Factors associated with contraceptive practices of married women in Bangladesh with respect to their employment status

Objective?There might be a difference between non-working and working women in their perception of rights and privileges which may influence their contraceptive behavior. The purpose of this study was to examine contraceptive behavior among non-working and working women in Bangladesh determining associated factors.

Method?Analysis was based on data from the 1999–2000 Bangladesh Demographic and Health Survey which employs nationally representative sample.

Results?The prevalence of current contraceptive use (any method) was 58.2% among non-working women and 65.5% among working women. Both rates are still low for the country. Some factors, such as discussed family planning with husband, husband approves family planning, desire for more children, and husband lives together, were influential determinants of lower contraceptive prevalence among the non-working women.

Conclusion?The results indicate a necessity for social activities promoting husband–wife communication and women's participation in employment to enhance the use of contraceptives among Bangladeshi women, especially non-working women.     

Bangladesh: modern methods are well known but not widely used

A follow-up to the 1985 Contraceptive Prevalence Survey, this 1988 study of contraceptive use in Bangladesh revealed that although modern methods are well-know, contraceptive prevalence is low. This study reinterviewed 2586 women living in rural Bangladesh who had participated in the earlier survey. The study found a high level of knowledge about modern contraception, with nearly 95% of the women able to identify at least on modern method (94% mentioned oral contraceptives, 65% IUDs, 76% condoms, 64% injectables, 89% female sterilization, and 74% male sterilization). Concerning traditional family planning methods, only 40% could identify at least one. Despite knowing about modern methods, most women did not identify the advantages or disadvantages of the methods known, making informed choice problematic. Additionally, only 21% of the women interviewed were actually using method at the time of the survey. Contraceptive prevalence among women under 25 years of age and among women with only one child were 2% and 10%, respectively. The study also found that the level of the woman's education had a significant impact on her contraceptive behavior, with 65% of women with 10 or more years of schooling using a method, compared to 18% among women with no schooling. Among the women using contraception, younger women opted for birth spacing methods, while older women generally preferred sterilization. Over 90% of the women using contraception expressed satisfaction with the method they were using. The report regards the high level of contraceptive knowledge as a positive sign, adding that contraceptive prevalence could be increased by bringing services closer to the user, having each women of reproductive age visited by a family planning worker, and through careful follow-up.     

Family planning in grand multiparous women in Diyarbakir, Turkey, 1998: the factors affecting contraceptive use and choice of method.

Family planning is an important service for preventing maternal deaths. A 3-year project on children and maternal health was conducted in suburban areas of the Diyarbakir province of Turkey. In this project, volunteer women told women resident in the area about family planning as well as other maternal and child health-related subjects. Within 3 years, all women were visited at least five times and changes in contraceptive use were recorded. A cross-sectional study was planned to understand the factors affecting contraceptive use in grand multiparous women. A total of 200 grand multiparous women were selected from visit cards and various characteristics of these women were evaluated. Odds ratios and 95% confidence intervals were calculated using logistic regression analyses. The use of contraceptives had increased from 33.5% to 59.5% by the end of the 3 years in the 200 women. The main factors affecting contraceptive use were misconceptions and concerns about health-related risks, having a child younger than 14 years working outside the home to contribute to the household income, religious opposition, a gap between the desired and actual number of sons, number of previous deaths of children and discussion with the husband about family planning.     

Determinants of oral contraceptive pill use and its discontinuation among rural women in Bangladesh

Oral contraceptive pills (OCP) contribute a major share in the current method-mix in Bangladesh. However, multiple studies show high discontinuation rates of OCP. The present study examines the behavior and attitude towards OCP use, and investigates the determinants of its discontinuation among the rural married women of Bangladesh. The present study is based on critical analyses of the data from 24 focus group discussions and 135 in-depth-interviews with women, their husbands and key informants conducted over the period of 1 year. The present study shows that more than two-thirds of married women have at one time or another used OCP as a method of family planning. However, many women did not take the pills regularly and about one-quarter of ever users had taken, at one stage or another, a ‘short break’ from OCP use. Although nearly half of them took a break because of side effects, interestingly, 16% took a break as the result of fear of health problems that were related to ‘folk stories’ and other misconceptions. The individual assessment by users of the national family planning service delivery, perceived side effects, misconceptions about continuous use of pills, quality of counseling and information, and contraceptive behavior of the OCP users considerably influenced the decisions on contraceptive use or non-use.     

