Factors associated with contraceptive use in a rural area in Western Cape Province

Abstract

Background. Safe and effective contraceptive use can substantially improve women's reproductive health. Although the contraceptive prevalence rate (CPR) in South Africa is comparable to rates globally, inequalities in CPR affect poor and rural women. This study aimed to determine the CPR and factors associated with contraceptive use in a rural district of Western Cape Province. Method. Cross-sectional survey data based on 412 face-to-face interviews with female participants between 18 and 44 years of age were collected in 2006 for a primary fetal alcohol syndrome prevention study in a rural district in Western Cape Province. The study used effective contraception (ECC) as the outcome variable. ECC included use of oral contraceptives, condoms, injectables or sterilisation. Independent variables included socio-demographic factors, substance use, psychosocial factors, community factors, childbearing characteristics and partner characteristics. Results. Women were more likely to use ECC if they reported high self-esteem (compared with low or moderate self-esteem (prevalence risk ratio (PRR)=1.23; 95% confidence interval (CI) 0.99 -1.53); if they strongly or moderately agreed that their culture entitled men to make decisions regarding child-bearing compared with those who disagreed (PRR=1.28; 95% CI 0.96 -1.71); and if they had one child or more compared with no children (PRR=1.62; 95% CI 1.24 -2.11). Conclusion. The CPR for sexually active women in this study was low at 39.3%. To promote contraceptive use in similar rural populations, family planning programmes should focus on increasing men's approval of contraception, improving partner communication around family planning and bolstering women's confidence in their reproductive decision-making, and particularly their self-esteem. There should be greater focus on nulliparous women.

Knowledge and attitudes towards use of long acting reversible contraceptives among women of reproductive age in Lubaga division, Kampala district, Uganda

“…Partner decision was associated with women’s contraceptive use similar to findings from Ghana, Nigeria and Rwanda where partner approval, partner’s support [39,40] or partner objections [41-43] towards contraceptive choice influenced contraceptive use. In South Africa, women that strongly agreed to male decision making regarding child-bearing did not influence effective contraception [44]. In Uganda [45,46] and Burkina Faso [47], scientific evidence has also shown that positive influence of male partners may affect maternal and child health outcomes.…”

Factors influencing contraceptive use and non-use among women of advanced reproductive age in Nigeria

“…Three variables, namely remarriage, paternal education and women’s autonomy were selected for statistical control. The selection of the variables was guided by literature [8, 9, 12, 37, 38]. Some of the variables were however re-classified.…”

“…Women who reported no frequency of exposure were grouped as ‘none’, women who accessed at least one of the three outlets less than once a week were grouped as ‘low’ while women who accessed all media outlets more than once a week were grouped as ‘moderate’. Two control variables, namely women autonomy and partner education, were included based on their significance in earlier studies [8, 17, 39]. Women autonomy was derived from responses on women’s participation in three household decisions, namely decisions on own health, purchase of large household items and visit to friends and relatives.…”

Men’s reproductive health knowledge in Mankweng District, Limpopo Province

“…Some of those participants, who reportedly knew about family planning, provided wrong explanations of family planning. Contraceptive use can substantially improve women’s reproductive health (Peer & Morojele 2013). However, because of men’s misconceptions about contraceptives, women might be prevented from accessing contraceptives.…”