Contraceptive Use

The United States has long grappled with the question of how to maintain an appropriate combination of religion and politics in the public sphere. The current electoral cycle is no different, as Presidential candidates attempt to negotiate both the political and religious landscapes. This essay introduces a special forum on rhetoric and religion in contemporary politics and touches on some recent instances of how religious differences have played out in the current political environment. Some of the issues discussed include the separation of church and state, Mitt Romney’s membership in the Church of Jesus Christ of Latter-day Saints (Mormons), Rick Santorum’s conception of the “war on religion,” and the controversy over contraceptives at religious institutions and Rush Limbaugh’s attacks on a Georgetown law student.

This study aimed to compare complete blood cell parameters obtained using the automated XN-1000 analyzer with those
obtained by manual methods at the Kenyatta National Hospital hematology laboratory. About 110 samples were obtained from
patients requesting complete blood count (CBC) test that were used in this study. Automated CBC test was done on Sysmex
XN-100 hematology analyzer and validated against peripheral blood slide films read by a qualified lab technologist. Obtained
data were analyzed using STATA v13 and the two methods compared using t-test and correlation. The study results showed a
strong positive correlation between the automated and manual reader (p<0.001). However, basophil readings had a negative
correlation for the two methods. A statistically significant difference was noted in neutrophil (p=0.013), monocyte (p<0.001)
eosinophil (p=0.054) and MCHC (p<0.001) readings. The automated analyzer was unable to detect abnormal cell types. The
study concluded that Peripheral blood film proved superior in detection of abnormal blood cells though the automated analyzer
was able to handle a bigger workload and reduce the turnaround time. In view of the results, it is important to confirm results
flagged by the automated analyzer using manual PBF.

Just over 20% of white women in America will never bear children, the highest percentage in modern history.  Only half of this group-10% of women without children- are considered infertile.  Many women in the fertile but childless group are voluntarily so:  the self-proclaimed childfree.

Yet despite the growing acceptability in remaining a childfree adult, doctors are resistant to sterilizing women without children. Access to sterilization is usually repeatedly denied, often with tactics of humiliation, hoop jumping, or second-guessing the legitimacy of the patient’s desire for sterilization, despite the legal status of voluntary sterilization for any competent person over the age of 21- regardless of parity.     

This paper will examine the many reasons why a woman who does not have children would want to continue in her childfree lifestyle, evaluate the accessibility of sterilization for women who are childfree by examining the reported reasons for denial of sterilization- both from the woman’s and the physicians’ perspective, and assess the legal status of voluntary sterilization for nonparous women. The paper will conclude that sterilization for childfree women is an ethical, legal option and that willing doctors should follow recommended guidelines for counseling women who desire sterilization, and urge hesitant doctors to reconsider their oppositions to voluntary sterilization for childfree women and provide the contraception of preference to women.

Introductory courses dealing with sex, gender and sexuality are usually quite biased, going as far as to deny the reality of biology. Drawing on the Catholic tradition (Aquinas), this article presents an accessible argument aimed at restoring deliberative balance in the classroom.

The evidence concerning contraceptive use/nonuse, choice of method and adherence to regimen may help to guide clinical and public health education programs and policies to provide optimal contraceptive choice and to optimize adherence thereby reducing unintentional pregnancy.Contraceptive use among married women in Rural kerala is a less explored area by researchers. To study the pattern of use of contraceptive methods among married women of reproductive age group (15-49yrs) in Vembayam panchayath, a rural panchayath in Kerala and to understand attitudes towards different contraceptive methods and the reason for choosing a contraceptive method. This is a cross sectional study done among 135 women, by house to house survey using structured questionnaire. 71.1% of the study participants were using contraceptive methods, and of these 58.5% had sterilization, 5.9% were using condoms and rest of them using other different methods. 37.8% had selected their contraceptive preference without any expert guidance. Female sterilization remains the widely accepted method as a contraceptive method among women in rural areas of Kerala.

Having unprotected sex with multiple sexual partners (MSP) is the greatest risk factor for human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs) among youths. Young people with MSPs are less likely to use a condom and the greater the risk for STIs. This study examines the associated risk factors of STIs and multiple sexual partnerships among youths aged 15–24 years. Data and methods; The Malawi Demographic Health Survey 2010 data was used. Out of a sample of 2,987 males and 9,559 females aged 15–24 years, 2,026 males and 6,470 females were considered in the study. Chi square test and logistic regression techniques were performed. Analysis was performed using Statistical Package for Social Sciences (SPSS) version 22. Findings; The results indicate that 1,399 (69.0%) males and 2,290 (35.4%) females reported multiple sexual partnerships (MSP). Within the rural area, females (n = 1779) were more likely to report MSP than males (n = 1082) and within the urban areas, a higher proportion of females (n = 511) still reported MSP, with males (n = 316). About 78% rural females aged 20–24 years, and about 79% rural males aged 15–19 years reported MSP. The likelihood of MSP was higher among females in the poorest households (OR = 1.31), being married (OR = 5.71) and Catholic males (OR = 1.63), who were married (OR = 1.59). Catholic males (OR = 1.82) in the rural areas, who were married (OR = 1.80) and rural females in the northern region (OR = 1.26) were more likely to have MSP. The odds ratios were higher among urban females in the poorest (OR = 3.45) households who were married (OR = 4.22). Conclusion; Having more than one sexual partner increases the risk of STIs and sexuality education programs should be introduced that emphasize the danger that surrounds MSP.

