and child health in Ethiopia.
SUBMITTER: Beyene FY
PROVIDER: S-EPMC8254279 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundPost-abortion contraceptive utilization is the initiation and use of family planning methods at the time of management of abortion or before fertility returns. A significant discrepancy was reported regarding the prevalence and its associated factors of post-abortion contraceptive utilization in Ethiopia. So, this systematic review and meta-analysis aimed to estimate the pooled prevalence of post-abortion contraceptive utilization and its associated factors in Ethiopia.MethodsPreferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline was used. The databases such as PubMed, Google Scholar, Science Direct, Cochrane library, Scopus, CINAHL, Web of Science, and additional searches by using direct Google search, libraries, and preprint were searched. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used for critical appraisal.ResultsA total of 17 studies with 13,075 individuals were included. Of these, 14 studies with 5,719 individuals were used to estimate the prevalence. The pooled prevalence of post-abortion contraceptive utilization in Ethiopia was 63.64% (95% CI: 57.75-69.53). The subgroup analysis reported the highest prevalence of post-abortion contraceptive utilization in a study conducted in Addis Ababa (77.40%), a study published in 2015-2021 (66.15%), and among studies with a sample size >400 (66.84%). The pooled odds ratio (OR) of post-abortion contraceptive utilization for the mothers who had post-abortion family planning counseling was 4.15 (95% CI = 1.30, 13.2), and history of family planning utilization was 4.28 (95% CI = 2.66, 6.89).ConclusionsThe pooled prevalence of utilization of post-abortion contraceptives in this meta-analysis remains low. Post-abortion family planning counseling and the history of the utilization of modern family planning methods were significantly associated with the practice of post-abortion contraceptives. The Ministry of Health should encourage post-abortion family planning utilization, making more efforts on post-abortion contraceptive counseling. Health facilities should work hard to strengthen the family planning counseling service, especially focusing on those who had no previous family planning utilization.
| S-EPMC9163437 | biostudies-literature
Project description:IntroductionPost-partum family planning is a novel strategy to reduce maternal and neonatal mortality by preventing unwanted pregnancy and unsafe abortion. However, little was done on community-based design to assess modern contraceptive use during an extended postpartum period in southern Ethiopia. Therefore, this study aimed to assess modern contraceptive use during extended postpartum period and factors associated among women who gave birth in the previous twelve months in southern Ethiopia.MethodsA community-based cross-sectional study was conducted among 416 women in Arba Minch town. A systematic random sampling technique was employed to select the enrolled women. Data were collected using a structured and pretested questionnaire. The data were entered into Epi-Data version 4.6 then exported to statically package of social science (SPSS) version 25 for data analysis.ResultAmong enrolled postpartum women, 64.7% were used modern contraceptives for the last 12 months. Women were more likely to use a modern contraceptive during the extended period of postpartum if they resumed sexual intercourse (AOR:7.4 [4.08, 13.23]), received post-partum family planning counseling (AOR: 3.2 [1.95, 5.28]), and if they resumed menses (AOR: 5.3 [3.12, 9.15]) than the counterpart. Being young age women (AOR: 3.2 [1.05, 9.82]) compared to age above 35 years and married (AOR:3.2 [1.17-10.28]) compared to currently unmarried were significantly associated factors for modern contraceptive use during the extended period of postpartum.ConclusionThe level of modern contraceptive utilization during the extended postpartum period was satisfactory. Therefore, in light of this finding, there is a need to improve the strengthening and scale-up antenatal and postnatal counseling of contraceptive use during the extended postpartum period, advice on preceding the return of menses, and give better attention for older age and unmarried women education on family planning.
