Uptake and predictors of contraceptive use in Afghan women

Springer Science and Business Media LLC - 2015
Mohammad H Rasooly1, Mohamed M Ali2, Nick JW Brown3,4, Bashir Noormal1
1Afghanistan National Public Health Institute, Ministry of Public Health, Kabul, Afghanistan
2Eastern Mediterranean Regional Office, World Health Organization, Cairo, Egypt
3Aga Khan University, Karachi, Pakistan
4Salisbury District Hospital, Salisbury, UK

Tóm tắt

Afghanistan has one of the world’s highest fertility rates and, related to this, an infant mortality rate far higher than its South Asian neighbors. Contraception enhances family spacing, improves women’s safety in child birth and, as a result, reduces infant and child mortality. Until recently, there has been a paucity of information on the comparative rates of contraceptive practices in the country and socioeconomic correlates of uptake. We aimed to elucidate the factors influencing the use of contraception in Afghanistan using recent, robust national data. Using Afghanistan Mortality Survey (AMS) 2010 data, the distribution of Contraceptive Prevalence Rate (CPR) and correlates of contraceptive use among currently married women aged 15–49 years were explored. We initially summarised descriptive data on 25,743 married women and then derived predictors of the use of any form of contraception using a multiple logistic regression model. The prevalence of self-reported current use of any contraceptive method was 21.8% (95% CI: 20.4-23.4) at the national level though there was a wide variation in practice between provinces. Herat province in the West region had a highest contraceptive prevalence rate of 49.4% while Paktika in the Southeast region had the lowest CPR of 2%. Multiple logistic regression analysis showed that a family size of greater than 6 living children strongly predicted contraceptive use (AOR 7.4 (95% CI:6.1-9.0)). Other independent predictors included: secondary or high level of education (AOR 2.1 (95% CI: 1.8-2.5)) and being in the wealthiest stratum (OR 2.1 (95% CI 1.5-3.0)). Rural residence predicted a lower use of contraception (AOR, 0.72; 95% CI: 0.56-0.92). Contraceptive uptake rate was low overall with wide inter provincial variation. Strengthening female education, targeting married women in rural area and women with no education may enhance the effectiveness of National Family planning program in Afghanistan.

Từ khóa


Tài liệu tham khảo

Central Statistic Organization, population estimation, [http://cso.gov.af/en/page/demography-and-socile-statistics/demograph-statistics/3897]

Afghan Public Health Institute, Central Statistics Organization, ICF Macro, Indian Institute of Health Management Research & World Health Organization Regional Office for the Eastern Mediterranean, Afghanistan Mortality Survey 2010 [http://dhsprogram.com/publications/publication-fr248-other-final-reports.cfm]

Bartlett LA, Mawji S, Whitehead S, Crouse C, Dalil S, Ionete D, et al. Where giving birth is a forecast of death: maternal mortality in four districts of Afghanistan, 1999–2002. Lancet. 2005;365(9462):864–70. doi:10.1016/S0140-6736(05)71044-8.

Maurice J. WHO heads efforts to restore Afghanistan’s shattered health. Bull World Health Organ. 2001;79(12):1174.

Mayhew M, Hansen PM, Peters DH, Edward A, Singh LP, Dwivedi V, et al. Determinants of skilled birth attendant utilization in Afghanistan: a cross-sectional study. Am J Public Health. 2008;98(10):1849–56.

United Nation, Department of Economic and Social Affairs, World Population Prospects: The 2012 Revision, mortality data available at http://esa.un.org/unpd/wpp/Excel-Data/mortality.htm

United Nation, Department of Economic and Social Affairs, World Population Prospects: The 2012 Revision, Fertility data available at http://esa.un.org/unpd/wpp/Excel-Data/fertility.htm

The DHS program, Demographic and Health Survey, Survey Dataset Files, Afghanistan : Special, 2010 available at http://dhsprogram.com/data/dataset/Afghanistan_Special_2010.cfm?flag=0

Lasee A, McCormick JB. Demographic and socio-economic determinants of contraceptive use in a low income community of Karachi. JPMA. 1996;46:228.

Ali S, Rozi S, Mahmood MA. Prevalence and factors associated with practice of modern contraceptive methods among currently married women in district naushahro feroze. JPMA. 2004;54:461.

ICON-INSTITUTE. National risk and vulnerability assessment 2007/08: A profile of Afghanistan, main report. Cologne, 2009

Johns Hopkins University Bloomberg School of Public Health (JHUBSPH), & Indian Institute of Health Management Research (IIHMR). Afghanistan health survey: Estimates of priority health indicators. Kabul: Ministry of Public Health; 2006.

Central Statistics Organization & United Nations Children’s Fund, Afghanistan multiple indicator cluster survey 2010–2011: Final report. Kabul

Adebimpe Wasiu O, Asekun-Olarinmoye Esther O. A comparative study of contraceptive use among rural and urban women in osun state, Nigeria. Int J Trop Dis Health. 2012;2(3):214–24.

Janevic T, Sarah PW, Leyla I, Elizabeth BH. Individual and community level socioeconomic inequalities in contraceptive use in 10 Newly Independent States: a multilevel cross-sectional analysis. Int J Equity Health. 2012;11:69.

Adebowale SA, Adedini SA, Ibisomi LD, Palamuleni ME. Differential effect of wealth quintile on modern contraceptive use and fertility: evidence from Malawian women. BMC Women's Health. 2014;14:40.

Babalola S, Fatusi A Determinants of use of maternal health services in Nigeria - Looking beyond individual and household factors. BMC Pregnancy Childbirth 2009, 9(43).

Beekle AT, McCabe C. Awareness and determinants of family planning practice in Jimma, Ethiopia. Int Nurs Rev. 2006;53(4):269–76.

Fantahun M. Comparative study of the characteristics of family planning service users and non-users in northwest Ethiopia. Afr J Reprod Health. 2006;10(1):62–70.

Sueyoshi S, Al-Khozahe HO, Ohtsuka R. Effects of reproduction norms on contraception practice among Muslim women in Amman, Jordan. Eur J Contracept Reprod Health Care. 2006;11:138–45.

Al Riyami A, Afifi M, Mabry RM. Women’s autonomy, education and employment in Oman and their influence on contraceptive use. Reprod Health Matters. 2004;12:144–54.

Cindoglu D, Sirkeci I, Sirkeci RF. Determinants of choosing withdrawal over modern contraceptive methods in Turkeyو. Eur J Contracept Reprod Health Care. 2008;13:412–21.

Bangladesh Demographic and Health Survey: Contraception in Bangladesh: a review of 22 years of family planning and projection for the next 17 years. Dhaka 1998.

Koc I. Determinants of contraceptive use and method choice in Turkey. J Biosoc. 2000;32:329–42.

Thông tin
Thông tin xuất bản

Springer Science and Business Media LLC

Thông tin tác giả