Background: Long-acting and reversible contraceptive methods hold great potential as solutions to address the unmet need for contraception and the significant discontinuation rates, especially in sub-Saharan Africa. A...Background: Long-acting and reversible contraceptive methods hold great potential as solutions to address the unmet need for contraception and the significant discontinuation rates, especially in sub-Saharan Africa. Among these methods, the Implant has gained popularity in sub-Saharan Africa, whereas the utilization of Intrauterine Devices (IUDs) has remained comparatively low, particularly in Burkina Faso. This study aims to evaluate the shifts in IUD and Implant usage from 2010 to 2020 and to pinpoint the factors influencing the choice of IUDs among LARCs users in Burkina Faso. Data and Methods: We conducted an analysis using data from Burkina Faso, drawn from the 2010 Demographic and Health Survey (DHS) and the 2020 PMA Phase 1 data. The 2010 DHS garnered responses from 17,087 women aged 15 - 49, achieving a response rate of 98.4%. The 2020 PMA data collected responses from 6590 women aged 15 - 49, with a response rate of 95.8%. The final sample of Long-Acting Reversible Contraceptives (LARCs) users consisted of 1502 women, including 576 women from the 2010 survey and 926 women from the 2020 survey. Results: The study demonstrates an expansion of IUD usage to include socioeconomically disadvantaged segments among LARC users. However, higher levels of education, older age, and decisions influenced by healthcare providers are correlated with the preference for IUDs over Implants. The choice of IUDs is also connected to a comprehensive understanding of contraceptive methods, suggesting potential biases in the counseling process. Conclusion: Facilitating the broader adoption of IUDs among disadvantaged groups could be achieved by improving the accessibility of IUD products and services in rural areas. Nevertheless, there should be focused initiatives to enhance access to removal services, as this factor could dissuade specific users. Further efforts are required to train healthcare providers, aiming to mitigate biases in delivering Long-Acting Reversible Contraceptives (LARCs). Providers should provide impartial counseling, irrespective of the selected type of LARC.展开更多
Introduction: Breast feeding may pose a further challenge to uptake of contraception by possibly restricting use of certain methods for real or perceived risks of side effects. Methodology: A retrospective study was d...Introduction: Breast feeding may pose a further challenge to uptake of contraception by possibly restricting use of certain methods for real or perceived risks of side effects. Methodology: A retrospective study was done at the Barau Dikko Teaching Hospital, Kaduna. Available family planning clinic client cards from January 1<sup>st</sup>, 2000 to March 31<sup>st</sup>, 2014 were retrieved and information collected on demographics, reproductive and menstrual history, contraceptive choices and breast feeding status. Data were analyzed using the statistical package for social sciences (SPSS) version 15. Missing responses were stated and excluded from analysis. Chi square was used as a test of association with significance level established at p value, 0.05. Results: A total number of 5992 client cards were retrieved. All clients were female and married, and majority of clients aged between 25 - 34 years (53.1%), had either completed their secondary education or gone further (56%) and were Muslims (52.3%). Only 2924 women stated that they were currently breastfeeding (48.8%), 1828 women were not breastfeeding (30.5%) and 1240 women (20.7%) did not state their breastfeeding status. Younger and more educated women were more likely to be breastfeeding than older women and less educated ones (p < 0.05). Only 4636 cards (77%) had correctly filled data on the choice of contraceptives chosen by breastfeeding status with 2854 women breast feeding and 1302 (45.6%) chose injectable hormonal contraception, 888 (31.1%) chose intrauterine contraceptive devices, 484 (17%) chose oral contraceptive pills and 180 (6.3%) chose contraceptive implants. There was no record of condom use or use of permanent methods of contraception. Conclusion: Breastfeeding rates were high among women seeking contraception. The pattern of contraception is similar among both breastfeeding and non-breastfeeding women, with injectable contraception being the preferred choice. Awareness should be raised on the safety of a wider variety of contraception available for breastfeeding women.展开更多
<strong>Background:</strong> Contraceptive use reduces the need for abortion by preventing unwanted pregnancies, and the causes of maternal death worldwide. Contraceptive use helps women to plan their preg...<strong>Background:</strong> Contraceptive use reduces the need for abortion by preventing unwanted pregnancies, and the causes of maternal death worldwide. Contraceptive use helps women to plan their pregnancies and contributes for population growth. This study aims to analyze the attitudes and knowledge of the women attending Van Norma Clinic for the use of contraceptive methods. <strong>Methods:</strong> A cross-sectional study was used to analyze the information. A convenience sampling method has been used to select the 100 women who attended Van Norman Clinic in Family planning service in the period of the study of four months (April to July, 2020). A self-administered questionnaire with four parameters addressing importance of using contraceptive methods, the factors affecting the women’s attitudes for not using contraceptive methods, types of contraceptive methods currently used, advantages and disadvantages of using contraceptive methods was used to collect data. <strong>Results:</strong> Research findings show that the majority of respondents knew the importance of using contraceptive methods like preventing unwanted pregnancies (97%), spacing pregnancies (96%), planning pregnancies (92%), and getting well (70%). Two factors affecting women for not using contraceptive methods had been identified such as religion (73%) and fear (70%). In addition, the women attending Van Norman Clinic prefer using implants (99%) and injectable (99%). It is clear that women do not know the consequences related to the nonuse of contraceptive methods. Some recommendations have been made to the health care facilities, parents, women themselves, churches’ leaders and government in general. <strong>Conclusion:</strong> Factors which influence women’s attitudes for not using contraceptive methods were notified in our study such as religion (73.0%) and fear (70.0%) which was explained by the fact that in Burundi most people are catholic which is the most religion prohibiting the use of contraceptive methods. However, the participants’ knowledge was significantly good as their score was more than 50% for all variables.展开更多