| S-EPMC8926256 | biostudies-literature
Project description:BackgroundDual contraceptive is the use of a barrier like condom along with any modern contraceptive methods which has double significance for the prevention STI including HIV and unintended pregnancy. The prevalence and determinants of dual contraceptive utilization described by different studies were highly inconsistent in Ethiopia. Therefore, this systematic review and meta-analysis aimed to estimate the pooled prevalence and determinants of dual contraceptive utilization among HIV positive women in Ethiopia.MethodsInternational database mainly Pub Med, Google scholar, HINARI, EMBASE, Cochrane Library, AJOL was applied to identify original studies. STATA software version 14 was applied to analyze the pooled prevalence of dual contraceptive. I2 test statistics was computed to check the presence of heterogeneity across the studies and eggers test was used to identify publication bias. The pooled prevalence of dual contraceptive utilization was estimated by using a random effects model. The associations between determinants and dual contraceptive utilization were evaluated by using both random and fixed effect models.ResultA total 9 studies with 9168 HIV positive women were enrolled in this study. The pooled prevalence of dual contraceptive utilization among HIV positive women in Ethiopia was 26.14% (95% CI 21.20-31.08). Disclosure of HIV status (OR = 4.18,95%CI:2.26-7.72), partner involvement in post-test counselling (OR = 2.31,95%CI:1.63-3.25), open discussion about dual contraceptive with partner (OR = 4.27 95% CI:1.69-10.77), provision of counselling on dual contraceptives by health care provider (OR = 4.47,95% CI:3.81-5.24) and CD4 count > 350 cells/ mm3 (OR = 3.87,95%CI:3.53-4.23) were among the significant factors associated with dual contraceptive utilization.ConclusionThe overall prevalence of dual contraceptive utilization among HIV positive women was significantly low. Disclosure of HIV status, partner involvement in post-test counselling, open discussion about dual contraceptive with partner, counselling on dual contraceptive by health care provider and CD4 count > 350 cells/ mm3 were positively affect dual contraceptive utilization. This study implies the need to develop plans and policies to improve partner involvement posttest counseling, integrate the counseling and provision of dual contraceptive at ART clinic at each level of health system.
| S-EPMC8247245 | biostudies-literature
Project description:Background: Post-abortion contraceptive utilization prevents unintended pregnancies, reduces the number of abortions, and lowers the morbidity and mortality related to obstetric complications. It plays a central role in improving maternal health and reducing child mortality. However, many women are suffering from unintended pregnancy and its complications after abortion care. Hence, the main objective of this study was to determine the magnitude of post-abortion contraceptive utilization and its associated factors in Bahir Dar City. Methods: Health-facility-based cross-sectional study was conducted in Bahir Dar city health facilities from April 1 to May 30, 2018. A systematic random sampling technique was used to select 354 eligible study participants. A pre-tested semi-structured questionnaire was used to collect the data. Data entry was done using Epi Data version 3.7 software and analyzed by SPSS v23 software. Descriptive statistics were done based on the nature of the data. A simple logistic regression model was used to identify the association and strength of exploratory variables and the outcome variables. Associations were announced at a 95% confidence interval and p-value <0.05 with adjusted odds ratio. Model fitness was checked by the Hosmer-Lemeshow goodness of fit test for logistic regression. Results: In this study, 348 aborted participants were involved with a mean age of 24.37 (±5.73) years. About 40% of the participants were not currently married and 12.9% were unable to read and write. The magnitude of post-abortion contraceptive utilization was 65.8%. The number of alive children (adjusted odds ratio: 7.0, 95% confidence interval: 1.54, 31.95), lower income (adjusted odds ratio: 0.14, 95% confidence interval: 0.03, 0.60), and (adjusted odds ratio: 0.11, 95% confidence interval: 0.02, 0.46), primary school education (adjusted odds ratio: 0.18, 95% confidence interval: 0.03, 0.97), and currently unemployed (adjusted odds ratio: 0.23, 95% confidence interval: 0.06, 0.85) were significantly associated with the post-abortion contraceptive utilization. Conclusion: The level of post-abortion contraceptive utilization is low as per the national plan. The number of alive children, lower income, lower education, and currently unemployed were the identified factors affecting post-abortion contraceptive utilization. Therefore, a collaborative effort is needed among stakeholders to increase the utilization and avoid factors that prevent the utilization of post-abortion contraceptive utilization.
| S-EPMC10865936 | biostudies-literature
Project description:BackgroundContraceptive use is the best and most cost-effective strategy to reduce feto-maternal adverse effects of short birth intervals. More than two-thirds of women in developing countries who do not want to conceive are not using contraception methods. Although there were various primary studies in different parts of the country, there is no nationally representative evidence on postpartum modern contraception utilization and its determinants in Ethiopia.ObjectiveThis review was aimed to determine the best available pieces of evidence to pool the magnitude of postpartum modern contraception utilization and find out its determinants.MethodsPublished studies were extensively searched by using electronic databases and unpublished studies were identified from the digital library. All observational studies conducted on the magnitude of postpartum modern contraception utilization and its determinants in Ethiopia were included. Data were extracted on the Microsoft Excel spreadsheet and analyzed using STATA 14.1 version. A random-effects model was used to estimate the pooled magnitude of postpartum modern contraception utilization with a 95% confidence interval (CI). Inverse variance (I2) was used to identify the presence of heterogeneity and forest plot was used to estimate the pooled magnitude of postpartum contraception utilization. The presence of publication bias was assessed by funnel plots and Egger's statistical tests. Sub-group analysis was computed to minimize underlying heterogeneity.FindingsIn this review, 19 primary studies were included. The pooled magnitude of postpartum modern contraception utilization in Ethiopia was 45.79% (95%CI 36.45%, 55.13%). The review found that having more than four Antenatal care visits(ANC), having postnatal care visit (PNC), having a formal education, history of family planning use, history of counseling on family planning, and having greater than four alive children as significant determinants of postpartum modern contraception utilization.ConclusionThe magnitude of postpartum modern contraception utilization in Ethiopia was low. ANC visit, PNC visit, maternal educational status, history of previous family planning use, counseling on family planning, and number of alive children were found to be significant determinants of postpartum modern contraception utilization. Therefore, strengthening focused ANC and PNC services to encourage women in utilizing modern contraception during the postnatal period is needed.