This study investigated the socioeconomic determinants of contraceptive use among women of reproductive age in Tarauni local government area of Kano state, Nigeria. The research used descriptive survey design to collect and analyse cross sectional data from the study population with the aid of structured questionnaire that was validated. The population of this study comprised of Women of Reproductive Age-15-49 living in urban and rural parts of the study area. A total of one hundred and twenty (120) participants, selected through simple and systematic random sampling technique participated in the study. The study data was analysed with SPSS version 20 and presented as frequency tables and simple percentage, while chi-square statistics was used to answer the formulated research hypotheses at a 0.05 level of significance. The findings of this study indicate that religion, cultural norms and occupational status of the woman are strongly associated with the use of family planning by women of reproductive age. However, level of education was not significantly associated with the use of contraceptive in this study. The study recommends that interventions targeting Muslims should recognise the diversity among sects and be more targeted; Family planning messages should target and address cultural beliefs and norms including gender roles that hinder use of contraceptive method among women of reproductive age. Government should provide income generating opportunity for women and expand service delivery points with adequate and affordable products and services to encourage use.

Background: Use of contraceptives improves individual and national health outcomes and indices as it prevents
maternal mortality and morbidity, child mortality, incidence of sexually transmitted infections and retains adolescents
and young girls in school with improvement in the economic earning power. Contraceptive Logistics is the supply of
contraceptives in the right quantity and quality at the right place at the right time for the right cost to the right people.
The Contraceptive Logistics Management System in Nigeria stipulates that to ensure uninterrupted product availability
and minimal stock out, Family Planning Service Delivery Points (SDPs) are to be re-supplied on a bi-monthly basis to
bring their stock level to a maximum of 4 months of stock at any given time.
Method: A retrospective analysis of the impacts of the three logistic models operational in six southern states in Nigeria
under the auspice of UNFPA funded family planning logistics supply chain. Three outcomes of interest used to asses the impacts were stock out rates, gaps in supply and proportion of new users of contraceptives. The three models of family planning logistics reviewed were direct government last mile distribution with external funding, direct government last mile distribution without external funding and a third party private logistic company last mile  distribution
Result: The stock out rates for the direct government logistics with external funding was 6-20%, the direct government logistics last mile distribution (LMD) without external funding had a stock out rate of 20-58% and the private logistic company last mile distribution had a stock out rate of 10-30%. In terms of the gap in supply, the supply gap with the direct government LMD with external funding model was 48%, while the direct government LMD with no external funding model had a supply gap of 73% and the private company LMD logistics model had a low supply gap of 28%. The proportion of FP users who were new users was 19% in the direct government LMD with external funding, 8% in direct government LMD without external funding, and 16% in private logistic company LMD.
Discussion: Direct government last mile distribution (LMD) with external funding reached the highest number of new FP users followed by private logistic company LMD and therefore contributed the greatest to the reduction of unmet need in family planning and increasing the contraceptive prevalence rates. The highest stock out rate of contraceptives was associated with direct government LMD without external funding and the least stock out rate was associated with
same direct government LMD but with external funding. The greatest gap in supply of contraceptives was seen with direct government LMD without external funding followed by direct government LMD with external funding. Private company LMD had the least supply gap in contraceptives.

Background: Choosing the contraception method remains one of the most critical decisions made by women of reproductive age. Not only does this have a direct impact on women's reproductive health, it also affects their social and economic well-being. This study was carried out to determine the factors affecting choice of contraceptives among women of reproductive age in Lagos State, Nigeria. Methods: This descriptive cross-sectional study was conducted on 200 women aged 15-45 years who visited the family planning clinic at the Lagos State University Teaching Hospital in Nigeria in 2019. The subjects were enrolled through a convenience sampling method. Data were collected using a demographic information form and a self-structured questionnaire on knowledge about family planning methods (n=9), the choice of contraceptives (n=8) and factors influencing the choice of family planning (n=15). Data were analyzed using descriptive statistics (frequency and percentage) and the Pearson correlation coefficient at significance level of 0.05. Results: We found that 82.8% of the respondents had good knowledge about the contraceptives. The most commonly used methods of contraception were birth control pills (38.3%) and implants (36.1%), while the least commonly used methods were tubal ligation (29.4%) and withdrawal (29.4%). The choice of contraceptives was significantly correlated with level of knowledge (r=-0.564, P=0.001) and religion (r=-0.173, P=0.020) of the subjects. Conclusion: The majority of women in the study area have good knowledge about contraceptives, and factors such as parity and fear of injury from contraceptives affect their choice of contraceptives. This study recommends implementation of extensive health education and counseling sessions to assist women in contraceptive decision making.