Background: Family planning has clearly been a major public health success as evidenced by substantial fertility decline and reductions in maternal mortality in countries with high contraceptive prevalence rates. Nige...Background: Family planning has clearly been a major public health success as evidenced by substantial fertility decline and reductions in maternal mortality in countries with high contraceptive prevalence rates. Nigerian governments have continued to expand the scope and improve accessibility and availability of contraceptive commodities to improve uptake, giving the numerous benefits. Objective: To determine the trends in contraceptive usage and the preferred method among clients visiting the family planning clinic of University of Port Harcourt Teaching Hospital (UPTH), Nigeria. Method: It was a cross sectional study of all clients who accepted contraceptive methods at the UPTH, between 1st January 2000 and 31st December, 2015. Results: During the period, a total of 9190 clients accepted contraceptive methods, and 40,334 women were delivered in the maternity unit giving an acceptance rate of 1 in 4 deliveries or 22.8%. The acceptors of modern contraceptives increased steadily from 491 clients in 2001 to a peak in 2008 with 1477 clients and sharply declined to 381 in 2009 before increasing gradually again to 519 clients in 2015. The most commonly used method was the male condom by 3194 clients (37.9%), followed by injectables, which was accepted by 2185 clients (23.8%) while 1752 clients (19.1%) used the IUD. Implant contraceptive was used by 915 clients (9.9%), followed by oral contraceptive pills used by 547 (6.0%). Female sterilization was the least commonly used method by 302 clients (3.3%). There was no vasectomy over the 15 years period. Conclusion: Contraceptive trend in Port Harcourt has an ambivalent acceptance pattern. Although male condom and injectable contraceptives are the most commonly used method over time, the subdermal implants are increasingly becoming very popular in recent time. Female sterilization remains the least common method with no record of vasectomy.展开更多
Objectives: Determination of influence of direct interview of postpartum women about their awareness and knowledge regarding contraception and modern contraceptive methods. Patients & Methods: 1437 women joined th...Objectives: Determination of influence of direct interview of postpartum women about their awareness and knowledge regarding contraception and modern contraceptive methods. Patients & Methods: 1437 women joined the intervention and underwent evaluation of their knowledge about the concept and methods of contraception. Then, an interview was conducted with each woman to clarify advantages and appropriateness of various contraceptives and the proper time for initiation of contraception. All women were asked to discuss these data with their families and return to give their decision. Study outcomes included evaluation of women’s knowledge about contraception and its modalities, frequency of non-users who accepted to use contraception and is considered as success of the intervention and frequency of requesting each modality of contraception. Results: TV programs and discussion with local health provider, relatives or friends are the main sources of knowledge of primiparas. 182 primiparas had good knowledge and chose the appropriate method of contraception during the 1st session of discussion, and 81 primiparas required >2 sessions to choose the method appropriate for them, while 21 primiparas insisted not to use contraception for an acceptance rate of 92.6% among primipara. Among multiparas, 222 multiparas were non-users, but after discussion 133 couples accepted to use contraception. Thus, 396 non-users had accepted to use contraception for an intervention success rate of 78.3%. Collectively 692 women (52.1%) received IUD and 635 women (47.9%) received hormonal contraception;432 orally (32.6%) and 203 parenterally (15.3%). Conclusion: Ignorance, low financial status and cultural beliefs deleteriously affect knowledge about contraception options and its methods, so direct interview is mandatory. The applied intervention succeeded to replenish women’s knowledge about benefits of using contraception. Primiparas had knowledge about contraception but their knowledge about methods is deficient or hazy. Contraception using IUD is the most acceptable method especially for primiparas.展开更多
Introduction: Youth is the period of life when one usually experiences sexual relations for the first time. Lack of preparation and inexperience lead to unwanted pregnancies and sexually transmitted infections. The ai...Introduction: Youth is the period of life when one usually experiences sexual relations for the first time. Lack of preparation and inexperience lead to unwanted pregnancies and sexually transmitted infections. The aim was to study the knowledge, attitudes and practices of sexuality and modern contraceptive methods among young people in Cotonou. Method: This was a descriptive and prospective study that was conducted from August to September 2017 among young people living in Cotonou. Results: We had questioned 500 young people. The sex ratio was 0.6 with 267 girls (61.1%). 27.9% of young people surveyed do not know the fertility period. 76.2% of young people are sexually active and 39.8% have at least 2 sexual partners. Most of these young people had early sexual intercourse at an average age of 16.73 ± 2.85 years. Half of the boys have sex for pleasure and half of the girls have sex for love. 100% of young people know at least one STI, especially HIV/AIDS. Of the 15.10% of cases of reported pregnancy, 49.2% resulted in an abortion. 99% are aware of modern contraceptive methods for the prevention of pregnancy. But 53.7% are unaware that modern contraceptive methods prevent STIs. The main sources of information on contraception are the media and teachers. The main modern contraceptive method used is the condom in 73%. Young people surveyed do not use modern contraceptive methods in 57.5%. Conclusion: The practices of sexuality and modern contraceptive methods remain quite limited among young people. It is important to intensify information and awareness activities.展开更多
As in other countries of West Africa, Benin has a low rate of MCM utilization. The factors which lead to this low rate of use vary from one country to another. Purpose: The purpose of this work was to determine the fa...As in other countries of West Africa, Benin has a low rate of MCM utilization. The factors which lead to this low rate of use vary from one country to another. Purpose: The purpose of this work was to determine the factors associated with the use of modern contraceptive method (MCM) by women of childbearing age (WCBA) in Parakou in 2017. Materials and Methods: It was a cross-sectional and descriptive study with an analytical purpose among WCBA selected in households of the municipality of Parakou after a 2-degree cluster survey. Results: The WCBA’s average age was 29 ± 5.6 years old with extremes of 15 and 46 years. The modern contraceptive prevalence was 14.74%. Among WCBA, 57.14% had an average level of knowledge. The media were the main source of information (75.84%). Among them 34.39% never discussed the matter with their spouse;the latter were not in favor of contraception. The educational level, the perception of woman, the spouse’s favorable opinion, the discussion with the spouse, the level of knowledge of MCM and the knowledge of the existence of FP service were significantly associated with the use of MCM with p = 0.0000 after multivariate analysis. Conclusion: The level of MCM use still remains low. Any effort to increase the modern contraceptive prevalence should take into account its associated factors in order to optimize the use of MCM in the municipality of Parakou in 2017.展开更多
