Spousal communication, fertility preference and other factors affecting contraceptive use among married couples in Ekiti State, Nigeria

Objective:To assess and compare the relationship between spousal communication,fertility preference,and other factors with contraceptive use among married couples in Ekiti State,Nigeria.Methods:This cross-sectional study was carried out in AdoEkiti Local Government Area of Ekiti State,Nigeria between the 12th of August 2017 and the 15th of February 2018.A pre-tested,semi-structured interviewer-administered questionnaire was used to collect data from 976 respondents by a multi-stage sampling technique.Data were analyzed(univariate,bivariate,and binary logistic regression analysis)using SPSS version 24.0.Factors that showed statistical significance(P<0.05)were included in a binary logistic regression to determine significant predictors of contraceptive use.Results:The proportion of respondents currently using contraceptives was 56.9%.The education status of the respondents revealed that those with primary education were more likely to use contraceptives than those without formal education[adjusted odds ratio(aOR)8.4,95%confidence interval(CI)1.97-36.2,P<0.001].Respondents with fair spousal communication were more likely to use contraceptive than those with poor communication(aOR 4.9,95%CI 2.80-8.71,P<0.001).In addition,fertility preference of 4 or less children was found to be significantly associated with contraceptive use(aOR 3.0,95%CI 1.67-5.50,P<0.001)compared to a preference of more than 4 children.Finally,the urban respondents were more likely to use contraceptives than those in the rural setting(aOR 1.7,95%CI 1.16-2.41,P=0.047).Conclusions:Educational status,residential site,spousal communication,and fertility preference significantly influence the level of contraceptive use among married couples.Couples should endeavor to discuss more on issues bordering on their fertility preference and contraceptive issue.Government should formulate policies to improve the rural uptake of contraceptives using identified target interventions.

Characteristics of Contraceptive Use in So Paulo State,Brazil

Objective To know the characteristics of contraceptive use in Sao Paulo State collected by the Demographic and Health Survey （DHS） conducted in 1996. Methods Data of Sao Paulo in 1996 were analyzed compared with the previous DHS carried on in 1986focusing on Sao Paulo State. Contraceptive use among married or cohabiting women by age, number of children and schooling was closely examined. Age and timing of female sterilization were also analyzed. Results The results showed that unlike Brazil there was a stability of female sterilization in Sao Paulo State during 1986 and 1996. There was a pattern in Sao Paulo： up to 30 years old the pill was the most used contraceptive, after 30 there was a predominance of female sterilization, which increased with the number of children and decreased with schooling. The use of male methods had also increased in the 1986 and 1996 period, being greater in Sao Paulo than in Brazil. Sao Paulo also presented more diversity in the use of reversible contraceptives. Conclusions The predominant two contraceptive methods in Brazil and Sao Paulo changed from 1986 to 1996, i.e..from pill to female sterilization.

Meta-analysis of the risk factors of breast cancer concerning reproductive factors and oral contraceptive use

The authors performed a meta-analysis of case-control studies that addressed whether reproductive factors and oral contraceptive use were associated with breast cancer by searching the MEDLINE,PubMed,Proquest,Embase,ScienceDirect,African Healthline,BMJ Health Intelligence and Chinese Periodical net databases for all English-language and Chinese-language papers published from January 1,1997 to December 31,2007.A total of 15 studies calculating pool ORs indicated that menopausal age>50 yr[odds ratio(OR),1.39;95%confidence interval(CI),1.22–1.57]and oral contraceptive use(OR,2.12*,“*”:summary OR was adjusted;95%CI,1.24–3.62)were correlated with the increase in breast cancer risk while the summary OR based on number of full-term pregnancies≥1(OR,0.63*;95%CI,0.60–0.68)and breast-feeding(OR,0.76;95%CI,0.64–0.90)indicated no association with breast cancer risk.The correlation was statistically significant.Menopausal age>50 yr and oral contraceptive use are positively correlated with an increase in breast cancer risk while breast-feeding and number of full-term pregnancies≥1 are protective factors.