This study examined the effectiveness of contraceptive measures as means of child spacing methods among the civil servants of reproductive age in Ibadan. The research design used was a descriptive research design. A total number of 110 senior cadre civil servants and 40 junior cadre civil servants making a total of 150 civil servants were selected using accidental sampling technique. A self-structured questionnaire 'effectiveness of contraceptive measures for child spacing methods among civil servants tagged 'CMCSCS' was used. A validated questionnaire by experts with a reliability level of 0.78 was used. Simple percentages and inferential statistic of t-test was used to test the hypothesis at 0.05 level of significance. The findings revealed that the senior cadre civil servants had the knowledge of child spacing from friends, parents and colleagues while the junior cadre identified friends and parents. Very many of the senior cadre used safe periods and withdrawal system among other contraceptives. The results also showed that the major reason why junior cadre space their children was to assist in limiting the size of the family due to their income, while the senior cadre identified many reasons. Further finding showed that there was a significant difference in the type of contraceptive measures used by the senior cadre and junior cadre civil servants. It is recommended that the civil servants should be educated on the need to adopt the effective contraceptive measures.

Co-organised by Alana Harris and Wannes Dupont. In anticipation of the 50​ th anniversary of Pope Paul VI's promulgation of the encyclical ​ Humanae Vitae (1968), which sought to prohibit the use of contraception by practising Catholics through deeming it 'intrinsically dishonest', this colloquium seeks to bring together world­leading historians of gender, sexuality and modern Catholicism to discuss the differing reactions to and reception of the encyclical by Catholic laity and clergy across Europe. Situating the Vatican's highly controversial intervention in sexual ethics within the larger trajectory of debates about 'birth control' and the role of sex within marriage emerging since the Second World War, and as a little explored analogue to the social and sexual upheavals of the 1960s counter­cultural movements, the workshop will make an essential contribution to a growing historiography exploring 'around '68' by illuminating the gendered, material and metaphysical grounds for heated opposition and reinterpretation of the Vatican ruling. The format of the colloquium will be highly discussion­orientated, based on the pre­circulation of papers and very short presentations (with a designated respondent) at the gathering. This is to ensure that there is ample time for in­depth consideration of commonalities and contrasting factors in the 'reception' of ​ HV and the identification of constructive theoretical and methodological perspectives. Well­advanced conversations are underway for the subsequent publication of selected contributors' papers within an edited volume to be published by ​ Palgrave Macmillan ​. Research questions and scholarly objectives of the focused, comparative and interdisciplinary discussions include:

Background: Despite the enormous benefits of family planning services, the contraceptive utilization still remains low in Sub-Saharan Africa. There is regional variation in modern contraceptive utilization in Ethiopia. Therefore, this study was aimed to determine the prevalence of modern contraceptive utilization and determinants in Dabat demographic and health surveillance system site, northwest Ethiopia. Methods: A re-census was carried out in Dabat Health and Demographic Surveillance System (HDSS) site from October to December 2014. Data of 8271 married women collected in the re-census was used. The outcome variable was current utilization of any modern contraceptive methods whereas socio demographic and economic variables were the potential determinants considered. Bi-variable and multivariable binary logistic regression along with odds ratio and 95% confidence interval were used to describe the strength of association. Results: Prevalence of modern contraceptive utilization among married women in Dabat DHSS site was found to be 32.5% (95%CI: 31.5, 33.5%). After adjusting for covariates; the odds of using modern contraceptive were 2.35 times, 1.91 times, and 1.39 times higher among women of secondary and above educational level, urban residents, and women having six and above living children, respectively. Conclusion: Modern contraceptive utilization was found to be very low. Effort has to be applied to improve women's educational level that increases their understanding of reproductive health issues. It is also important to give special emphasis for rural residents, those aged 20-40 years, and those with six or more living children while serving for modern contraceptive methods.

Engelli bireyler, toplumda karşılaştıkları çeşitli durumlar nedeniyle özel bakıma ve desteğe ihtiyacı olan gruplardır. Bundan dolayı sağlık profesyonellerinin toplum sağlığını koruma ve geliştirme kapsamında engelli birey ve ailesinin bakım ve sağlık hizmetlerine yönelik sorunlarının çözümünde kilit rolleri bulunmaktadır. Sağlık profesyonelleri, engelli bireylere bütüncül bakım felsefesi doğrultusunda topluma liderlik ve eğitimci/danışman rollerini ön plana çıkararak farkındalık yaratmalıdır. Bu nedenle özellikle; hemşireler ve ebeler engelli bireylerin üreme sağlığı ve aile planlamasına yönelik problemlerini iyi tanımalı ve bireylere doğrudan iletişime geçmelidirler. Disabled individuals are groups that need special care and support due to various situations they encounter in society. Therefore, health professionals have a key role in solving the problems of the disabled individual and their families regarding care and health services within the scope of protecting and improving public health. Health professionals should raise awareness by emphasizing leadership and educator/counselor roles in the society in line with the philosophy of holistic care for people with disabilities. Therefore, especially; Nurses and midwives should know the reproductive health and family planning problems of individuals with disabilities and should communicate directly with individuals.