Background: Efforts have been made in Burkina Faso, a French-speaking country, since 2010 to improve healthcare access and provide affordable contraceptive methods to women. With the increasing prevalence of modern co...Background: Efforts have been made in Burkina Faso, a French-speaking country, since 2010 to improve healthcare access and provide affordable contraceptive methods to women. With the increasing prevalence of modern contraceptives in Burkina Faso, it is important to examine the socio-demographic factors that contribute to this new pattern of contraceptive use. This study aims to analyze the changes in socio-demographic factors associated with long-term contraceptive use and provide scientific evidence to guide policy development and action planning in family planning. Data and Methods: We utilized data from the 2010 Demographic and Health Survey, which included 17,087 women aged 15 - 49 years, and the 2015 Demographic and Health Module, which included 11,504 women in the same age group. For the analysis of contraceptive use, we focused on women who were in need of contraception (either met or unmet), of reproductive age, non-pregnant, and either married or sexually active but not married. We included users of modern reversible methods and excluded non-users, as well as users of traditional or permanent methods. Results: Our findings revealed a high prevalence of long-term contraceptive use across all categories;however, certain challenges were identified, such as lower levels of information about contraceptive methods among users and the persistence of inequalities. Family planning discussions and partner approval did not influence long-term contraceptive choice. Additionally, some providers selectively offered specific methods based on women’s life course characteristics, such as parity and marital status, despite evidence suggesting that young and nulliparous women can effectively use long-term methods. Conclusion: Given the high effectiveness of long-term contraceptive methods, it is crucial to address barriers that hinder their utilization among young and nulliparous women, as well as those who desire to delay pregnancy. Efforts should focus on improving knowledge and dispelling misconceptions surrounding long-term methods. Providers play a pivotal role in this process by adopting counseling strategies that enhance users’ understanding and facilitate informed decision-making regarding contraceptive options.展开更多
Introduction: Maternal mortality, which is estimated at 614 deaths per 100,000 births in Côte d’Ivoire, is associated with a low national contraceptive prevalence rate of 13.9%. In this study, we are interes...Introduction: Maternal mortality, which is estimated at 614 deaths per 100,000 births in Côte d’Ivoire, is associated with a low national contraceptive prevalence rate of 13.9%. In this study, we are interested in the contraceptive experiences of women who attend health centers to estimate their rate of contraceptive use and to assess the factors involved in the use of modern contraceptive methods among women of childbearing age who are exposed to the risk of pregnancy. Method: A descriptive cross-sectional study was conducted from December 2018 to September 2019 among 423 women, who attended two health centers in Abidjan. A bivariate analysis identified factors associated with contraceptive use by these women. A descriptive analysis determined the means for the quantitative variables and the frequencies and percentages of qualitative variables. Interpretation of results was based on significance (α = 5%, 95% CI). Results: Contraceptive prevalence was 37%. There was a significant relationship between contraceptive use and the socio-demographic and reproductive characteristics of women (p Conclusion: Women who were over 35 years age, uneducated, primary school graduates, housewives, unemployed, in the informal sector, Muslims, nulliparous, and lacking information and decision-making power were less likely to use modern contraceptive methods. They are the target population for strategic interventions to improve contraceptive prevalence.展开更多
Background: After a live birth, there is much unsatisfied interest in, and unmet family planning need for contraception. Waiting at least for 24 months before attempting the next pregnancy was recommended to reduce th...Background: After a live birth, there is much unsatisfied interest in, and unmet family planning need for contraception. Waiting at least for 24 months before attempting the next pregnancy was recommended to reduce the risk of adverse maternal, perinatal and infant outcomes. The purpose of this study was to assess the determinants of long acting reversible contraception method use among mothers in extended postpartum period in Durame Town, Southern Ethiopia. Methods: A community based cross sectional study was conducted in Durame Town, Southern Ethiopia in December, 2014. Systematic random sampling technique was employed to recruit a total 460 study participants. Structured and pretested questioner was used to collect the data. Descriptive statistics was employed to characterize the study population using frequencies and proportions. Bivariate logistic regression analysis was conducted to identify all possible factors affecting utilization of LARC method. Multivariable logistic regression model was developed to control the confounding variables. Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was computed in identifying the real factors associated with use of LARC methods. Results: In this study we found that the prevalence of LARC method use among mothers during their extended postpartum period was 36.7% (95%CI: 32.2, 41.0). The unmet family planning need of mothers in the extended postpartum period was 123 (27.9%). The odds of using LARC by literate mother were four fold higher than their counterpart illiterate mothers (AOR 4.09 95%CI: 1.68, 9.58, P value < 0.001). The odds of mother who had pervious experiences of using LARC were up to eight folds higher than mother never used LARC methods (AOR 7.84 95% CI: 3.78, 16.23, P value< 0.001). Mother who received counseling service on LARC methods during delivery was up to three times more likely to utilize the services than not counseled (AOR 3.29 95% CI: 1.53, 7.03, P value < 0.001). And odds of mothers who received counseling service on LARC during immediate postpartum period were up to five fold more likely to opt method than never got the counseling service (AOR 4.55 95 % CI: 1.94, 10.66, P value < 0.001). Conclusions: In the study area, about one third of mothers utilized LARC methods during their extended postpartum period. Another one third of mother had unmet need for family planning. Participant’s education, previous history of using LARC methods, receiving counseling services on LARC during delivery and immediate postpartum periods were found major determinant for LARC use. Educating women, providing counseling service on LARC methods during antenatal, delivery and postnatal were recommended.展开更多
