Factors associated with contraceptive use in a rural area in Western Cape Province
Factors associated with contraceptive use in a rural area in Western Cape Province
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DOI：
10.7196/samj.6201
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发表时间：
2013-06-01
期刊：
影响因子：
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通讯作者：
London, L
中科院分区：
文献类型：
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作者：
Peer, N;Morojele, N;London, L
背景。安全有效地使用避孕药具可以大大改善妇女的生殖健康。尽管南非的避孕普及率（CPR）与全球相当，但CPR的不平等影响着贫困和农村妇女。本研究旨在确定在西开普省农村地区的CPR和相关因素的避孕使用。2006年，在西开普省的一个农村地区进行了一项预防原发性胎儿酒精综合征的研究，收集了基于412名18至44岁女性面对面访谈的横断面调查数据。本研究以有效避孕（ECC）作为结局变量。ECC包括使用口服避孕药、避孕套、注射剂或绝育。自变量包括社会人口因素、药物使用、心理社会因素、社区因素、生育特征和伴侣特征。与低自尊或中度自尊相比，高自尊的女性更有可能使用ECC(患病率风险比(PRR)=1.23；95%置信区间（CI） 0.99 ~ 1.53)；是否强烈或适度同意他们的文化赋予男性在生育问题上做决定的权利（PRR=1.28; 95% Cl = 0.96 - 1.71）；如果他们有一个或多个孩子，与没有孩子相比（PRR=1.62; 95% CI 1.24 - 2.11）。本研究中性活跃女性的CPR较低，为39.3%。为了在类似的农村人口中促进避孕药具的使用，计划生育方案应侧重于增加男子对避孕药具的赞同，改善有关计划生育的伙伴交流，增强妇女对其生殖决策的信心，特别是她们的自尊。应该更多地关注未生育妇女。
Background. Safe and effective contraceptive use can substantially improve women's reproductive health. Although the contraceptive prevalence rate (CPR) in South Africa is comparable to rates globally, inequalities in CPR affect poor and rural women. This study aimed to determine the CPR and factors associated with contraceptive use in a rural district of Western Cape Province.Method. Cross-sectional survey data based on 412 face-to-face interviews with female participants between 18 and 44 years of age were collected in 2006 for a primary fetal alcohol syndrome prevention study in a rural district in Western Cape Province. The study used effective contraception (ECC) as the outcome variable. ECC included use of oral contraceptives, condoms, injectables or sterilisation. Independent variables included socio-demographic factors, substance use, psychosocial factors, community factors, childbearing characteristics and partner characteristics.Results. Women were more likely to use ECC if they reported high self-esteem (compared with low or moderate self-esteem (prevalence risk ratio (PRR)=1.23; 95% confidence interval (CI) 0.99 - 1.53); if they strongly or moderately agreed that their culture entitled men to make decisions regarding child-bearing compared with those who disagreed (PRR=1.28; 95% Cl 0.96 - 1.71); and if they had one child or more compared with no children (PRR=1.62; 95% CI 1.24 - 2.11).Conclusion. The CPR for sexually active women in this study was low at 39.3%. To promote contraceptive use in similar rural populations, family planning programmes should focus on increasing men's approval of contraception, improving partner communication around family planning and bolstering women's confidence in their reproductive decision-making, and particularly their self-esteem. There should be greater focus on nulliparous women.