The sexual behaviour of youths in Malawi is believed to play an important role in the spread of sexually transmitted infections (STIs). Relevant data from the Malawi Demographic and Health Survey 2010 and a sample of 16,217 youths aged 15–24 have been studied and subjected to bivariate and logistic regression analysis. The results show that married youths were not interested in using condoms (94.2%, p &lt; 0.05) and that those who were living together were 69 times (OR = 1.69, 95% CI, 1.26–2.26) more likely to be involved in early sexual activity than those who were not living together. It is argued that the results should help other researchers, policy makers and planners to create strategies to encourage these youths make use of contraception.

Fertility in Ghana has fallen sharply in recent years, with the rate of decline being one of the most rapid in Sub-Saharan Africa. Ghana's fertility decline has coincided with an increase in the percentage of women of reproductive age reporting exposure to family planning messages via the media, a rise in the education of women of reproductive age, and a decline in under five mortality. This paper presents a multilevel, multinomial analysis of the 1998 Ghana Demographic and Health Survey data to investigate the effects of exposure to family planning messages on the type of method of contraception a woman uses. A multilevel logistic model is used to investigate the effects on fertility. The results show exposure to family planning messages via the radio and printed sources substantially increase use of modern contraception. Secondary-level education, urban residence, a large number of surviving children, and being aged 20-34 are other factors associated with increased use of modern contraception. However, exposure to family planning messages appears not have significant effects on fertility.

This study examines the risk associated with inconsistent use of condoms as a risk factor for human immunodeficiency virus/sexually transmitted infections (HIV/STIs) and sexual risk behaviours. The Malawi Demographic Health Survey 2010 data were used. Out of a sample of 2987 males and 9559 females aged 15–24 years, 511 males and 675 females were filtered in the present study. A Chi square test and logistic regression techniques were performed. About 147(28.7%) males and 240(35.6%) females reported inconsistent condom use. The likelihood of inconsistent condom use was higher among females with secondary/higher education (odds ratio’s (OR)=1.46), with more than one partner (OR=4.27), and married males (OR=8.76), with more than one sex partner (OR=1.78).There is a need to raise condom use awareness and improve sexual education about consistent condom use, especially among females, in order to curb the spread of HIV/STIs and reduce sexual risk behaviours.

Summary: Research has been conducted on medicinal plants as fertility regulators by indigenous populations of Paraguay. Studies were conducted on 10 ethnically different groups, and information was gathered on 22 plants. The scientific name, popular name, empirical properties and ways of using each of them are given.

Background: The largest proportion of women with an unmet need for contraception is found among those in their first year after childbirth; concentrating efforts to reduce unmet need among these women could have additionally bigger impact on increasing contraceptive use than concentrating on any other group. Aims & Objectives: To know the knowledge & practices of post – partum contraception among mothers in urban slums. Material & Methods: Cross sectional study conducted in urban slums for duration of six months. Study population included mothers in extended post – partum period residing in urban slums. Mothers were interviewed using pre – tested, semi – structured questionnaire. Data was analyzed using SPSS v 22.0 and, chi square test and logistic regression analysis was employed. P value of <0.05 was considered statistically significant. Results: Majority of the mothers in our study were in the age group of 20-24 years (46%). Mean age was 21.6 ± 3.1years. Majority of the mothers (56%) were Hindus. Mean age of marriage observed was 18.2±2.1years. In the present study, majority (76%) had knowledge of post – partum contraceptive methods, but only 17% of the mothers were using contraception. Unmet need for post – partum contraception was found among 49% of mothers. Conclusions: Inspite of being aware, the practice of family planning was very low among post-partum mothers. The study highlights the impact of socio cultural factors like religion, caste, number of living children, duration of marriage and ANC service utilization on post – partum contraception usage among mothers.

The paper presents the interaction effect of poverty-wealth status and autonomy on modern contraceptive use in Nigeria and Namibia with a view to examining whether poor women with less autonomy are less likely to use modern contraception than other women. A weighted sample of 3,451 currently married women in 2006-07 Namibia Demographic and Health Survey (DHS) and 23,578 in 2008 Nigeria (DHS) are used in the analysis. In Nigeria, the odds of using modern contraception is nearly 15 times higher among rich women with more autonomy than their counterparts who are poor and less autonomous, and 5.5 times higher among Namibian women. The study concluded that contraceptive behaviour of currently married women of Namibia and Nigeria are not independent of the linkage between poverty and autonomy and thus recommended that more concerted efforts be made in addressing poverty and improving the autonomous status of women in sub-Sahara Africa.

