Factors influencing utilization of modern family planning services by persons living with Human Immunodeficiency Virus at Luwero Hospital, Uganda

Introduction: The use of modern family planning methods is key for achieving the prevention of unintended pregnancies among women living with HIV, in the prevention of Mother-to-child transmission (PMTCT) package. The purpose of this study was to examine the factors influencing the utilization of modern family planning services by persons living with HIV at Luwero Hospital, Uganda. Methods: The study was conducted among 210 persons living with HIV attending the ART clinic and was based on cross-sectional descriptive and analytical design. Sampling was by simple random techniques. Data was collected using researcher-administered questionnaires. Results: The uptake of Modern FP services is low (36.7%) among persons living with HIV. It was attributed to client-related factors such as being married [AOR: 2.2, 95% CI [1.123-4.140], p = 0.038]) and other factors. These are; religious views discouraging use of modern FP (p= 0.034), negative side effects (AOR: 1.8, 95% CI [0.043-1.968], p = 0.044) and services being unfriendly for persons living with HIV (p=0.000]). Conclusions: Despite the presence of modern family planning services, uptake among persons living with HIV is low. Poor utilization is a recipe for unintended pregnancy and thus jeopardizes efforts in the elimination of mother-to-child transmission of HIV

Factors Associated with Failed Contraception in Women Attending Level One Hospitals in Lusaka, Zambia

Background: Unintended pregnancy is a major public health concern due to its impact on maternal morbidity and mortality. Contraceptive failure is one of the causes of unintended pregnancy. Data on factors associated with contraceptive method failure is scarce. This study therefore aimed to explore factors associated with contraceptive failure. Methodology: Unmatched case-control study was conducted at five Level One Hospitals in Lusaka. Convenience sampling was used to enrol 108 cases for whom pregnancy occurred while on a modern contraceptive method and 108 hospital-based controls who were on a modern contraceptive method and not pregnant. Binary and multiple logistic regressions were utilized for assessment of factors associated with failed contraception. Results: Among the 108 cases, 46 (42.6%), 40 (37%), 17 (15.7%) and 1 (0.9%) were on the oral contraceptive pill, injectable, implant and intrauterine device contraception methods respectively while 2 (1.9%) were on barrier and emergency contraceptive methods respectively. The odds of contraceptive failure when using the oral contraceptive pill was more than 7 times (AOR 7.790, 95% CI 1.210-50.161, p=0.031). Those who had contraception failure were more than 3 times more likely to be younger than 30 years old compared to those whose contraceptive method did not fail (AOR 3.559, 95% CI 1.100-11.521, p=0.034 and AOR 3.596, 95% CI 1.354-9.550, p=0.010 respectively for age groups 18-24 years and 24-30 years old). Other factors associated with higher odds of contraceptive failure were duration of marriage greater than one year, with the highest odds in those married for more than 10 years (AOR 9.744, 95% CI 2.232-42.537, p=0.002), higher social support (AOR 2.402, 95% CI 1.085-5.321, p=0.031), multiparity (AOR 15.299, 95% CI 3.034- 77.151, p=0.001), and duration of use of antecedent contraception method of more than 2-3 years (AOR 4.913, 95% CI 1.662-14.526, p=0.004). Conclusion: The oral contraceptive pill, younger age, marriage duration of more than one year and contraceptive use more than three years were associated with contraceptive failure. Good messaging and counseling on usage of the oral contraceptive pill are recommended.

Knowledge and practice regarding the use of emergency contraception among the higher secondary students of Nepal

Background: Emergency contraception or post coital contraception refers to methods of contraception that can be used to prevent pregnancy after sexual intercourse. Among the adolescents, premarital and unplanned sexual intercourse mostly result unintended pregnancy. In such conditions, emergency contraception is effective, safe and relatively inexpensive and can prevent pregnancies up to 95% if taken immediately or within 5 days after the sexual intercourse. Emergency contraception is available in pill form and IUD. Objective of this study was to assess the knowledge and practice of emergency contraception use among the higher secondary level students.Methods: Study includes descriptive cross-sectional method with total 190 respondents who were selected though census method of sampling. Study data were collected through semi structured questionnaire and the data was analyzed by using the SPSS version 20.Results: Mean age of the respondent was 17.8 years and 98.4% of them were unmarried. Among the total respondents only 63.7% of them have heard about the emergency contraception. About 14.2% of the respondents had experience sexual intercourse, out of those 51.8% have used emergency contraceptive method to prevent them from unintended pregnancies. Among those who had experience sexual intercourse, 22% of them got unintended pregnancies, which were managed through surgical abortion (83.3%) and medical abortion (16.7%).Conclusions: Knowledge on proper use of emergency contraceptives can prevent unintended pregnancies that may occur among the adolescents due to premarital and unplanned sexual intercourse. However, only two third of respondents have heard about the emergency contraceptives. So it is important to raise awareness on emergency contraception and its rational use among the adolescents.