Introduction: Maternal mortality is still very high in Benin. Being one of the methods of reducing this mortality, contraception is still very rarely used in Benin, particularly in Borgou district. The objective of th...Introduction: Maternal mortality is still very high in Benin. Being one of the methods of reducing this mortality, contraception is still very rarely used in Benin, particularly in Borgou district. The objective of this work was to evaluate the experience of using Jadelle contraceptive implants by women in the city of Parakou in the Borgou department. Methodology: This was a descriptive cross-sectional study, with retrospective and prospective data collection over the period from March 1 to July 31, 2016. Results: A total of 320 women were involved in the study. The mean age was 28.29 years, with extremes of 16 and 44 years. Socio-professionally, housewives predominated (56.88%). Sixty-eight point forty-four percent of women were educated and only 111 (34.69%) women had reached secondary school;married women were mostly represented. Obstetrically, multi-gestures were the most affected (43.75%). Birth spacing was the main reason for choosing Jadelle (48.13%). Majority of patients had their husbands consent to use Jadelle contraceptive method (85.31%). Sixty-eight point fifty-two percent of women had used this contraceptive method for 2 to 4 years. Jadelle had been chosen by the majority (78.75%) of the women, for its long duration of action and its easy use. The dropout rate for Jadelle was 35/320 (10.94%) after 3 years of use. The failure rate for this method was 0.31% (1/320). The satisfaction rate was 87.5%. Conclusion: Jadelle contraceptive implants are an important part of contraceptive methods in Parakou.展开更多
<strong>Introduction:</strong> Modern family planning methods (MFPM) prevent unwanted pregnancies, reduce fertility rate, and increase the interval between pregnancies. They prevent pregnancy by preventing...<strong>Introduction:</strong> Modern family planning methods (MFPM) prevent unwanted pregnancies, reduce fertility rate, and increase the interval between pregnancies. They prevent pregnancy by preventing fertilization or implantation of the fertilized ovum. MFPM include tubal ligation (TL), vasectomy, oral contraceptive pills, the intrauterine contraceptive device (IUCD), depot injections, sub-dermal implants, and male and female condoms. <strong>Objective: </strong>To determine the level of knowledge of modern family planning methods (MFPM) among women of reproductive age (18 - 49 years) at the Mathari North Health Center in Nairobi County, Kenya. <strong>Methods: </strong>The study conducted among women of reproductive age at Mathare North Health Center in Nairobi was a cross-sectional descriptive survey between March 2016 and November 2018. It provided both qualitative and quantitative data. The sample size comprised of 274 women of reproductive age,<em> i.e.</em> (18 - 49 years) attending antenatal and postnatal clinics at the facility. Those excluded were women below 18 years of age, as they could not give consent according to Kenyan Laws. The data were collected using an interviewer-administered structured questionnaire, which consisted of socio-demographic and characteristics, knowledge of modern family planning methods and distance from the facility. Likert scale was used to ensure that data was tabulated on daily basis and subjected to statistical manipulation using Statistical Package for Social Sciences (SPSS). <strong>Results:</strong> The four leading MFPM in use in order of acceptability were injectables, implants, intrauterine contraceptive device and pills in that order. 91% of respondents were aware or had heard about modern family planning methods. Level of education of mother and father were the two variables that influenced the uptake of MFPM with <em>p</em>-values of 0.0260 and 0.025, respectively. The study further found that knowledge of MFPM had a significant influence on their assimilation and utilization. All secondary variables considered in the research exhibit a substantial relationship concerning the use of MFPM. <strong>Conclusion:</strong> Communities around Mathari North Health Center need to be given information;education and counselling on MFPM to enable them make an informed decision and choice on their preferred method of family planning.展开更多
Introduction: Postpartum family planning is the prevention of pregnancies during the 12 months following childbirth. Few studies have been devoted to postpartum family planning in Mali. Our work will contribute to red...Introduction: Postpartum family planning is the prevention of pregnancies during the 12 months following childbirth. Few studies have been devoted to postpartum family planning in Mali. Our work will contribute to reducing unmet need for family planning. Objective: To study the use of contraceptive methods in the postpartum period in the obstetrics and gynecology unit of Timbuktu hospital. Materials and Methods: This was a descriptive and analytical cross-sectional study with prospective collection of data from January 1, 2022 to December 31, 2023. All women who gave birth having chosen and benefited from a contraceptive method were included. The statistical test used was the Fisher test with a significance threshold fixed at 5%. Results: The frequency of contraception in the postpartum period was 17.03%. The average age of clients was 26.14% with extremes of 14 and 45 years. They were paupiparous at 56.4% with an inter-birth interval of less than 12 months at 12.3%. More than half of the counseling (58.5%) was done during postnatal visits. The methods chosen were implants at 48.1%, injectable progestins at 21.3%, intrauterine device at 14.7%, miro-progestin pills at 13.5%, tubal ligation at 1 .4% and condoms at 1%. The regular follow-up rate was 51.1% of cases and 25.6% had no follow-up. Conclusion: The overall rate of postpartum family planning of 17.08% remains low. Improving FP staff skills will reduce unmet needs and contribute to increasing contraceptive prevalence in Timbuktu.展开更多
Objective The effectiveness and acceptability of Billings Ovulation Method (BOM) during breastfeeding were studied. At the same time, the monitoring indexes of fertility return were studied.Methods It was a clinical c...Objective The effectiveness and acceptability of Billings Ovulation Method (BOM) during breastfeeding were studied. At the same time, the monitoring indexes of fertility return were studied.Methods It was a clinical comparative study of BOM and IUD containing copper (200mm 2). The annual rate of pregnancy, discontinuation rate and continuation rate in the two groups was determined. The serum prolactin and estradiol in 90 breastfeeding mothers and urine estrogen and pregnanediol in different feeding mothers were measured.Results There were 219 subjects in the BOM group and 200 in the IUD group. The pregnancy rate in this two groups was 1. 43% and 1. 54% respectively. The rates of discontinuation and continuation in the IUD group were:8. 87% and 91. 35% as well as in the BOM group were 8. 53% and 90. 17% respectively. Neither result was statistically significant (P>0. 05). The experimtal research showed that menses return was well estimated by 0. 35 ratio of serum prolactin vs. estrodiol. Sensitivity and specificity was 94. 61% and 84. 61% respectively. It also indicated that (1) the levels of urine hormone were closely related to the patterns of cervical mucus and (2) the incidence of ovulating before the second return of menses in partially breastfeeding mothers was much lower than that of bottle-feeding mothers (47. 05% vs. 94. 20%). Conclusion BOM is a simple, reliable and well accepted contraceptive method of during breastfeeding. If it can be combined with the measurement of serum prolactin/ estradiol, the date of menses return will be determined more easily. Encouraging mothers to breast-feed will be beneficial to the health of both babies and mothers and delay the fertility return of mothers.展开更多