Levonorgestrel (LNG), a progestin widely used for regular hormonal contraception, is also used for emergency contraception (EC) to prevent pregnancy after unprotected intercourse. However, its mode of action in EC is only partially understood. One unresolved question is whether or not EC prevents pregnancy by interfering with postfertilization events. Here, we report the effects of acute treatment with LNG upon ovulation, fertilization and implantation in the rat. LNG inhibited ovulation totally or partially, depending on the timing of treatment and/or total dose administered, whereas it had no effect on fertilization or implantation when it was administered shortly before or after mating, or before implantation. It is concluded that acute postcoital administration of LNG at doses several-fold higher than those used for EC in women, which are able to inhibit Ovulation, had no postfertilization effect that impairs fertility in the rat.

Using data from the Ghana Demographic and Health Survey 1998, this paper analyzed the duration of use of a contraceptive method and the reasons for its non-use given by former users of contraception. The results showed that the duration of use tended to be short, particularly so for the use of condom and withdrawal. Injectable contraceptives and periodic abstinence tended to be used for relatively
long periods. After type of method, a woman’s age and residence (urban or rural) were the most significant predictors of duration of use. The reasons for not currently using contraception given by significant numbers of former users of pill and injectable contraceptives should concern service providers and educators.

Objective: 'Low socioeconomic status' and 'religiousness' appear to have gained status as nearly universal explanatory models for why women in minority groups are less likely to use contraception than other women in the Scandinavian countries. Through interviews with pious Muslim women with immigrant background, living in Denmark and Sweden, we wanted to gain empirical insights that could inform a discussion about what 'low socioeconomic status' and 'religiousness' might mean with regard to women's reproductive decisions. Design: Semi-structured interviews were conducted in Denmark and Sweden between 2013 and 2016. Findings: We found that a low level of education and a low income were not necessarily obstacles for women's use of contraception; rather, these were strong imperatives for women to wait to have children until their life circumstances become more stable. Arguments grounded in Islamic dictates on contraception became powerful tools for women to substantiate how it is religiously appropriate to postpone having children, particularly when their financial and emotional resources were not yet established. Conclusion: We have shown that the dominant theory that 'low socioeconomic status' and 'religiousness' are paramount barriers to women's use of contraception must be problematized. When formulating suggestions for how to provide contraceptive counseling to women in ethnic and religious minority groups in Denmark and Sweden, one must also take into account that factors such as low financial security as well as religious convictions can be strong imperatives for women to use contraception. Implications for practice: This study can help inform a critical discussion about the difficulties of using broad group-categorizations for understanding individuals' health-related behavior, as well as the validity of targeted interventions towards large heterogeneous minority groups in Scandinavian contraceptive counseling.

Adolescents&#39; health is greatly influenced by social determinants, including gender norms. Although research has shown that there is an association between gender attitudes and adolescents&#39; sexual behaviour, few studies have assessed this relationship carefully. The Attitudes toward Women Scale for Adolescents (AWSA) is widely used to assess gender attitudes among adolescents; however, to our knowledge it has not been applied in Latin America. To apply AWSA in Latin America for the first time, to perform a factorial validation of this scale and to assess the relationship of gender attitudes and sexual behaviour in Bolivian and Ecuadorian adolescents. This cross-sectional study was carried out in 2011 among 14-18 year olds in 20 high schools in Cochabamba (Bolivia) and six in Cuenca (Ecuador) as a part of a larger project. Schools were purposively selected. A Spanish version of the 12-item AWSA was employed for this study. The assessed aspects of adolescent sexual behaviour we...

Background: Use of contraceptives improves individual and national health outcomes and indices as it prevents maternal mortality and morbidity, child mortality, incidence of sexually transmitted infections and retains adolescents and young girls in school with improvement in the economic earning power. Contraceptive Logistics is the supply of contraceptives in the right quantity and quality at the right place at the right time for the right cost to the right people. The Contraceptive Logistics Management System in Nigeria stipulates that to ensure uninterrupted product availability and minimal stock out, Family Planning Service Delivery Points (SDPs) are to be re-supplied on a bi-monthly basis to bring their stock level to a maximum of 4 months of stock at any given time. Method: A retrospective analysis of the impacts of the three logistic models operational in six southern states in Nigeria under the auspice of UNFPA funded family planning logistics supply chain. Three outcomes of...

Making universal access to sexual and reproductive health care a reality, and thus building momentum for comprehensive family planning by 2030, is key for achieving sustainable development goals. However, in the last decade, India has been retreating from progress achieved in access to family planning. Family planning progress for a large country such as India is critical for achieving sustainable developmental goals. Against this backdrop, the paper investigated the question of how far family welfare expenditure affects contraceptive use, sources of contraceptive methods, and method-mix using triangulation of micro and macro data analyses. Our findings suggest that, except for female sterilizations, modern methods of contraception do not show a positive relationship with family welfare expenditure. Notwithstanding a rise in overall family welfare expenditure, spending on core family planning programs stagnates. State-wise and socio-economic heterogeneity in source-mix and method-mi...

