Differences in family planning outcomes between military and general populations in Kinshasa, Democratic Republic of the Congo: a cross-sectional analysis

Abstract

ObjectivesTo examine family planning outcomes among women living in military camps in Kinshasa, Democratic Republic of the Congo, and compare these outcomes with a representative sample of non-military women in Kinshasa.ParticipantsWomen of reproductive ages, 15–49 years. We compare two populations: women living in military camps and the general (non-military) population in Kinshasa.Study designFor sampling, we used a two-stage cluster sampling design, where we first randomly selected enumeration areas (EA), and then randomly selected women within each EA (separately for each of the two populations). We administered a survey on contraceptive use and family planning to all participating women. We use bivariate and multivariate analysis to compare these populations for a range of family planning outcomes.ResultsWe find many statistically significant differences between women in military camps and general female population of Kinshasa. Although they do not have more children, women in military camps are less likely to be using contraception (all methods OR 0.24, 95% CI 0.11 to 0.53; modern methods OR 0.25, 95% CI 0.08 to 0.79; traditional methods OR 0.41, 95% CI 0.24 to 0.71) and less knowledgeable about many family planning methods (less likely to have heard of implants (OR 0.23, 95% CI 0.11 to 0.48), injectables (OR 0.19, 95% CI 0.08 to 0.44), condoms (OR 0.23, 95% CI 0.12 to 0.47), withdrawal (OR 0.05, 95% CI 0.02 to 0.17) and rhythm (OR 0.12, 95% CI 0.03 to 0.44) methods), while at the same time they are more likely to want to limit their births (OR 5.17, 95% CI 2.52 to 10.62), and less likely to have obtained their preferred family planning method (OR 0.14, 95% CI 0.03 to 0.64).ConclusionsWomen in military camps in Kinshasa appear to be an important and underserved population with regard to family planning. Our results suggest that women in military camps have limited access to modern family planning methods.

The influence of health facility-level access measures on modern contraceptive use in Kinshasa, DRC

“…Surprisingly, our findings did not confirm the role of wealth on modern contraceptive use. This finding is in contrast with previous results of studies from other countries [ 14 , 45 , 46 ], but consistent with another study from the DRC [ 47 ].…”

Incidence and determinants of Implanon discontinuation: Findings from a prospective cohort study in three health zones in Kinshasa, DRC

“…Women in military camps have limited access to modern family planning methods and are less likely to be using contraception [27]. In the DRC, military camps are closed environments and difficult to access by the civilian population; as such, they are not often targeted by mass health activities, including FP campaigns.…”

Family Planning in the Democratic Republic of the Congo: Encouraging Momentum, Formidable Challenges

“…The study showed as of 2016, the mCPR of married women living in military camps was much lower (16.0%) than the total population (23.4%). 34 Because military camps are often considered a “difficult location” to work, previous programs had avoided them. Instead, they are currently partners in programming that trains personnel in fixed facilities, establishes community-based distribution outlets, and features military personnel in billboards promoting family planning in Kinshasa and the adjacent province of Kongo Central.…”