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      Factors associated with modern contraceptive use among young and older women in Uganda; a comparative analysis

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          Abstract

          Background

          Much of the research literature about the use of family planning generalizes contraceptive use among all women, using age as a covariate. In Uganda, a country with divergent trends in modern family planning use, this study was set to explore whether or not the predictors of contraceptive use differ by age. This was assessed by using data from the 2011 Uganda Demographic and Health Survey (UDHS).

          Methods

          We restricted the sample from each round to fecund, non-pregnant married women age 15–34 who were sexually active within one year prior to the survey, resulting in a sample of 2,814 women. We used logistic regression with age variable used as an interaction term to model the relationship between selected independent variables and the outcome variable (modern contraception use) for each group of women.

          Results

          We found that the key factors associated with use of modern contraceptives varied among young and older married women age 15–24 and 25–34 respectively. Results showed that perception on distance to health facility, listening to radio and geographical differences exhibited significant variability in contraceptive use among the young and the older women. Other key factors that were important for both age groups in explaining contraceptive use were; desire to have children after two years and education level.

          Conclusions

          Addressing contraceptive use among old and young women in Uganda requires concerted efforts that target such women to address the socio economic barriers that exist. There is need for increased access of family planning service to the population through strengthening the use of Village Health Teams (VHTs) whose service is currently limited in coverage (MoH, 2009). Given the variation in contraceptive use between the two age groups, our findings further suggest that there is need for variability in media targeting among the young and the older women categories for improved use of modern contraceptives, for instance using alternative media strategies to reach the young women. Family planning policies should also be tailored to address the specific needs of different age groups of women with varied geographical locations.

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          Most cited references24

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          Family planning: the unfinished agenda.

          Promotion of family planning in countries with high birth rates has the potential to reduce poverty and hunger and avert 32% of all maternal deaths and nearly 10% of childhood deaths. It would also contribute substantially to women's empowerment, achievement of universal primary schooling, and long-term environmental sustainability. In the past 40 years, family-planning programmes have played a major part in raising the prevalence of contraceptive practice from less than 10% to 60% and reducing fertility in developing countries from six to about three births per woman. However, in half the 75 larger low-income and lower-middle income countries (mainly in Africa), contraceptive practice remains low and fertility, population growth, and unmet need for family planning are high. The cross-cutting contribution to the achievement of the Millennium Development Goals makes greater investment in family planning in these countries compelling. Despite the size of this unfinished agenda, international funding and promotion of family planning has waned in the past decade. A revitalisation of the agenda is urgently needed. Historically, the USA has taken the lead but other governments or agencies are now needed as champions. Based on the sizeable experience of past decades, the key features of effective programmes are clearly established. Most governments of poor countries already have appropriate population and family-planning policies but are receiving too little international encouragement and funding to implement them with vigour. What is currently missing is political willingness to incorporate family planning into the development arena.
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            Women's autonomy, education and employment in Oman and their influence on contraceptive use.

            Since 1970 political and economic changes have brought about great improvements in health and education in Oman, and since 1994 the government has provided free contraceptives to all married couples in primary health care centres. Despite rapid socio-economic development, the fertility rate was 4.2 in 2001. The aim of this study was to define baseline data on ever-married women's empowerment in Oman from a national study in 2000, analyse the correlates of women's empowerment and the effect of empowerment on unmet need for contraception. Two indicators of empowerment were used: women's involvement in decision-making and freedom of movement. Bivariate analysis was used to link these measures and their proxies, education and employment status, with use of a family planning method. Education was a key indicator of women's status. Unmet contraceptive need for women exposed to pregnancy was nearly 25%, but decreased significantly with educational level and paid employment. While empowered women were more likely to use contraception, women's education was a better predictor of "met need" than autonomy, as traditional factors and community influence remain strong. For nearly half the 1,830 women in the study, the husband decided whether contraception was used. Fewer than 1% were using contraception before their first child as women are expected to have a child within the first year of marriage.
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              Uganda Demographic and Health Survey 2011

              (2012)
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                Author and article information

                Contributors
                asiimweajb@gmail.com
                patnduggab@yahoo.com
                mushojohn@yahoo.com
                jntozi@bams.mak.ac.ug
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                8 September 2014
                8 September 2014
                2014
                : 14
                : 1
                : 926
                Affiliations
                [ ]Department of Planning and Applied Statistics, School of Statistics and Planning, College of Business and Management Sciences, Makerere University, Kampala, Uganda
                [ ]Department of Population Studies, School of Statistics and Planning, College of Business and Management Sciences, Makerere University, Kampala, Uganda
                Article
                7053
                10.1186/1471-2458-14-926
                4169837
                25195645
                08b122bb-31f3-4078-8057-bbce46af149f
                © Asiimwe et al.; licensee BioMed Central Ltd. 2014

                This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.

                History
                : 20 April 2013
                : 5 September 2014
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2014

                Public health
                family planning,modern contraception,dhs,uganda,young women,older women,age differences,media messages,village health teams

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