Making universal access to sexual and reproductive health care a reality, and thus building momentum for comprehensive family planning by 2030, is key for achieving sustainable development goals. However, in the last decade, India has been retreating from progress achieved in access to family planning. Family planning progress for a large country such as India is critical for achieving sustainable developmental goals. Against this backdrop, the paper investigated the question of how far family welfare expenditure affects contraceptive use, sources of contraceptive methods, and method-mix using triangulation of micro and macro data analyses. Our findings suggest that, except for female sterilizations, modern methods of contraception do not show a positive relationship with family welfare expenditure. Notwithstanding a rise in overall family welfare expenditure, spending on core family planning programs stagnates. State-wise and socio-economic heterogeneity in source-mix and method-mi...

Making universal access to sexual and reproductive health care a reality, and thus building momentum for comprehensive family planning by 2030, is key for achieving sustainable development goals. However, in the last decade, India has been retreating from progress achieved in access to family planning. Family planning progress for a large country such as India is critical for achieving sustainable developmental goals. Against this backdrop, the paper investigated the question of how far family welfare expenditure affects contraceptive use, sources of contraceptive methods, and method-mix using triangulation of micro and macro data analyses. Our findings suggest that, except for female sterilizations, modern methods of contraception do not show a positive relationship with family welfare expenditure. Notwithstanding a rise in overall family welfare expenditure, spending on core family planning programs stagnates. State-wise and socio-economic heterogeneity in source-mix and method-mix continued to influence contraceptive access in India. Method-mix continued to skew towards female sterilization. Public sector access is helpful only for promoting female sterilization. Thus, the source-mix for modern contraceptives presents a clear public-private divide. Over time, access to all contraceptive methods by public sources declined while the private sector has failed to fill the gap. In conclusion, this study identified a need for revitalizing family planning programs to promote spacing methods in relatively lower-performing states and socio-economic groups to increase overall contraceptive access and use in India through the rise in core family planning expenditure.
Keywords: contraceptive use; family welfare expenditure; sources of contraception; method-mix; India

Background: Contraceptive failure increases the chances of pregnancy termination, including both induced abortions and spontaneous terminations. Proper separation requires accounting for competing risks of pregnancy outcomes. Objective: To measure the differential risk of spontaneous termination and induced abortion according to contraceptive use prior to pregnancy based on pooled Demographic and Health Survey calendar data. Methods: We use multinomial logistic models controlling for demographic and socioeconomic variables to estimate the differential risk of spontaneous termination and induced abortion according to contraceptive use at the time of pregnancy. We address data limitations including recall error, omission error, and possible misclassification of outcomes. Results: We find higher risk of induced abortion (RRR = 7.18, CI = 6.38–8.09) and spontaneous termination (RRR = 1.38, CI = 1.13–1.69) after contraceptive failure, with stronger effect for women under 30. Parity, union status, education, and wealth have a strong effect on induced abortion. Regarding spontaneous termination, age mainly explains the increased risk. Conclusions: Since pregnancies following contraceptive failure are less likely to end in a live birth, aggregate models of the impact of family planning should reflect that contraceptive use and induced abortion conform interdependent strategies and that spontaneous termination is a competing risk of induced abortion. Contribution: This is the first study reporting differences in the risk of spontaneous termination and induced abortion according to contraceptive use prior to pregnancy. We account for competing risks using a multinomial logit model of pregnancy outcomes conditional on pregnancy, new in the literature. Data limitations are addressed in novel ways.

Background: Women's ability to determine whether and when to have children, enhances their health, education and employment chances. Determinants of contraceptives use are key variables in the evaluation of family planning programmes. The study assessed the knowledge, prevalence and determinants of contraception among women of child-bearing age (WCA) in a rural community. Method: A total population study was conducted using a descriptive cross-sectional study design among women of child-bearing age in Awuyemi community of Etsako East LGA, Edo State, Nigeria. A pre-tested, structured interviewer-administered questionnaire was the tool for data collection. Data was analyzed using SPSS version 21.0. Test of associations were carried out using Chi-squared tests and binary logistic regression was used to determine significant predictors of contraceptive use. The level of significance was set at p < 0.05. Results: Two hundred and ninety-five WCA with mean age of 27.4 ± 7.9 years participated in the study. One hundred and seventy-seven (60.0%) of them were multiparous women. Of these, 115 (65.0%) had an average birth interval of ≤ 2 years. About one-third had ever used contraceptives while 26.4% were current users. The commonest contraceptive used by the respondents was condoms (33.3%). Determinants of current use of contraceptive were cost of contraceptive (p = 0.036), informed choice (p < 0.001), and level of education (p = 0.024). Conclusion: Contraceptive prevalence rate among the respondents was low. Determinants of current use of contraceptive were cost of contraceptives, informed choice and level of education and these should be used for targeted interventions by all stakeholders in intervention programmes.

