Trends and socio-demographic components of modern contraceptive use among sexually active women in Rwanda: a multivariate decomposition analysis

Kalinda, Chester; Phiri, Million; Chimpinde, Kafiswe; Ishimwe, Marie Consolatrice Sage; Simona, Simona J.

doi:10.1186/s12978-022-01545-0

Cited by 6 publications

(9 citation statements)

References 28 publications

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“…The finding of this study, which show that education played a key role in contributing to the observed change in contraceptive use in Zambia resonates with what has been reported in prior studies conducted in Rwanda, Ethiopia, Kenya and Cameroon [ 12 , 17 , 60 , 61 , 66 ]. This observation potentially suggests that educated women are more likely to make informed decisions on their reproductive health by adopting contraceptive use.…”

Section: Discussionsupporting

confidence: 90%

“…This study showed that change in contraceptive use was mainly as a result of changes in women’s contraceptive behaviour. However, the finding that 15% of the increase in contraceptive use in Zambia was explained by differences in women’s characteristics is lower compared to what was found in Ethiopia (34%), Cameroon (69%) and Rwanda (23%) [ 12 , 17 , 61 ]. The variations in population structure and socio-economic characteristics of women in the study countries may account for the disparity in the observed changes in CPR across different counties.…”

Section: Discussionmentioning

confidence: 84%

“…Literature show that contraceptive use transition differs across countries in SSA. While there has been an increase in contraceptive use in some countries, in others there has been a stall and yet a decrease is noted in some countries [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

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Social context of contraceptive use transition among sexually active women in Zambia (1992–2018): A decomposition analysis

Phiri,

Odimegwu,

Adewoyin

2024

PLoS ONE

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Background Contraception is an important public health initiative for addressing maternal health outcomes associated with unplanned pregnancies, unsafe abortions and maternal deaths. Although contraceptive use has been on the rise globally, the observed increases in sub-Saharan Africa (SSA) are sub-optimal and vary among countries. In Zambia, drivers of contraceptive use transition are not well documented. Thus, this study examined the drivers of contraceptive use change among sexually active women in Zambia between 1992 and 2018. Methods Data came from the six Zambia Demographic and Health Surveys conducted between 1992 and 2018. A sample of 44,762 fecund sexually active women aged 15–49 years was analysed using multivariable Blinder Oaxaca decomposition regression analysis. Analysis took into account the complex survey design. Results were presented using adjusted coefficients, their 95% confidence intervals, and percentages. Results The prevalence of contraceptive use among sexually active women increased significantly by 30.8 percentage points from 14.2% (95% CI: 12.8, 15.6) to 45.0% (95% CI: 43.6, 46.4) during the period 1992 to 2018. The major share of the increase happened during the period 1992–1996 (10.2%) while the least increase occurred between 2013 and 2018 (0.2%). Overall, about 15% of the increase in the prevalence of contraceptive use was attributable to changes in the compositional characteristics of women. On the other hand, 85% of the increase was due to change in contraceptive behaviour of sexually active women. Changes in women’s compositional characteristics such as secondary education (5.84%), fertility preference (5.63%), number of living children (3.30%) and experience of child mortality (7.68%) were associated with the increase in contraceptive use prevalence. Conclusion Change in contraceptive behaviour of sexually active women contributed largely to the observed increase in contraceptive use prevalence in Zambia. Increase in the proportion of women attaining secondary education, decrease in the percentage of women who want large families and improvement in child survival were the major compositional factors driving the rise in contraceptive use. The findings imply that increasing investment in education sector and enhancing existing family planning programmes has the potential to further improve contraceptive use prevalence in Zambia.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 84%

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Social context of contraceptive use transition among sexually active women in Zambia (1992–2018): A decomposition analysis

Phiri,

Odimegwu,

Adewoyin

2024

PLoS ONE

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“…Teenagers who live in rural areas and are from poorest households had an increase in teenage pregnancy over the four surveys analysed for this study. This finding could be explained by inadequate access to SRH information and low contraception use among young teenager from rural areas and those from poor communities [ 9 , 10 , 23 , 33 ]. The increase in the trends of teenage pregnancy was also observed among those illiterate and married/formerly married teenage women.…”

