Predictors of modern contraceptive use among adolescent girls and young women in sub-Saharan Africa: a mixed effects multilevel analysis of data from 29 demographic and health surveys.
Predictors of modern contraceptive use among adolescent girls and young women in sub-Saharan Africa: a mixed effects multilevel analysis of data from 29 demographic and health surveys.
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DOI：
10.1186/s40834-020-00138-1
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发表时间：
2020-11-19
影响因子：
2.9
通讯作者：
Ahinkorah BO
中科院分区：
文献类型：
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作者：
Ahinkorah BO
撒哈拉以南非洲少女和年轻妇女使用现代避孕药具的情况仍然是一个迫切需要关注的问题。本研究评估了与现代避孕药具的使用AGYW在SSA之间的个人和背景因素。这项研究的数据来自2010年1月至2018年12月在SSA的29个国家进行的最新人口与健康调查（DHS）。采用独立性Pearson卡方检验和多水平二元logistic回归，用Stata 14.2版分析数据。多水平模型的变量选择基于其在卡方检验中p < 0.05的统计学显著性。使用对数似然比和Akaike信息准则（AIC）检查多水平模型的模型拟合度，并使用95%置信区间（CI）下的校正比值比（aOR）显示结果。调查发现，撒哈拉以南非洲24.7%的女青年使用现代避孕药具。在个体水平因素中，年龄在15-19岁的AGYW [aOR = 0.86，CI = 0.83-0.90]、已婚者[aOR = 0.83，CI = 0.79-0.87]、穆斯林[aOR = 0.59，CI = 0.57-0.62]、工作者[aOR = 0.92，CI = 0.89-0.95]、无子女者[aOR = 0.44，CI = 0.42-0.47]、不接触报纸/杂志者[aOR = 0.44，CI = 0.63-0.71]和广播者[aOR = 0.82，CI = 0.78-0.86]使用现代避孕药的几率较低。而首次性行为年龄在15-19岁的AGYW中，现代避孕药具的使用率较高[aOR = 1.20，CI = 1.12-1.28]。在环境因素方面，生活在农村地区的AGYW使用现代避孕药具的几率较低[aOR = 0.89，CI = 0.85-0.93]，文化水平低[aOR = 0.73，CI = 0.70-0.77]和社会经济地位低[aOR = 0.69，CI = 0.65-0.73]的社区。一些个人和背景因素与撒南非洲青年妇女使用现代避孕药具有关。因此，本研究报告所审议的各国政府应加强关于使用现代避孕药具的大众教育。这种教育应该更加集中于社会经济处境不利社区的青年男女总干事、未婚者、穆斯林、高生育率和高生育偏好者以及工作者。
The use of modern contraceptives among adolescent girls and young women (AGYW) in sub-Saharan Africa (SSA) remains an issue that needs urgent attention. This present study assesses the individual and contextual factors associated with modern contraceptive use among AGYW in SSA. Data for this study was obtained from the latest Demographic and Health Surveys (DHS) conducted between January 2010 and December 2018 across 29 countries in SSA. Data were analysed with Stata version 14.2 by employing both Pearson’s chi-square test of independence and a multilevel binary logistic regression. The selection of variables for the multilevel models was based on their statistical significance at the chi-square test at a p < 0.05. Model fitness for the multilevel models was checked using the log likelihood ratios and Akaike’s Information Criterion (AIC) and the results were presented using adjusted odds ratios (aOR) at 95% confidence interval (CI). It was found that 24.7% of AGYW in SSA use modern contraceptives. In terms of the individual level factors, the study showed that AGYW aged 15–19 [aOR = 0.86, CI = 0.83–0.90], those who were married [aOR = 0.83, CI = 0.79–0.87], Muslims [aOR = 0.59, CI = 0.57–0.62], working [aOR = 0.92, CI = 0.89–0.95], those who had no child [aOR = 0.44, CI = 0.42–0.47], those who had no exposure to newspaper/magazine [aOR = 0.44, CI = 0.63–0.71] and radio [aOR = 0.82, CI = 0.78–0.86] had lower odds of using modern contraceptives. Conversely, the use of modern contraceptives was high among AGYW whose age at first sex was 15–19 years [aOR = 1.20, CI = 1.12–1.28]. With the contextual factors, the odds of using modern contraceptives was low among AGYW who lived in rural areas [aOR = 0.89, CI = 0.85–0.93] and in communities with low literacy level [aOR = 0.73, CI = 0.70–0.77] and low socio-economic status [aOR = 0.69, CI = 0.65–0.73]. Several individual and contextual factors are associated with modern contraceptive use among AGYW in SSA. Therefore, Governments in the various countries considered in this study should intensify mass education on the use of modern contraceptives. This education should be more centered on AGYW who are in socio-economically disadvantaged communities, those who are not married, Muslims, those with high parity and high fertility preferences and those who are working.