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Contraceptive Use in Ghana: What about Women Empowerment?  [PDF]
Edward Kwabena Ameyaw, Francis Appiah, Catherine Selorm Agbesi, Patience Kannor
Advances in Sexual Medicine (ASM) , 2017, DOI: 10.4236/asm.2017.71004
Abstract: Introduction: Although contraceptive usage appears to be increasing in Ghana, 30 and 42 percent of married and unmarried women respectively still have unmet need for family planning services partly due to their inability to exercise their basic rights on fertility issues. Meanwhile, expanding freedom of choice and actions to shape women’s life is critical to how women can be autonomous about issues surrounding their fertility. On this premise, this study aimed at investigating empowerment status and usage of contraceptives among women in the reproductive age in Ghana. Methods: The study made use of the 2014 Ghana Demographic and health survey with a sample size of 9396. The outcome variable was contraceptive use whilst the main independent variable was women empowerment (measured by ability to decide on a woman’s own healthcare, large household purchases and visiting family members). Both bivariate and multivariate binary logistic regressions were carried out generating odd ratios to explore the association at 95% confidence interval. Results: The results indicated that women who were not deciding alone on their own healthcare were less probable to use contraceptives (OR = 0.92, CI = 0.80 - 1.07) as well as those who were not deciding alone on large household purchases (OR = 0.96, CI = 0.82 - 1.11) and visiting family members (OR = 0.63, CI = 0.93 - 1.25) at the bivariate level. However, at the multivariate level, higher likelihoods of contraceptive use were found among those who were not deciding alone on health (OR = 1.26, CI = 1.18 - 1.68), large household purchases (OR = 1.30, CI = 1.08 - 1.55) and visiting family members (OR = 1.32, CI = 1.12 - 1.57). Conclusion: This has inspired the need to intensify women empowerment interventions through mass media and all possible avenues in order to enhance reproductive health.
Low Fertility and Contraceptive Sterilization: The Canadian Case  [PDF]
Laurence Charton,Evelyne Lapierre-Adamcyk
Canadian Studies in Population , 2010,
Abstract: This article presents fertility variations among the Canadian regions and analyses the paths leading to the choice of contraceptive sterilization. Based on data from the 2001 General Social Survey, the research shows that while every region has adopted a low fertility regime, substantial differences are observed among women aged 40-49 in 2001: Quebec couples had fewer children; among those in stable unions, Quebec couples were also more likely to choose contraceptive sterilization, while this was not the case among those couples where at least one of the spouses was in a second union; moreover, couples in such unions were less likely to have a common child in Québec than in other regions. In the end, if regional differences in the choice of sterilization persist, they are not large, and this choice is driven by fertility decisions everywhere.
Sexual and reproductive health in Accra, Ghana
RM Adanu, J Seffah, JK Anarfi, N Lince, K Blanchard
Ghana Medical Journal , 2012,
Abstract: Objective: To describe sexual and reproductive health among women in Accra and explore the burden of sexual and reproductive ill health among this urban population. Design: Cross-sectional study. Methods: We analysed data from the WHSA-II (n=2814), a cross-sectional household survey on women’s health, and supplemental data from an in-depth survey (n=400), focus groups discussions (n=22) and in-depth interviews (n=20) conducted among a subsample of women which focused specifically on reproductive health issues. Results: Modern contraceptive use was uncommon. More than one third of women reported ever using abstinence; condoms, injectables and the pill were the most commonly reported modern methods ever used. The total fertility rate among this sample of women was just 2.5 births. We found a considerable burden of sexual and reproductive ill health; one in ten women reported menstrual irregularities and almost one quarter of women reported symptoms of a Sexually Transmitted Infection (STI) or Reproductive Tract Infection (RTI) in the past 6 months. Focus group results and indepth interviews reveal misperceptions about contraception side-effects and a lack of information. Conclusion: In urban Ghana, modern contraceptive use is low and a significant proportion of women experience reproductive ill health (defined here as menstrual irregularity or RTI, UTI, STI symptoms). Increased access to information, products and services about for preventive care and contraception could improve reproductive health. More research on healthy sexuality and the impact of reproductive ill health on sexual experience is needed.
