Determinants of modern contraceptive use among married women of reproductive age: a cross-sectional study in rural Zambia

Objective Zambia is among the world’s top 10 countries with higher fertility rate (5.5 births/woman); unmet family planning need for births spacing (14%) and limiting births (7%). Women in rural Zambia (24%) are reported to have unmet need for family planning than those in urban areas (17%). This st...

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Main Authors: Yuan Zhang, Huiping Zhang, Joseph Lasong, Simon Afewerki Gebremedhin, Sampson Opoku, Chrissie Stansie Abaidoo, Tamara Mkandawire, Kai Zhao
Format: Article
Language:English
Published: BMJ Publishing Group 2020-03-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/10/3/e030980.full
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author Yuan Zhang
Huiping Zhang
Joseph Lasong
Simon Afewerki Gebremedhin
Sampson Opoku
Chrissie Stansie Abaidoo
Tamara Mkandawire
Kai Zhao
author_facet Yuan Zhang
Huiping Zhang
Joseph Lasong
Simon Afewerki Gebremedhin
Sampson Opoku
Chrissie Stansie Abaidoo
Tamara Mkandawire
Kai Zhao
author_sort Yuan Zhang
collection DOAJ
description Objective Zambia is among the world’s top 10 countries with higher fertility rate (5.5 births/woman); unmet family planning need for births spacing (14%) and limiting births (7%). Women in rural Zambia (24%) are reported to have unmet need for family planning than those in urban areas (17%). This study was conducted to ascertain factors associated with modern contraceptive use among rural Zambian women.Design Cross-sectional study.Setting Rural Zambia.Participants Secondary data of 4903 married or cohabiting rural women (15–49 years) after filtering out the pregnant, urban based and unmarried women from 2013 to 2014 Zambian Demographic and Health Survey (ZDHS) were analysed using SPSS V.22. Multiple logistic regression, Pearson’s χ2 and descriptive statistics were performed to examine factors associated with modern contraceptive use.Results Factors that were positively associated with contraceptive use were respondent’s education (secondary adjusted ORs (AOR = 1.61, p≤0.002); higher (AOR = 2.39, p≤0.050)), wealth index (middle class, (AOR = 1.35, p≤0.005); rich (AOR = 2.04, p≤0.001) and richest (AOR = 1.95, p≤0.034)), high parity (1–2 (AOR = 5.31, p≤0.001); 3–4 (AOR = 7.06, p≤0.001); 5+ (AOR = 8.02, p≤0.001)), men older than women by <10 years (AOR = 1.50, p≤0.026) and women sensitised about family planning at health facility (AOR = 1.73, p≤0.001). However, old age (40–49 years (AOR = 0.49, p≤0.001)), other religions (Protestants, African traditionalists and Muslims) (AOR = 0.77, p≤0.007), ever had pregnancy miscarried, aborted or stillbirth (AOR = 0.78, p≤0.026) and women without knowledge of number of children husband desires (AOR = 0.71, p≤0.001) were negatively associated with contraceptive use.Conclusion Modern contraceptive use in rural Zambia among currently married women of reproductive age group is relatively low (43%). We recommend that appropriate interventions are instituted to increase contraceptive access and use especially among uneducated older rural Zambian women.
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spelling doaj-art-dada4b69caa941e28443e16878d548802024-12-06T21:20:08ZengBMJ Publishing GroupBMJ Open2044-60552020-03-0110310.1136/bmjopen-2019-030980Determinants of modern contraceptive use among married women of reproductive age: a cross-sectional study in rural ZambiaYuan Zhang0Huiping Zhang1Joseph Lasong2Simon Afewerki Gebremedhin3Sampson Opoku4Chrissie Stansie Abaidoo5Tamara Mkandawire6Kai Zhao7Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, CanadaSchool of Medical and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaInstitute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, ChinaPublic Health School, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, ChinaDepartment of Social Health Management, School of Public Health, Huazhong University of Science and Technology, Tongji Medical College, Wuhan, Hubei, ChinaDepartment of Anatomy, Kwame Nkrumah University of Science and Technology, Kumasi, Ashanti, GhanaPublic Health School, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, ChinaXuzhou Medical University, Xuzhou, Jiangsu, ChinaObjective Zambia is among the world’s top 10 countries with higher fertility rate (5.5 births/woman); unmet family planning need for births spacing (14%) and limiting births (7%). Women in rural Zambia (24%) are reported to have unmet need for family planning than those in urban areas (17%). This study was conducted to ascertain factors associated with modern contraceptive use among rural Zambian women.Design Cross-sectional study.Setting Rural Zambia.Participants Secondary data of 4903 married or cohabiting rural women (15–49 years) after filtering out the pregnant, urban based and unmarried women from 2013 to 2014 Zambian Demographic and Health Survey (ZDHS) were analysed using SPSS V.22. Multiple logistic regression, Pearson’s χ2 and descriptive statistics were performed to examine factors associated with modern contraceptive use.Results Factors that were positively associated with contraceptive use were respondent’s education (secondary adjusted ORs (AOR = 1.61, p≤0.002); higher (AOR = 2.39, p≤0.050)), wealth index (middle class, (AOR = 1.35, p≤0.005); rich (AOR = 2.04, p≤0.001) and richest (AOR = 1.95, p≤0.034)), high parity (1–2 (AOR = 5.31, p≤0.001); 3–4 (AOR = 7.06, p≤0.001); 5+ (AOR = 8.02, p≤0.001)), men older than women by <10 years (AOR = 1.50, p≤0.026) and women sensitised about family planning at health facility (AOR = 1.73, p≤0.001). However, old age (40–49 years (AOR = 0.49, p≤0.001)), other religions (Protestants, African traditionalists and Muslims) (AOR = 0.77, p≤0.007), ever had pregnancy miscarried, aborted or stillbirth (AOR = 0.78, p≤0.026) and women without knowledge of number of children husband desires (AOR = 0.71, p≤0.001) were negatively associated with contraceptive use.Conclusion Modern contraceptive use in rural Zambia among currently married women of reproductive age group is relatively low (43%). We recommend that appropriate interventions are instituted to increase contraceptive access and use especially among uneducated older rural Zambian women.https://bmjopen.bmj.com/content/10/3/e030980.full
spellingShingle Yuan Zhang
Huiping Zhang
Joseph Lasong
Simon Afewerki Gebremedhin
Sampson Opoku
Chrissie Stansie Abaidoo
Tamara Mkandawire
Kai Zhao
Determinants of modern contraceptive use among married women of reproductive age: a cross-sectional study in rural Zambia
BMJ Open
title Determinants of modern contraceptive use among married women of reproductive age: a cross-sectional study in rural Zambia
title_full Determinants of modern contraceptive use among married women of reproductive age: a cross-sectional study in rural Zambia
title_fullStr Determinants of modern contraceptive use among married women of reproductive age: a cross-sectional study in rural Zambia
title_full_unstemmed Determinants of modern contraceptive use among married women of reproductive age: a cross-sectional study in rural Zambia
title_short Determinants of modern contraceptive use among married women of reproductive age: a cross-sectional study in rural Zambia
title_sort determinants of modern contraceptive use among married women of reproductive age a cross sectional study in rural zambia
url https://bmjopen.bmj.com/content/10/3/e030980.full
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