Reasons for nonuse of contraceptive methods by women with demand for contraception not satisfied: an assessment of low and middle-income countries using demographic and health surveys
Reasons for nonuse of contraceptive methods by women with demand for contraception not satisfied: an assessment of low and middle-income countries using demographic and health surveys
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DOI：
10.1186/s12978-019-0805-7
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发表时间：
2019-10-11
影响因子：
3.4
通讯作者：
Silveira, Mariangela Freitas
中科院分区：
文献类型：
--
作者：
Moreira, Laisa Rodrigues;Ewerling, Fernanda;Silveira, Mariangela Freitas
背景：需要避孕的女性不使用避孕方法可能会影响她们的性健康和生殖健康。本研究的目的是描述低收入和中等收入国家避孕需求未得到满足的女性不采取避孕措施的原因（考虑整个国家和各个女性亚群）。方法：我们使用了来自 47 个国家的最新人口和健康调查数据。对避孕需求未得到满足的性活跃女性不使用避孕方法的原因进行描述性分析。还根据婚姻状况、女性年龄和受教育程度、居住地区、财富指数和奇偶性来评估每个报告原因的发生率。还使用不平等斜率指数评估了每种原因的与财富相关的绝对不平等。有利于富人的不平等模式意味着这种原因在最富有的女性中更为普遍，而有利于穷人的不平等模式则意味着这种原因在最贫穷的女性中更为普遍。 结果：平均而言，需要避孕的女性中有 40.9% 没有使用任何避孕方法来避免怀孕。总体而言，不使用避孕药具的最普遍原因是“健康问题”和“性生活频率低”，但各个原因的流行率在不同国家之间存在很大差异。已婚女性因“他人反对”而不使用的比例高于未婚女性；反过来，由于"缺乏机会"或"缺乏知识"而导致不使用的发生率在农村地区大约是城市地区的两倍。受教育程度较低的女性更常报告称，由于“缺乏机会”而未使用。有利于富人的不平等的原因是“健康问题”、“性生活频率低”和“与方法有关”，而“其他反对”、“宿命论”、“缺乏机会”和“缺乏知识”的原因则与有利于穷人的不平等模式有关。 结论：计划生育促进政策必须考虑到每个国家不使用避孕方法的不同原因以及背景差异 关于育龄妇女（例如阻碍妇女获得和使用避孕药具的社会规范和障碍）。
Background: Nonuse of contraceptive methods by women in need of contraception may impact their sexual and reproductive health. The aim of this study was to describe the reasons for nonuse of contraception among women with demand for contraception not satisfied in low and middle-income countries (considering both overall countries and various subgroups of women).Methods: We used the latest Demographic and Health Survey data from 47 countries. A descriptive analysis of the reasons for nonuse of contraceptive methods was performed among sexually active women with demand for contraception not satisfied. The prevalence of each reported reason was also evaluated according to marital status, woman's age and schooling, area of residence, wealth index, and parity. Wealth-related absolute inequality for each reason was also evaluated using the Slope Index of Inequality. A pro-rich inequality pattern means that the reason is more prevalent among the richest women while a pro-poor means the reason is more common among the poorest ones.Results: On average, 40.9% of women in need of contraception were not using any contraceptive methods to avoid pregnancy. Overall, the most prevalent reasons for nonuse of contraceptives were "health concerns" and "infrequent sex," but the prevalence of each reason varied substantially across countries. Nonuse due to "opposition from others" was higher among married than unmarried women; in turn, the prevalence of nonuse due to "lack of access" or "lack of knowledge" was about two times higher in rural areas than in urban areas. Women with less schooling more often reported nonuse due to "lack of access." Pro-rich inequality was detected for reasons "health concerns," "infrequent sex," and "method-related", while the reasons "other opposed," "fatalistic," "lack of access," and "lack of knowledge" were linked to patterns of pro-poor inequality.Conclusions: Family planning promotion policies must take into account the different reasons for the nonuse of contraceptive methods identified in each country as well as the contextual differences regarding women of reproductive age (such as social norms and barriers that prevent women from accessing and using contraceptives).