Unintended pregnancy is a global issue, with approximately 85,000,000 women around the world having unintended pregnancy annually. The contents of clinical application of women’s contraceptive methods are very wide, ...Unintended pregnancy is a global issue, with approximately 85,000,000 women around the world having unintended pregnancy annually. The contents of clinical application of women’s contraceptive methods are very wide, involving multiple areas. This consensus deeply discusses the specific contraceptive needs at different statuses, combined with gynecological diseases, postabortion contraception, and postpartum family planning, ensuring the correct use of contraceptive methods under the corresponding status. The top priority of the consensus is the specific contraception consensus section for women combined with gynecological diseases because medical treatment effect as well as side effects should be weighed carefully. The consensus is to make high-efficiency and individual contraceptive strategy for different groups based on multidisciplinary(gynecology, obstetrics, and family planning) and multidimensional aspects, which can provide uniform guidance for medical and health organizations under the condition as relevant global guidance or consensus is still lacking.展开更多
文摘Background: Long-acting and reversible contraceptive methods hold great potential as solutions to address the unmet need for contraception and the significant discontinuation rates, especially in sub-Saharan Africa. Among these methods, the Implant has gained popularity in sub-Saharan Africa, whereas the utilization of Intrauterine Devices (IUDs) has remained comparatively low, particularly in Burkina Faso. This study aims to evaluate the shifts in IUD and Implant usage from 2010 to 2020 and to pinpoint the factors influencing the choice of IUDs among LARCs users in Burkina Faso. Data and Methods: We conducted an analysis using data from Burkina Faso, drawn from the 2010 Demographic and Health Survey (DHS) and the 2020 PMA Phase 1 data. The 2010 DHS garnered responses from 17,087 women aged 15 - 49, achieving a response rate of 98.4%. The 2020 PMA data collected responses from 6590 women aged 15 - 49, with a response rate of 95.8%. The final sample of Long-Acting Reversible Contraceptives (LARCs) users consisted of 1502 women, including 576 women from the 2010 survey and 926 women from the 2020 survey. Results: The study demonstrates an expansion of IUD usage to include socioeconomically disadvantaged segments among LARC users. However, higher levels of education, older age, and decisions influenced by healthcare providers are correlated with the preference for IUDs over Implants. The choice of IUDs is also connected to a comprehensive understanding of contraceptive methods, suggesting potential biases in the counseling process. Conclusion: Facilitating the broader adoption of IUDs among disadvantaged groups could be achieved by improving the accessibility of IUD products and services in rural areas. Nevertheless, there should be focused initiatives to enhance access to removal services, as this factor could dissuade specific users. Further efforts are required to train healthcare providers, aiming to mitigate biases in delivering Long-Acting Reversible Contraceptives (LARCs). Providers should provide impartial counseling, irrespective of the selected type of LARC.
文摘Introduction: Breast feeding may pose a further challenge to uptake of contraception by possibly restricting use of certain methods for real or perceived risks of side effects. Methodology: A retrospective study was done at the Barau Dikko Teaching Hospital, Kaduna. Available family planning clinic client cards from January 1<sup>st</sup>, 2000 to March 31<sup>st</sup>, 2014 were retrieved and information collected on demographics, reproductive and menstrual history, contraceptive choices and breast feeding status. Data were analyzed using the statistical package for social sciences (SPSS) version 15. Missing responses were stated and excluded from analysis. Chi square was used as a test of association with significance level established at p value, 0.05. Results: A total number of 5992 client cards were retrieved. All clients were female and married, and majority of clients aged between 25 - 34 years (53.1%), had either completed their secondary education or gone further (56%) and were Muslims (52.3%). Only 2924 women stated that they were currently breastfeeding (48.8%), 1828 women were not breastfeeding (30.5%) and 1240 women (20.7%) did not state their breastfeeding status. Younger and more educated women were more likely to be breastfeeding than older women and less educated ones (p < 0.05). Only 4636 cards (77%) had correctly filled data on the choice of contraceptives chosen by breastfeeding status with 2854 women breast feeding and 1302 (45.6%) chose injectable hormonal contraception, 888 (31.1%) chose intrauterine contraceptive devices, 484 (17%) chose oral contraceptive pills and 180 (6.3%) chose contraceptive implants. There was no record of condom use or use of permanent methods of contraception. Conclusion: Breastfeeding rates were high among women seeking contraception. The pattern of contraception is similar among both breastfeeding and non-breastfeeding women, with injectable contraception being the preferred choice. Awareness should be raised on the safety of a wider variety of contraception available for breastfeeding women.
文摘<strong>Background:</strong> Contraceptive use reduces the need for abortion by preventing unwanted pregnancies, and the causes of maternal death worldwide. Contraceptive use helps women to plan their pregnancies and contributes for population growth. This study aims to analyze the attitudes and knowledge of the women attending Van Norma Clinic for the use of contraceptive methods. <strong>Methods:</strong> A cross-sectional study was used to analyze the information. A convenience sampling method has been used to select the 100 women who attended Van Norman Clinic in Family planning service in the period of the study of four months (April to July, 2020). A self-administered questionnaire with four parameters addressing importance of using contraceptive methods, the factors affecting the women’s attitudes for not using contraceptive methods, types of contraceptive methods currently used, advantages and disadvantages of using contraceptive methods was used to collect data. <strong>Results:</strong> Research findings show that the majority of respondents knew the importance of using contraceptive methods like preventing unwanted pregnancies (97%), spacing pregnancies (96%), planning pregnancies (92%), and getting well (70%). Two factors affecting women for not using contraceptive methods had been identified such as religion (73%) and fear (70%). In addition, the women attending Van Norman Clinic prefer using implants (99%) and injectable (99%). It is clear that women do not know the consequences related to the nonuse of contraceptive methods. Some recommendations have been made to the health care facilities, parents, women themselves, churches’ leaders and government in general. <strong>Conclusion:</strong> Factors which influence women’s attitudes for not using contraceptive methods were notified in our study such as religion (73.0%) and fear (70.0%) which was explained by the fact that in Burundi most people are catholic which is the most religion prohibiting the use of contraceptive methods. However, the participants’ knowledge was significantly good as their score was more than 50% for all variables.