Religiosity as a Factor of Fertility and Contraceptive Behavior in Pakistan  [PDF]
M. Iqbal Zafar,Fawad Asif,Sultan Adil
Journal of Applied Sciences , 2003,
Abstract: A study was conducted in two major urban centres Faisalabad and Lahore of Pakistan to know the views of respondents about the contraceptive use and family size and composition. Total 1100 women (400 users and 700 non-users of contraception) were interviewed to explore objectives. The high level of fatalism regarding procreation with low sense of personal effectiveness in controlling fertility and prohibition of contraceptive use (perceived by people) in Islamic for birth spacing are undoubtedly responsible for high fertility in Pakistan. The Islamic view point on the issue of fatalism and contraceptive use clearly demonstrates that pronatalist tendencies in Islam stem less from direct injunctions to procreate than from the support of other socio-cultural values and misinformation about the religion. Islam imposes restriction, on procreation in terms of responsibilities involved in children`s socialization. Islam does not encourage the viewpoint that predestination makes a human being skeptical with regard to control over his own actions. The use of wisdom to plan every day life for the betterment of family and society is according to the principles of Islam. A number of hadiths permit the use of `Al-azl or coitus interruptus` as a method of contraception. From the findings of this study it can be argued that fertility decline is only possible when it is no longer regarded as fatalistic and comes into the realm of perceived personal control.
Trends in contraceptive use among female adolescents in Ghana
L Abdul-Rahman, G Marrone, A Johansson
African Journal of Reproductive Health , 2011,
Abstract: Within the past one and half decades many efforts have been made to improve the availability and access to adolescent sexual and reproductive health services. Despite these efforts, adolescents still face a number of sexual and reproductive health problems. This paper uses data from the 2003 and 2008 Ghana Demographic and Health Surveys to examine changes in contraceptive use among sexually active female adolescents (15-19 years old). The results show that between 2003 and 2008 there was a significant increase in the current use of any contraceptive method (from 23.7% to 35.1%, p=0.03). It also indicates a shift from modern to traditional contraceptive methods. Traditional methods recorded about 60% (7.8 percentage points) increase as compared to 5.5% (2.6 percentage points) for modern methods. Also ever use of any traditional method recorded a higher increase as compared to any modern method. There was a slight decline 7% (4.4 parentage points) in the number of non-users who intended to use contraceptives in the future. On the whole the findings indicate increasing unmet need for modern contraception due to barriers such as limited access, cost and misconceptions about the effects of contraceptives.
Contraceptive Effectiveness of Breastfeeding and Current Contraceptive Practice in Bangladesh  [PDF]
M. S. Mazumder,M. K. Hossain,M. N. Islam,Kh. N. Islam
Journal of Medical Sciences , 2001,
Abstract: The study was conducted to investigate the opinion about reproductive behavior commodity participation in contraceptive mothers opinion about suitable contraceptive method during breastfeeding in Bangladesh. For this purpose secondary data were collected from Bangladesh Institute of Research for Promotion of Essential and Reproductive Health and Technologies (BIRPERHT), in Bangladesh in the year 1995. The contraceptive effectiveness of lactational amenorrhoea during exclusive breastfeeding the baby, 35.6% mentioned that this period is fully protective from risk of contraception; about 37.9% stated that there is a partial risk of pregnancy. The suckling of the infant appears to trigger the chain of events. Stimulating the hypothalamus and anterior pituitary to release some hormones and inhibit the release of mothers. This has the total effect of suppressing ovulation with contraceptive effect being strongest during lactational period. Mothers in rural and urban area may choose to adopt a contraceptive method during breastfeeding and that is suitable method in this period oral pill 33% and condom 28% by their opinions. The overall distribution of opinion about risk of conception reflects that significantly larger proportion with 99% confidence level of urban mothers think that lactational period does not provide adequate protection from conception. Mothers should be informed about the maternal health benefit of breastfeeding including lactational period and its contraceptive effect, which increases birth interval and maintain good health of the mothers.