Factors affecting unmet need for contraception among currently married fecund young women in Bangladesh

Objectives: The aim of our study was to explore the factors associated with unmet need for contraception among currently married fecund women under age 25, in Bangladesh.

Methods: This study utilised a cross-sectional data (n?=?4982) extracted from the Bangladesh Demographic and Health Survey (BDHS) 2011. Multinomial logistic regression was used to identify the determinants of unmet need for contraception among currently married fecund young women.

Results: The unmet need for contraception was 17% and contraceptive prevalence was 54% in this young group. Total demand for contraception was 71% and the proportion of demand satisfied was 77%. The results suggest that region, place of residence, religion, husband’s desire for children, visits of FP workers, decision-making power on child health care, reading about FP in newspaper/magazine and number of births in three years preceding the survey were significant predictors of unmet need for contraception.

Conclusions: The BDHS of 2011 found that unmet need for contraception among currently married, fecund women under 25 years old is higher than the national level, and hence different or more intensive programme initiatives are required for them than for older women. The present study identifies important predictors of unmet need for contraception among fecund married Bangladeshi women under age 25.     

Contraceptive use and family planning after labor in the European part of the Russian Federation: 2-year monitoring.

OBJECTIVES: To explore the main determinants of the reproductive behavior of nursing mothers, all inhabitants of the central part of the European region of the Russian Federation, their use of modern contraceptive methods and their attitude to future family planning. METHODS: Open cohort multicenter study of 1200 nursing mothers aged 16-42 years interviewed at 3-5 days' postpartum, with subsequent longitudinal monitoring ofthe majority in the local family planning centers during the 2 years after labor. RESULTS: The main determinants of the reproductive behavior of this cohort of women are an early debut of sexual activity, several partners in their reproductive history, relatively early marriage with a motivation to have one child in their family and the tendency to use induced abortion as one of the methods of birth regulation. Our experience of postpartum counselling demonstrated positive changes in the women's attitudes to modern contraceptive methods. The data reveal that the induced abortion rate among 639 mothers regularly followed-up during the first year postpartum was 4.4%, and among 606 during the second year was 5.1%. The corresponding rates among 129 women who did not visit the family planning centers and who were only interviewed 2 years after labor were 9.3% and 8.5%, respectively. CONCLUSIONS: Our data show that the unmet needs are remarkably concentrated among women who have given birth within the last year or two, and who need augmented attention from the family planning and reproductive health services.     

北京市无痛人工流产育龄妇女接受流产服务的现状调查

目的:了解选择行无痛人工流产术的育龄妇女接受流产服务的现状。方法:采用分层随机抽样的方法在北京市18个区县中抽取6个区县的18家开展计划生育技术服务的医疗机构,在门诊对早孕后选择终止妊娠的育龄妇女进行问卷调查。结果:在至少有1次流产史的1 005例行无痛人工流产调查对象中,前次流产有49.2%的人选择了无痛人工流产,在前次流产时有77.9%接受了避孕宣传教育,只有50.1%获得了避孕药具,前次流产告知流产后需避孕者其流产后首次性生活避孕的比例明显高于未告知者,而且提供避孕宣传教育服务与流产的地点有关。本次流产83.6%为意外妊娠,外地户籍、大学或大专学历、收入>3 000元、丈夫或性伴年龄<25岁的育龄妇女选择无痛人工流产的比例较高,选择无痛人工流产的育龄妇女中有29.0%存在高危因素,仅有61.9%被告知无痛人工流产可能发生并发症。结论:无痛人工流产育龄妇女高危流产的比例较高,其流产前、后获得的知识和信息不足,应开展多种形式的生殖健康知识宣传教育,落实避孕措施,减少非意愿妊娠。     

Contraception within six-month postpartum in rural Vietnam: implications on family planning and maternity services.