文摘Background: Family planning has clearly been a major public health success as evidenced by substantial fertility decline and reductions in maternal mortality in countries with high contraceptive prevalence rates. Nigerian governments have continued to expand the scope and improve accessibility and availability of contraceptive commodities to improve uptake, giving the numerous benefits. Objective: To determine the trends in contraceptive usage and the preferred method among clients visiting the family planning clinic of University of Port Harcourt Teaching Hospital (UPTH), Nigeria. Method: It was a cross sectional study of all clients who accepted contraceptive methods at the UPTH, between 1st January 2000 and 31st December, 2015. Results: During the period, a total of 9190 clients accepted contraceptive methods, and 40,334 women were delivered in the maternity unit giving an acceptance rate of 1 in 4 deliveries or 22.8%. The acceptors of modern contraceptives increased steadily from 491 clients in 2001 to a peak in 2008 with 1477 clients and sharply declined to 381 in 2009 before increasing gradually again to 519 clients in 2015. The most commonly used method was the male condom by 3194 clients (37.9%), followed by injectables, which was accepted by 2185 clients (23.8%) while 1752 clients (19.1%) used the IUD. Implant contraceptive was used by 915 clients (9.9%), followed by oral contraceptive pills used by 547 (6.0%). Female sterilization was the least commonly used method by 302 clients (3.3%). There was no vasectomy over the 15 years period. Conclusion: Contraceptive trend in Port Harcourt has an ambivalent acceptance pattern. Although male condom and injectable contraceptives are the most commonly used method over time, the subdermal implants are increasingly becoming very popular in recent time. Female sterilization remains the least common method with no record of vasectomy.
文摘Objectives: Determination of influence of direct interview of postpartum women about their awareness and knowledge regarding contraception and modern contraceptive methods. Patients & Methods: 1437 women joined the intervention and underwent evaluation of their knowledge about the concept and methods of contraception. Then, an interview was conducted with each woman to clarify advantages and appropriateness of various contraceptives and the proper time for initiation of contraception. All women were asked to discuss these data with their families and return to give their decision. Study outcomes included evaluation of women’s knowledge about contraception and its modalities, frequency of non-users who accepted to use contraception and is considered as success of the intervention and frequency of requesting each modality of contraception. Results: TV programs and discussion with local health provider, relatives or friends are the main sources of knowledge of primiparas. 182 primiparas had good knowledge and chose the appropriate method of contraception during the 1st session of discussion, and 81 primiparas required >2 sessions to choose the method appropriate for them, while 21 primiparas insisted not to use contraception for an acceptance rate of 92.6% among primipara. Among multiparas, 222 multiparas were non-users, but after discussion 133 couples accepted to use contraception. Thus, 396 non-users had accepted to use contraception for an intervention success rate of 78.3%. Collectively 692 women (52.1%) received IUD and 635 women (47.9%) received hormonal contraception;432 orally (32.6%) and 203 parenterally (15.3%). Conclusion: Ignorance, low financial status and cultural beliefs deleteriously affect knowledge about contraception options and its methods, so direct interview is mandatory. The applied intervention succeeded to replenish women’s knowledge about benefits of using contraception. Primiparas had knowledge about contraception but their knowledge about methods is deficient or hazy. Contraception using IUD is the most acceptable method especially for primiparas.
文摘Introduction: Youth is the period of life when one usually experiences sexual relations for the first time. Lack of preparation and inexperience lead to unwanted pregnancies and sexually transmitted infections. The aim was to study the knowledge, attitudes and practices of sexuality and modern contraceptive methods among young people in Cotonou. Method: This was a descriptive and prospective study that was conducted from August to September 2017 among young people living in Cotonou. Results: We had questioned 500 young people. The sex ratio was 0.6 with 267 girls (61.1%). 27.9% of young people surveyed do not know the fertility period. 76.2% of young people are sexually active and 39.8% have at least 2 sexual partners. Most of these young people had early sexual intercourse at an average age of 16.73 ± 2.85 years. Half of the boys have sex for pleasure and half of the girls have sex for love. 100% of young people know at least one STI, especially HIV/AIDS. Of the 15.10% of cases of reported pregnancy, 49.2% resulted in an abortion. 99% are aware of modern contraceptive methods for the prevention of pregnancy. But 53.7% are unaware that modern contraceptive methods prevent STIs. The main sources of information on contraception are the media and teachers. The main modern contraceptive method used is the condom in 73%. Young people surveyed do not use modern contraceptive methods in 57.5%. Conclusion: The practices of sexuality and modern contraceptive methods remain quite limited among young people. It is important to intensify information and awareness activities.
文摘As in other countries of West Africa, Benin has a low rate of MCM utilization. The factors which lead to this low rate of use vary from one country to another. Purpose: The purpose of this work was to determine the factors associated with the use of modern contraceptive method (MCM) by women of childbearing age (WCBA) in Parakou in 2017. Materials and Methods: It was a cross-sectional and descriptive study with an analytical purpose among WCBA selected in households of the municipality of Parakou after a 2-degree cluster survey. Results: The WCBA’s average age was 29 ± 5.6 years old with extremes of 15 and 46 years. The modern contraceptive prevalence was 14.74%. Among WCBA, 57.14% had an average level of knowledge. The media were the main source of information (75.84%). Among them 34.39% never discussed the matter with their spouse;the latter were not in favor of contraception. The educational level, the perception of woman, the spouse’s favorable opinion, the discussion with the spouse, the level of knowledge of MCM and the knowledge of the existence of FP service were significantly associated with the use of MCM with p = 0.0000 after multivariate analysis. Conclusion: The level of MCM use still remains low. Any effort to increase the modern contraceptive prevalence should take into account its associated factors in order to optimize the use of MCM in the municipality of Parakou in 2017.
