Unmet need for family planning among reproductive-age women living with HIV in Ethiopia: A systematic review and meta-analysis

Kefale, Bereket; Adane, Bezawit; Damtie, Yitayish; Arefaynie, Mastewal; Andargie, Assefa; Addisu, Elsabeth

doi:10.1371/journal.pone.0255566

Cited by 6 publications

(9 citation statements)

References 24 publications

(58 reference statements)

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“…Our analysis revealed that geographical residence (rural vs urban), age of woman, socioeconomic status, number of children ever born to a woman (parity), employment status and partner’s age constituted factors significantly associated with unmet need for family planning. These findings are largely consistent with other studies (22, 30-31) including a Zambian study which analysed unmet need for family planning using the 2018 DHS data (30). From a review of literature predictors of contraceptive uptake and unmet need for family planning are similar for HIV positive and HIV negative women.…”

Section: Discussionsupporting

confidence: 90%

“…Nonetheless, findings from some cross-sectional studies show similar levels reported in different survey points in our study. For example, a meta-analysis of unmet need for family planning among reproductive age women living with HIV in Ethiopia reported a pooled prevalence of 25% (22). Similarly, an analysis of DHS data from twelve African countries with an HIV prevalence of more than 3%, including Zambia, showed an unmet need for family planning among women with HIV ranging from 9% to 23% (23)…”

Section: Discussionmentioning

confidence: 99%

“…There is also evidence that even modest decreases in the number of pregnancies to HIV-positive women could significantly reduce new HIV infections among children from both women living with HIV who are not on treatment (where prong 2 has the largest effect) and women living with HIV who are on treatment and desire to space or limit birthing (13). Moreover, some regional evidence suggests that an estimated “ 333,000 new infant infections could be averted annually, if all women in the sub-Sahara Africa who did not wish to become pregnant could have access to contraceptive services” (22). This evidence renders it highly probable that greater strides could have been made in reducing vertical transmission if unmet need for family planning reduced at a faster rate than current trends in Zambia.…”

Section: Discussionmentioning

confidence: 99%

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Trends and predictors of unmet need for family planning among women living with HIV in Zambia: implications for elimination of Mother to Child Transmission of HIV

Lungu

Chewe

2022

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Introduction Prevention of Mother To Child Transmission (PMTCT) of HIV is one of the key strategies towards HIV epidemic control. Despite considerable progress in PMTCT of HIV over the past decade in Zambia, the country is yet to reach global and national target for elimination of Mother To Child Transmission of HIV. Avoidance of unintended pregnancy among women living with HIV provides is one of the cost-effective interventions in a comprehensive PMTCT of HIV approach. This study therefore aimed at ascertaining trends in and predictors of unmet need for family planning among women living with HIV in Zambia Methods The study employed a repeated cross sectional (RCS) study design, using data from the three (3) most recent consecutive rounds of the Zambia Demographic and Health Survey (ZDHS) conducted in 2007, 2013/2014 and 2018. The study used data from a total of 34,204 women aged 15-49 years from the three survey points, 2007, 2013/14 and 2018, among whom 4,985 were HIV positive, with a final sample size constituting 2,675 married women living with HIV. We used descriptive statistics and logistic regression analyses to respectively ascertain trends in and predictors of unmet need for family planning among married women living with HIV. Results Over the three survey points, unmet need for family planning among married women living with HIV has hardly declined, registering 22% in both the 2007 and 2018. Residence, age of women, household wealth, woman’s parity, employment, and age of spouse emerged as significant predictors of unmet need for family planning among women living with HIV in Zambia Conclusion Preventing one HIV infection in a child is averting lifetime costs of HIV treatment and associated healthcare costs. There is need to consider optimization of PMTCT interventions including shaping programming regarding prong 2 in a way that it responds to main causes of mother to child transmission of HIV in Zambia. Among other aspects, policy and practice needs to strengthen SRH/HIV integration and better target rural residents, younger women, those with high parity and consider positive male engagement to reduce unmet need for family planning among women living with HIV.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Trends and predictors of unmet need for family planning among women living with HIV in Zambia: implications for elimination of Mother to Child Transmission of HIV

Lungu

Chewe

2022

Preprint

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“…The UNFP in sexually active unmarried women was 8.0% and in married women 3.7% ( 18 ). The UNFP has been barely studied in populations with special needs, such as those with chronic diseases ( 22 , 23 ) including MS ( 24 ).…”

