Scaling up contraceptives use in the division with lowest contraceptives use in Bangladesh: sources, methods, and determinants

Abstract

BackgroundTotal fertility rate (TFR) is high and at a static level for the last two decades in Bangladesh. Reduction of fertility by increasing contraceptives use could reduce maternal and neonatal mortality. To achieve the targeted contraceptive prevalence rate (CPR) of Family Planning 2020 (FP2020) Initiative, it is important to increase CPR in all regions of the country. However, it is lower in Sylhet Division compared to other divisions in Bangladesh. This study looked into the methods, source and determinants of contraceptives use in this division.MethodsData from the Bangladesh Demographic and Health Survey 2014 (BDHS 2014) were analyzed. After reporting the sources of obtaining contraceptives and choice of methods, distributions of contraceptives use were reported by selected characteristics. Logistic regression was applied to calculate the odds ratios.ResultsA total of 599 women were analyzed. CPR was lower in rural areas compared to urban areas, 45.4% and 58.5%, respectively. The majority of the women received services from governmental sectors. The birth control pill was the most common contraceptive method. The proportion of women using long-acting permanent methods was low (<10%) in both urban and rural areas.In the multivariate analyses, number of alive children (adjusted odds ratio (AOR) of ≥5 children: 1.6, 95% confidence interval (CI): 1.1–2.2), presence of a male child (AOR: 1.7; 95% CI: 1.1–2.6), higher education level of the husband (AOR: 1.7; 95% CI: 1.1–2.6), receiving a visit from a family planning worker (AOR: 2.4; 95% CI: 1.6–3.4) and membership in a non-governmental organization (AOR:1.4, 95% CI: 1.1–1.8) were positively associated with contraceptives use in Sylhet after controlling for age, education level and other contextual factors. Conversely, rural women had the lower likelihood of using contraceptives (AOR: 0.6; 95% CI: 0.4–0.8) than urban women. Women’s education level and religion were not statistically significant.ConclusionsA comprehensive strategy is required for this division to address multiple factors which simultaneously influence contraceptives use. In addition to more awareness programs to increase contraceptives use, providing contraceptive distribution services through family planning workers, involving women with non-governmental organizations and prioritizing rural areas could increase contraceptives use in Sylhet Division.

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].…”

Regional variations of contraceptive use in Bangladesh: A disaggregate analysis by place of residence

“…The success story of family planning programs in Bangladesh led many researchers to examine the determinants of contraceptive use in Bangladesh [4,[10][11][12][13][14][15]. In general, the findings of these studies showed that the women's age [16], education [16,17], employment status [11,18], wealth index [11], living in urban areas [11], husband's education [18], desire for smaller family size [16], discussion about family planning with husband [17], visit of family planning workers within the last six months [18,19], and media exposure [11,16] were positively associated with contraception use in Bangladesh. In addition, significant variations in contraception usage were found across religion [18], division [16], number of children that had died [17], and number of children ever-born [11,17].…”

“…Women ages 35 years and above have a lower rate of contraception use because of their greater concern about self-perceived health complications [23][24][25]. Women with a higher level of education are more likely to use contraception than women with lower level of education due to their greater awareness about the negative consequences of having more children on both maternal and child health [18,26]. Employed women are also more likely to use contraception than unemployed women to avoid the negative consequences of having more children on their career and future aspirations [27].…”

Effects of Son Preference on Contraceptive Use in Bangladesh

“…In their study, Kibria found that the Sylhet division in Bangladesh has a lower CPR than any other divisions. 27 On the other hand, the demographic variable of respondent age showed that the older respondents were less likely to practice contraceptive methods, for those who have only sons and only daughters. These results indicated that women's age had a statistically significant positive effect on contraceptive use.…”