文摘Background: Efforts have been made in Burkina Faso, a French-speaking country, since 2010 to improve healthcare access and provide affordable contraceptive methods to women. With the increasing prevalence of modern contraceptives in Burkina Faso, it is important to examine the socio-demographic factors that contribute to this new pattern of contraceptive use. This study aims to analyze the changes in socio-demographic factors associated with long-term contraceptive use and provide scientific evidence to guide policy development and action planning in family planning. Data and Methods: We utilized data from the 2010 Demographic and Health Survey, which included 17,087 women aged 15 - 49 years, and the 2015 Demographic and Health Module, which included 11,504 women in the same age group. For the analysis of contraceptive use, we focused on women who were in need of contraception (either met or unmet), of reproductive age, non-pregnant, and either married or sexually active but not married. We included users of modern reversible methods and excluded non-users, as well as users of traditional or permanent methods. Results: Our findings revealed a high prevalence of long-term contraceptive use across all categories;however, certain challenges were identified, such as lower levels of information about contraceptive methods among users and the persistence of inequalities. Family planning discussions and partner approval did not influence long-term contraceptive choice. Additionally, some providers selectively offered specific methods based on women’s life course characteristics, such as parity and marital status, despite evidence suggesting that young and nulliparous women can effectively use long-term methods. Conclusion: Given the high effectiveness of long-term contraceptive methods, it is crucial to address barriers that hinder their utilization among young and nulliparous women, as well as those who desire to delay pregnancy. Efforts should focus on improving knowledge and dispelling misconceptions surrounding long-term methods. Providers play a pivotal role in this process by adopting counseling strategies that enhance users’ understanding and facilitate informed decision-making regarding contraceptive options.
文摘Introduction: Maternal mortality, which is estimated at 614 deaths per 100,000 births in Côte d’Ivoire, is associated with a low national contraceptive prevalence rate of 13.9%. In this study, we are interested in the contraceptive experiences of women who attend health centers to estimate their rate of contraceptive use and to assess the factors involved in the use of modern contraceptive methods among women of childbearing age who are exposed to the risk of pregnancy. Method: A descriptive cross-sectional study was conducted from December 2018 to September 2019 among 423 women, who attended two health centers in Abidjan. A bivariate analysis identified factors associated with contraceptive use by these women. A descriptive analysis determined the means for the quantitative variables and the frequencies and percentages of qualitative variables. Interpretation of results was based on significance (α = 5%, 95% CI). Results: Contraceptive prevalence was 37%. There was a significant relationship between contraceptive use and the socio-demographic and reproductive characteristics of women (p Conclusion: Women who were over 35 years age, uneducated, primary school graduates, housewives, unemployed, in the informal sector, Muslims, nulliparous, and lacking information and decision-making power were less likely to use modern contraceptive methods. They are the target population for strategic interventions to improve contraceptive prevalence.
文摘Background: After a live birth, there is much unsatisfied interest in, and unmet family planning need for contraception. Waiting at least for 24 months before attempting the next pregnancy was recommended to reduce the risk of adverse maternal, perinatal and infant outcomes. The purpose of this study was to assess the determinants of long acting reversible contraception method use among mothers in extended postpartum period in Durame Town, Southern Ethiopia. Methods: A community based cross sectional study was conducted in Durame Town, Southern Ethiopia in December, 2014. Systematic random sampling technique was employed to recruit a total 460 study participants. Structured and pretested questioner was used to collect the data. Descriptive statistics was employed to characterize the study population using frequencies and proportions. Bivariate logistic regression analysis was conducted to identify all possible factors affecting utilization of LARC method. Multivariable logistic regression model was developed to control the confounding variables. Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was computed in identifying the real factors associated with use of LARC methods. Results: In this study we found that the prevalence of LARC method use among mothers during their extended postpartum period was 36.7% (95%CI: 32.2, 41.0). The unmet family planning need of mothers in the extended postpartum period was 123 (27.9%). The odds of using LARC by literate mother were four fold higher than their counterpart illiterate mothers (AOR 4.09 95%CI: 1.68, 9.58, P value < 0.001). The odds of mother who had pervious experiences of using LARC were up to eight folds higher than mother never used LARC methods (AOR 7.84 95% CI: 3.78, 16.23, P value< 0.001). Mother who received counseling service on LARC methods during delivery was up to three times more likely to utilize the services than not counseled (AOR 3.29 95% CI: 1.53, 7.03, P value < 0.001). And odds of mothers who received counseling service on LARC during immediate postpartum period were up to five fold more likely to opt method than never got the counseling service (AOR 4.55 95 % CI: 1.94, 10.66, P value < 0.001). Conclusions: In the study area, about one third of mothers utilized LARC methods during their extended postpartum period. Another one third of mother had unmet need for family planning. Participant’s education, previous history of using LARC methods, receiving counseling services on LARC during delivery and immediate postpartum periods were found major determinant for LARC use. Educating women, providing counseling service on LARC methods during antenatal, delivery and postnatal were recommended.
文摘Introduction: Maternal mortality is still very high in Benin. Being one of the methods of reducing this mortality, contraception is still very rarely used in Benin, particularly in Borgou district. The objective of this work was to evaluate the experience of using Jadelle contraceptive implants by women in the city of Parakou in the Borgou department. Methodology: This was a descriptive cross-sectional study, with retrospective and prospective data collection over the period from March 1 to July 31, 2016. Results: A total of 320 women were involved in the study. The mean age was 28.29 years, with extremes of 16 and 44 years. Socio-professionally, housewives predominated (56.88%). Sixty-eight point forty-four percent of women were educated and only 111 (34.69%) women had reached secondary school;married women were mostly represented. Obstetrically, multi-gestures were the most affected (43.75%). Birth spacing was the main reason for choosing Jadelle (48.13%). Majority of patients had their husbands consent to use Jadelle contraceptive method (85.31%). Sixty-eight point fifty-two percent of women had used this contraceptive method for 2 to 4 years. Jadelle had been chosen by the majority (78.75%) of the women, for its long duration of action and its easy use. The dropout rate for Jadelle was 35/320 (10.94%) after 3 years of use. The failure rate for this method was 0.31% (1/320). The satisfaction rate was 87.5%. Conclusion: Jadelle contraceptive implants are an important part of contraceptive methods in Parakou.
