Factors associated with contraceptive use among young women in Malawi: analysis of the 2015–16 Malawi demographic and health survey data

Contraception and Reproductive Medicine - Tập 3 - Trang 1-8 - 2018
Chrispin Mandiwa1,2, Bernadetta Namondwe3, Andrew Makwinja4, Collins Zamawe5
1Ministry of Health, South–West Zone Health Support Office, Blantyre, Malawi
2Malawi Health Sector Programme (DFID Project), Lilongwe, Malawi
3University of Malawi, Kamuzu College of Nursing, Lilongwe, Malawi
4University of Malawi, College of Medicine, Blantyre, Malawi
5University College London, Institute for Global Health, London, UK

Tóm tắt

Although Malawi is one of the countries with highest Contraceptive Prevalence Rate (CPR) in Sub–Saharan Africa, pregnancies and fertility among young women remain high. This suggests low up take of contraceptives by young women. The aim of this study was to investigate the factors associated with contraceptive use among young women in Malawi. This is a secondary analysis of household data for 10,422 young women aged 15–24 years collected during the 2015–16 Malawi Demographic and Health Survey (MDHS). The sample was weighted to ensure representativeness. Descriptive statistics, bivariate and multivariate logistic regressions were performed to assess the demographic, social – economic and other factors that influence contraceptive use among young women. Crude Odds Ratio (COR) and Adjusted Odds Ratio (AOR) with their corresponding 95% confidence intervals (95% CI) were computed using the Statistical Package for the Social Sciences version 22.0. Of the 10,422 young women, 3219 used contraception representing a prevalence of 30.9%. The findings indicate that age, region of residence, marital status, education, religion, work status, a visit to health facility, and knowledge of the ovulatory cycle are significant predictors of contraceptive use among young women in Malawi. Women who were in the age group 20–24 years (AOR = 1.93; 95% CI = 1.73–2.16), working (AOR = 1.26; 95% CI = 1.14–1.39), currently married (AOR = 6.26; 95% CI = 5.46–7.18), knowledgeable about their ovulatory cycle (AOR = 1.75; 95% CI = 1.50–2.05), and those with primary education (AOR = 1.47; 95% CI = 1.18–1.83) were more likely to use contraceptives than their counterparts. This study has demonstrated that several social demographic and economic factors are associated with contraceptive use among young women in Malawi. These findings should be considered and reflected in public health policies to address issues that could be barriers to the use of contraception by young women. Strengthening access to family planning information and services for young women is highly recommended to reduce pregnancies among young women in Malawi.

Tài liệu tham khảo

Simwaka BN, Theobald S, Amekudzi YP, Tolhurst R. Meeting millenium development goals 3 and 5: gender equality needs to be put on the African agenda. Brit Med J. 2005;331(7519):708–9.

ICF NSONMa. Malawi demographic and health survey 2015–16. Zomba and Rockville: NSO and ICF; 2017.

Ganchimeg T, Ota E, Morisaki N, Laopaiboon M, Lumbiganon P, Zhang J, et al. Pregnancy and childbirth outcomes among adolescent mothers: a World Health Organization multicountry study. BJOG. 2014;121(Suppl 1):40–8. https://doi.org/10.1111/1471-0528.12630.

Olson RM, Kamurari S. Barriers to safe abortion access: uterine rupture as complication of unsafe abortion in a Ugandan girl. BMJ Case Rep. 2017;2017 https://doi.org/10.1136/bcr-2017-222360.

Vallely LM, Homiehombo P, Kelly-Hanku A, Whittaker A. Unsafe abortion requiring hospital admission in the Eastern Highlands of Papua New Guinea--a descriptive study of women's and health care workers’ experiences. Reprod Health. 2015;12:22. https://doi.org/10.1186/s12978-015-0015-x.

Abbasi S, Chuang CH, Dagher R, Zhu J, Kjerulff K. Unintended pregnancy and postpartum depression among first-time mothers. J Women's Health (2002). 2013;22(5):412–6. https://doi.org/10.1089/jwh.2012.3926.

Ahmed S, Li Q, Liu L, Tsui AO. Maternal deaths averted by contraceptive use: an analysis of 172 countries. Lancet. 2012;380(9837):111–25. https://doi.org/10.1016/s0140-6736(12)60478-4.

Ganatra B, Faundes A. Role of birth spacing, family planning services, safe abortion services and post-abortion care in reducing maternal mortality. Best Pract Res Clin Obstet Gynaecol. 2016;36:145–55. https://doi.org/10.1016/j.bpobgyn.2016.07.008.

Cleland J, Conde-Agudelo A, Peterson H, Ross J, Tsui A: Contraception and health. Lancet. 2012;380(9837):149–56.

Canning D, Schultz TP. The economic consequences of reproductive health and family planning. Lancet. 2012;380(9837):165–71.

Diamond-Smith N, Potts M. A woman cannot die from a pregnancy she does not have. Int Perspect Sex Reprod Health. 2011;37(3):155–7.

Stover J, Ross J. How increased contraceptive use has reduced maternal mortality. Matern Child Health J. 2010;14(5):687–95.

Palamuleni ME. Socio-economic and demographic factors affecting contraceptive use in Malawi. Afr J Reprod Health. 2013;17(3):91–104.

