Determinants of modern contraceptive practice in Yaoundé-Cameroon: a community based cross sectional study

Abstract

Background: Despite numerous efforts put in place to increase modern contraceptive use in Cameroon as a means to fight maternal and infant mortality, the prevalence of modern contraception has shown only a slow increase and maternal mortality is constantly rising. This paper attempts to identify barriers to contraceptive use in Biyem-Assi, Yaoundé-Cameroon so as to clearly define in which domain and how to intervene concerning contraceptive use in Cameroon.Methods: It was a community-based cross sectional study involving a two-steps cluster sampling. Data were collected from November 2014 to April 2015 and analysis done with Epi-Info version 3.5.4. Association between contraceptive use and independent factors was estimated by calculating odds ratio (OR) and confidence interval at 95%. Significance of association in univariate analysis was estimated by calculating the p value with chi2 test. Potential confounder (pregnancy intention) controlled in a multiple logistic regression.Results: A total of 613 sexually active women were enrolled into the study with a mean age of 27.2 (δ ± 6.2) years. Among the women, 293 (47.8%) were in a union and 530 (86.8%) of them had attended at least a secondary education. Also, 107 (17.5%) responded that their beliefs do not approve contraceptive use and 101 (16.6%) said their partners do not approve contraception. At the moment of data collection, 361 (58.9 [54.9-62.8] %) were currently using a modern contraceptive method. The rate of use of modern contraception was significantly lower in women in a union (OR 0.57, p = 0.0002) and in those with age greater than 30 years (OR 0.45, p = 0.0004). Conversely, the rate of use was significantly higher in women whose partners approved contraception (OR 4.14, p = 0.0000) or when family planning was discussed within the couple (OR 1.93, p = 0.0028). Conclusion:The rate of use of modern contraception in Biyem-Assi Health District is relatively high. Women in a union and those aged greater than 30 years turn to be less likely to use a contraceptive method than the rest of the population meanwhile women whose partner approve contraceptive-use or who discuss about family planning with their partners, are most likely to use a contraceptive method than others. To increase the rate of use of modern contraception in Yaoundé-Cameroon, interventions should target more of couples and not women alone.

Modern contraceptive utilization and associated factors among reproductive-age women in Ethiopia: evidence from 2016 Ethiopia demographic and health survey

“…The current result was also consistent with the results of two cross-sectional studies done in Northwest and Western Ethiopia where reproductive age women aged 35-49 years and > 44 years respectively were less likely utilized modern contraceptive method [10,14]. Another cross-sectional study done in Cameroon in 2014 and 2015 also showed that age > 30 years was negatively associated with modern contraceptive method utilization which was also consistent with the current study [8]. This might be due to the reason that reproductive-age women from low-income countries become more economically stable at their late reproductive age and might not want to utilize contraceptive methods to bear more children.…”

“…To the contradict, another study was done in the same country (Ghana) showed a prevalence of only 21% [7]. A community-based crosssectional study done on reproductive-age women in Yaoundé-Cameroon showed that 58.9% used a modern contraceptive method [8]. Different studies done in Ethiopia [9][10][11][12][13][14] showed extremely variable results in the prevalence of modern contraceptive use which ranged from 20.8% from the study done at Bale Zone, South East Ethiopia [9] to 71.9% from the community-based cross-sectional study done at western Ethiopia [14].…”

“…Religious opposition, desire for more children, fear of side effects, husband opposition, inter-spousal discussion, Perceived husband approval, discussion with HEW, perceived cultural acceptability, Women's educational status, gravidity, postnatal care utilization, age, Husband's education, marital status, monthly income, fertility, media exposure, number of living children, woman's decision making autonomy, family planning counseling and Having postnatal care were some of the factors independently associated with modern contraceptive utilization [6,[8][9][10][11][12][13][14][15].…”

Changes in Determinants and Equity of Family Planning Utilization after the Implementation of a National Health Insurance Policy in Indonesia: A Secondary Analysis of The 2012-2016 National Socio-Economic Survey of Indonesia

“…We assumed that there is a shift of values in the society in Indonesia, but this assumption must be proved through further qualitative research. The same results were shown by studies in Bangladesh and Cameroon [36][37][38]. However, the studies in North Ethiopia and Malawi showed that education contributes significantly to the use of overall contraception method [39,40].…”

Determinants of unmet need for family planning among married women of reproductive age in Burundi: a cross-sectional study

“…One study from Cameroun [ 12 ] revealed that the husband’s approval of contraception and discussion about FP within the couple had a protective relationship with unmet need. A study from Rwanda [ 13 ] went on explaining that unmet need was higher among women who did not approve FP, those who believed their partner did not approve FP or who did not know his attitude and those who had never discussed FP with their partners or had done so, rarely.…”