Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2018

Open Access 01-12-2018 | Research article

Community influences on modern contraceptive use among young women in low and middle-income countries: a cross-sectional multi-country analysis

Authors: Massy Mutumba, Eliud Wekesa, Rob Stephenson

Published in: BMC Public Health | Issue 1/2018

Login to get access

Abstract

Background

Despite investment in family planning programs and education, unmet need for family planning remains high among young women (aged 15–24) in low and middle-income countries, increasing the risk for unwanted pregnancies and adverse social and reproductive health outcomes. There is a dearth of cross-national research that identifies the differential impact of community level factors among youth in low and middle-income countries (LMICs), which is imperative for the design of structural level interventions aimed at increasing family planning use.

Methods

Grounded in the socio-ecological framework, this paper utilizes Demographic and Health Survey (DHS) from 52 LMICs to examine the influence of community level reproductive, gender, fertility, literacy and economic indicators on modern contraceptive use among female youth. Analyses are conducted using multi-level logistic regressions with random community-level effects.

Results

Our findings highlight the positive influence of community level education attainment and negative influence of gender and fertility related norms on young women’s contraceptive use. Additionally, increased exposure to mass media did not positively influence young women’s uptake of modern contraceptive methods.

Conclusions

Taken together, findings indicate that young women’s contraceptive decision-making is greatly shaped by their social contexts. The commonalities and regional variations in community level influences provide support for both structural level interventions and tailored regional approaches to family planning interventions.
Literature
1.
Bongaarts J, Cleland J, Townsend JW, Bertrand JT, Gupta MD. Family planning programs for the 21st century. New York: Population Council; 2012.
2.
Singh S, Darroch JE, Vlassoff M, Nadeau J. Adding it up: the benefits of investing in sexual and reproductive health care. New York: Alan Guttmacher Institute; 2013.
3.
National Research Council, Institute of Medicine. The science of adolescent risk-taking: workshop report. Washington: National Academies Press; 2011. p. 6–33.
4.
MacQuarrie K. Unmet need for family planning among young women: levels and trends. DHS comparative reports no.34. Rockville: ICF International; 2014.
5.
Cleland J, Conde-Agudelo A, Peterson H, Ross J, Tsui A. Contraception and health. Lancet. 2012;380(9837):149–56.CrossRefPubMed
6.
Magnani RJ, Karim AM, Weiss LA, Bond KC, Lemba M, Morgan GT. Reproductive health risk and protective factors among youth in Lusaka, Zambia. J Adolesc Health. 2002;30(1):76–86.CrossRefPubMed
7.
Ngome E, Odimegwu C. The social context of adolescent women’s use of modern contraceptives in Zimbabwe: a multilevel analysis. Reprod Health. 2014;11(1):64.CrossRefPubMedPubMedCentral
8.
9.
McGuire C, Stephenson R. Community factors influencing birth spacing among married women in Uganda and Zimbabwe. Afr J Reprod Health. 2015;19(1):14–24.PubMed
10.
Stephenson R, Baschieri A, Clements S, Hennink M, Madise N. Contextual influences on modern contraceptive use in sub-Saharan Africa. Am J Public Health. 2007;97(7):1233–40.CrossRefPubMedPubMedCentral
11.
Metheny N, Stephenson R. How the community shapes unmet need for modern contraception: an analysis of 44 demographic and health surveys. Stud Fam Plan. 2017;48(3):235–51.CrossRef
12.
Asiimwe JB, Ndugga P, Mushomi J, Ntozi JP. Factors associated with modern contraceptive use among young and older women in Uganda; a comparative analysis. BMC Public Health. 2014;14(1):926.CrossRefPubMedPubMedCentral
13.
Bronfenbrenner U. Toward an experimental ecology of human development. Am Psychol. 1977;32(7):513.CrossRef
14.
Bronfenbrenner U. Ecological systems theory. London: Jessica Kingsley Publishers; 1992.
15.
Williamson LM, Parkes A, Wight D, Petticrew M, Hart GJ. Limits to modern contraceptive use among young women in developing countries: a systematic review of qualitative research. Reprod Health. 2009;6(1):3.CrossRefPubMedPubMedCentral
16.
Wood K, Jewkes R. Blood blockages and scolding nurses: barriers to adolescent contraceptive use in South Africa. Reprod Health Matters. 2006;14(27):109–18.CrossRefPubMed
17.
Nalwadda G, Mirembe F, Byamugisha J, Faxelid E. Persistent high fertility in Uganda: young people recount obstacles and enabling factors to use of contraceptives. BMC Public Health. 2010;10(1):530.CrossRefPubMedPubMedCentral
18.