Lakew Y, Reda AA, Tamene H, Benedict S, Deribe K. Geographical variation and factors influencing modern contraceptive use among married women in Ethiopia: evidence from a national population based survey. Reprod Health. 2013;10(1):52.

Medhanyie AA, Desta A, Alemayehu M, Gebrehiwot T, Abraha TA, Abrha A, et al. Factors associated with contraceptive use in Tigray, North Ethiopia. Reprod Health. 2017;14(1):27.

Sun G-W, Shook TL, Kay GL. Inappropriate use of bivariable analysis to screen risk factors for use in multivariable analysis. J Clin Epidemiol. 1996;49(8):907–16.

Binu W, Marama T, Gerbaba M, Sinaga M. Sexual and reproductive health services utilization and associated factors among secondary school students in Nekemte town, Ethiopia. Reprod Health. 2018;15(1):64. https://doi.org/10.1186/s12978-018-0501-z.

Tamang L, Raynes-Greenow C, McGeechan K, Black K. Factors associated with contraceptive use among sexually active Nepalese youths in the Kathmandu Valley. Contracept Reprod Med. 2017;2:13. https://doi.org/10.1186/s40834-017-0040-y.

Asiimwe JB, Ndugga P, Mushomi J, Manyenye Ntozi JP. Factors associated with modern contraceptive use among young and older women in Uganda; a comparative analysis. BMC Public Health. 2014;14:926. https://doi.org/10.1186/1471-2458-14-926.

Alemayehu T, Haider J, Habte D. Determinants of adolescent fertility in Ethiopia. Ethiop J Health Dev. 2010;24(1):e3086.

White JS, Speizer IS. Can family planning outreach bridge the urban-rural divide in Zambia? BMC Health Serv Res. 2007;7(1):143.

Pradhan R, Wynter K, Fisher J. Factors associated with pregnancy among adolescents in low-income and lower middle-income countries: a systematic review. J Epidemiol Community Health. 2015;69(9):918–24.

Abiiro GA, Mbera GB, De Allegri M. Gaps in universal health coverage in Malawi: a qualitative study in rural communities. BMC Health Serv Res. 2014;14(1):234.

Tekelab T, Melka AS, Wirtu D. Predictors of modern contraceptive methods use among married women of reproductive age groups in western Ethiopia: a community based cross-sectional study. BMC Womens Health. 2015;15:52. https://doi.org/10.1186/s12905-015-0208-z.

Mekonnen W, Worku A. Determinants of low family planning use and high unmet need in Butajira District, south Central Ethiopia. Reprod Health. 2011;8:37. https://doi.org/10.1186/1742-4755-8-37.

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. https://doi.org/10.1186/1471-2393-9-43.

Adanu RM, Seffah JD, Hill AG, Darko R, Duda RB, Anarfi JK. Contraceptive use by women in Accra, Ghana: results from the 2003 Accra Women's Health Survey. Afr J Reprod Health. 2009;13(1):123–33.

Nketiah-Amponsah E, Arthur E, Aaron A. Correlates of contraceptive use among Ghanaian women of reproductive age (15-49 years). Afr J Reprod Health. 2012;16(3):155–70.

Nyarko SH. Prevalence and correlates of contraceptive use among female adolescents in Ghana. BMC Womens Health. 2015;15(1):60.

Jalang'o R, Thuita F, Barasa SO, Njoroge P. Determinants of contraceptive use among postpartum women in a county hospital in rural KENYA. BMC Public Health. 2017;17(1):604. https://doi.org/10.1186/s12889-017-4510-6.

Wuni C, Turpin CA, Dassah ET. Determinants of contraceptive use and future contraceptive intentions of women attending child welfare clinics in urban Ghana. BMC Public Health. 2017;18(1):79. https://doi.org/10.1186/s12889-017-4641-9.

Ebrahim NB, Atteraya MS. Structural correlates of modern contraceptive use among Ethiopian women. Health Care Women Int. 2018;39(2):208–19. https://doi.org/10.1080/07399332.2017.1383993.

Lee JK, Parisi SM, Akers AY, Borrerro S, Schwarz EB. The impact of contraceptive counseling in primary care on contraceptive use. J Gen Intern Med. 2011;26(7):731–6.

Kanwal Aslam S, Zaheer S, Qureshi MS, Aslam SN, Shafique K. Socio-economic disparities in use of family planning methods among Pakistani women: findings from Pakistan demographic and health surveys. PLoS One. 2016;11(4):e0153313. https://doi.org/10.1371/journal.pone.0153313.

Mekonnen FA, Mekonnen WN, Beshah SH. Predictors of long acting and permanent contraceptive methods utilization among women in Rural North Shoa, Ethiopia. Contracept Reprod Med. 2017;2:22. https://doi.org/10.1186/s40834-017-0049-2.

Rasooly MH, Ali MM, Brown NJ, Noormal B. Uptake and predictors of contraceptive use in Afghan women. BMC Womens Health. 2015;15:9. https://doi.org/10.1186/s12905-015-0173-6.

Thông tin
Thông tin xuất bản

Contraception and Reproductive Medicine

Tập 3

1-8

Thông tin tác giả