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Objective: This study aims to explore and analyze the modern contraceptive use of National Health Insurance (NHI) participants before and during the COVID-19 pandemic in South Kalimantan, Indonesia. Methods: This research is an ecological study using aggregated data from 13 Districts/Cities in South Kalimantan. This study used secondary data in 2018-2020 from the official website of the National Population and Family Planning Agency. Spatial analysis and paired T-test were used. Results: There were 30.7% of Districts/Cities in stagnation and 30.7% in the decline of modern contraception use during the pandemic (2019-2020). In addition, the study showed that there were differences in the use of modern contraception before (2019) and during the COVID-19 pandemic (2020) among active family planning acceptors of NHI participants (p=0.048). Conclusion: The existence of NHI, especially recipients of contribution assistance, can increase the use of modern contraception in South Kalimantan. There are differences in the use of modern contraception before and during the COVID-19 pandemic among NHI participants.

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BACKGROUND: Even though family planning 2020 has made remarkable progress about solving the issue of unmet need for family planning, 70% of women in a developing countries who do not want to conceive are not using it. There are limited research that provided detail information regarding barriers of modern contraceptive utilization during postpartum period in the study area. In addition, previous study also recommended that to conduct using mixed quantitative and qualitative design for further investigations to answer these "why" questions and narrow these gaps. OBJECTIVE: This study aimed to assess postpartum modern contraceptive utilization and associated factors among postpartum women in Kena woreda, Konso zone, South Ethiopian Regional State, Ethiopia, 2023. METHODS: A mixed type community based cross-sectional study design was conducted among 605 women in Kena woreda, from September 1-30/2023 out of 628 sampled mothers. Multistage sampling technique was used to select study participant and data was collected using semi-structured pretested questionnaire and entered in to Epi data version 3.1 and then exported to STATA version 14 for analysis for quantitative. The association between variables was analyzed using bivariate and multivariable binary logistic regression and level of significant determined with adjusted odd ratio at 95% CI and P-value less than < 0.05. After translation and transcription, manual thematic analysis was applied to the qualitative data. RESULTS: The prevalence of modern contraceptive use among women during postpartum period in Kena woreda was found to be 39.01% [95% CI: 35.18-42.96%]. Menses resumed (AOR = 1.63; 95% CI: 1.02, 2.59), linked to the family planning unit during their child`s immunization (AOR = 2.17; 95% CI: 1.45, 3.25), family planning counselling during antenatal care visit (AOR = 1.63; 95% CI: 1.10, 2.42) and good knowledge towards modern contraceptive (AOR = 1.53; 95% CI: 1.03, 2.26) were factors associated with postpartum contraceptive utilization. Partner oppose, myths and misconception, need for excess family size, religious prohibition, fear of side effect,menses not resumed, lack of counselling and privacy room, and lack of transportation to health facility were barriers to modern postpartum contraceptive utilization.   CONCLUSIONS AND RECOMMENDATIONS: The utilization of postpartum contraceptives was found to be lower than the target set by the 2020/21 national reproductive health strategy plan, which aimed to increase contraceptive method usage to 50%. Menses resumed, family planning counselling during antenatal care visit, linked to the family planning unit during child immunization and good knowledge were factors associated to modern postpartum contraceptive utilization. Strengthening service integration and family planning counseling during antenatal care visits and encourage mothers to start using modern family planning methods before menses resume are important. Overcoming barriers including partner opposition, myths, religious beliefs, fear of side effects, lack of counseling at health facilities, and transportation challenges is essential.

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INTRODUCTION: Contraception is the deliberate prevention of unwanted pregnancy through various contraceptive methods. Its uptake is low in Sub-Saharan African countries, particularly in east Africa. This might be linked to the high prevalence of unwanted pregnancies and the high fertility rate in the area. Although studies reporting the prevalence and associated factors of modern contraceptive uptake are available in other African countries, no study has been conducted in Somaliland. Therefore, the current study aimed to assess its prevalence and associated factors in Somaliland using Somaliland Health and Demographic Survey (SLHDS) data. METHODS AND MATERIALS: The study used Somaliland Demographic Health Survey (SLDHS) 2020 data. The survey was a national-level survey using a cross-sectional study design. A total of 3656 reproductive-age women were included in the current study. To determine independent predictors of modern contraceptive uptake, a multi-level multivariable logistic regression analysis was done. Random effect analysis, standard error (SE) and intra-cluster correlation (ICC) were computed. RESULTS: The proportion of modern contraceptive uptake among reproductive age groups in Somaliland is 1%. Modern contraceptive uptake is significantly associated with the residence, educational level and wealth index of participants. Women from nomadic communities had lower odds (AOR: 0.25; 95% CI: 0.10, 0.66) of modern contraceptive uptake compared to those from urban areas. Being in the highest wealth quintiles (AOR: 17.22; 95% CI: 1.99, 155.92) and having a tertiary educational level (AOR: 2.11; 95% CI: 1.29, 9.11) had higher odds of using the modern contractive method compared to those with the lowest wealth quintiles and non-formal education, respectively. CONCLUSION: The prevalence of modern contraceptive uptake in Somaliland was very low. It is associated with the level of education, wealth index and residence of the women.

