Husband's/partner's support for family planning may influence a women's modern contraceptive use. Socio-demographic factors, couple communication about family planning, and fertility preferences are known to play a role in contraceptive use. We conducted logistic regression analysis to investigate the relationship between perceived husband's/partner's approval and husband's/partner's encouragement of modern contraceptive use, adjusting for socio-demographic factors and recent couple communication about family planning. We also examined mediating roles potentially played by perceived contraceptive accessibility and contraceptive self-efficacy (using index created by principal component analysis). Perceived husband's/partner's approval was associated with triple the odds of women's modern contraceptive use and remained significantly associated with 1.6 times the odds, after controlling for contraceptive accessibility and contraceptive self-efficacy. Husband's/partner's encouragement, while initially significantly associated with contraceptive use, became non-significant after adjustments for socio-demographic factors and couple communication. Key words: Contraception, male involvement, approval, encouragement, sub-Saharan Africa RésuméLe soutien du mari ou du partenaire pour la planification familiale peut influencer l'utilisation des contraceptifs modernes chez les femmes. Les facteurs sociodémographiques, la communication en couple sur la planification familiale et les préférences en matière de fécondité jouent un rôle dans l'utilisation des contraceptifs. Nous avons procédé à une analyse de régression logistique pour étudier la relation entre l'approbation perçue du mari /du partenaire et l'encouragement du mari / du partenaire à l'utilisation des contraceptifs modernes, en adaptant les facteurs sociodémographiques et la communication récente sur la planification familiale. Nous avons également examiné les rôles médiateurs potentiellement joués par l'accessibilité des contraceptifs perçue et l'auto-efficacité des contraceptifs (en utilisant l'indice créé par l'analyse des composantes principales). L'approbation perçue du mari / du partenaire était associée au triple des probabilités d'utilisation des contraceptifs modernes des femmes et est restée significativement associée à 1,6 fois la probabilité, après avoir contrôlé l'accessibilité des contraceptifs et l'auto-efficacité des contraceptifs. Les encouragements du conjoint et du partenaire, tout en étant initialement associés à l'utilisation des contraceptifs, sont devenus non significatifs après des ajustements pour les facteurs sociodémographiques et la communication en couple. L'approbation perçue du mari / du partenaire, séparée du sentiment d'auto-efficacité d'une femme et de l'accessibilité perçue des contraceptifs, apparaît fortement et positivement associée à l'utilisation actuelle des contraceptifs modernes. Une communication accrue en couple peut aider les femmes à identifier l'approbation de leur mari /de leur partenaire. La différence entre...
BackgroundThe objective of this study is to identify factors associated with current modern contraceptive use among Angolan women. By differentiating according to age groups (15–24 and 25–49 years), this study aimed to help family planning program planners better tailor interventions to improve utilization of modern contraception.MethodsA household survey was used to collect data from 1,545 women of reproductive age living in Luanda Province, Angola. Data on sociodemographic characteristics, reproductive behavior and intentions, contraceptive knowledge and use, and attitudes and beliefs regarding contraception and abortion were collected. The analyses were stratified based on age: 15–24 years (youth) and 25–49 years (adult). Multivariate logistic regression models were built for each age group, adding different subsets of variables in groups to see how relationships changed across the models.ResultsCommon factors associated with modern contraceptive use among all ages include education level, perceived contraceptive accessibility, contraceptive knowledge, communication with partner about family planning in last year, and self-efficacy. Exposure to family planning information in the media in the last few months, perceived partner approval of family planning, and marital status were all positively associated with current modern contraceptive use among women aged 15–24 years. Meanwhile, receiving information about family planning from a pharmacy in the last year was uniquely associated with current modern contraceptive use among women aged 25–49 years.ConclusionYoung women in Luanda, Angola seem to have a unique set of factors affecting their contraceptive use. These findings highlight the need for family planning programs to cater services and messages toward specific age groups.
Introduction The Government of Angola is engaged in ongoing efforts to increase access to contraceptives, in particular contraceptive implants (CIs). Discontinuation of CIs, however, has been identified as being a challenge to this work, hindering the improvement of contraceptive prevalence, and in turn, maternal and child health. The objective of this study was to understand motives for contraceptive implant discontinuation in Luanda and Huambo, Angola. Methods We conducted 45 in-depth interviews and six focus groups amongst former and current contraceptive implant clients and family planning nurses in eight clinics across the provinces of Huambo and Luanda. Data collectors transcribed and translated key information from Portuguese into English. We used a combined deductive/inductive approach to code and analyze data. Results Participants described adverse side effects, desire for pregnancy, partner dissatisfaction, quality of care, alternative or lack of information, and religion as motives for discontinuation. Adverse side effects, including prolonged bleeding, amenorrhea, and headaches were most commonly cited by both clients and providers. Discussion Motives for discontinuation reflect existing findings from other studies in similar settings, in particular the influence of adverse side effects and desire for pregnancy as motivating factors. We contextualize these findings in the Angolan setting to tease out the relationship between cultural norms of ideal family size and the perceived role of women in regards to fertility and child-bearing. We suggest that programs enter into dialog with communities to address these concerns, rather than working exclusively on improving service delivery and quality.
High rates of fertility contribute directly and indirectly to poor maternal and child health by increasing exposure to pregnancy related risks in women, and reducing availability of scarce resources for children. The Republic of Angola currently has the world's highest under-five mortality rate at 157/1000 live births 1 and a maternal mortality ratio of 460/100,000 live births 2 , coupled with a crude birth rate of 44 births/1000 people 3 . To address these challenges, Jhpiego has been working since 2011 to implement the ForçaSaúde Program, where a key component has been to increase access to and utilization of modern contraceptives, including sub-dermal implants. The program initially saw 13,000 women receiving contraceptive implants over a 14-month period 4 , but anecdotal evidence suggests that there have been an increasing number of women returning to remove their implants. In response, we conducted a formative evaluation to understand drivers for discontinuation and barriers to use, and to identify possible interventions.
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