Article knowledge, Attitude And Perception Of Contraception Among Medical Students In Universiti Putra Malaysia

@#The incidence of unintended pregnancy and unsafe abortion are significantly high due to the lack of knowledge and negative attitude towards contraception and it can be prevented by effective and appropriate contraceptive knowledge and usage. Considering the future role of medical students as family planning educator as well as counsellors, it is not only important to determine their knowledge, attitude and perception towards contraception but also should be updated for improvement on the quality of future healthcare professionals on contraceptive knowledge which may lead to the reduction in the number of unintended pregnancy with improving maternal morbidity and mortality. This was a cross sectional study using self-reported questionnaires survey that consists of four sections as socio-demographic characteristics information, knowledge towards contraception, attitude towards contraception, and perception of education and training in sexual and reproductive health among medical student. Questions were, distributed among medical students in Faculty of Medicine and Health Sciences and analyzed. The response rate was 100%. and most of the respondents in this study were Malay (64·4%), female (68·3%), single (98·6%) and live in urban area (69·1%). Most of their parents had tertiary education level (father educational level, 63·3%; mother educational level, 50·0%). 56·1% of the respondents had poor level of knowledge and 59.2% of them had negative attitude towards contraception. Regarding the perception on contraception, most of the respondents thought that they did not have sufficient clinical practice (50·4%) though adequate training (57·6%) in counselling the patients for family planning service during their clinical posting. There was a significant association between gender, place of birth, ethnicity, marital status, father educational status and level of knowledge. There were a higher percentage of respondents who had poor knowledge and negative attitude towards contraception. Assessing the knowledge and attitude of medical students on contraception and their relationship with socio-demographic characteristics and socio-economic factors plays a leading role in public health projects which are aimed to combat maternal mortality through reducing unintended pregnancies. To change the attitude towards contraception and further increase the level of knowledge of contraception among medical students, collaborated health education and similar studies among health workers are highly recommended.

Intentions On Contraceptives Use And Method Of Choice Among The Postpartum Women Attending A Tertiary Care Hospital In Jharkhand

Background: Postpartum family planning (PPFP) information and services can prevent maternal and child morbidity and mortality in low–resource countries, like India, where high unmet need for PPFP remains despite opportunities offered by routine postnatal care visits. There is a high unmet need for limiting and spacing child births during the postpartum period. Our objective was to establish the intentions on contraceptive uptake among postpartum women in a referral hospital in Jharkhand. Methods: We conducted a cross–sectional study using a convenience sample of 100 Postpartum women before their discharge following delivery at a tertiary care hospital from January 2018 to March 2018 in MGM Medical college Jamshedpur. Participants were interviewed using structured questionnaires, data was collected and information was obtained from mothers regarding their perceptions on family planning methods, use, availability, and acceptability. Result: 100 women participated in the study. 86% women intend to use a method of postpartum contraception. The most preferred intended postpartum contraceptive was IUDs (25.5%) followed by injectables (20.9%) and condom (11.6%). The most commonly cited reason for the intended choice of contraceptive method was convenience . Reasons for non–use of postpartum contraception include spouse refusal, religious beliefs, effect on fertility, desire for further child beå. Conclusion: Although most women intended to use contraceptive, they did not receive adequate prenatal counseling on postpartum contraception. Counselling on postpartum contraception during the antenatal and postnatal period can help women to make informed choices among the wide range of available contraception.