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BACKGROUND: Ethiopia is one of the countries in sub-Saharan Africa with the lowest prevalence of the use of modern contraceptive methods. On the frequency and determinants of modern contraceptive method in the Ethiopian women who live a nomadic lifestyle, there is, however, scant research. Therefore, the purpose of this study was to evaluate the factors that influence how often women in Ethiopia's nomadic tribes use modern contraceptive method. METHODS: In the nomadic community of Ethiopia, a community-based retrospective cross-sectional study was carried out between January 18 and June 27, 2016. From the 15,683 nationally representative datasets on the 2016 Ethiopian Demography and Health Survey, a sample of 3,415 women from nomadic communities was chosen. To determine factors linked to modern contraceptive method usage within the nomadic group, a multivariable logistic regression model analysis was considered. RESULT: In the nomadic population of Ethiopia, 10% (95% CI (9.10, 11.1)) of respondents reported using modern contraceptive method overall. The most popular way to use modern contraceptive method was through injection (73.5%). In the multivariable logistic regression model analysis, secondary and above-educated husbands (AOR = 1.6, 95% CI (1.01, 2.24)) and primarily educated husbands (AOR = 1.4, 95% CI (1.027, 2.0)), rich (AOR = 1.6, 95% CI (1.03, 2.74)) and middle wealth index (AOR = 1.58, 95% CI (1.25, 2.38)), public health place of delivery (AOR = 2.5, 95% CI (1.55, 3.0)), being a working husband (AOR = 3.8, 95% CI (1.96, 4.22)), and respondents working (AOR = 1.5, 95% CI (1.04, 1.79)) were positively critical risk predictors associated with modern contraceptive method usages. Compared to the Somali region, women living in the Afar (AOR = 2.58, 95% CI (1.68, 3.95)) and Benshangul-Gumuz (AOR = 3.40, 95% CI (2.22, 5.21)) regions had higher use of modern contraceptive method. CONCLUSION: In Ethiopia, modern contraceptive method usage is still quite uncommon among women who live in nomadic communities. Therefore, in order to increase modern contraceptive method service utilization and improve the wealth index of households, two key strategies, government professionals and concerned body service providers should pay special attention to educational opportunities for husbands and give valuable and effective counseling information during child delivery for women.

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Background: Despite efforts to increase modern contraceptive use in Ghana, prevalence rates remain low; particularly in Northern Ghana. This study, therefore, sought to determine the predictors of modern contraceptive use among couples in Northern Ghana. This research was the baseline assessment for a broader study aimed at determining the effect of an intervention to improve outcomes of modern contraception. Methods: The study was a cross-sectional design. Data was collected from 508 couples (1016 participants), using a multistage sampling technique; both members of each couple were interviewed separately. Univariate and stepwise multivariate logistic regression were used to identify predictors associated with modern contraceptive use. Qualitative data were analyzed to triangulate the findings from the quantitative data. Results: More than 97% of couples were Muslims. Qualitative data indicates that Muslims are less inclined to use Modern Contraceptives. Most participants had no education. The regression model shows that all demographic characteristics were not significant in Model 3 for men. Socio-culturally, men who gave the reason of "unconcerned" for men's non-involvement in contraceptive adoption, had less odds of using modern contraception (AOR=0.19). Men with high subjective norms were more than 15 times more likely to use modern contraception. Female farmers were less likely to use contraceptives (AOR= 0.45). Women who reported that "nothing prevented men" from getting involved in contraceptive adoption had greater odds of adopting modern contraception (AOR= 11.15). Women with good perceived behavioral control were more likely to use modern contraception (AOR=5.03). Women with high enacted stigma and men and women with high interspousal communication were more likely to adopt modern contraception. Conclusion: Taking cognizance of demographic and sociocultural characteristics and behavioral constructs is needed when determining the predictors of modern contraceptive use among couples in Northern Ghana.