Nalwadda G, Tumwesigye NM, Faxelid E, Byamugisha J, Mirembe F. Quality of care in contraceptive services provided to young people in two Ugandan districts: a simulated client study. PLoS One. 2011;6(11):e27908.CrossRefPubMedPubMedCentral
19.
Stephenson R, Beke A, Tshibangu D. Contextual influences on contraceptive use in the eastern cape, South Africa. Health Place. 2008;14(4):841–52.CrossRefPubMed
20.
Moursund A, Kravdal Ø. Individual and community effects of women's education and autonomy on contraceptive use in India. Popul Stud. 2003;57(3):285–301.CrossRef
21.
Cleland JG, Ndugwa RP, Zulu EM. Family planning in sub-Saharan Africa: progress or stagnation? Bull World Health Organ. 2011;89(2):137–43.CrossRefPubMed
22.
Bongaarts J. The causes of educational differences in fertility in sub-Saharan Africa. In: Vienna yearbook of population research; 2010. p. 31–50.
23.
Westoff CF. Age at marriage, age at first birth, and fertility in Africa. Washington: World Bank Technical Paper No; 1990. p. 160.
24.
Jessor R. Successful adolescent development among youth in high-risk settings. Am Psychol. 1993;48(2):117.CrossRefPubMed
25.
26.
Bronfenbrenner U. Environments in developmental perspective: theoretical and operational models. In: Friedman SL, Wachs TD, editors. Measuring environment across the life span: emerging methods and concepts. Washington, DC: American Psychological Association; 1999. p. 3–28.CrossRef
27.
Bosmans M, Cikuru MN, Claeys P, Temmerman M. Where have all the condoms gone in adolescent programmes in the Democratic Republic of Congo. Reprod Health Matters. 2006;14(28):80–8.CrossRefPubMed
28.
Massey DB, Jess PM. The conceptualization of space: a place in the world? In: Massey DB, Jess PM, editors. Places, cultures and globalization. Oxford: Oxford University Press/The Open University; 1995.
29.
Woodman D, Leccardi C. Time and space in youth studies time space. Handbook of children and youth Studies; 2015. p. 705–21.CrossRef
30.
Wexler L, Eglinton KA. Reconsidering youth well-being as fluid and relational: a dynamic process at the intersection of their physical and social geographies. Handbook of children and youth Studies; 2014. p. 1–9.
31.
Westoff CF, Bankole A. Reproductive preferences in developing countries at the turn of the century. ORC Macro: Calverton; 2002.
32.
Bongaarts J. Can family planning programs reduce high desired family size in sub-Saharan Africa? Int Perspect Sex Reprod Health. 2011;37(4):209–16.CrossRefPubMed
33.
Richter MS, Mlambo GT. Perceptions of rural teenagers on teenage pregnancy. Health SA Gesondheid. 2005;10(2):61–9.CrossRef
34.
Castle S. Factors influencing young Malians’ reluctance to use hormonal contraceptives. Stud Fam Plan. 2003;34(3):186–99.CrossRef
35.
Siegler AJ, Mbwambo JK, McCarty FA, DiClemente RJ. Condoms “contain worms” and “cause HIV” in Tanzania: negative condom beliefs scale development and implications for HIV prevention. Soc Sci Med. 2012;75(9):1685–91.CrossRefPubMedPubMedCentral
36.
Mensch BS, Grant MJ, Blanc AK. The changing context of sexual initiation in sub-Saharan Africa. Popul Dev Rev. 2006;32(4):699–727.CrossRef
37.
Hine DW, Reser JP, Morrison M, Phillips WJ, Nunn P, Cooksey R. Audience segmentation and climate change communication: conceptual and methodological considerations. Wiley Interdiscip Rev Clim Chang. 2014;5(4):441–59.CrossRef
38.
Maibach EW, Maxfield A, Ladin K, Slater M. Translating health psychology into effective health communication: the American Healthstyles audience segmentation project. J Health Psychol. 1996;1(3):261–77.CrossRefPubMed
Metadata
Title
Community influences on modern contraceptive use among young women in low and middle-income countries: a cross-sectional multi-country analysis
Authors
Massy Mutumba
Eliud Wekesa
Rob Stephenson
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2018
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-018-5331-y

Other articles of this Issue 1/2018

BMC Public Health 1/2018 Go to the issue

Research article

Healthy offshore workforce? A qualitative study on offshore wind employees’ occupational strain, health, and coping

Research article

Knowledge and awareness of the general public and perception of pharmacists about antibiotic resistance

Research article

The relationship between socioeconomic status and risky drinking in Denmark: a cross-sectional general population study

Research article

Validation of the NPAQ-short – a brief questionnaire to monitor physical activity and compliance with the WHO recommendations

Research article

The usefulness of small-area-based socioeconomic characteristics in assessing the treatment outcomes of type 2 diabetes patients: a register-based mixed-effect study

Research article

Objectively evaluated physical activity and sedentary time in primary school children by gender, grade and types of physical education lessons