Contextual Influences on Modern Contraceptive Use in Sub-Saharan Africa

Stephenson, Rob; Baschieri, Angela; Clements, Steve; Hennink, Monique; Madise, Nyovani

doi:10.2105/ajph.2005.071522

Cited by 211 publications

(251 citation statements)

References 15 publications

Supporting

Mentioning

222

Contrasting

Order By: Relevance

“…First, we grouped women (and men) from a PSU to represent the aggregate belief in myths for individuals in that PSU, which is the standard approach for analyses of community-level influences using DHS data. 27–29,37 However, the use of PSUs to represent urban communities may not have been the best strategy, because women in urban settings may be influenced by individuals outside of their community (e.g., where they work, shop and visit). Future analyses that examine the cohesion of urban communities will help determine how to define “community” in complex urban settings.…”

Section: Discussionmentioning

confidence: 99%

“…Numerous studies focused on community-level health outcomes have examined whether socioeconomic status, supply environment and quality of health care are associated with a health behavior or outcome–that is, these studies have demonstrated that women's (or men's) behaviors are associated with the behaviors or attitudes of other who live around them. 27–33 For example, Speizer et al found that the increasing prevalence of sexual violence reported by women within a community was negatively associated with women's use of condoms at last sex and positively associated with their being HIV positive or having had an adolescent pregnancy; 34 other studies among adults found similar results. 27,35,36 And according to an analysis of 2005–2009 DHS data from 21 African countries, contraceptive use remained associated with community demographics and fertility norms, community-level gender norms and inequalities, and health knowledge after individual factors were controlled for.…”

mentioning

confidence: 98%

See 1 more Smart Citation

Belief in Family Planning Myths at the Individual and Community Levels and Modern Contraceptive Use in Urban Africa

Guèye

Speizer²,

Corroon³

et al. 2015

IPSRH

100

View full text Add to dashboard Cite

Context Negative myths and misconceptions about family planning are a barrier to modern contraceptive use. Most research on the subject has focused on individual beliefs about contraception; however, given that myths spread easily within communities, it is also important to examine how the prevalence of negative myths in a community affects the aggregate level of method use. Methods Baseline data collected in 2010–2011 by the Measurement, Learning & Evaluation project on women aged 15–49 living in selected cities in Kenya, Nigeria and Senegal were used. Multivariate analyses examined associations between modern contraceptive use and belief in negative myths for individuals and communities. Results In each country, the family planning myths most prevalent at the individual and community levels were that “people who use contraceptives end up with health problems,” “contraceptives are dangerous to women's health” and “contraceptives can harm your womb.” On average, women in Nigeria and Kenya believed 2.7 and 4.6 out of eight selected myths, respectively, and women in Senegal believed 2.6 out of seven. Women's individual-level belief in myths was negatively associated with their modern contraceptive use in all three countries (odds ratios, 0.2–0.7). In Nigeria, the women's community-level myth variable was positively associated with modern contraceptive use (1.6), whereas the men's community-level myth variable was negatively associated with use (0.6); neither community-level variable was associated with modern contraceptive use in Kenya or Senegal. Conclusion Education programs are needed to dispel common myths and misconceptions about modern contraceptives. In Nigeria, programs that encourage community-level discussions may be effective at reducing myths and increasing modern contraceptive use.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 98%

Belief in Family Planning Myths at the Individual and Community Levels and Modern Contraceptive Use in Urban Africa

Guèye

Speizer²,

Corroon³

et al. 2015

IPSRH

100

View full text Add to dashboard Cite

show abstract

“…Use of modern contraceptives was positively associated with women's BMI and household use of adequately iodized salt. Previous research has shown that modern contraceptive users tend to have higher education levels and exposure to information in media and to come from wealthier households (40) . Because our analysis has adjusted for education and wealth index, the noted 'modern contraceptive use' effect on BMI and use of adequately iodized salt goes beyond these two factors and may be an indicator A general lack of awareness of existing programmes or products such as iodized salt may lead to lower levels of demand and use, and cultural preference for locally produced non-iodized salt may also hinder consumption of the imported iodized salt (41) .…”

Section: Discussionmentioning

confidence: 99%

Geographic distribution and socio-economic determinants of women's nutritional status in Mali households

Gewa

Leslie

Pawloski

2012

Public Health Nutr.

