Year: 2008
Type: dissertation
Study design: Observational Study
Abstract: \nContext: Estimating demand for contraception from married women only may \nmisrepresent unmet need for family planning; given that unmarried women, who are often \nyoung, are equally if not more exposed to unwanted pregnancy and have good reasons to \npractice contraception. Past studies mainly focused on married women, which limits the \nability to estimate demand among all women; specifically it is unclear if intention to use \ncontraception among married women predicts use among all women. \nMethods: The study site is a rural, marginalized district in northern Ghana, where contraceptive \nuse is low based on the complex interplay of culture, preferences and contraceptive availability. \nThe district is a site under demographic surveillance since 1993. Using data collected \nlongitudinally from 1995 to 2003, this study examines if intention to use contraception \namong all women can be used to predict their actual use. The study also describes the main \ncontraceptive methods used and reasons for non-use in the district. A panel survey was \nintroduced to monitor changes in fertility and contraceptive use following the introduction \nof a community health and family planning intervention project. Data from the 2001 and \n2003 panel survey were used for the analysis. The sample consisted of 2827 non-users of \ncontraception in the baseline year (2001). Logistic regression analysis was used to calculate \nthe adjusted effect of contraceptive intention on future use. \nResults: About two thirds (65%) of the respondents were in a marital union while 23% had \nnever been married. Among all women, those who expressed the need to use contraception \nwere more than twice as likely to have used contraception when compared with those \nwithout such intentions (OR 2.04; CI: 1.47; 2.82). Among the married women, those with \nintention to use contraception were close to two times as likely to have used contraception \ncompared to those without (OR 1.88; CI: 1.31; 2.72). The main family planning methods used were injectables (55%) followed by prolonged abstinence (22%) and the pill (10%). \nMore than half of the women not using a method reported not being at risk as the main \nreason for non-use. Results for all women and for married women alone demonstrate that, \nin this setting, intention can be used to predict future use. \nConclusion: Stated contraceptive intention is a significant determinant and measure of \nfuture family planning needs when the needs of unmarried women as well as married \nwomen are considered. Unmarried women and not only married women should therefore be \na focus in family planning studies for their intentions count in determining who is in need \nof contraception and the nature and scale of that need.
Author: Maurice Mutisya Joseph
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2288720310