Terminal fertility control: Clients’ own reason for the choice of the contraceptive method  [PDF]
Daniel Adebode Adekanle, Adeola Folashade Afolabi, Adewale Samson Adeyemi
Open Journal of Obstetrics and Gynecology (OJOG) , 2013, DOI: 10.4236/ojog.2013.39130
Abstract:

Background: The prevalence of contraceptive use has increased worldwide due to the development and introduction of modern contraceptives and the establishment of organized family planning programs. In Nigeria, there is a very slow rise in contraceptive use prevalence, resulting in high fertility rate. Generally contraceptive is either used for birth spacing, or for the purpose of terminal fertility control to limit the number of children, and the choice of method for this purpose varies. Aims and Objectives: To determine the contraceptive methods of choice among clients seeking terminal fertility control, and their reasons for the choice of such methods. Materials and Methods: A cross-sectional study of clients attending the family planning clinic of Ladoke Akintola University of Technology Teaching hospital over a period of twenty-four months, between July, 2009 and June, 2011. All clients who had completed their family, and wanted a contraceptive method to limit their family size filled the semi-structured questionnaire after giving their informed consent. Clients’ own reasons for the choice of the particular contraceptive method were grouped, entered into SPSS work sheet, and analyzed using SPSS version 17. Result: There were five hundred and ninety-two new contraceptive method acceptors during the study period, of which 264 (44.6%) were for terminal fertility control. Progestogen-only injectable contraceptive was the method of choice for terminal fertility control by 145 (54.9%) of the clients, while 85 (32.2%) made intrauterine contraceptive device (copper-T) their method of choice, and the least chosen method was female surgical sterilization (2, 0.8%). Ease of administration, satisfaction with previous use, long duration of action, and husband’s preference were the reasons for the choice of the methods. Conclusion: There is awareness of terminal fertility control in Nigeria, especially in the southwestern region of the country, and this may be responsible for the decreasing prevalence of grandmultiparity in the region. However, reversible contraceptive method is the preferred option for this purpose.

A decade of contraceptive use in Cameroon: influences of structural changes
Vijayan K Pillai, Consoler Teboh
Open Access Journal of Contraception (OAJC) , 2011, DOI: http://dx.doi.org/10.2147/OAJC.S12621
Abstract: decade of contraceptive use in Cameroon: influences of structural changes Original Research (3317) Total Article Views Authors: Vijayan K Pillai, Consoler Teboh Published Date December 2010 Volume 2011:2 Pages 5 - 11 DOI: http://dx.doi.org/10.2147/OAJC.S12621 Vijayan K Pillai, Consoler Teboh School of Social Work, University of Texas at Arlington, Arlington, TX, USA Abstract: The purpose of this article is to examine the impact of social changes over the last two decades in Cameroon. The data for this study are from the 2004 Demographic and Health Survey (DHS) (Enquête Démographique et de Santé au Cameroun [EDSC-III]), the third DHS carried out in Cameroon. The first one was in 1991. The 1991Cameroon DHS is a sample of 3871 women aged between 15 and 49 years. The EDSC-III was carried out from February to August 2004 and covered 10,462 households, 10,656 women aged 15–49 years, and 5280 men aged 15–59 years. Logistic regression was used to estimate the effects of proposed determinants of modern contraceptive use among a sample of respondents in the 1991 and 2004 DHSs. We found that respondents from both surveys with an education compared with women with no education were more likely to use modern contraception. The two decision-making-related variables, “discuss” and “husband OK with family planning”, had significant positive effects on modern contraceptive use in both surveys. A few variables such as age at marriage had a significant effect on modern contraceptive use among respondents in one of the two samples. The differences in the effects of the determinants in the proposed models on contraceptive use in the two samples were decomposed into processual, compositional, and interaction components as suggested by the cohort effect model made famous by the demographer Norman Ryder. The compositional changes during 1991 and 2004 contributed more toward an improvement in modern contraceptive use than the rest of the components.
