Socioeconomic Position in Modern Contraceptive Uptake and Fertility Rate among Women of Childbearing Age in 37 Sub-Saharan Countries

Ekholuenetale, Michael; Owobi, Olah Uloko; Shishi, Benedict Terfa

doi:10.3390/world3040048

Cited by 9 publications

(5 citation statements)

References 34 publications

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“…Males who are knowledgeable about contraception are more likely than their counterparts who lack this knowledge to participate in FP decisions. This finding was supported by studies conducted in Tanzania [ 77 ] and Ethiopia [ 66 ]. This might be because knowledge of available contraceptive methods enables individuals to make informed decisions and use contraception to plan, delay, and space the pregnancies of their spouses [ 78 ], which is linked to improved birth outcomes for the mother and the newborns, either directly or indirectly.…”

Section: Discussionsupporting

confidence: 76%

Male Involvement in Family Planning Decisions in Malawi and Tanzania: What Are the Determinants?

Osuafor

Akokuwebe

Idemudia

2023

IJERPH

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The participation of males in joint spousal decisions is urgently needed in achieving the fundamental indicators of reproductive health. The low involvement of males in family planning (FP) decision-making is a major determining factor in low FP usage in Malawi and Tanzania. Despite this, there are inconsistent findings regarding the extent of male involvement and the determinants that aid male participation in FP decisions in these two countries. The objective of this study was to assess the prevalence of male involvement in FP decisions and its associated determinants within the household context in Malawi and Tanzania. We used data from the 2015–2016 Malawi and Tanzania Demographic and Health Surveys (DHSs) to examine the prevalence and the determinants inhibiting male involvement in FP decisions. The total sample size of 7478 from Malawi and 3514 males from Tanzania aged 15–54 years was employed in the analysis by STATA version 17. Descriptive (graphs, tables and means), bi-variate (chi-square) and logistic regression analyses (unadjusted (U) and adjusted odds ratio (AOR)) were performed to identify the determinants associated with male involvement in FP decisions. The mean age of respondents in Malawi was 32 years (±8 SD) and in Tanzania, 36 years (±6 SD), with the prevalence of male involvement in FP decisions being 53.0% in Malawi and 26.6% in Tanzania. Being aged 35–44 years [AOR = 1.81; 95% CI: 1.59–2.05] and 45–54 years [AOR = 1.43; 95% CI: 1.22–1.67], educated (secondary/higher) [AOR = 1.62; 95% CI: 1.31–1.99], having access to media information [AOR = 1.35; 95% CI: 1.21–1.51] and having a female head of household [AOR = 1.79; 95% CI: 1.70–1.90] were determinant factors of male involvement in FP decisions in Malawi. Primary education [AOR = 1.94; 95% CI: 1.39–2.72], having a middle wealth index ranking [AOR = 1.46; 95% CI: 1.17–1.81], being married [AOR = 1.62; 95% CI: 1.38–1.90] and working [AOR = 2.86; 95% CI: 2.10–3.88] were higher predictors of male involvement in FP decisions in Tanzania. Increasing the role of males in FP decisions and involvement in FP utilization may improve uptake and continuity of FP usage. Therefore, the findings from this cross-sectional study will support redesigning the ineffective strategic FP programs that accommodate socio-demographic determinants that may increase the likelihood of male involvement in FP decisions, especially in the grassroots settings in Malawi and Tanzania.

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Section: Discussionsupporting

confidence: 76%

Male Involvement in Family Planning Decisions in Malawi and Tanzania: What Are the Determinants?

Osuafor

Akokuwebe

Idemudia

2023

IJERPH

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“…The reasons for the variation could be differences in sample size, study populations, and the study periods. On the other hand, the prevalence of modern contraceptive use in this study was lower than a previous study reported from Southern SSA(57.0%) [28] and Malawi (75%) [27]. The possible reason for the difference might be variations in study settings and the availability of the contraceptive.…”

Section: Discussioncontrasting

confidence: 86%

Modern contraceptive utilization and its associated factors in East Africa: Findings from multi-country demographic and health surveys