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BACKGROUND: Globally, sexual and reproductive health is a significant public health issue for women of the reproductive age group. A modern contraceptive method enables individuals and families to manage fertility by reducing unintended pregnancies, abortions, pregnancy-related morbidity, and death. A modern contraceptive method is a drug or medical treatment that prevents sexual activity from leading to pregnancy. However, there is limited reliable and updated data on factors associated with modern contraceptive utilization among reproductive-age women at the national level in Kenya. So, the major goal of this study was to evaluate factors associated with modern contraceptive utilization among women of reproductive age in Kenya at the national level, as evidenced by the 2022 Kenyan demographic and health survey. METHODS: The most recent datasets from the Kenyan Demographic and Health Survey were used for secondary data analysis. In all, 14,987 women of reproductive age participated in the investigation. Data for multivariable analysis on the factors influencing modern contraceptive utilization among Kenyan women of reproductive age can be obtained from the Kenyan Demographic and Health Survey. Finally, the odd ratio and percentages were presented along with their 95% confidence intervals. RESULT: This study includes a total weighted sample of 14,987 reproductive-age women from the Kenyan demographic and health survey. Of the total contraceptive use, 90.1% of the study participants used modern contraceptives. Being married [AOR: 1.593, 95% CI (1.302, 1.948)], living in an urban area [AOR: 1.230, 95% CI (1.060, 1.428)], reading a magazine [1.002, 95% CI (0.921, 1.091)], listening to radio [AOR: 1.265, 95% CI (1.101, 1.454)], not breastfeeding [AOR: 1.296, 95% CI (1.114, 1.507), and having more than two children [AOR: 2.350, 95% CI (1.603, 3.445)] were the factors that promote modern contraceptive utilization. Conversely, having a history of terminated pregnancy [AOR: 0.767, 95% CI (0.657, 0.897), being Muslim [AOR: 0.566, 95% CI (0.418, 0.766)], and being in the 35-39 age range [AOR: 0.766, 95% CI (0.605, 0.971)] were all associated with a lower use of modern contraceptives. CONCLUSION: Certain factors such as marriage, living in urban areas, having more than two children, having a female-led household, belonging to the middle class, reading magazines, listening to the radio, and not breastfeeding have a positive correlation with the use of modern contraceptives. Conversely, being a Muslim, aged between 35 and 39, and having a history of miscarriages are negatively correlated with the use of modern contraceptives. This indicates that addressing socioeconomic, geographic, and cultural barriers could improve the effectiveness of modern contraceptive.

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Cet article intitulé«Déterminants communs et différents de l'utilisation des services de Planification Familiale danstrois communes à faible prévalence contraceptive du Burkina Faso, du Mali et du Nigeresttiré des résultats d'une étude transversale quantitative,menée par un consortium de trois instituts de recherche à savoir, le Centre Muraz au Burkina Faso,l'Institut Nationalde Santé publique au Mali etl'Initiative OASIS au Niger. L'étude a concerné 660 ménages, 790 femmes et 520 hommes. La collecte des données a été effectuée à l'aide d'un questionnairesemi-directif. Nous avons fait à une analyse descriptive uni-variée et bi-variée en utilisant le test de Khi-deux au seuil de 5%.Les déterminants identifiés étaient entre autres: le niveau descolarisation du chef de ménage, le statut matrimonial, l'occupation et l'autonomie reproductive de la femme et enfin sa connaissance des méthodes contraceptives modernes.

This article entitled "Common and different determinants of the use of Family Planning services in three communes with low contraceptive prevalence in Burkina Faso, Mali and Niger is drawn from the results of a quantitative cross-sectional study, conductedby a consortium of three research institutes namely, the Muraz Center in Burkina Faso, the National Institute of Public Health in Mali,and the OASIS Initiative in Niger. The study involved 660 households, 790 women and 520 men. Data collection was carried out using a semi-structured questionnaire. We carried out a univariate and bivariate descriptive analysis using the Chi-square test at the 5% threshold.The determinants , among others: the level of education of the head of , the , the occupation,and reproductive autonomy of the woman and finally her knowledge of modern contraceptive methods.