OBJECTIVES: This longitudinal study documents contraception practice and factors influencing contraception decision within the first six months postpartum, amongst women residing in the rural Northern Central region of Vietnam. METHODS: A sample of 463 rural women who gave birth during August-October 2002 were recruited and interviewed at one, 16 and 24 weeks postpartum. RESULTS: The proportion of contraceptive users at weeks 16 and 24 were 17% and 43% respectively. At week 24, of contraceptive users, 57% used IUD, 25% used condom, and 14% used traditional methods. Logistic regression analysis found age, sufficient knowledge on contraceptives and husband/partner opinion can significantly affect the contraception decision. CONCLUSIONS: In order to improve the situation, health authorities should be encouraged to provide counselling on postpartum contraceptive methods during ante- and postnatal care visits. Health education on family planning and breastfeeding should also involve the husband/partner group taking into account local socio-cultural features.     

Sex preference as a determinant of contraceptive use in matrilineal societies: A study on the Garo of Bangladesh

Objectives This paper explores the presence of sex preference and its influence on contraceptive use among the Garo, a matrilineal community, of Bangladesh.

Methods In this study, 223 currently married Garo women were interviewed, selected purposively from two districts of Bangladesh, where most of the Garo people live. A binary logistic regression model was fitted to explore the determinants of current use of contraceptives among the Garo community.

Results About 80% of the Garo women were currently using contraceptive methods, which was much higher than the contraceptive prevalence at the national level (55.8%). However, the use of modern male methods was very low in that community. Regression analysis revealed that the strong preference for girls was a significant determinant of contraceptive use.

Conclusions Even though the Garo apply contraception more than the Bangladeshi community in general, their strong preference for girls may restrain its success. Family planning information can be designed so as not to challenge the matrilineal structure of the society and both spouses counselled together to promote also modern male methods.     

Sociologic problems of contraception in the opinion of women from urban and rural areas

The paper, having a diagnostic character, discusses the problems of birth control, family planning and contraception methods. The methods of the investigation were a questionnaire, interview and analysis of documentation. The investigation was carried out in two areas: urban--Katowice and rural--Istebna. The investigation was carried out among a group of 100 women between 20 and 55 years of age. All the women questioned have been married for 1-30 years. Most of them have two children--30%. Most women from both the urban and rural areas use natural methods of contraception, in. the town--Billings method and in the country--conjugal diary. Thermal method is less popular as it is time-consuming. The main reasons for choosing a natural method of contraception control are moral, religious and biological aspects, which give the women a psychic comfort and a strong feeling of attachment to the husband. Women from the urban area say that they started to use contraceptive methods after getting married whereas women from the rural area--after giving birth to a child. Contraceptive devices are used by about 30% of women. The most popular are: among women from the town--coitus interruptus, artificial abortion and less popular contraceptive devices such as oral contraceptives, intrauterine devices and chemical substances. Among women from the rural area the most common is coitus interruptus and then 2-1 cases of each of the remaining methods. Women applying contraceptive devices are aware of their harmful effects, their unreliability, immorality and violating nature. Women in the country face a lot of difficulties in buying contraceptive devices and they also (22%) use artificial abortion.(ABSTRACT TRUNCATED AT 250 WORDS)     

Contraceptive use among women with medical conditions: Factors that influence method choice

