Relationships matter: contraceptive choices among HIV-positive women in Tanzania

Efforts to eliminate mother-to-child transmission of HIV in Tanzania are guided by a four-prong strategy advocated by the World Health Organization (WHO). Prong 2, prevention of unintended pregnancies among women living with HIV, has, however, received the least attention and contraceptive use to prevent unintended pregnancies remains low. This study explored the perceived barriers to the use of modern methods of contraception, and factors influencing contraceptive choice among HIV-positive women in urban Dar-es-Salaam, Tanzania. A qualitative multi-site study was conducted, utilising in-depth interviews and focus group discussions with 37 sexually active HIV-positive women aged between 20 and 44 years, attending three health facilities within Dar-es-Salaam. The theoretical framework was a patient centred model. Four barriers were identified: the influence of the women's spousal relationships; personal beliefs and the relationship of these in understanding her disease; the influence of the social demands on the woman and her relationships; and the importance of a woman's relationship with her healthcare provider/healthcare system. Being the bearers of bad news (HIV-positive status) the pregnant women experienced conflicts, violence, abandonment and rejection. The loss in negotiating power for the women was in relation to their intimate partners, but also in the patient­healthcare provider relationship. The role of the male partner as a barrier to contraceptive use cannot be understated. Therefore, the results suggest that healthcare providers should ensure patient-focused education and provide support that encompasses the importance of their relationships. Additional research is required to elucidate the functional association between contraceptive choices and personal and social relationships

Facteurs associés à l'utilisation des méthodes contraceptives à longue durée d'action et permanentes dans la ville de Lubumbashi, RD Congo

Introduction : Cette étude avait l'objectif de déterminer les facteurs qui sont associés à l'utilisation des Méthodes Contraceptives à Longue Durée d'Action et Permanente par les femmes (MCLDAP) dans la ville de Lubumbashi. Patientes et méthodes : Nous avons mené une étude transversale d'avril à juin 2015, auprès des femmes en union conjugale de la ville de Lubumbashi, d'où un échantillon a été tiré. L'échantillonnage en strates nous a permis de sélectionner les femmes ; les données étaient récoltées par interview guidée par un questionnaire ; les tests de Khi-deux de PEARSON, au seuil de risque de 5% et le Rapport de Prévalence et son Intervalle de Confiance à 95% nous ont permis de déterminer l'association. Les logiciels Excel et Epi Info version 3.3.2 nous ont aidés à analyser. Résultats : La prévalence contraceptive des MCLDAP était de 8,9%. Les facteurs associés à l'utilisation de ces méthodes étaient l'âge de la femme supérieur ou égal à 35 ans ; les religions catholique, protestante, musulmane et kimbanguiste prédisposaient les femmes à l'usage des MCLDAP, ainsi que les occupations telles que les entreprises publiques, la fonction publique et les entreprises privées ; les femmes dont les ménages possédaient la radio et la TV utilisaient plus la contraception à longue durée et permanente, de même que les femme qui avaient quatre à cinq enfants vivants ; nous avons également noté que les femmes qui avaient une attitude favorable face aux méthodes et un niveau de connaissance élevé avaient cette même chance. Enfin, celles qui discutaient couramment avec leurs conjoints et qui avaient obtenu leur soutien, avaient aussi plus de chance d'utiliser les MCLDAP.Conclusion : Ces facteurs devraient être soutenus pour optimiser l'utilisation des MCLDAP par les femmes dans la ville de Lubumbashi

Determinants of unmet need for modern contraception andreasons for non-use among married women in rural areas of Burkina Faso

Burkina-Faso (TFR=6.0) is among the top-ten high fertility countries world-wide and CPR (15) among women is low. This study examined the factors associated with non-use of modern contraception among married women residing in the rural areas of Burkina-Faso. The study used 2010 Burkina Faso Demographic and Health Survey data-set and focussed on married women aged 15-49 years (n=7;191). Chi-square and logistic regression techniques were used for the analysis (a=5). Mean number of living children was significantly higher among women who have UNMC (3.92) than those with met need (3.01). Modern CPR and UNMC among married women was 12.7 and 40.7 respectively. The multivariate analysis reveals that being married more than once increases the likelihood of UNMC (OR=1.304; C.I=1.0821.571; p0.05). Husbands' approval of FP is a protective factor of UNMC (OR

Echec de l'utilisation des produits contraceptifs chez les femmes de deux districts sanitaires en Côte d'Ivoire

Cet article analyse la situation reproductive des femmes sous methodes contraceptives dans deux districts sanitaires ivoiriens. Il s'agit d'une etude retrospective realisee dans les services de planification familiale (SPF) et de maternite des districts sanitaires d'Adzope et d'Agboville dans le sud-est de la Cote d'Ivoire. La methodologie de collecte des donnees a consiste a l'analyse de (150) dossiers de femmes frequentant les SPF et l'exploitation de rapports d'activites des centres de sante. Ensuite; des entretiens ont ete effectues; a l'aide d'un guide; avec les sages-femmes et les femmes enceintes. Les resultats etablissent une faible couverture contraceptive (2 a 5) et le recours frequent a la contraception orale ; l'echec de la contraception a ete traduit par l'abandon des consultations prenatales (34 a Agboville et 49 a Adzope); les accouchements a risques effectues a domicile (19 a Agboville et 18 a Adzope) ainsi que les avortements spontanes (58 cas a Agboville et 240 cas a Adzope) et provoques (69 a Agboville et 146 cas a Adzope) avec une augmentation (+63) a Adzope de 2001 a 2002 chez les utilisatrices de contraceptifs des districts sanitaires