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Introduction: The increasing rate of unsafe abortion among adolescents and young women (AYW) in Sub-Saharan Africa may be attributed to a high rate of undesirable pregnancies and limited access to contraception services. The study looked at the prevalence of current contraception use among young women (15-24 years old) in the Democratic Republic of the Congo (DRC). Methods: The study analyzed secondary data from the demographic health survey (DHS) and UNICEF concerning AYW aged 15-24 years using IBM Corp. Released 2021. IBM SPSS Statistics for Windows, Version 28.0. (Armonk, NY: IBM Corp.). The study population included 15,319 female adolescents and young adults in DRC. DHS datasets for 2001, 2010, 2017/2018, and UNICEF 2007 and 2013-2014 were downloaded after permission to use the data. Results: The AYW aged 20-24 accounted for 67% of the study population. The use of modern contraceptives has followed a roller coaster course. It dropped significantly from 2.6% in 2001 to 0.1% in 2007; it climbed to 2.7% in 2010 and 3.3% in 2013/14 but dropped to 2% in 2017/18. The most used method was male condoms (1.76%). A higher proportion of unmarried (2.3%) used any methods than married (1.8%). Those who attained secondary/higher education (2.6%) used modern contraceptives more than those with no formal education (1.5%), P < 0.0001. Those residing in the urban areas (4.5%) used modern contraceptives compared to those who lived in rural areas (1.7%) P < 0.0001. Modern contraceptive use among those with birth histories (2.6%) was comparatively higher than those who have not (2.3%), P < 0.0001. Those who lived in urban areas were adjusted odds ratio (AOR) = 2.504 times (95% confidence interval (CI): 1.793-3.497) more likely to use birth control than those in rural areas (P < 0.001). Conclusion: As reported in this study, the proportion of AYW's awareness of modern contraceptives is deficient in DRC, which might be attributed not only due to a lack of knowledge or enlightenment but also due to healthcare facilities' limited capacity to provide reproductive and sexual health services. Educating the AYW about modern contraceptive methods and interventions, including parents, the school system, and youth organizations, and strengthening the capacity of health facilities to provide modern contraception should be considered.

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BACKGROUND: A demonstrated technique to enhance reproductive health and economic progress is through ensuring that family planning services are accessible universally. Those studies that used Ethiopia Demographic and Health Survey (EDHS) data did not assess individual and community-level factors in contraceptive utilization. Thus, the study employs a multilevel mixed effects analysis approach, which allows for the examination of individual and community-level factors that influence contraceptive utilization. METHODS: This study analyzed the 2019 Ethiopia Min Demographic and Health Survey datasets. A total of 1916 married women in the 2019 surveys were included in the analysis. The data were analyzed using Stata version 17.0. The data were analyzed using Multi-level mixed-effect logistic regression to identify the individual and community-level factors associated with modern contraceptive utilization. An adjusted odds ratio with a 95% confidence interval was used to. Show the strength and direction of the association and statistical significance was declared at a P value less than 0.05. RESULTS: Factors significantly associated with modern contraceptive utilization were; Muslim and protestant followers [AOR = 0.31, 95% CI: (0.134, 0.714)] and [AOR = 0.35, 95% CI: (0.173, 0.691)] respectively, women with no education (OR = 0.46; 95% CI: 0.293, 0.710), those women who belong to the poor and middle wealth of household [AOR = 0.35, 95% CI: (0.237, 0.527)] and [AOR = 0.56, 95% CI: (0.347, 0.919)] respectively, women who had one to five and greater than or equal to six living children [AOR = 11.36, 95% CI:(2.119, 60.918)] and [AOR = 7.44, 95% CI:(1.437, 38.547)]respectively, Women in clusters poor wealth status [AOR = 0.40, 95% CI: (0.183, 0.875)] and women who belong to the Somali region [AOR = 0.20, 95% CI: (0.0.070, 0.506)]. CONCLUSION: The study revealed that both individual and community-level factors determined modern contraceptive utilization. At the individual level, the religion of women, educational status, the wealth of the household, and the total number of living children were significantly associated with modern contraceptive utilization. At community-level factors, community wealth status and belonging to the Somali region were significantly associated with modern contraceptive utilization. The findings suggest that interventions aimed at increasing modern contraceptive utilization should target women with lower levels of education, those living in households with lower wealth, and those with larger families. Additionally, efforts should be made to improve access to modern contraceptives in communities with lower wealth status and in regions where traditional beliefs may hinder their use.

