Women in Cairo, Egypt and their risk factors for unmet contraceptive need: a community-based study

Abstract

Background and methodology Although modern family planning methods are readily available in Egypt at low cost, a considerable proportion of women still have an unmet contraceptive need. The aim of this study was to detect the risk factors of unmet contraceptive need among married women in the childbearing period in an underprivileged area in Cairo with high population density. A survey of 2340 women in the Marg district of Eastern Cairo was conducted by means of home interviews. For every woman identifi ed as having an unmet contraceptive need (n=174), the next two women identifi ed with met contraceptive need were selected as controls (n=348). Results The prevalence of unmet need was 7.4%. Risk factors identifi ed were: belief that contraception is religiously prohibited (OR 2.08, 95% CI 1.06-4.09); poor interspousal communication about the desired number of children (OR 2.59, 95% CI 1.40-4.79); husband opposition to contraceptive use (OR 2.96, 95% CI 1.47-5.97); a previous history of unwanted pregnancy (OR 2.98, 95% CI 1.73-5.14); and experiencing side effects from previous contraceptive use (OR 5.69,. Conclusions The authors propose training physicians to identify and counsel women who experience contraceptive side effects and/or a previous unwanted pregnancy, as well as the transmission of clear media messages on the religious acceptability of contraceptive use. IntroductionRates of contraceptive use have increased recently in most developing countries, as has the desire of most married couples for smaller families.1 However, an estimated 17% of married women in the developing world still have an unmet need for contraception, defined as use of no contraceptive method in spite of sexual exposure and an expressed desire to avoid pregnancy.2 Women identified as having an unmet need include those who expressed a desire to postpone their next birth for more than 2 years (spacing) as well as those who wish to have no more children (limiting). Women who are pregnant or have postpartum amenorrhoea who report that their pregnancy was unintended (either mistimed or unwanted) are also classified as having an unmet need. 1Unintended pregnancy is an important public health issue in both developed and developing countries because of its negative association with social and health outcomes for both mothers and children. Numerous risk factors for unmet need in developing countries have been identified. In Egypt, perceived low risk of fertility (infrequent or no sex, infecundity, postpartum amenorrhoeic, or breastfeeding), fear of the side effects of contraception, lack of knowledge of family planning methods and husband opposition have been reported. 4 5 Understanding the underlying reasons of unmet contraceptive need will help to reduce the number of unwanted pregnancies and reduce the birth rate of Egyptian women. Subjects and methodsThe study aim was to identify the risk factors of unmet contraceptive need among married women in the childbearing period in an underprivileged district in Cairo.

Prevalence of Family Planning Practices among Women Influenced by Husband’s Socio Demography and Decision Making

“…Husband's religion (Muslim) was significantly related to wife practice FP (p = 0.008), indicating that Islamic allowed FP practices only if there are complications with wife and babies. However, this is different with the result obtained by Mahmoud Kotb et al (2011) which that FP among couple using contraceptive religiously unacceptable (haram), making it as a reason not to practice family planning.…”

“…One of The issues in FP is because husband reluctant for wife to practice FP because of religion beliefs (Mahmoud Kotb et al 2011) and husband's socio-demographic factors (Hamid et al 2011). The various possible reasons whereby husband discourages wife from practicing FP are due to the facts that those women married at a later age, high medical risk, complications in pregnancy (Rosniza Aznie et al 2013) and complications of contraceptives (Agha 2010).…”

“…Furthermore, women lack discussion about FP with husband, whereby they used less contraceptive methods (Mahmoud Kotb et al 2011) because of lack of support from husband. Silva et al (2013) found in their study that husband participates less in FP leading to the wife's taking more responsibility in contraceptive use.…”

Unmet need for family planning in Indonesia and the policy strategy of intervention in several countries

“…12 In Cairo, one of risk factors of unmet need was husbands disapproval in using contraception with OR=2.96; 95% CI=1.47-5.97. 13 In six cities in Iran was also mentioned that family disapproval also became the reason of the high unmet need.…”

Modelling with multiple explanatory variables

“…This statistical technique has been used in two papers in this issue of the Journal, namely those by Kotb et al 1 and Schembri et al 2 These notes are intended to provide a supplementary explanation of this method. [See Box 1 for a glossary of terms used in this article.…”