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ABSTRACT
Background
Understanding a woman’s future contraceptive needs and enhancing her chances of putting those needs into action depend heavily on her intentions to use contraceptive methods. However, there is little information about global perspectives of intention to utilise contraceptives among fecund sexually active women.
Objectives
This study examines the patterns and determinants of contraception intention of fecund sexually active women.
Methods
The most recent Demographic and Health Surveys (DHS) from 59 countries were used for secondary data analysis. The DHSs applied a cross-sectional survey design to collect data from women between the ages of 15 and 49. The study comprises a sample of 697,590 fecund sexually active women in the reproductive ages. The desire to utilise contraceptive methods was examined using a multivariable binary logistic regression analysis. All analyses were weighted to allow for a complex survey design.
Results
A pooled prevalence of intention to utilise contraception was 42.8% (95% CI: 42.5, 43.1) at the global level. Eastern and Southern Europe had the lowest prevalence, 17.3% (95% CI: 16.4, 18.2), and the highest prevalence was observed in countries from Latin America and the Caribbean, 68.0% (95% CI: 67.5, 69.9). Attaining secondary-level education (adjusted odds ratio (aOR) = 1.68; 95% CI: 1.62–1.72) or higher (aOR = 1.71; 95% CI: 1.63–1.80), working (aOR = 1.21; 95% CI: 1.18–1.24), experience of a pregnancy loss (aOR = 1.06; 95% CI: 1.03–1.09), or being exposed to media family planning messages (aOR = 1.51; 95% CI: 1.48–1.55) were factors associated with an increased likelihood of intent to use contraceptives.
Conclusions
The study has established that contraceptive use intention was low in many developing countries. Education, age, employment status, fertility preference, and exposure to family planning messages influenced contraceptive use intention. Health policy-makers ought to consider these factors when designing sexual and reproductive health strategies in developing countries.
Responsible Editor Jennifer Stewart Williams
Responsible Editor Jennifer Stewart Williams
Acknowledgments
The authors express profound gratitude to DHS programme funders and all the collaborators who provided technical support in conducting the country-level DHSs that were utilised in this study. Further, the authors are indebted to Ms. Liness Shasha and Ms. Sibongile Namayawa, who worked tirelessly to extract the DHS datasets from the DHS programme website.
Author contributions
CO and MP conceptualised the idea for this study. MP wrote the background and methods sections as well as the interpretative text for the manuscript results. MP and SS conducted data analysis. MP and SS wrote the discussion and conclusion sections. CO and TT performed the overall review of the manuscript for quality checks and intellectual content. After carefully reviewing the manuscript, each author gave their stamp of approval to the final version.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Ethics and consent
Data analysed in this study are available in the public domain and can be accessed on the DHS programme website. Authority to use DHS datasets for 59 countries was granted by the DHS programme. The ethical review body of each country and the Research Ethics Review Board at the Centers for Disease Control and Prevention (CDC), Atlanta, approved the original DHS biomarker and survey protocols. As a result, all data collection was carried out in line with set ethical standards and regulations. All survey participants who were over the age of 18 were requested to provide their informed consent before being interviewed by the survey enumerator, according to the DHS guidelines. Prior to interviewing legal minors aged 15–17, their parents or guardians were required to give informed consent beforehand to enable the legal minors to provide their assent.
Paper context
Utilisation of contraceptives among women is widely recognised as a global public health strategy for reducing maternal mortality. While extensive research exists on this subject, little global attention has been paid to improve understanding of the drivers of women’s contraceptive use intention. This study helps fill that gap by providing insights into the characteristics of women who intend to use contraceptives. This information serves to inform future design of family planning interventions.