Islam; Polygyny and Modern Contraceptive Use in Francophone Sub-Saharan Africa

Francophone sub-Saharan African countries have among the highest fertility rates and lowest modern contraceptive prevalence rates worldwide. This analysis is intended to identify the factors driving contraceptive prevalence in this population. In addition to testing the usual correlates; we have included three other variables potentially related to lower contraceptive use in the Francophone African context: being Muslim; being in a polygynous union; and participation in crucial decision-making processes. We obtained descriptive statistics for 11 Francophone African countries with DHS data collected since 2000 for relevant variables. As expected; education; place of residence; age and number of children were significant for most countries in predicting modern contraceptive use. The final three factors yielded inconclusive results. The conventional correlates were by far the most predictive of MCPR; although women's participation deserves further analysis. These results dispel anecdotal evidence that being Muslim and in a polygynous union explain low CPR in this region

Use of modern birth control methods among rural communities in Imo State, Nigeria

This paper studied the extent of utilization of Modern Birth Control Methods (MBCM) among rural dwellers in Imo State Nigeria. Three hundred and sixty households were randomly selected and data were obtained from them with the use of questionnaires and Focus Group Discussion. The results showed that only 30% of the respondents used MBCM while 57% of them used the traditional birth control methods. The most popular modern method was the condom (24.2%). This was followed by the IUD, used by only 2.5% of the respondents. Some of the identified factors that hindered the use of MBCM included perceived negative health reaction, fear of the unknown effects, cost, spouse's disapproval, religious belief and inadequate information. For a better understanding and utilization of MBCM, it is recommended that adequate educational campaign should be mounted in the rural areas on the advantages of MBCM. This campaign should target the men the more because they make the major decisions on MBCM use. (Afr Reprod Health 2008; 12[1]:101-108)

Factors Related to the Uptake of Natural Family Planning by Clients of Catholic Health Units in Masaka Diocese; Uganda

Globally and locally in Uganda; family planning (FP) is promoted to enable individuals and couples to space and limit childbirth. FP promotion is based on demographic and health concerns and basic human rights. Clients can use either artificial family planning (AFP) or natural family planning (NFP) methods but none is 100effective. Whereas NFP methods are known to be free from side effects; with no continuous costs; and widely accepted by most religions and cultures; most clients use AFP methods despite their many side effects and costs. The Roman Catholic Church (RCC) opposes AFP methods on fundamental grounds such as the definition of the onset of life and the purpose of sexual union. Additional reasons fronted by the church include the potential misuse of AFP methods and the false sense of security they impart to the users. This study set out to find out how health services under the RCC promote the use of NFP methods in an area of heavy RCC presence; and how these efforts translate into uptake of the methods. It shows that despite the recommendation of NFP methods; RCC health units did not have staff trained in promoting and offering NFP methods. There were no budgets; supplies; registers; teaching AIDS; and no records of NFP clients were kept. No space for NFP clinics was provided and there was no arrangement for continuous professional education (CPE) for NFP providers. Basic knowledge about NFP e.g. the role of breastfeeding and periodic abstinence was acquired from friends. Knowledge about NFP methods was insufficient among clients to the services and in some health workers. Most of the respondents; of which 76( 154/202) were Catholics had more information about AFP methods and knew where to access them. The study recommends that RCC authorities in Uganda; as the main champions of NFP; need to provide political commitment to NFP; invest more in and reinvigorate the teaching of NFP methods through their structures. In addition; there is need for support supervision on NFP access and use within RCC health facilities

The prevalence of unwanted pregnancies among young women in the greater Freetown area

1896 women aged 12-22 yaers in the greater Freetown area were interviewed. 91 per cent were either students; petty traders or uneployed. The abortion rate was 20 per cent; the valuntary abortion rate was 11.9 per cent. Most of the valuntary abortions were done by doctors in hospitals. Only 6 per cent of 1st abortion was done free of charge. The partner paid for 54 per cent and the clients paid for themselves in 23 per cent of cases. The post secondary educated group recorded a significantly higher voluntary abortion rate

Trends and Determinants of Contraceptive Use in Rakai District; Uganda; 1995-98

A prospective study conducted between 1995 and 1998 assessed trends in contraceptive use in rural Rakai District; Uganda.Over a period of 30 months; women's use of modern contraceptives increased significantly from 11 percent to 20 percent. Male condom use inceased from 10 percent to 17 percent The prevalence of pregnancy among sexually active women 15-49 declined significantly from 15 percent to 13 percent. Women practicing family planning for pregnancy prevention were predominantly in the 20-39-year age group; married; better educated; and had higher parity than others; whereas women or men adopting condoms were predominantly young; unmarried; and better educated. Condom use was particularly high among individuals reporting multiple sexual partners or extramarital relationships. Contraceptive use was higher among women who desired fewer children; among those who wished to space or terminate childbearing; among women with previous experience of unwanted births or abortions. Self-perception of HIV risk increased condom use; but HIV testing and counseling had only modest effects. Contraception for pregnancy prevention and for HIV/STD prophylaxis are complementary