Section: Discussionmentioning

confidence: 99%

A multilevel analysis of trends and predictors associated with teenage pregnancy in Zambia (2001–2018)

et al. 2023

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Background Teenage pregnancy remains a major social and public health challenge in developing countries especially sub-Saharan Africa (SSA) where prevalence rates are still increasing. Even if considerable effort has been made over the years to study determining factors of teenage pregnancy in SSA, few studies have looked at the trends and associated factors over a longer period. Furthermore, no known study has focussed on both individual and contextual factors influencing teenage pregnancy in Zambia. This study, thus sought to fill this gap in knowledge by simultaneously investigating trends of teenage pregnancy as well as its individual and contextual determining factors. Methods A total pooled weighted sample of 10,010 teenagers (in the age group 15–19) from four waves of the Zambia Demographic and Health Surveys were extracted. Using bivariate analysis, we investigated the trends of teenage pregnancy between 2001 and 2018. Separate multilevel logistic regression models were fitted on pooled teenage pregnancy data in relation to several individual and contextual level factors. Both fixed and random effects were produced. Bayesian parameter estimates were produced using lme4 package in R statistical programming environment. Results Results of the trends of teenage pregnancy in Zambia have shown an overall decrease of 2% between 2001 and 2018. Almost all the socioeconomic and demographic variables were consistently associated with teenage pregnancy (p < 0.001) in a bivariate analysis across the four survey. In multilevel analysis, the odds of being pregnant were higher for teenagers who were employed (aOR = 1.21, 95% CI: 1.02–1.42), married (aOR = 7.71, 95% CI: 6.31–9.52) and those with knowledge of ovulation period (aOR = 1.58, 95% CI: 1.34–1.90). On the other hand, belonging to households in high wealth quintiles, being literate, exposure to mass-media family planning messages and delayed sexual debut were associated with decreased odds of teenage pregnancy. Conclusion The study shows that teenage pregnancy remains a social and public health challenge in Zambia as the country has seen little decrease in the prevalence over the years under consideration. Factors associated with teenage pregnancy include marital status, and employment, knowledge of ovulation period, wealth quintile, sexual debut and exposure to mass-media family planning messaging. Concerted effort must be made to improve literacy levels, reduce poverty and enhance sexual health promotion through the mass media in view of cultural norms, which may prevent parents and children from discussion sexual education topics thus exacerbate the vice.

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“…There is consensus in literature that access to family planning education influences reproductive outcomes such as age at first sex, contraception, age at first birth, teenage pregnancy and fertility preference among women of reproductive age [ 16 – 21 ]. Given the observed high levels of fertility in SSA [ 6 , 8 , 22 ], family planning education campaigns have focused on disseminating messages on benefits of smaller family sizes on both maternal and child health.…”

Section: Introductionmentioning

confidence: 99%

Perceived ideal number of children among adolescent girls in sub-Saharan Africa: does exposure to family planning messages matter?

Phiri,

Lemba,

Shasha

et al. 2023

BMC Women's Health

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Background Even though evidence shows that fertility transition has begun almost everywhere in sub–Saharan Africa (SSA), the decline has been slower than in other parts of the world. Research shows that there is a positive relationship between fertility levels and fertility preference. Therefore, many countries in the region are implementing family planning education campaigns targeting at influencing reproductive behavior of women. Thus, this study aimed to examine the extent to which exposure to family planning communication influences fertility preferences of adolescent girls in SSA. Methods This study used data extracted from the most recent Demographic and Health Survey datasets for 28 countries in SSA. Analyses were conducted on a pooled sample of 87,950 female adolescents’ aged 15–19 years who were captured in respective country’s survey. Multivariable binary logistic regression model was fitted in Stata version 17 software to examine the association between exposure to family planning communication and fertility preference among adolescent girls in SSA. Results The average fertility preference among adolescent girls in SSA was 4.6 children (95% CI: 4.5, 4.7). Findings show that regardless of the country, adolescents who had exposure to family planning messages [aOR = 0.76, 95% CI = 0.72–0.80] were less likely to prefer 4 or more children. On average, fertility preference among adolescents who had exposure to family planning communication was (3.8 children compared to 4.5 children; p < 0.001) among those with no exposure. Furthermore, results show that married adolescents in SSA who had exposure to family planning message had a higher average preferred family size compared to those who were not married (4.8 versus 3.8; p < 0.001). Conclusion Exposure to family planning communication has shown the potential to influence adolescents’ fertility preference in sub-Saharan Africa. Adolescents with exposure to family planning messages preferred a small family size. Therefore, there is a need to scale-up family planning education programmes in order to reduce fertility further in SSA.

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Trends and socio-demographic components of modern contraceptive use among sexually active women in Rwanda: a multivariate decomposition analysis

Cited by 6 publications

References 28 publications

Social context of contraceptive use transition among sexually active women in Zambia (1992–2018): A decomposition analysis

Social context of contraceptive use transition among sexually active women in Zambia (1992–2018): A decomposition analysis

A multilevel analysis of trends and predictors associated with teenage pregnancy in Zambia (2001–2018)

Perceived ideal number of children among adolescent girls in sub-Saharan Africa: does exposure to family planning messages matter?

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