Este trabalho teve por objetivo comparar a idade da primeira relação sexual, a informação sobre métodos contraceptivos, além de seu uso com a ocorrência da gestação na adolescência em dois grupos (50 grávidas e 50 não grávidas). Foi utilizado um questionário desenvolvido para o estudo que investigou essas variáveis. Verificou-se que não há diferença significativa nos grupos entre idade da sexarca, uso de contracepção na sexarca e tipo de contraceptivo utilizado. Contudo, os grupos diferem em relação ao uso de métodos contraceptivos nas relações sexuais subsequentes. Os dados revelam a multiplicidade de fatores envolvidos no comportamento contraceptivo demonstrando a necessidade de absorção desses fatores por parte das políticas públicas voltadas para o público adolescentes.
Abstract This study aimed to compare the age at first sexual intercourse, information about contraceptive methods, besides its use with the occurrence of adolescent pregnancy in two groups (50 pregnant and 50 nonpregnant). The questionnaire developed for the study investigated these variables. It was found that there is no significant difference between groups in age at first sexual intercourse , use of contraception at first sexual intercourse and type of contraceptive used. However, the groups differ with respect to the use of contraceptives in the subsequent sexual intercourses. The data reveals the multiplicity of factors involved in contraceptive behavior demonstrating the need for absorption of these factors on the part of public politics directed to adolescents. Sexarca, información y uso de métodos anticonceptivos: comparación entre adolescentes Resumen Este estudio tuvo como objetivo comparar la edad de la primera relación sexual, la información sobre los métodos anticoncepti-vos, además de su uso con la ocurrencia del embarazo en la adolescencia en dos grupos (50 embarazadas y 50 no embarazadas). El cuestionario elaborado para el estudio investigó esas variables. Se encontró que no hay diferencia significativa en los grupos entre edad de la sexarca, el uso de anticonceptivos en la sexarca y el tipo de anticonceptivo utilizado. Sin embargo, los grupos difieren con respecto a la utilización de anticonceptivos en las relaciones sexuales posteriores. Los datos revelan la multiplicidad de factores implicados en el comportamiento anticonceptivo que demuestran la necesidad de absorción de estos factores en las políticas públicas vueltas a los adolescentes.

Background: Estimates of unplanned pregnancy worldwide are of concern, especially in low and middle-income countries, including Brazil. Although the contraceptive prevalence rate is high in Brazil, almost half of all pregnancies are reported as unintended. The only source of nationally representative data about pregnancy intention is the Demographic and Health Survey, as with many other countries. In more recent years, however, it has been realized that concept of unintended pregnancy is potentially more complex and requires more sophisticated measurement strategies, such as the London Measure of Unplanned Pregnancy (LMUP). The LMUP has been translated and validated in other languages, but not Portuguese yet. In this study, we evaluate the psychometric properties of the LMUP in the Portuguese language, Brazilian version. Methods: A Brazilian Portuguese version of the LMUP was produced via translation and back-translation. After piloting, the mode of administration was changed from self-completion to interviewer-administration. The measure was field tested with pregnant, postpartum, and postabortion women recruited at maternity and primary health care services in Sao Paulo city. Reliability (internal consistency) was assessed using Cronbach's alpha and item-total correlations. Construct validity was assessed using principal components analysis and hypothesis testing. Scaling was assessed with Mokken analysis. Results: 759 women aged 15–44 completed the Brazilian Portuguese LMUP. There were no missing data. The measure was acceptable and well targeted. Reliability testing demonstrated good internal consistency (alpha = 0.81, all item-rest correlations >0.2). Validity testing confirmed that the measure was unidimensional and that all hypotheses were met: there were lower LMUP median scores among women in the extreme age groups (p < 0.001) , among non-married women (p < 0.001) and those with lower educational attainment (p < 0.001). The Loevinger H coefficient was 0.60, indicating a strong scale. Conclusion: The Brazilian Portuguese LMUP is a valid and reliable measure of pregnancy planning/intention that is now available for use in Brazil. It represents a useful addition to the public health research and surveillance toolkit in Brazil.

Using data from all three rounds of National Family Health Survey, this study examines the trends and determinants of unmet need for family planning in the state of Bihar. Bivariate analysis was carried out to examine the level and trends in unmet need for family. Binary logistic regression was used to examine the factor affecting unmet need for family planning. About 25% of the currently married women, aged 15 -49 years, in Bihar at present have an unmet need for family planning services, 11% for spacing and 12% for limiting. Only 18% of total demand for spacing methods is met compared to about 72% of total demand for limiting methods. The unmet need for family planning among Muslim (32%), rural (24%) and adolescent (36%) and poor women (26%) is relatively higher than other groups. "Religious prohibition" and "husband opposed" were main reasons for not using contraception. A considerable proportion of older women (45 -49 years) and those living in urban areas cited method-related reasons. About 86% of Muslim women cited opposition to use as main reason for not using family planning. The same is also substantiated by logistic regression analysis where the odds of unmet need were significantly higher among Muslim women (OR = 1.88; p < 0.05). Women from Other Backward Castes (OR = 0.74; p = 0.05) and rich households (OR = 0.55; p = 0.00) had lower odds of unmet need for family planning. The results highlight the need of an effective implementation of information, education and communication activities in the communities and improvement in the quality of advice and care services related to family planning. Family planning policies and programs in Bihar should focus on reaching out to the women from disadvantaged groups such as adolescent, Muslim, poor and Scheduled Caste.