文摘<strong>Introduction:</strong> Modern family planning methods (MFPM) prevent unwanted pregnancies, reduce fertility rate, and increase the interval between pregnancies. They prevent pregnancy by preventing fertilization or implantation of the fertilized ovum. MFPM include tubal ligation (TL), vasectomy, oral contraceptive pills, the intrauterine contraceptive device (IUCD), depot injections, sub-dermal implants, and male and female condoms. <strong>Objective: </strong>To determine the level of knowledge of modern family planning methods (MFPM) among women of reproductive age (18 - 49 years) at the Mathari North Health Center in Nairobi County, Kenya. <strong>Methods: </strong>The study conducted among women of reproductive age at Mathare North Health Center in Nairobi was a cross-sectional descriptive survey between March 2016 and November 2018. It provided both qualitative and quantitative data. The sample size comprised of 274 women of reproductive age,<em> i.e.</em> (18 - 49 years) attending antenatal and postnatal clinics at the facility. Those excluded were women below 18 years of age, as they could not give consent according to Kenyan Laws. The data were collected using an interviewer-administered structured questionnaire, which consisted of socio-demographic and characteristics, knowledge of modern family planning methods and distance from the facility. Likert scale was used to ensure that data was tabulated on daily basis and subjected to statistical manipulation using Statistical Package for Social Sciences (SPSS). <strong>Results:</strong> The four leading MFPM in use in order of acceptability were injectables, implants, intrauterine contraceptive device and pills in that order. 91% of respondents were aware or had heard about modern family planning methods. Level of education of mother and father were the two variables that influenced the uptake of MFPM with <em>p</em>-values of 0.0260 and 0.025, respectively. The study further found that knowledge of MFPM had a significant influence on their assimilation and utilization. All secondary variables considered in the research exhibit a substantial relationship concerning the use of MFPM. <strong>Conclusion:</strong> Communities around Mathari North Health Center need to be given information;education and counselling on MFPM to enable them make an informed decision and choice on their preferred method of family planning.
文摘Introduction: Postpartum family planning is the prevention of pregnancies during the 12 months following childbirth. Few studies have been devoted to postpartum family planning in Mali. Our work will contribute to reducing unmet need for family planning. Objective: To study the use of contraceptive methods in the postpartum period in the obstetrics and gynecology unit of Timbuktu hospital. Materials and Methods: This was a descriptive and analytical cross-sectional study with prospective collection of data from January 1, 2022 to December 31, 2023. All women who gave birth having chosen and benefited from a contraceptive method were included. The statistical test used was the Fisher test with a significance threshold fixed at 5%. Results: The frequency of contraception in the postpartum period was 17.03%. The average age of clients was 26.14% with extremes of 14 and 45 years. They were paupiparous at 56.4% with an inter-birth interval of less than 12 months at 12.3%. More than half of the counseling (58.5%) was done during postnatal visits. The methods chosen were implants at 48.1%, injectable progestins at 21.3%, intrauterine device at 14.7%, miro-progestin pills at 13.5%, tubal ligation at 1 .4% and condoms at 1%. The regular follow-up rate was 51.1% of cases and 25.6% had no follow-up. Conclusion: The overall rate of postpartum family planning of 17.08% remains low. Improving FP staff skills will reduce unmet needs and contribute to increasing contraceptive prevalence in Timbuktu.
基金The project was funded by Shanghai Municipal Science & Technology Commission
文摘Objective The effectiveness and acceptability of Billings Ovulation Method (BOM) during breastfeeding were studied. At the same time, the monitoring indexes of fertility return were studied.Methods It was a clinical comparative study of BOM and IUD containing copper (200mm 2). The annual rate of pregnancy, discontinuation rate and continuation rate in the two groups was determined. The serum prolactin and estradiol in 90 breastfeeding mothers and urine estrogen and pregnanediol in different feeding mothers were measured.Results There were 219 subjects in the BOM group and 200 in the IUD group. The pregnancy rate in this two groups was 1. 43% and 1. 54% respectively. The rates of discontinuation and continuation in the IUD group were:8. 87% and 91. 35% as well as in the BOM group were 8. 53% and 90. 17% respectively. Neither result was statistically significant (P>0. 05). The experimtal research showed that menses return was well estimated by 0. 35 ratio of serum prolactin vs. estrodiol. Sensitivity and specificity was 94. 61% and 84. 61% respectively. It also indicated that (1) the levels of urine hormone were closely related to the patterns of cervical mucus and (2) the incidence of ovulating before the second return of menses in partially breastfeeding mothers was much lower than that of bottle-feeding mothers (47. 05% vs. 94. 20%). Conclusion BOM is a simple, reliable and well accepted contraceptive method of during breastfeeding. If it can be combined with the measurement of serum prolactin/ estradiol, the date of menses return will be determined more easily. Encouraging mothers to breast-feed will be beneficial to the health of both babies and mothers and delay the fertility return of mothers.
文摘Unintended pregnancy is a global issue, with approximately 85,000,000 women around the world having unintended pregnancy annually. The contents of clinical application of women’s contraceptive methods are very wide, involving multiple areas. This consensus deeply discusses the specific contraceptive needs at different statuses, combined with gynecological diseases, postabortion contraception, and postpartum family planning, ensuring the correct use of contraceptive methods under the corresponding status. The top priority of the consensus is the specific contraception consensus section for women combined with gynecological diseases because medical treatment effect as well as side effects should be weighed carefully. The consensus is to make high-efficiency and individual contraceptive strategy for different groups based on multidisciplinary(gynecology, obstetrics, and family planning) and multidimensional aspects, which can provide uniform guidance for medical and health organizations under the condition as relevant global guidance or consensus is still lacking.