ObjectiveTo identify factors that influence contraceptive initiation among women with medical conditions.Study designWe conducted an exploratory cross-sectional survey of women 18–45 years old with medical conditions who received contraception consultation from complex family planning specialists at five University of California Medical Centers from June 2014-June 2015. We asked survey participants about factors that influence their decision of choosing and initiating a contraceptive method, how they accessed family planning specialists and the impact of this consultation on their contraceptive method choice.ResultsAmong 97 participants, 61 (63%) had one medical condition, 28 (29%) had two medical conditions, and 8 (8%) had three or four medical conditions. A majority of participants initiated long-acting reversible contraceptive methods including an intrauterine device (n = 54, 56%) and the contraceptive implant (n = 17, 18%). The most common reason for initiating contraception was to avoid pregnancy in the immediate future for personal reasons (n = 43, 44%). The most common reason for initiating a particular contraceptive method was safety given their medical condition (n = 19, 20%). After the consultation with the complex family planning specialist, participants commonly reported that the person with the most influence on their contraceptive method choice was the complex family planning specialist (n = 35, 36%) and less commonly the primary care provider (n = 9, 9%) and not at all by a family member or friend (n = 0, 0%).ConclusionWomen with medical conditions are highly influenced by a complex family planning specialist in regard to their contraceptive options and when receiving such counseling, will often choose highly effective methods.ImplicationsThis study provides insight into contraceptive decision-making among women with medical conditions referred to a complex family planning specialist for contraceptive care.     

Discontinuation pattern among IUCD users at the family planning clinic, University College Hospital, Ibadan.

Despite the high popularity of the intrauterine contraceptive device (IUCD) among family planning clients at University College Hospital, Ibadan, some users discontinued its use for a variety of reasons. This study was to determine the discontinuation rate among IUCD users at UCH, Ibadan. It was a 5-year retrospective analytical study. The records of patients using an IUCD seen at the Family Planning Clinic between 1 January, 1998 and 31 December, 2003 were analysed. A total of 867 clients were seen during the study period; 258(29.8%) clients discontinued within 5 years with the highest rate at 1 year 10.1% and least after 5 years 2.8%. The most common reason for discontinuation was the desire for pregnancy (57.0%). Other reasons included: side-effects (28.3%), husband's views (7.0%) and the menopause (8.0%). The reason for discontinuation varied significantly with the age of the clients (92.5% of clients that discontinued were less than 35 years), educational status, husband coercion, number of living children and religion. The discontinuation rate for the IUCD is high inspite of the high initial acceptability of the method in Nigeria. In a country experiencing a very rapid population growth where the prevalence of contraceptive use hardly attains double figures, it is imperative that policy makers double their efforts at ensuring an appreciable continuation rate of contraceptive use in general and IUCD in particular, among Nigerian women.     

Distribution of contraceptive use in a Turkish population

OBJECTIVE: This study is designed to estimate the distribution of contraceptive use among reproductive age women in a Turkish population (Turkey). STUDY DESIGN: We included 2365 women of reproductive age in this study. Women were given a questionnaire via a face-to-face interview. RESULTS: During the time period just after marriage, 1914 women (80.9%) declared that they did not use any type of contraception. Among 451 women who had used a contraceptive method just after marriage, the most commonly used method was condoms (34.2%), followed by oral contraceptives (31.2%) and coitus interruptus (25.9%). When their history of contraceptive use was asked, 1903 women (80.2%) stated that they used a method of contraception while 462 women (19.5%) had never used any type of contraceptive. Distribution of contraceptive methods among women was analyzed and intrauterine devices were detected to be the most commonly used method (n=1046, 55%). CONCLUSION: A point that should be emphasized is that there is a marked increase in contraceptive prevalence, and expansion of family planning activities in Turkey. This change, we believe, is due to improvements in health services of Turkey, realized in recent years.     

Reasons for not using family planning methods in Eastern Turkey.

