Unmet Need for Contraception among Clients of FP/HIV Integrated Services in Nigeria: The Role of Partner Opposition

Article · June 2014with18 Reads
While women are aware of family planning (FP) methods in Nigeria, the unmet need for modern contraception remains high. We assessed the association between male partner opposition to FP and unmet need for modern contraception among women seeking anti-retroviral therapy (ART), HIV counseling and testing (HCT) and prevention-of-mother-to-child-transmission of HIV (PMTCT) services in Cross-River State, Nigeria. This secondary analysis used data from a facility-based FP/HIV integration study. Logistic regression was used to model the association of interest. Unmet need for modern contraception was high among all clients – ART (49%), HCT (75%), and PMTCT (32%). Perceived partner opposition to FP was widespread (≥70%); however, multivariate analysis showed no significant association with unmet need for modern contraception. Significant covariates were woman’s age, marital status, parity, and previous use of modern contraception. Efforts to improve modern contraceptive use among women at risk of HIV infection in Nigeria should contemplate involving their male partners.
    • 50.6% of the spouses did not support contraception for them. This association between male partner opposition to contraception and unmet need was observed among women seeking HIV services in Cross‑River State, Nigeria, where perceived partner opposition to FP was ≥70%.[19]This indicates the need to involve men in FP issues for improved access and utilization.
    Article · Jan 2016
    • However, not many FP programs have involved men. Among the few studies in sub-Saharan Africa that include men, a majority focus on factors associated with couples' FP practices within the context of HIV/AIDS [15, 23, 24] or men's reported knowledge and use of contraceptive methods25262728 rather than the impact of reproductive health programs on men's contraceptive behaviors. Therefore , there remains a dearth of knowledge on the best strategies to engage men in sexual and reproductive health programs and the impact of male involvement on FP adoption and continuation.
    [Show abstract] [Hide abstract] ABSTRACT: Family planning (FP) researchers and policy makers have often overlooked the importance of involving men in couples' fertility choices and contraception, despite the fact that male involvement is a vital factor in sexual and reproductive health programming. This study aimed to assess whether men's exposure to FP demand-generation activities is associated with their reported use of modern contraceptive methods. We used evaluation data from the Measurement, Learning & Evaluation project for the Urban Reproductive Health Initiative (URHI) in select cities of three African countries (Kenya, Nigeria, and Senegal) collected in 2012/2013. A two-stage cluster sampling design was used to select a representative sample of men in the study sites. The sample for this study includes men aged 15-59 years who had no missing data on any of the key variables: 696 men in Kenya, 2311 in Nigeria, and 1613 in Senegal. We conducted descriptive analyses and multivariate logistic regression analyses to assess the associations of interest. All analyses were weighted to account for the study design and non-response rates using Stata version 13. The proportion of men who reported use of modern contraceptive methods was 58 % in Kenya, 43 % in Nigeria, and 27 % in Senegal. About 80 % were exposed to at least one URHI demand-generation activity in each country. Certain URHI demand-generation activities were significantly associated with men's reported use of modern contraception. In Kenya, those who participated in URHI-led community events had four times higher odds of reporting use of modern methods (aOR: 3.70; p < 0.05) while in Senegal, exposure to URHI-television programs (aOR: 1.40; p < 0.05) and having heard a religious leader speak favorably about FP (aOR: 1.72; p < 0.05) were associated with modern contraceptive method use. No such associations were observed in Nigeria. Study findings are important for informing future FP program activities that seek to engage men. Program activities should be tailored by geographic context as results from this study indicate city and country-level variations. These types of gender-comprehensive and context-specific programs are likely to be the most successful at reducing unmet need for FP.
    Full-text · Article · Jul 2015
    • This association between male partner opposition to contraception and unmet need was observed among women seeking HIV services in Cross-River State, Nigeria, where perceived partner opposition to FP was ≥70%. [19] This indicates the need to involve men in FP issues for improved access and utilization. This study yielded more findings because women who recently had children were interviewed as these were an indication of recent or ongoing sexual activity.
    Full-text · Article · Oct 2012
  • [Show abstract] [Hide abstract] ABSTRACT: Male involvement is crucial to female contraceptive use. This study examined how male knowledge and cultural perceptions of modern female contraceptives influence involvement in contraceptive use. A cross-sectional survey of 389 men from Ayete, Nigeria was used to regress a continuous male involvement score on demographic variables, knowledge of at least one method of modern female contraception and a scored male perception variable using Ordinary Least Squares regression. Controlling for perception, the knowledge of at least one method of modern female contraception was not significantly associated with a change in male involvement (p=0.264). Increasing positive perception was associated with higher male involvement scores (p=0.001). Higher educated males, those with a current desire to have children and males whose partners were currently using a method had greater male involvement scores (p<0.05). Policy and intervention efforts should be focused on changing cultural perceptions, in addition to providing in-depth knowledge of contraceptive methods.
    Full-text · Article · Dec 2014
  • [Show abstract] [Hide abstract] ABSTRACT: Provider perspectives have been overlooked in efforts to address the challenges of unmet need for family planning (FP). This qualitative study was undertaken in Tanzania, using 22 key informant interviews and 4 focus group discussions. The research documents perceptions of healthcare managers and providers in a rural district on the barriers to meeting latent demand for contraception. Social-ecological theory is used to interpret the findings, illustrating how service capability is determined by the social, structural and organizational environment. Providers’ efforts to address unmet need for FP services are constrained by unstable reproductive preferences, low educational attainment, and misconceptions about contraceptive side effects. Societal and organizational factors-such as gender dynamics, economic conditions, religious and cultural norms, and supply chain bottlenecks, respectively-also contribute to an adverse environment for meeting needs for care. Challenges that healthcare providers face interact and produce an effect which hinders efforts to address unmet need. Interventions to address this are not sufficient unless the supply of services is combined with systems strengthening and social engagement strategies in a way that reflects the multi-layered, social institutional problems. © 2015, Women's Health and Action Research Centre, All rights reserved.
    Full-text · Article · Dec 2015 · JBI Database of Systematic Reviews and Implementation Reports
  • [Show abstract] [Hide abstract] ABSTRACT: Review question/objective: The objective of this review is to systematically identify, appraise and synthesize the best available evidence on the effect of family planning counseling during antenatal care attendance on postpartum contraceptive uptake.The review question is, what is the effect of family planning counseling during antenatal care attendance on postpartum contraceptive uptake in Africa?
    Article · Mar 2016
December 2011 · Studies in Family Planning · Impact Factor: 1.28
    One strategy for meeting the contraceptive needs of HIV-positive women is to integrate family planning into HIV services. In 2008 in Cross River State, Nigeria,family planning was integrated into antiretroviral (ART) services in five local government areas. A basic family planning/HIV integration model was implemented in three of these areas, and an enhanced model in the other two. We... [Show full abstract]
    September 2014 · African Journal of Reproductive Health
      This study aimed to examine the risk factors for engaging in transactional sex among young females in Montserrado County, Liberia. Data from an HIV behavioral survey conducted among young people aged 14 - 25 years were used. The analytical sample included 493 sexually-experienced females. Bivariate and multivariate analyses were conducted. We found that 72% of our sample had ever engaged in... [Show full abstract]
      June 2014 · African Journal of Reproductive Health
        We examined the association between intimate partner violence and unmet need for modern contraception in post-conflict Liberia. This is a secondary analysis of data collected using the Priorities for Local AIDS Control Efforts (PLACE) method. Data from 499 sexually experienced young women (aged 14-25) in Montserrado County, Liberia were examined. Intimate partner violence (55.7%), unintended... [Show full abstract]
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