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BACKGROUND: Timely initiation of modern contraceptive use is vital to prevent unintended pregnancy and its related morbidities and mortalities. However, there is a scarcity of evidence about the duration of time elapsing from childbirth to initiating modern contraceptive use following childbirth and its associated factors in the study area for evidence-based interventions. Therefore, we aimed to assess the time to initiation of modern contraceptive method use and its predictors in Hossana town, southern Ethiopia. METHODS: A retrospective follow-up study was conducted at public health facilities in Hosanna town. A total of 503 study participants were included in the study using a systematic random sampling technique. The Box and Whisker plot was used to estimate the time to initiation of modern contraceptive use. A Weibull regression model was applied to identify predictors of time to initiation of modern contraceptive use. Adjusted Hazard Ratio (AHR) with a 95% confidence interval (CI) was used to interpret the strength of the association. RESULTS: The median time to initiation of modern contraceptive use was 6 months, with an interquartile range of 3 months. Husband/partner attending higher education [AHR = 1.64, 95% CI: 1.04, 2.57], women who had parity of more than two [AHR = 1.93, 95% CI: 1.01, 3.67], and women who had communicated with their husband/partner about modern contraceptive methods [AHR = 3.03, 95% CI: 1.41, 6.67] were more likely to initiate modern contraceptive method use within six months after childbirth. In contrast, women with an older age of greater than or equal to 30 years [AHR = 0.32, 95% CI: 0.13, 0.82] and who did not resume sexual intercourse after childbirth [AHR = 0.02, 95% CI: 0.01, 0.03] were less likely to initiate modern contraceptive method use within six months after childbirth. CONCLUSIONS: The median time to initiation of modern contraceptive method use after childbirth in the postpartum period was delayed from the World Health Organization recommendation of at most 6 weeks. Emphasis should be given to older women, women with lower parity, and men's participation in contraceptive communication to improve timing for initiation of modern contraceptive use after childbirth and to curb the five-month lag periods.

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BACKGROUND: Prevention of unplanned pregnancies through modern contraceptives among HIV-positive women is one of the essential strategies for reducing mother-to-child transmission of HIV. Family planning and HIV services integration is a national strategy designed to scale-up modern contraceptives among HIV-positive women. This study aims to evaluate the success of a service integration strategy by comparing the prevalence of modern contraceptive use among HIV-positive women receiving ART within integrated services and those not on integrated services (HIV-negative women and HIV-positive women unaware of their status). METHODS: We used data from the Tanzania HIV impact survey (THIS) of 2016/17. THIS provided HIV counselling and testing with a return of results in over 30,000 adults over 15 years of age. Women tested positive self reported their enrollment into ARV with further confirmation through laboratory analysis for any detectible ARV in their blood. All non-pregnant women reported their contraceptive use. Univariate and multivariate logistic regression was used to assess the effect of accessing integrated services controlling for potential confounders. RESULTS: A total of 14,986 women were included in the analysis; HIV-positive women were 1,066 and HIV-negative women were 13,830. Modern contraceptive use prevalence was 35% among HIV-positive women and 30% among HIV-negative women. Among HIV-positive women, those enrolled in integrated services (ART) had a higher prevalence of modern contraceptive (40%) compared to HIV-positive women unaware of their status (27%, p-value = 0.0014). The most common contraceptive methods in HIV-positive women were injectables (32%) and male condoms (31%), while in HIV-negative women, injectables (39%) and implants (30%, n = 1032) were the most preferred methods. Among HIV-positive women, enrolment into integrated services (currently on ART) demonstrated an increase in the odds of modern contraceptives by 85% (AOD = 1.85, 95%CI: 1.27-2.71). CONCLUSION: This study found relatively low modern contraceptive use among HIV-positive women in the general population despite the existance of service integration program and guidelines to guide its implementation.Our study therefore calls for the evaluation on the implementation of the integration programme to identify factors that constrain or facilitate programme effectiveness.

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BACKGROUND: The most common family planning method is modern contraception. It is a cost-effective way to reduce maternal and neonatal morbidity and mortality and enable women to make informed choices about their reproductive and sexual health. The trend of modern contraceptive utilization has shown drastic change in Ethiopia, and identifying the major factors contributing to such a drastic change is vital to improving plans and strategies for family planning programs. Therefore, this study analyzed the trend, geographical distribution, and determinants of modern contraceptive use among married reproductive-age women in Ethiopia. METHOD: This study used secondary data from the EDHS 2000-2016, collected from a population-based cross-sectional study by the Central Statistical Agency, focusing on married reproductive-age women aged 15-49. The study analyzed the modern contraceptive use trends through descriptive analyses conducted in three phases: 2000-2005, 2005-2011, and 2011-2016. The study utilized bivariable and multivariable logistic regression analyses to identify determinant factors, with significant variables declared using a P-value of 0.05 and an adjusted OR with 95% confidence interval. Analysis was conducted using STATA.14 and R. Spatial analysis was done using ArcGIS version 10.8 and SatScan™ version 9.6. RESULT: A weighted total of 33,478 women are included in the study, with a mean age of 31.4 years (8.6 SD). There was a significant increase in the trend of modern contraceptive use among married women over the study period, from 2000 to 2016, from 7.2% to 2000 to 15.7% in 2005, to 30% in 2011, and to 39.5% in 2016. The maximum increase was seen in the second phase (2005-2011), with a 14.3% increase. Factors like age of respondents, educational status, religion, residence, region, wealth index, number of living children, husbands' desire to have more children, and media exposure were found to be predictors for modern contraceptive utilization. CONCLUSION: The prevalence of modern contraceptive use is below 50%, and there is also evidence of wide geographical variation in modern contraceptive use in Ethiopia. Thus, policymakers, high institutions, and other stakeholders must work collaboratively with the government in order to improve awareness about modern contraceptive use.

