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Assessing the effect of concerns about contraceptive-induced fertility impairment on hormonal contraceptive use by parity and residence: evidence from PMA Ethiopia 2020 cross-sectional survey.
- Source :
-
BMJ open [BMJ Open] 2024 Aug 13; Vol. 14 (8), pp. e077192. Date of Electronic Publication: 2024 Aug 13. - Publication Year :
- 2024
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Abstract
- Objectives: This study aims to describe patterns of beliefs about contraceptive-induced infertility and assess their relationship with current contraceptive use, including whether these relationships vary by parity and residence.<br />Design: We use data from Performance Monitoring for Action Ethiopia, a nationally representative, cross-sectional survey of 7491 women, aged 15-49, to assess agreement with the statement 'If I use family planning, I may have trouble getting pregnant next time I want to.' We used multilevel hierarchical models to identify the association between agreement and use of a hormonal method of contraception among 3882 sexually active, fecund women who wish to prevent pregnancy. We include interaction terms for parity and residence.<br />Results: 4 in 10 women disagreed (42.3%) and 2 in 10 strongly disagreed (20.7%) with the statement. Relative to women who strongly disagreed, women who disagreed and women who agreed had significantly lower odds of using a hormonal method of contraception (adjusted OR (aOR) 0.65, 95% CI 0.44 to 0.97 and 0.46, 95% CI 0.46, 95% CI 0.30 to 0.70). The effect of agreeing with the statement was strongest among high parity women (aOR 0.54, 95% CI 0.30 to 0.95). Greater agreement with the statement at the community-level use was associated with a reduction in the odds of using hormonal contraception but only among rural women.<br />Conclusions: Efforts to address concerns around contraceptive-induced fertility impairment through the provision of comprehensive counselling and through community education or mass media campaigns are necessary, particularly among high-parity women and in rural communities. Interventions should acknowledge the possibility of delayed return to fertility for specific methods and attempt to address the root causes of concerns.<br />Competing Interests: Competing interests: None declared.<br /> (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.)
- Subjects :
- Humans
Female
Ethiopia epidemiology
Adult
Cross-Sectional Studies
Adolescent
Young Adult
Middle Aged
Pregnancy
Rural Population statistics & numerical data
Family Planning Services
Infertility chemically induced
Contraceptive Agents, Hormonal adverse effects
Hormonal Contraception adverse effects
Parity
Contraception Behavior statistics & numerical data
Health Knowledge, Attitudes, Practice
Subjects
Details
- Language :
- English
- ISSN :
- 2044-6055
- Volume :
- 14
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- BMJ open
- Publication Type :
- Academic Journal
- Accession number :
- 39142681
- Full Text :
- https://doi.org/10.1136/bmjopen-2023-077192