| S-EPMC7735615 | biostudies-literature
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.
| S-EPMC7396020 | biostudies-literature
Project description:BackgroundThe intrauterine contraceptive device, a type of long-acting reversible contraception, is one of the most effective and safe contraceptive methods. In Ethiopia, intrauterine contraceptive device is little known and practised to delay pregnancy. Therefore, this study aimed to assess post-partum intrauterine contraceptive device utilisation and its associated factors among women in Ethiopia.MethodIn the current meta-analysis, variables were searched from different electronic database systems, including PubMed, Google Scholar, EMBASE, HINAR, Scopus, Web of Sciences, and Grey literature. Data were extracted using a standardised data collection measurement tool. The data were also analysed by using STATA 16 statistical software. I2 tests assessed heterogeneity between the studies. A random-effect model was used to forecast the pooled utilisation of postpartum intrauterine contraceptive device.ResultsTwelve full-article studies were included. The pooled prevalence of post-partum intrauterine contraceptive device among women in Ethiopia was 21.63%. Occupation (OR = 4.44, 95% CI, 2.24-8.81), educational level of college and above (OR = 5.93, 95% CI, 2.55-13.8), antenatal care (OR = 2.09, 95% CI, 1.4-3.12), age (OR = 4.8, 95% CI, 2.3-10.04), good knowledge (OR = 4.16, 95% CI, 1.65-10.49), counseling (OR = 3.05, 95%CI, 1.41-6.63), husband support (OR = 11.48, 95% CI, 6.05-21.79) and awareness about IUCD (OR = 3.86, 95% CI, 1.46-10.2) were positively associated with utilization of postpartum intrauterine contraception device.ConclusionsUtilisation of post-partum intrauterine contraceptive device was significantly low. Scaling up women's educational status and ANC use has paramount importance in increasing post-partum IUD use, which further improves maternal and child health in general. This finding may be useful in both reproductive health promotion at an individual level and policy-making regarding this issue.
| S-EPMC8590214 | biostudies-literature
Project description:BackgroundIn the context of high maternal morbidity and mortality in Sub-Saharan Africa, less than 80% of pregnant women receive antenatal care services. According to a 2016 national report, only 62% of pregnant women in Ethiopia made at least one antenatal care visit. The aim of this review was to systematically and quantitatively summarize the factors affecting utilization of antenatal care in Ethiopia.MethodsWe searched PubMed, Medline, EMBASE, CINAHL, Google Scholar and Maternity and Infant Care database for studies that had been conducted in Ethiopia between 2002 and 2016. We summarized the studies on the use of antenatal care services quantitatively and qualitatively. A random-effects model was conducted to obtain the pooled estimates.ResultsA total of fifteen observational studies were included in this review. The pooled prevalence of utilization of antenatal care services in Ethiopia was 63.77% (95CI 53.84-75.54). The pooled odds ratio showed that a significant positive association was found between utilization of antenatal care and urban residence (OR = 1.92, 95%CI = 1.35-2.72), women's education (OR = 1.90, 95%CI = 1.52-2.37), husband's education (OR = 1.49, 95%CI = 1.32-1.69) and planned pregnancy (OR = 2.08, 95%CI = 1.45-2.98). Based on narrative synthesis exposure to mass media, family income and accessibility of the service were strongly associated with utilization of antenatal care.ConclusionThe findings of this review found several modifiable factors such as empowering women through education and increasing their decision-making power, promoting family planning to prevent unplanned pregnancy, increasing awareness of women through mass media and making services more accessible would likely to increase utilization of antenatal care. Further research is needed on accessibility and availability of the service at the individual and community level to assess the predictors of antenatal care service utilization.
