Married women’s autonomy and post-delivery modern contraceptive use in the Democratic Republic of Congo

Sano, Yuji; Antabe, Roger; Atuoye, Kilian Nasung; Braimah, Joseph Asumah; Galaa, Sylvester Zackaria; Luginaah, Isaac

doi:10.1186/s12905-018-0540-1

Cited by 34 publications

(40 citation statements)

References 28 publications

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“…Lastly and critical to the success of any health system is service acceptability, which is a function of the fit between provided service and user expectations. While education, age and religion have been identified as important correlates of health care service use, they have also been reported to greatly influence service acceptability (Peters et al, 2008;Negin et al, 2009;Sano et al, 2018a).…”

Section: Theoretical Backgroundmentioning

confidence: 99%

Access to primary health care among women: the role of Ghana’s community-based health planning and services policy

Braimah

Sano

Atuoye

et al. 2019

Prim Health Care Res Dev

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Background:Ghana in 1999 adopted the Community-based Health Planning and Service (CHPS) policy to enhance access to primary health care (PHC) service. After two decades of implementation, there remains a considerable proportion of the country’s population, especially women who lack access to basic health care services.Aim:The aim of this paper is to understand the contribution of Ghana’s CHPS policy to women’s access to PHC services in the Upper West Region (UWR) of Ghana.Methods:A logistic regression technique was employed to analyse cross-sectional data collected among women (805) from the UWR.Findings:We found that women who resided in CHPS zones (OR = 1.612;P ≤0.01) were more likely to have access to health care compared with their counterparts who resided in non-CHPS zones. Also, rural-urban residence, distance to health facility, household wealth status and marital status predicted access to health care among women in the region. Our findings underscore the need to expand the CHPS policy to cover many areas in the country, especially rural communities and other deprived localities in urban settings.

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Section: Theoretical Backgroundmentioning

confidence: 99%

Access to primary health care among women: the role of Ghana’s community-based health planning and services policy

Braimah

Sano

Atuoye

et al. 2019

Prim Health Care Res Dev

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“…CCU is common in male-dominated settings where women lack the autonomy to make choices on their health [ 18 ]. Studies have shown a positive association between women empowerment and autonomy and their use of contraceptives [ 19 – 21 ]. Women should be free to decide and choose their preferred FP method even in settings with better male involvement and spousal communication on FP [ 22 , 23 ].…”

Section: Introductionmentioning

confidence: 99%

Prevalence and factors associated with covert contraceptive use in Kenya: a cross-sectional study

2021

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Background Family planning (FP) is a key intervention for preventing unplanned pregnancies, unsafe abortions, and maternal death. Involvement of both women and their partners promotes contraceptive acceptance, uptake and continuation, couple communication and gender-equitable attitude. Partner involvement is a key strategy for addressing about 17.5% of the unmet needs in FP in Kenya. This study assessed the prevalence and factors associated with covert contraceptive use (CCU) in Kenya. Methods We used data from the sixth and seventh rounds of the performance monitoring for accountability surveys. We defined CCU as “the use of contraceptives without a partner’s knowledge”. We used frequencies and percentages to describe the sample characteristics and the prevalence of CCU and assessed the associated factors using bivariate and multivariable logistic regressions. Results The prevalence of CCU was 12.2% (95% CI: 10.4–14.2%); highest among uneducated (22.3%) poorest (18.2%) and 35–49 years-old (12.8%) women. Injectables (53.3%) and implants (34.6%) were the commonest methods among women who practice CCU. In the bivariate analysis, Siaya county, rural residence, education, wealth, and age at sexual debut were associated with CCU. On adjusting for covariates, the odds of CCU were increased among uneducated women (aOR 3.79, 95% CI 1.73–8.31), women with primary education (aOR 1.86, 95% CI 1.06–3.29) and those from the poorest (aOR 2.67, 95% CI 1.61–4.45), poorer (aOR 1.79, 95% CI 1.05–3.04), and middle (aOR 2.40, 95% CI 1.52–3.78) household wealth quintiles and were reduced among those with 2–3 (aOR 0.49, 95% CI 0.33–0.72) and ≥ 4 children (aOR 0.62, 95% CI 0.40–0.96). Age at sexual debut (aOR 0.94, 95% CI 0.89–0.99) reduced the odds of CCU. Conclusion About one in 10 married women in Kenya use contraceptives covertly, with injectables and implants being the preferred methods. Our study highlights a gap in partner involvement in FP and calls for efforts to strengthen their involvement to increase contraceptive use in Kenya while acknowledging women’s right to make independent choices.

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“…Previous research has shown influence of male partners in contraception decisions (Morse, Rowen, Steinauer, Byamugisha, & Kakaire, 2014;M. F. Muanda, Ndongo, Messina, & Bertrand, 2017;Orji, Ojofeitimi, & Olanrewaju, 2007;Sano et al, 2018). The limitations of our study could be addressed in future work by using a welldefined family planning intervention, prospectively following women after the discussion with a nurse, and studying a less restricted study population.…”

Section: Discussionmentioning

confidence: 91%

Effect of Family Planning Counseling After Delivery on Contraceptive Use at 24 Weeks Postpartum in Kinshasa, Democratic Republic of Congo

Zivich

Kawende

Lapika

et al. 2018

Matern Child Health J

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Introduction-Unintended pregnancy during the postpartum period is common. The aim of this study was to describe contraceptive use among postpartum women and assess whether family planning counseling offered by health care providers during well-baby clinic visits increased use of modern contraceptive methods at six months following delivery. Methods-Data comes from a cohort of women enrolled in a breastfeeding promotion trial in Kinshasa, Democratic Republic of Congo who reported being sexually active at 24-weeks postpartum. Modern contraceptive methods included intrauterine devices, injectables, implants, and contraception pills. Logistic regression models were used to estimate odd ratios (OR) and 95% confidence intervals (CI) for the impact of nurse counseling on use of modern birth control methods. Results-Of 522 participants who reported being sexually active, 251 (48.0%) reported doing at least one thing to avoid pregnancy and were included in this analysis. Of these 251, 14.3% were using a modern contraceptive method, despite availability at the clinic. Discussion with a nurse about family planning was associated with increased odds of using modern birth control relative to other methods (OR = 4.0, 95%CI: 1.9, 8.6). Discussion-Discussion of family planning with a nurse increased the odds of using a modern contraceptive among postpartum women. Integration of family planning counseling into postpartum services offers a potential avenue to increase modern contraceptive use among women with access.

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Married women’s autonomy and post-delivery modern contraceptive use in the Democratic Republic of Congo

Cited by 34 publications

References 28 publications

Access to primary health care among women: the role of Ghana’s community-based health planning and services policy

Access to primary health care among women: the role of Ghana’s community-based health planning and services policy

Prevalence and factors associated with covert contraceptive use in Kenya: a cross-sectional study

Effect of Family Planning Counseling After Delivery on Contraceptive Use at 24 Weeks Postpartum in Kinshasa, Democratic Republic of Congo

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