OBJECTIVE: The reasons for not using family planning methods among women aged 15-45 years were investigated in the Eastern region of Turkey. METHODS: A total of 518 randomly selected women were interviewed with a questionnaire. Information was collected on women's fertility behavior and intentions, sources of knowledge and practice of contraception and sociodemographic characteristics. RESULTS: The rate of women who were not using any form of family planning was 45.2%. The reasons for not using any form of family planning were: not having the approval of the husband or family leaders (38%); believing that it was a sin to use a family planning method (32.5%); believing that it could cause abnormal bleeding (14.1%); believing that it could cause infertility (7.3%); believing that it could cause cancer (4.7%); and believing that it could cause pelvic pain (3.4%). CONCLUSION: Efforts should be directed towards education of family members and religious leaders to increase the usage of family planning methods.     

The next chapter in Bangladesh''s demographic success story: Conflicting readings

A series of recent papers based on longitudinal research in Bangladesh warns that shifting from door-to-door contraceptive distribution to a system based on fixed facilities, satellite clinics and supply depots would undermine demand for family planning and lead to higher discontinuation, decreased contraceptive prevalence rates and diminished quality ofcare, and would reduce women's status. This paper questions the interpretations of data upon which these concerns are based and suggests that what is being interpreted as fragile demand for contraception may in fact be a symptom of inadequate quality ofintormation, counselling and care. It offers evidence that suggests that women will be willing to take more initiative in getting access to clinic-based family planning services if these services are of relatively high quality and if the women can simultaneously gain access to other resources that they value, such as more integrated reproductive health care services.     

中国少数民族避孕现用率、效果及影响因素

本文应用国家计划生育委员会１９８８年组织的全国２‰生育节育抽样调查资料，分析中国少数民族避孕现用率、避孕效果及其影响因素。１９８８年全国少数民族避孕现用率为５９．４１％，低于汉族避孕现用率７３．１８％，在十五个主要少数民族中满族现用率最高，为７３．４５％，高于汉族现用率；维吾尔族的现用率最低，仅为１７．６％。少数民族中各种方法的现用率，宫内节育器为最高，在使用者中占４９％；而汉族以绝育为最高，在使用者中占４８．３８％。居住在城市的少数民族避孕现用率高于农村中的避孕现用率。年龄３０～４４岁已婚育龄少数民族妇女中，约有８５％避孕，其中３５～３９岁妇女的避孕现用率最高，为９１．８９％。文化程度高者避孕现用率高，文化程度低者避孕现用率较低。无论宫内节育器、绝育、口服避孕药或避孕套，意外妊娠、副反应和宫内节育器的脱落，为少数民族终止某种避孕方法的主要原因，其中意外妊娠占的比例较高。这说明避孕失败仍是终止使用的最重要的原因。经比例风险模型分析，发现宫内节育器失败妊娠受放器时年龄、居住地城市或农村、放器医院、有无副反应、孩子性别和成活孩子数等多种因素的影响。同样，绝育失败妊娠受妇女文化程度、医院手术水平和成活孩子数的影响?     

Knowledge, attitude and practice of modern contraception among single women in a rural and urban community in southeast Nigeria.

The contraceptive information and services offered to single women in most developing countries is compromised by stigma attached to premarital sex. This study was to ascertain the knowledge, attitude and practice of contraception among single women in a rural and urban community in southeast Nigeria, using a cross-sectional survey of 279 and 295 single women in Ngwo (rural) and Enugu (urban) community. The mean age of the population was 21.3 years. Contraceptive awareness was more among the urban than rural respondents (90.2% vs 34.1%). The major sources of contraceptive knowledge were mass media (68%) and peer groups (86.3%) for the urban and rural respondents, respectively. Most respondents in both groups had positive attitude towards contraception. More urban than rural respondents (68.3% vs 12.5%) began sexual activity during adolescence and the level of contraceptive use during first coitus were 48.4% and 13.7%, respectively. Of the currently sexually active respondents, 32.5% (rural) and 59.7% (urban) were using a form of modern contraception. Condoms, followed by oral pills were the most popular contraceptive method because they can easily procure them over the counter. Poor contraceptive information, highly critical behavior of family planning providers towards unmarried women seeking contraception and attitude of male partners militate against contraceptive practice. There is need to promote information and education on contraception among single women, their male partners and family planning providers.     