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BACKGROUND: Contraception is widely recognized as an effective technique for avoiding unplanned pregnancies and sexually transmitted diseases. Promoting contemporary contraceptive methods would minimize the number of unplanned pregnancies and the high number of maternal fatalities connected with unsafe abortions. OBJECTIVE: This study aims to assess the level of knowledge, attitude, and practice of modern contraceptive methods and its associated factors among housemaid residents of Debre Tabor Town, northwest Ethiopia: METHODS: A structured questionnaire supplemented with face-to-face interviews was used to conduct a community-based cross-sectional study with 423 housemaids' women of reproductive age in Debre Tabor City. The data were analyzed using descriptive analysis, binary analysis, and multivariable logistic regression. RESULTS: A 12.8% of respondents in this study used modern contraceptive methods. A 44.68% of study participants had good knowledge of modern contraceptive methods, and 36.40% had a positive attitude towards them. Housemaids' older age, urban location, educational status, work experience, and family situation were found to be positive predictors of a good understanding of current contraceptive techniques. Housemaids' older age, urban residence, educational level, work experience, family situation, and first sex before now are all positive predictors of a positive attitude and good practices. CONCLUSIONS: Housemaids' knowledge, attitude, and practice of modern contraceptive methods were influenced by a variety of socio-demographic factors. As a result, housemaids should be educated about modern contraceptive methods by the health sector and other stakeholders to improve their knowledge, attitude, and practices.

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BACKGROUND: Modern contraceptive has been identified as a key strategy to control unintended pregnancy, protect the health of the mother and child, and promote women wellbeing. Despite this and increasingly wider availability of modern contraceptives, however, there are still high levels of unmet need for birth interspacing and contraceptive use in Amhara regions. This study aimed to identify factors associated with the enhancing of modern contraceptives utilization among reproductive aged women in Amhara region, using a mixed effects multilevel modeling data from mini-EDHS 2019. METHODS: A community-based cross-sectional study was conducted among 711(wt = 100%) samples of reproductive-aged women. The data were interviewed by trained data collectors using a semi-structured questionnaire for the final mini-EDHS 2019 data set. A multilevel binary logistic regression model was fitted to identify the enhancing factors for modern contraceptive utilization Adjusted Odds Ratio (AOR) with 95% Confidence Intervals (CI) was used to identify factors associated with utilization. RESULT: The median age of the participants was 31 with (IQR ± 13) years. The overall modern contraceptive utilization was 42.3% (95%CI: 38.7; 46.1). Individual and community factors accounted for 21.4% of the variation in modern contraceptive utilization at the cluster level. Being age 25 years (AOR = 12.99; 95%CI: 4.5-37.2), 26-35 years (AOR = 8.8, 95%CI: 3.25- 24), 36-45 years (AOR = 5.6, 95%CI: 2.2-16.2), being married (AOR = 4.2, 95%CI: 2.21-6.97), educated women (AOR = 11.6, 95%CI: 3.22-40.4), and being middle-economic class (AOR = 3.03; 95%CI: 1.87-4.91) were identified as individual enhancing factors. Whereas, being urban resident (AOR = 5.19; 95%CI: 5.19: 41.7) and having media exposure (AOR = 1.5; 95%CI: 1.58-3.7) were community-level enhancing factors for modern contraceptive utilization. CONCLUSION: Compared to earlier studies, in Amhara region, a lower prevalence rate of modern contraceptive utilization was reported. The variation in utilization at the cluster level, 21.4%, was attributed to individual and community-level factors. Healthcare providers should prioritize raising awareness about contraceptive side effects to encourage new users and decrease the number of individuals who discontinue contraceptive methods.