Inconsistent fertility motivations and contraceptive use behaviors among women in Honduras
Ilene S Speizer, Laili Irani, Janine Barden-O'Fallon, Jessica Levy
Reproductive Health , 2009, DOI: 10.1186/1742-4755-6-19
Abstract: Data come from a one-year panel study conducted in Honduras from October 2006 to December 2007. A total of 633 women aged 15-44 years were interviewed at baseline and follow-up and have non-missing information on the key variables of interest. At baseline and follow-up, women were asked how much of a problem it would be (no problem/small problem/big problem) if they got pregnant in the next couple of weeks. At follow-up, women were asked an open-ended question on reasons it would be no problem, a small problem, or a big problem. The open-ended question was recoded into a smaller set of response categories. Univariate and bivariate analyses are presented to examine inconsistencies and reasons for stated inconsistencies.At follow-up, over half the women using a contraceptive method said that it would be no problem if they got pregnant. Nearly half of the women changed their perceptions between baseline and follow-up. Common reasons for reporting no problem among contraceptive users were that they accepted a child as God's will or that children are a blessing, their last child was old enough and they wanted another child. Common reasons for reporting a big/small problem among non-users of family planning (who have an unmet need for family planning) were that they were not in a stable relationship, the husband was not present, and they would expect a negative response from their family.Inconsistent fertility motivations and contraceptive behaviors are common among effective contraceptive users. Women who are using contraception and become pregnant will not necessarily report the pregnancy as unintended, given the widespread acceptance of unintended pregnancies in Honduras. Family planning providers need to recognize that fertility motivations vary over time and that women may not have firm motivations to avoid a pregnancy.Information on whether a woman wants to get pregnant soon, delay a pregnancy, or not have any (more) children is used to measure pregnancy intentions.
A decade of contraceptive use in Cameroon: influences of structural changes
Vijayan K Pillai,Consoler Teboh
Open Access Journal of Contraception (OAJC) , 2010,
Abstract: Vijayan K Pillai, Consoler TebohSchool of Social Work, University of Texas at Arlington, Arlington, TX, USAAbstract: The purpose of this article is to examine the impact of social changes over the last two decades in Cameroon. The data for this study are from the 2004 Demographic and Health Survey (DHS) (Enquête Démographique et de Santé au Cameroun [EDSC-III]), the third DHS carried out in Cameroon. The first one was in 1991. The 1991Cameroon DHS is a sample of 3871 women aged between 15 and 49 years. The EDSC-III was carried out from February to August 2004 and covered 10,462 households, 10,656 women aged 15–49 years, and 5280 men aged 15–59 years. Logistic regression was used to estimate the effects of proposed determinants of modern contraceptive use among a sample of respondents in the 1991 and 2004 DHSs. We found that respondents from both surveys with an education compared with women with no education were more likely to use modern contraception. The two decision-making-related variables, “discuss” and “husband OK with family planning”, had significant positive effects on modern contraceptive use in both surveys. A few variables such as age at marriage had a significant effect on modern contraceptive use among respondents in one of the two samples. The differences in the effects of the determinants in the proposed models on contraceptive use in the two samples were decomposed into processual, compositional, and interaction components as suggested by the cohort effect model made famous by the demographer Norman Ryder. The compositional changes during 1991 and 2004 contributed more toward an improvement in modern contraceptive use than the rest of the components.Keywords: modern contraceptive use, logistic regression, decomposition, structural influences
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