Demeke,

Legese,

Nigussie

2024

PLoS ONE

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Background The use of modern contraceptives has been low in most Sub-Saharan African countries despite high population growth and a sluggish economy. This study aimed to identify the prevalence and determinants of modern contraceptive use among married reproductive-age women in East Africa. Methods For this study, the Demographic and health survey (DHS) data from nine countries in East Africa were analyzed, yielding a weighted sample of 32,925 married women. A multilevel mixed-effect logistic regression model was used to identify characteristics associated with the utilization of modern contraceptives at a p-value less than 0.05. For model comparison, we used the Akaike and Bayesian Information Criteria (AIC and BIC). For assessing variation (random effects), we used community-level variance with standard deviation and intra-cluster correlation coefficient (ICC). Results The overall prevalence of modern contraceptive use was 45.68%, 95% CI (45.15, 46.21). Women’s age, maternal education level, husband education level, media exposure, wealth status, occupation, religion, the total number of children ever born, distance to health facilities, history of termination of pregnancy, couple’s desire for children, women’s participation in decision making, living country and place of residence were significantly associated with modern contraceptive use in Eastern Africa. Conclusions Conferring to this study, utilization of modern contraceptives is low in East Africa. Interventions to improve the use of modern contraceptives should encompass disseminating awareness through mass media, enrolment of males in family planning, giving maternal education, building health facilities in remote areas, and encouraging family planning programs in rural areas.

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“…Evidence of the significant influence of women's marital status, age, education, employment status, wealth index, religion, and residence, as well as their partners' education, on the use of contraceptives in the literature [33][34][35], and their availability in the accessed dataset, informed the inclusion of selected covariates. The other covariates included in the analysis were the number of children ever born and the number of living children based on the documentation of their association with contraceptive use [36,37].…”

Section: Explanatory Variablementioning

confidence: 99%

Assessing the relationship between knowledge and the actual use of contraceptives among childbearing women in South-South Nigeria: evidence from the 2018 Nigeria demographic and health survey

2022

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Background Nigeria has one of the world's highest fertility rates, which is detrimental to its public health and socioeconomic growth. Despite several efforts by the country and other development partners to reduce high fertility by increasing contraceptive use, the contraceptive prevalence rate among childbearing women remains low, particularly in the South-South compared to other Southern regions. This study, therefore, assessed the relationship between knowledge of and actual use of contraception among women in South-South Nigeria. Methods The study employed a cross-sectional analysis of a nationally representative weighted sub-sample of 4,553 South-South childbearing women extracted from the 2018 National Demographic and Health Survey dataset. The dataset was weighted and examined for missing values that were excluded during the analyses at univariate, bivariate, and multivariate levels. The analyses involved a baseline descriptive analysis, a chi-square test, and logistic regression models using Stata software. The results of the explanatory variables were presented as odds ratios (OR) and 95% confidence intervals (CI). Results Eighty-two per cent of the respondents knew at least one form of contraception, while approximately 82% never used any contraceptive method. The likelihood of using any contraceptive method increased among those who knew about contraceptives (aOR: 1.40; CI: 0.93–2.11). Also, contraceptive use was significantly higher among women and their partners who had post-primary education (aOR: 1.34; CI: 1.25–2.43 and aOR: 1.74; CI: 1.25–2.43, respectively). Furthermore, the prevalence of contraceptive use among women significantly increased with an increase in the household wealth index. Similar results were recorded among women who had five or more living children, who were residents of Rivers State, were married or lived with their partners, were aged 35 years or older, and were currently working. Conclusions Contraceptive knowledge was high but did not translate into actual practice among childbearing women in South-South Nigeria. The use of any contraception was highly influenced by contraceptive knowledge, education, age, marital status, place of residence, and household wealth index, among others. Therefore, some policy issues relating to contraceptive knowledge and actual adoption must be addressed to improve the low rate of contraceptive use in Nigeria.

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Socioeconomic Position in Modern Contraceptive Uptake and Fertility Rate among Women of Childbearing Age in 37 Sub-Saharan Countries

Cited by 9 publications

References 34 publications

Male Involvement in Family Planning Decisions in Malawi and Tanzania: What Are the Determinants?

Male Involvement in Family Planning Decisions in Malawi and Tanzania: What Are the Determinants?

Modern contraceptive utilization and its associated factors in East Africa: Findings from multi-country demographic and health surveys

Assessing the relationship between knowledge and the actual use of contraceptives among childbearing women in South-South Nigeria: evidence from the 2018 Nigeria demographic and health survey

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