Low use of contraception among poor women in Africa: an equity issue
Low use of contraception among poor women in Africa: an equity issue
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DOI：
10.2471/blt.10.083329
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发表时间：
2011-04-01
期刊：
影响因子：
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通讯作者：
Tsui, Amy O
中科院分区：
文献类型：
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作者：
Creanga, Andreea A;Gillespie, Duff;Tsui, Amy O
目标 调查撒哈拉以南非洲 13 个国家的避孕措施使用情况；评估与财富相关的不平等相关的避孕需求的满足变化；并描述长期与短期避孕方法的使用与妇女的生育意愿和家庭财富之间的关系。方法本次分析是根据 13 个撒哈拉以南非洲国家的人口和健康调查数据进行的。使用家庭财富和集中度指数计算了避孕药具使用中与财富相关的不平等。 Logistic 回归模型适用于使用长期避孕方法的可能性，并调整了以下各项：财富指数五分位、生育意向（间隔生育与停止生育）、居住地（城市/农村）、教育、在世子女数量、婚姻状况和调查年份。 结果 在埃塞俄比亚、马达加斯加、莫桑比克、纳米比亚和赞比亚的调查期间，避孕措施的使用率大幅增加，但在肯尼亚、塞内加尔和乌干达。大多数国家，尤其是莫桑比克，在满足避孕需求方面与财富相关的不平等现象有所减少，但在肯尼亚、乌干达和赞比亚，在间隔生育方面，以及在马拉维、塞内加尔、乌干达、坦桑尼亚联合共和国和赞比亚，在限制生育方面，这种不平等现象有所加剧。在调整生育意愿后，最富有的五分之一的妇女比最贫穷的五分之一的妇女更有可能实行长期避孕。结论 撒哈拉以南非洲的计划生育方案在覆盖所有社会阶层方面取得了不同程度的成功，但所有国家都仍然存在不平等现象。
Objective To examine the use of contraception in 13 countries in sub-Saharan Africa; to assess changes in met need for contraception associated with wealth-related inequity; and to describe the relationship between the use of long-term versus short-term contraceptive methods and a woman's fertility intentions and household wealth.Methods The analysis was conducted with Demographic and Health Survey data from 13 sub-Saharan African countries. Wealth-related inequities in the use of contraception were calculated using household wealth and concentration indices. Logistic regression models were fitted for the likelihood of using a long-term contraceptive method, with adjustments for: wealth index quintile, fertility intentions (to space births versus to stop childbearing), residence (urban/rural), education, number of living children, marital status and survey year.Findings The use of contraception has increased substantially between surveys in Ethiopia, Madagascar, Mozambique, Namibia and Zambia but has declined slightly in Kenya, Senegal and Uganda. Wealth-related inequalities in the met need for contraception have decreased in most countries and especially so in Mozambique, but they have increased in Kenya, Uganda and Zambia with regard to spacing births, and in Malawi, Senegal, Uganda, the United Republic of Tanzania and Zambia with regard to limiting childbearing. After adjustment for fertility intention, women in the richest wealth quintile were more likely than those in the poorest quintile to practice long-term contraception.Conclusion Family planning programmes in sub-Saharan Africa show varying success in reaching all social segments, but inequities persist in all countries.