| S-EPMC6459485 | biostudies-literature
Project description:BACKGROUND:Globally, newborn death accounted for 46% of under-five deaths and more than 80% of newborn deaths are the result of preventable and treatable conditions. Findings on the prevalence and associated factors of essential newborn care utilization are highly variable and inconsistent across Ethiopia. Therefore, this systematic review and meta-analysis aimed to estimate the pooled prevalence of essential newborn care utilization and associated factors in Ethiopia. METHODS:The international databases accessed included MEDLINE/PubMed, EMBASE, Web of Sciences, Scopus, and Grey literature databases, Google Scholar, Science Direct and Cochrane library were scientifically explored. We considered all primary studies reporting the prevalence of essential newborn care utilization and associated factors in Ethiopia. We retrieved all necessary data by using a standardized data extraction format spreadsheet. STATA 14 statistical software was used to analyze the data and Cochrane Q test statistics and I2 test was used to assess the heterogeneity between the studies. There significant heterogeneity between the studies so a random effect model was employed. RESULTS:The pooled estimate of essential newborn care utilization from 11 studies in Ethiopia was 48.77% (95% CI: 27.89, 69.65). Residence [OR?=?2.50 (95% CI: 1.64, 3.88)], Postnatal care [OR?=?5.53, 95% CI?=?(3.02, 10.13], counseling during pregnancy and delivery [OR?=?4.39, 95% CI?=?(2.99, 6.45], antenatal care follows up (OR?=?6.84; 95% CI: 1.15, 4.70) and maternal educational status [OR?=?1.63 (95% CI: 1.12, 2.37)] were identified as associated factors of essential newborn care utilization. CONCLUSION:Based on the current study essential newborn care utilization in Ethiopia was significantly low in comparison with the current global recommendation on essential newborn care utilization. Place of residence, Postnatal care, counseling during pregnancy and delivery, antenatal care follow up, and maternal educational status were associated risk factors. Therefore, on the basis of the results, it is suggested that special attention should be given to attempts to ensure that education should focus on women during ante and postnatal follow-up, counseling during pregnancy and delivery, as well as rural and illiterate mothers. Finally, appropriate newborn services at health facilities and raising mother's level of awareness about newborn care practices are imperative in addressing the gaps in essential newborn care utilization in Ethiopia.
| S-EPMC7041192 | biostudies-literature
Project description:BackgroundThere is wide variation in the utilization of institutional delivery service in Ethiopia. Various socioeconomic and cultural factors affect the decision where to give birth. Although there has been a growing interest in the assessment of institutional delivery service utilization and its predictors, nationally representative evidence is scarce. This study was aimed to estimate the pooled national prevalence of institutional delivery service utilization and associated factors in Ethiopia.MethodsStudies were accessed through PubMed, Cochrane library, Web of Science, and Google Scholar. The funnel plot and Egger's regression test were used to see publication bias, and I-squared statistic was applied to check heterogeneity of studies. A weighted Dersimonian laired random effect model was applied to estimate the pooled national prevalence and the effect size of institutional delivery service utilization and associated factors.ResultTwenty four studies were included in this review. The pooled prevalence of institutional delivery service utilization was 31% (95% Confidence interval (CI): 30, 31.2%; I2 = 0.00%). Attitude towards institutional delivery (Adjusted Odd Ratio (AOR) = 2.83; 95% CI 1.35,5.92) in 3 studies, maternal age at first pregnancy (AOR = 3.59; 95% CI 2.27,5.69) in 4 studies, residence setting (AOR = 3.84; 95% CI 1.31, 11.25) in 7 studies, educational status (AOR = 2.91;95% 1.88,4.52) in 5 studies, availability of information source (AOR = 1.80;95% CI 1.16,2.78) in 6 studies, ANC follow-up (AOR = 2.57 95% CI 1.46,4.54) in 13 studies, frequency of ANC follow up (AOR = 4.04;95% CI 1.21,13.46) in 4 studies, knowledge on danger signs during pregnancy and benefits of institutional delivery (AOR = 3.04;95% CI 1.76,5.24) in 11 studies and place of birth of the elder child (AOR = 8.44;95% CI 5.75,12.39) in 4 studies were the significant predictors of institutional delivery service utilization.ConclusionThis review found that there are several modifiable factors such as empowering women through education; promoting antenatal care to prevent home delivery; increasing awareness of women through mass media and making services more accessible would likely increase utilization of institutional delivery.
| S-EPMC7296650 | biostudies-literature