Iran has experienced a dramatic decline in fertility in recent decades, but limited access to legal abortion continues to lead many women whose pregnancies are unwanted or mistimed to undergo clandestine, unsafe abortions. No official data on the abortion rate in Iran have been collected, however. This study uses the 2000 Iran Demographic and Health Survey to estimate the abortion rate for the country as a whole and for specific regions, and to explore the role of contraceptive use and religiosity in explaining regional variations in abortion rates. We estimate the total abortion rate for the country to be 0.26 abortions per married woman, and the annual general abortion rate to be 7.5 abortions per 1,000 married women aged 15–49. We find that the negative effect of modern contraceptive use on the abortion rate is 31 percent greater than the negative effect of religiosity, and we highlight the implications of these findings for policies on reproductive health and family planning.

Using data from all three rounds of the National Family Health Survey, this study examines the trends and determinants of unmet need for family planning in the state of Bihar. Bivariate analysis was carried out to examine the level and trends of unmet need for family. Binary logistic regression was used to examine the factor affecting unmet need for family planning. About 25% of the currently married women, aged 15 -49 years, in Bihar at present have an unmet need for family planning services, 11% for spacing and 12% for limiting. Only 18% of total demand for spacing methods is met compared to about 72% of total demand for limiting methods. The unmet need for family planning among Muslim (32%), rural (24%) and adolescent (36%) and poor women (26%) is relatively higher than other groups. "Religious prohibition" and "husband opposed" were the main reasons for not using contraception. A considerable proportion of older women (45 -49 years) and those living in urban areas cited method-related reasons. About 86% of Muslim women cited opposition to use as the main reason for not using family planning. The same is also substantiated by logistic regression analysis where the odds of unmet need were significantly higher among Muslim women (OR = 1.88; p < 0.05). Women from Other Backward Castes (OR = 0.74; p = 0.05) and rich households (OR = 0.55; p = 0.00) had lower odds of unmet need for family planning. The results highlight the need of an effective implementation of information, education and communication activities in the communities and improvement in the quality of advice and care services related to family planning. Family planning policies and programs in Bihar should focus on reaching out to the women from disadvantaged groups such as adolescent, Muslim, poor and Scheduled Caste.

Having unprotected sex with multiple sexual partners (MSP) is the greatest risk factor for human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs) among youths. Young people with MSPs are less likely to use a condom and the greater the risk for STIs. This study examines the associated risk factors of STIs and multiple sexual partnerships among youths aged 15-24 years. The Malawi Demographic Health Survey 2010 data was used. Out of a sample of 2,987 males and 9,559 females aged 15-24 years, 2,026 males and 6,470 females were considered in the study. Chi square test and logistic regression techniques were performed. Analysis was performed using Statistical Package for Social Sciences (SPSS) version 22. The results indicate that 1,399 (69.0%) males and 2,290 (35.4%) females reported multiple sexual partnerships (MSP). Within the rural area, females (n = 1779) were more likely to report MSP than males (n = 1082) and within the urban areas, a higher proportion...

Contraceptive use among women remains an important public health intervention. Imperatively, the equality of family planning access between rural and urban areas allows all women to have the same opportunities to receive family planning service towards better well-being of families. The study aims at comparing the family planning preferences among women aged 15 to 49 throughout Malaysia in 2018 according to the geographical locations of rural and urban areas. This is important for resource planning and allocation to the National Population and Family Development Board (NPFDB) clinic based on the locations. The data were collected from 49 NPFDB clinics throughout Malaysia. A total of 3668 married women aged 15 to 49 years used the family planning service in this NPFDB clinic in 2018. In this study, descriptive, Chi-Square, and logistic regression analyses were carried out to compare the patterns and preferences of contraceptive use. The results analysis shows that implant is the most popular method among all other contraceptive methods provided by the NPFDB clinics. Specifically, in both rural and urban areas, the three most popular contraceptive methods among married women in Malaysia in 2018 are implant, pill, and condom. Findings of the analysis based on the Chi-Square test show that age group, education levels, and different types of contraception methods were identified to have a significant association with the locations of either rural or urban areas. In conclusion, this study found that women who used implants as a method of contraceptives were often younger, better educated, and lived in an urban area. Therefore, the family planning providers especially NPFDB clinics play a key role in providing information, educating couples, and promoting the use of different family planning methods so that better family well-being could be achieved.