Ever Use of Modern Contraceptive among Adolescents in Uganda: A Cross-Sectional Survey of Sociodemographic Factors

Background: Six in ten sexually active adolescent women in Uganda have an unmet need for contraception yet there is limited data on what is driving its use. This study aimed to determine the associations between sociodemographic factors and modern contraceptive ever-use among adolescents in Uganda. Methods: A crossectional study was conducted among 337 adolescents aged 13 - 19 years who had ever had sex in Wakiso (urban) and Kamuli (rural) districts in Uganda. The outcome of interest was the ever-use of modern contraceptives. Generalized linear models with a Poisson link were used to examine the associations between sociodemographic factors and contraceptive ever use. Results: The weighted prevalence of ever-use of modern contraceptives was 30.9%. Contraceptive ever use was more likely among the older adolescents (adjusted Odds Ratio) aOR 1.31 (95% CI = 1.06 - 1.55), married aOR 1.67 (95% CI = 1.09 - 2.58) and the less educated were aOR 1.79 (95% CI = 1.14 - 2.83) compared to their counterparts. Adolescents living in the urban district (Wakiso) aOR 0.67 (95% CI = 0.49 - 0.92) were less likely to use modern contraceptives. In stratified analysis, the urban poor were more likely to use modern contraceptives (moderate aPR 0.35 95%CI (0.17 - 0.68) ** or high socioeconomic status aPR 0.62, 95%CI (0.28 - 1.37). Conclusions: The study shows low contraceptive ever-use among adolescents. Adolescents with low education and those from rural settings were more likely to ever-use modern contraceptives. Having good knowledge of contraception and discussing sex with parents promoted contraceptives ever-use. We recommend further studies assessing barriers to contraceptive use among adolescents in Uganda.

Retinal vein occlusion associated with combined hormonal contraceptive vaginal ring use

Dear Editor,We read with interest your recent article on the impact of combined oral contraceptives on ocular tissues.We report a case of a branch retinal vein occlusion（BRVO）associated with use of an etonogestrel/ethinyl estradiol vaginal ring（NuvaR ing）,an implantable combined hormonal contraceptive,in a young healthy female with no other identifiable risk factors.

Awareness and Factors Associated with Postpartum Modern Contraceptives Use among Women of Reproductive Age in Bukombe District, Geita Region

Introduction: Pregnancies that occur during the first year postpartum are more likely to be unplanned. This leads to an increased risk of adverse maternal and perinatal outcomes. However, modern contraceptive use during this period helps to reduce unplanned pregnancies and its associated adverse outcomes. There is scant data on postpartum contraceptives in pastoral communities in Tanzania. This study aimed to assess awareness and factors associated with postpartum modern contraceptives use among women of reproductive age in Bukombe District, Geita Region. Method: A community based cross-sectional study was conducted in a predominant pastoral community of Bukombe district in Geita region in north-western Tanzania from May-June 2018. A total of 511 postpartum women who were in their first year after child birth were studied. A multistage sampling technique was used to select study participants. Data analysis was performed using SPSS version 21. Multivariable logistic regression analysis was used to determine independent predictors of postpartum modern contraceptive use. Results: Most (97.3%) of the participants were aware about modern contraceptives. The prevalence of postpartum modern contraceptive use was 11.9%. The most frequent used contraceptive method was Implant 6.5%. Majority (75%) of women started to use the contraceptive at the first three months after delivery. Living in urban (AOR = 1.84, 95% CI: 1.20 - 3.79), business women’s (AOR = 2.34, 95% CI: 1.31 - 2.28), having last born aged 3 - 4 months (AOR = 3.30, 95% CI: 1.11 - 9.85) and menses resumption (AOR = 9.23, 95% CI: 3.60 - 23.72) were associated with postpartum modern contraceptive use. Fear of side effects, poor knowledge about contraceptives, husband restrictions, distance to health facility and availability of contraceptive were the barriers for use of contraceptive use. Conclusion: We found low uptake of postpartum modern contraceptive use in this population. Numerous factors were associated with modern contraceptive use. Therefore, health communication targeting this group is warranted to improve modern contraceptive uptake.

Induced abortion among married women in China:a study based on the 1997-2017 China Fertility Surveys

This study uses four sets of data from China Fertility Surveys completed during the years 1997-2017 to analyze the trend of induced abortion,with a focus on the twenty-first century.Married women of reproductive age who had a history of pregnancy during the 5 years prior to participating in a survey were the research object.The study also examines the variation of abortion proportions among different subgroups during different time periods,including an examination of the number and gender of children,place of residence,and contraceptive use of women who had induced abortions.The results show that the occurrence of induced abortion has decreased gradually,and that the risk of induced abortion was higher for those who had given birth to fewer children.However,induced abortion among women with two children has increased in recent years.It is noteworthy that induced abortions among childless premarital women have continued to increase in recent years,and that the sexual and reproductive health problems of adolescents remain of great concern.The occurrence of induced abortions after childbirth increased for those with one or two children,showing that the unmet need for contraception after childbirth should receive more attention.In addition,sex-selective abortion has been decreasing gradually,but still exists today.