Knowledge, attitude and practice of family planning among Igbo women of south-eastern Nigeria.

A total of 200 Nigerian women visiting Nnamdi Azikiwe University Teaching Hospital's antenatal clinic were interviewed about their knowledge, attitude and practice of family planning. About 90% were literate. Their knowledge (80%) and approval (87%) of family planning was high, but the practice of modern family planning was low (25%) with most women involved in Billings/safe period (56%). The common methods used were Billings/safe period, condom, withdrawal and the intrauterine contraceptive device (IUCD). A total of 81.5% of the respondents are still willing to give birth while 77% agreed that their last pregnancy was planned. A total of 58.5% of respondents were educated about family planning in the antenatal clinic. The most common source of family planning information was mass media, closely followed by health workers, while the most common single reason for non-practice of family planning was rejection by the husband. We therefore conclude that despite the high education/literacy with the attendant and high knowledge and approval rate of family planning in this part of Nigeria, the practice of family planning is still low, especially due to partner objection. Policy makers should therefore increase male involvement in family planning programmes and pursue a more aggressive public awareness campaign.     

An unaddressed issue: domestic violence and unplanned pregnancies among pregnant women in Turkey.

OBJECTIVE: The aim of this study was to estimate the prevalence and type of domestic violence during pregnancy in Turkey and to compare socioeconomic background factors. METHODS: A survey was carried out among a representative sample of 475 pregnant women. Data were collected on the incidence and the nature of domestic violence perpetrated by the woman's spouse or other family members during her current pregnancy and before. Sociodemographic characteristics such as age, duration of marriage, number of children, monthly income, education, occupation of the husband, domestic violence towards children, contribution to family decisions, smoking habits, sexual relations and whether the pregnancy was planned or not, were also recorded. RESULTS: Of the 475 women screened for domestic violence during pregnancy, 158 (33.3%) reported physical or sexual abuse since they had become pregnant. The source of the domestic violence was mainly the husband in 105 (66.5%) women. Types of abuse were psychological in 71 (44.9%) and physical in 87 (55.1%) women. The rate of women's satisfaction with their sexual life among abused women was 43.67% compared to 61.2% among non-abused women. Abused pregnant women were less educated, had lower income, had more children, had a longer duration of marriage, were applying violence towards their children, were not contributing to family decisions, were less satisfied with their sexual life and were more likely to have unplanned pregnancies when compared to non-abused women. CONCLUSION: Antenatal care protocols should be modified to address domestic violence and contributing factors during pregnancy so that identified women can be counseled appropriately and attempts can be made to intervene to prevent further episodes of domestic violence in primary care settings.     

上海市流动人口孕产妇平产分娩点医院避孕服务状况调查

目的:了解流动人口孕产妇平产分娩点计划生育和避孕咨询服务现状及医务人员的产后避孕知识。方法:通过结构式问卷,对2004年上海市卫生局设立的10家流动人口孕产妇平产分娩点医疗机构进行机构设置及避孕服务调查,对机构中涉及到计划生育/避孕咨询服务的医务人员进行产后避孕知识调查。结果:10家外来人口分娩点医院中,仅有3家医院设有独立的计划生育门诊,8家医院设有计划生育咨询室,所有的二级医院均设有计划生育病床,平均提供10.5种避孕方法的咨询,可以操作落实的避孕服务项目平均为7.1种。343名调查对象中,279人(80.8%)曾为孕妇或产后妇女提供过避孕咨询服务;109人(31.8%)曾参加过计划生育/避孕咨询方面的培训。产后避孕知识得分最高为82分,中位得分为34分;多因素分析显示,调整其他可能的影响因素后,培训是影响医务人员产后避孕知识最重要的因素。结论:大部分流动人口孕产妇平产分娩点机构的计划生育设置和避孕方法咨询服务能够达到管理文件要求。但仍需加强计划生育门诊的硬件建设和针对性地加强医务人员产后避孕知识的再培训,更新知识结构。