Evaluation of emergency contraception use among women receiving gynecological treatment in the Brazilian Amazon

INTRODUCTION: The use of a postcoital hormonal contraception regimen has been described and is known as emergency contraception (EC) or "the morning-after pill". The aim of this study was to evaluate the use and level of knowledge about emergency oral contraception (EC) among women attending the gynecology outpatient clinic of the Hospital Fundação Santa Casa de Misericórdia of the State of Pará, the second largest state in the Brazilian Amazon. METHODS: A cross-sectional study was conducted with 316 sexually active women, aged 18 to 50 years, who attended the gynecology outpatient clinic. Participants were included based on spontaneous demand between June and July 2012. Patients answered a questionnaire with 29 questions, including: age in years, educational attainment, knowledge about EC, and previous use of the method. The primary outcome was knowledge on EC use. RESULTS: Participants' mean age was 31.84 years (SD ±8.00). As for their educational level, 46.84% of them had completed high school, and only 8.55% had higher education. Most of the women obtained information about EC through friends (48.61%, n = 152), and only 7.30% from their doctors. Although most participants (83.54%) reported to be aware of the method, only 0.63% reported that EC could be used up to 5 days after unprotected intercourse; 57.59% did not know how to use it; and 76.58% (n = 242) had never used the method. CONCLUSION: The women in our study seem to have a high level of knowledge and prevalence of use of emergency contraception, although few of them knew about the time limit for its use. They should receive more information about emergency contraception

Decline in Child Marriage and Changes in Its Effect on Reproductive Outcomes in Bangladesh.

This paper explores the decline in child marriage and changes in its effect on reproductive outcomes of Bangladeshi women, using the 2007 Bangladesh Demographic and Health Survey data. Chi-square tests, negative binomial Poisson regression and binary logistic regression were performed in analyzing the data. Overall, 82% of women aged 20-49 years were married-off before 18 years of age, and 63% of the marriages took place before 16 years of age. The incidence of child marriage was significantly less among the young women aged 20-24 years compared to their older counterparts. Among others, women’s education appeared as the most significant single determinant of child marriage as well as decline in child marriage. Findings revealed that, after being adjusted for sociodemographic factors, child marriage compared to adult marriage appeared to be significantly associated with lower age at first birth (OR=0.81, 95% CI=76-0.86), higher fertility (IRR=1.45, 95% WCI=1.35-1.55), increased risk of child mortality (IRR=1.64, 95% WCI=1.44- 1.87), decreased risk of contraceptive-use before any childbirths (OR=0.56, 95% CI=0.50-0.63), higher risk of giving three or more childbirth (OR=3.94, 95% CI=3.38-4.58), elevated risk of unplanned pregnancies (OR=1.21, 95% CI=1.02-1.45), increased risk of pregnancy termination (OR=1.16, 95% CI=1.00-1.34), and higher risk of the use of any current contraceptive method (OR=1.20, 95% CI=1.06-1.35). Increased enforcement of existing policies is crucial for the prevention of child marriage. Special programmes should be undertaken to keep girls in school for longer period to raise the age of females at first marriage in Bangladesh and thereby reduce the adverse reproductive outcomes.

Study on the unintended pregnancy among married women of child-bearing age living in Qingshan district, Wuhan / 中华流行病学杂志

Objective To investigate the prevalence of unintended pregnancy (UP) and exploring the risk factors of UP for married women of child-bearing age from Qingshan district,Wuhan.Methods A cross-sectional study was adopted in this study.Cluster sampling method was used with 3256 women recruited,in 2010.Information on history and risks related to social-demographic factors of UP were collected,using a self-administered questionnaire.Results Of the 3256 participants,over half of them (53.8％) reorted ever having had the history of UP and 9.1％ reported UP in the past year.Rate of UP in the past year for different age cohorts (18-30,31-40,41-49 years) were 31.8％,10.5％ and 1.8％ respectively.The most frequently reported reason for UP across all the age cohorts was "Did not use any contraceptive methods",with proportions on the reason that reported by women at 18-30,31-40 and 41-49 year-olds,were 69.7％,51.1％ and 42.4％ respectively.The second frequently reported reasons for UP were "Failure of traditional contraception" for younger cohort ( 18-30 years:13.0％ ) and "IUD dropped or pregnancy with IUD" for older-age cohorts (23.4％ at 31-40 year-olds and 37.0％ at the 41-49 year-oplds).The most frequently cited reason for "Did not use any contraceptive methods" was "Believe we were lucky so far,not to get pregnant" (59.6％).The risk factors of UP were being at older age,experiencing sex debut at younger age and got married at younger age.Conclusion The prevalence of lifetime UP history was high among women at child-bearing age from Qingshan district,Wuhan.Reproductive health services and interventions should be taken according to the needs from different age cohorts of women.Younger cohort of women should receive more attention.