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BACKGROUND: For better maternal and child health, women's independence on reproductive health issues is crucial; however, couples are restricted from discussing openly with their partner. Regarding this, information about women's decision-making autonomy is low in the world, including Sub-Saharan Africa; therefore, this study was aimed to assess married women's decision-making autonomy on modern contraceptive utilization in high fertility SSA countries. METHODS: Data for this study was obtained from the most recent (2010-2018) Demographic and Health Surveys. A total of weighted sample of 14,575 married reproductive age women was included. A multilevel mixed-effect binary logistic regression model was fitted to identify the significant associated factors of decision-making autonomy on modern contraceptive utilization. Finally, the Adjusted Odds Ratio (AOR) with 95% confidence interval was used to declare as statistical significance. RESULTS: Overall prevalence of married women decision-making autonomy on modern contraceptive utilization in the high fertile SSA countries is 25.28% (95% CI:18.32%, 32.24%). The factors significantly associated with the decision-making autonomy on modern contraceptive utilization were women's age 25-34 years (AOR = 1.88, 95% CI = 1.84-1.93) and 35-49 years (AOR = 1.90, 95% CI = 1.82-1.92), had media exposure (AOR = 1.13, 95% CI = 1.00- 1.28), Number of alive children, 1-2 (AOR = 2.35, 95% CI = 1.38-4.01), 3-4 (AOR = 2.98, 95% CI = 1.74-5.10), [Formula: see text] 5 (AOR = 2. 82, 95% CI = 1.63-4.86), educational status; primary education (AOR = 1.93, 95% CI = 1.77-2.83), Secondary and higher (AOR = 2.11, 95% CI = 1.78-2.89), Community media exposure (AOR = 1.80, 95% CI = 1.38-2.34), Community level poverty, (AOR = 1.43, 95% CI = 1.09-1.86) and resides in rural (AOR = 0.67, 95% CI = 0.64-0.71). CONCLUSION: Women's decision-making autonomy on modern contraception utilization in this study was low. Therefore, the government should promote women's autonomy on contraceptive use as an essential component of SRH rights through mass media, with particular attention for, women living in the poorest communities, and those residing in rural settings of the country. Moreover, health professionals should counsel the women about the benefits of using modern contraceptive to help them managing their number of children.

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Despite the documented importance of sexual and reproductive health in women's life, access to sexual and reproductive health (SRH) services by migrant women remains low leading to negative sexual and reproductive health outcomes. This study investigated the factors associated with access to condoms and Human immunodeficiency virus (HIV) testing services among 2070 women aged 15-49 years residing in high migration communities. Logistic regression models were fitted and migration status was found to be an important factor in women's access to HIV testing services. In addition to migration status, age, educational level, marital status, religion, comprehensive knowledge about SRH, comprehensive knowledge about HIV, partner's age, and partner's educational level were significantly associated with access to condoms and HIV testing services. Programmes aimed at increasing access to condoms and HIV services should collaborate with adult basic education programmes in order to increase women's education and involve all women regardless of migration status, age and marital status. In addition, the involvement of male partners and religious leaders in disseminating and imparting accurate information and knowledge regarding SRH and HIV services to ensure women's access to both condoms and HIV testing services is required.

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The objective of the study was to ascertain the determinants of modern contraceptive use in Ghana among married women and those living with a partner. Secondary data from the Performance Monitoring and Accountability 2020 Ghana 2015 survey were used for the study. A multivariate logistic regression analysis was used. Modern contraceptive use was 25.5%. The significant predictors of modern contraceptive use were exposure to the media (AOR 2.07, 95% CI 1.20 - 3.55), residence in the Upper East region (AOR 0.26, 95% CI 0.10 - 0.71), final decision makers on contraceptive method either by themselves or jointly (AOR 0.26, 95% CI 0.14 -0.92), return to provider (AOR 6.96, 95% CI 3.59 - 13.49), refer relative or friend to provider (AOR 2.67, 95% CI 1.27 - 5.68), and parity of 5 or more (AOR 4.42, 95% CI 1.49 - 13.12). Media exposure on contraceptives and client satisfaction has the potential to improve modern contraceptive uptake in Ghana.

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BACKGROUND: Contraceptive use is crucial to achieving Sustainable Development Goal 3. Evidence of socioeconomic inequality in the use of modern contraceptives is essential to address the developing inequality in its utilisation given the low prevalence of contraceptive use among women in Benin. This study examined the socioeconomic inequalities in modern contraceptive use among women in Benin. METHODS: We performed a cross-sectional analysis of the 2017-18 Benin Demographic and Health Survey data. A weighted sample of 7,360 sexually active women of reproductive age was included in the study. We used a concentration curve to plot the cumulative proportion of women using modern contraception. Decomposition analysis was conducted to determine factors accounting for the socioeconomic disparities in modern contraceptive use. RESULTS: We noted that the richest women had higher odds of modern contraceptive use (adjusted odds ratio [aOR] = 1.67, CI = 1.22-2.30) compared to the poorest women. Other factors that showed significant associations with modern contraception use were age, marital status, religious affiliation, employment status, parity, women's educational level, and ethnicity. We found that modern contraceptive use is highly concentrated among the rich, with rich women having a higher propensity of using modern contraception relative to the poor. Also, the disadvantaged to modern contraceptive use included the poor, those aged 45-49, married women, those working, those with four or more live births, rural residents, and women of Bariba and related ethnicity. Conversely, favourable concentration in modern contraceptive use was found among the rich, women aged 20-24, the divorced, women with two live births, the highly educated, those with media exposure, and women of Yoruba and related ethnicity. CONCLUSION: The study has shown that wealthy women are more likely to utilize contraceptives than the poor. This is because wealthy women could afford both the service itself and the travel costs to the health facility, hence overcoming any economic barriers to using modern contraception. Other factors such as age, marital status, religion, employment status, parity, mother's educational level, and ethnicity were associated with contraceptive use in Benin. The Benin government and other stakeholders should develop family planning intercession techniques that address both the supply and demand sides of the equation, with a focus on reaching the illiterate and under-resourced population without admittance to modern contraception.