Section: Introductionmentioning

confidence: 99%

Fertility preferences and unmet need for family planning in women with multiple sclerosis

et al. 2022

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BackgroundMost women with multiple sclerosis (MS) have childbearing potential. Although fertility and pregnancy are not affected by MS, the fertility preferences of women with MS can change due to the risk of complications for the mother and/or adverse pregnancy outcomes resulting from the disease or its treatment.ObjectivesTo describe fertility preferences (FPs) and their associated factors, to estimate the Unmet Need for Family Planning (UNFP), use of contraceptives, and history of exposure to disease-modifying therapies (DMTs) during pregnancy in women with MS.MethodsIn a cross-sectional observational study, a random sample of women with MS were surveyed with the FP subset of the Demographic and Health Survey of Colombia. Factors associated with FP were evaluated through bivariate and logistic regression analysis. The proportion of pregnancies exposed to DMTs, UNFP, and use of contraceptives was estimated.ResultsOf the 141 women interviewed, 101 women had childbearing potential, of whom 49 did not want to have children, 38 were sterilized, 33 wanted to have more children, 19 were undecided, and 2 stated they were unable to bear children (menopause or hysterectomy). No MS-related variables were associated with the preference to have more children. Age (OR 0.91; 95% CI 0.84–0.98) and the number of children (OR 0.23; 95% CI 0.09–0.58) decreased the likelihood of desire for children. Of 116 sexually active women, 87.06 % (101) were using contraceptives, and among them, four were using fertility awareness methods and withdrawal. The UNFP was estimated at 6.03% and was not significantly different from the general population. Eighty-two pregnancies were identified, of which 48 occurred after diagnosis, and 25 were exposed to DMTs.ConclusionFertility preference in women with MS is not associated with clinical variables. A large proportion of women choose not to have children and prefer to use permanent contraceptive methods. Although the frequency of contraceptive use was high, some women have the UNFP and use low-efficacy contraceptive methods, which may result in unplanned pregnancies.

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“…According to a systematic review study, the prevalence of unmet family planning needs in Ethiopia ranged from 26.52 to 36.39 percent, which is higher than the results of the 2016 Ethiopian Demographic and Health Survey, which revealed a prevalence of 23 percent [ 5 ]. Other studies also show high level of unmet need like study done in southwest Ethiopia (26.1%) [ 6 ], a systematic review among HIV positive women(25%) [ 7 ], Eastern Ethiopia (33%) [ 8 ] and central Ethiopia (26) [ 9 ]. Those findings suggest that, further study is required to bring down the problem.…”

Section: Introductionmentioning

confidence: 99%

Trends and predictors of change of unmet need for family planning among reproductive age women in Ethiopia, based on Ethiopian demographic and health surveys from 2005–2016: Multivariable decomposition analysis

et al. 2022

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Background By spacing births and preventing unintended pregnancies, family planning is a crucial technique strategy for controlling the fast expansion of the human population. It also improves maternal and child health. women who are thought to be sexually active but who do not use modern contraception methods, who either do not want to have any more children (Limiting) or who want to delay having children for at least two years are considered to have an unmet need for family planning (Spacing). Objective This study carried out to determine which socio-demographic factors are the key contributors to the discrepancies in the unmet need for family planning among women of reproductive age between surveys years 2005 and 2016. Methods The data for this study arrived from the Ethiopia Demographic Health Surveys in 2005, 2011, and 2016 to investigate trends and Predictors of change of unmet need for family planning among reproductive age women in Ethiopia. Pooled weighted sample of 26,230 (7761 in 2005, 9136 in 2011 and 9,333 in 2016 Ethiopian demographic health surveys) reproductive-age women were used for this study. For the overall trend (2005–2016) multivariable decomposition analysis for non-linear response outcome was calibrated to identify the factors that contributed to the change of unmet need for family planning. The Logit based multivariable decomposition analysis utilizes the output from the logistic regression model to assign the observed change in unmet need for family planning over time into two components. Stata version 16.0 was used to analyze the data. Result The percentage of Ethiopian women of reproductive age who still lack access (unmet need) for family planning declined from 39.6% in 2005 to 23.6 percent in 2016. The decomposition analysis revealed that the change of unmet need for family planning was due to change in characteristics and coefficients. The difference in coefficients accounted for around nine out of 10 variations in unmet family planning need. Education level, birth order, and desired number of children were all factors that changed over the course of the last 11 years in relation to the unmet need for family planning. Conclusion Between 2005 and 2016, there were remarkable changes in unmet need for family planning. Women with birth orders of five and up, women with secondary education, and women who wanted fewer children overall were the main causes of the change in unmet need for family planning.

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Unmet need for family planning among reproductive-age women living with HIV in Ethiopia: A systematic review and meta-analysis

Cited by 6 publications

References 24 publications

Trends and predictors of unmet need for family planning among women living with HIV in Zambia: implications for elimination of Mother to Child Transmission of HIV

Trends and predictors of unmet need for family planning among women living with HIV in Zambia: implications for elimination of Mother to Child Transmission of HIV

Fertility preferences and unmet need for family planning in women with multiple sclerosis

Trends and predictors of change of unmet need for family planning among reproductive age women in Ethiopia, based on Ethiopian demographic and health surveys from 2005–2016: Multivariable decomposition analysis

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