View full text Add to dashboard Cite

Objective: Mali is one of the poorest countries in Africa, with 72 % of its population surviving on less than $US 1?00 per day. Health and demographic indicators are bleak. With few exceptions, studies related to the health of women in Mali have largely been under-represented. In addition, in recent years a new type of malnutrition stemming from weight gain and obesity has been observed throughout Africa. The present study aimed to (i) describe geographic and health variations of women of reproductive age, (ii) describe geographic variations of household salt iodine levels and (iii) investigate potential factors associated with women's anthropometric status and use of adequately iodized salt among households in Mali. Design: Demographic and Health Survey data, multistage-stratified cluster sampling methodology. Setting: Rural and urban areas of Mali. Subjects: Non-pregnant women (n 6015) between the ages of 19 and 44 years. Results: Nineteen per cent of the women were overweight or obese while 11 % were underweight. Seventy-eight per cent of the households utilized adequately iodized salt. Underweight women were more prevalent in southern Mali, while obesity was more frequent in the north-east and within the major urban areas. Households located within the southern parts of Mali were more likely to utilize adequately iodized salt. Education, age, modern contraceptive use, breast-feeding status at time of the survey and household wealth index were significantly associated with the women's BMI or households' use of adequately iodized salt. Conclusions: The combined use of statistical and geographic system analysis contributes to improve targeting of interventions among vulnerable populations. Keywords Non-pregnant women BMI Iodized salt utilization MaliMali is one of the poorest countries in Africa, with 72 % of its population surviving on less than $US 1?00 per day. Health and demographic indicators are bleak; life expectancy from birth is 49?8 years and maternal mortality is 580 per 100 000 people. Several studies including the most recent national analysis from the Demographic and Health Surveys (DHS) examining the nutritional situation of children throughout Mali have shown significant numbers of stunted and wasted children (1) . Further, the WHO reports that approximately 30 % of children under 5 years of age are underweight, 40 % are stunted and about 4 % are overweight (2) . Recent research has shown evidence of poor nutrition among adolescent girls in Mali, suggesting that poor nutritional status is not a risk limited to childhood but extends into adolescence (3,4) . Most of the studies concerning the nutritional situation in Mali have focused primarily on infants and children and have ignored adolescents and adults. With the exception of studies related to infant feeding, reproductive health and violence against women, studies related to the health of women in Mali have largely been under-represented. Other field studies in Mali are generally dated and focus on children and infant feeding (5,6)

show abstract

“…However, research in South Africa to date has not identified factors associated with women's increased risk of having an AEP. In South Africa, social norms favouring fertility and childbearing (Wood & Jewkes, 2006); barriers to attendance of and access to family planning clinics (Stephenson, Baschieri, Clements, Hennink, & Madise, 2007); and a lack of accurate and complete information about how to use contraceptives effectively (Beksinska, Rees, Nkonyane, & McIntyre, 1998) are among factors that prevent contraceptive use.…”

mentioning

confidence: 99%

Predictors of risk of alcohol-exposed pregnancies among women in an urban and a rural area of South Africa

Morojele

London

Olorunju

et al. 2010

Social Science & Medicine

View full text Add to dashboard Cite

a b s t r a c tThe study sought to determine the prevalence and predictors of being at risk of an alcohol-exposed pregnancy (AEP) among women of child-bearing age in an urban and rural location in South Africa. We conducted a cross-sectional household survey of 1018 women aged 18-44 years in one urban (n ¼ 606) and one rural (n ¼ 412) site. The women were interviewed using a structured questionnaire. We defined the primary dependent variable, being at risk of having an AEP, as current alcohol use, not being pregnant, being fertile, and no effective use of contraceptives. The independent variables included demographic, substance use, health perceptions, psycho-social, and partner characteristics. The rural women (21.84%) were more likely than their urban counterparts (11.22%) to be at risk of an AEP. In multiple logistic regression analyses, significant predictors of being in the ''at risk'' group for the urban women were (a) being 'white' as opposed to 'black/African', and being 'coloured' as opposed to 'black/African'; and (b) current smoking. For the rural women, significant risk factors were (a) current smoking and (b) early onset of alcohol use. The significant protective factors were (a) education; (b) knowledge about Fetal Alcohol Syndrome; (c) parity. Use of stricter alcohol use criteria (i.e., three or more drinks and five or more drinks per sitting) in the definition of risk of an AEP yielded slightly different patterns of significant predictors. The results revealed high levels of risk of an alcohol-exposed pregnancy, especially amongst the rural women, and a need for location-specific prevention programmes. The high burden of AEP in South Africa calls for the establishment of national AEP prevention strategies and programmes as a matter of urgency.

show abstract

Contextual Influences on Modern Contraceptive Use in Sub-Saharan Africa

Abstract: Aspects of a community's sociocultural and economic environment appear to influence a woman's use of modern contraceptive methods.

Cited by 211 publications

References 15 publications

Belief in Family Planning Myths at the Individual and Community Levels and Modern Contraceptive Use in Urban Africa

Belief in Family Planning Myths at the Individual and Community Levels and Modern Contraceptive Use in Urban Africa

Geographic distribution and socio-economic determinants of women's nutritional status in Mali households

Predictors of risk of alcohol-exposed pregnancies among women in an urban and a rural area of South Africa

Contact Info

Product

Resources

About