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INTRODUCTION: There is tremendous regional inequalities and low uptake of modern contraceptives particularly among young women (15-24 years), characterized by high fertility but high unmet need for contraceptives in Ethiopia. Hence, the present study aimed at exploring the spatial distribution and the multi-level determinants of modern contraceptive use among young women in Ethiopia. METHODS: This study was conducted using the 2019 Ethiopian demographic and health survey data on a weighted sample of 3,379 young women. STATA version 14 for the multi-level, and ArcGIS 10.7 and Sat Scan 9.6 for the spatial analysis were used. Spatial analysis was done to identify the hotspot areas of modern contraceptive use in Ethiopia. Multi-variable multi-level logistic regression was used for identifying determinants of modern contraceptive use and variables with a p-value < 0.05 were considered to be significant determinants. RESULT: The overall prevalence of modern contraceptive use among young women in Ethiopia was 17.23% (95% CI: 10.98, 23.47). The hotspots areas for modern contraceptive use were detected in the central and south-western Amhara, western and central Oromia, and western SNNPR regions. Whereas the Somali region, Dire dawa, and Harari cities were cold spot areas for modern contraceptive use. Being married (AOR = 18.5; 95% CI: 12.66, 27.27), parity (AOR = 4.82; 95% CI: 1.27, 18.32), having television (AOR = 2.39; 95%CI: 1.43, 3.99), having radio (AOR = 1.43; 95%CI: 1.05, 1.94) had higher odds of using modern contraceptives compared to their counterparts. Besides, family size of above five (AOR = 0.46; 95% CI: 0.34, 0.62) and living in Somali region (AOR = 0.05; 95% CI: 0.01, 0.32) were associated with decreased odds of using modern contraceptives among young women in Ethiopia. CONCLUSION: The modern contraceptive use was low among young women and considerably varied across regions in Ethiopia. A remarkably low rate of modern contraceptive use (cold spot) area was detected in Somali region-Ethiopia. Taking in to account a geographic perspective and key factors identified in this study would be vital for efficient resource allocation, targeted interventions, and informed decision-making to enhance contraceptive uptake in Ethiopia.

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BACKGROUND: Uganda has registered an increased investment in family planning (FP) programs, which has contributed to improvement in knowledge of modern contraceptive methods being nearly universal. However, this has not matched the uptake of modern methods or the reduction in the unmet need for FP. This may be explained by the different influences which include health workers, family, and friends. Due to the limited uptake of contraceptive methods, a program on improving awareness, access to, and uptake of modern contraceptives is being implemented in selected regions in Uganda. We, therefore, conducted a formative study to determine the influences on contraceptive uptake at the onset of this program. METHODS: Using a qualitative study design, we conducted thirty-two focus group discussions and twenty-one in-depth interviews involving men and women of reproductive age. We also carried out twenty-one key informant interviews with people involved in FP service delivery. Data was collected in four districts where implementation of the program was to take place. Audio recorders were used to collect data and tools were translated into local languages. A codebook was developed, and transcripts were coded in vivo using the computer software Atlas-ti version 7 before analysis. Ethical clearance was obtained from institutional review boards and informed consent was sought from all participants. RESULTS: From the study, most married people mentioned health workers as their main influence while adolescents reported their peers and friends. Religious leaders and mothers-in-law were reported to mainly discourage people from taking up modern contraceptive methods. The cultural value attached to having many children influenced the contraceptive use decision among people in rural settings. Other influences included a person's experience and housing. CONCLUSIONS: Health workers, religious leaders, and mothers determine the uptake of contraceptive services. The study recommends the consideration of the role of these influences in the design of FP program interventions as well as more involvement of health workers in sensitization of communities about contraceptive methods.

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