Covert contraceptive use among women attending a reproductive health clinic in a municipality in Ghana
Identifieur interne : 000143 ( Pmc/Curation ); précédent : 000142; suivant : 000144Covert contraceptive use among women attending a reproductive health clinic in a municipality in Ghana
Auteurs : F. Baiden ; G. P. Mensah ; N. O. Akoto ; T. Delvaux [Belgique] ; P. C. AppiahSource :
- BMC Women's Health [ 1472-6874 ] ; 2016.
Abstract
Covert contraceptive use (CCU) in sub-Saharan Africa is an indication of women’s inability to exercise autonomy in their reproductive choices. The aim of this study was to assess the prevalence and determinants of CCU among a sample of FP clients in a municipality of Ghana.
We conducted a mixed method study among women attending a public reproductive health clinic in Sunyani, a city of over 250,000 inhabitants in Ghana. An initial survey inquired into sociodemographic characteristics, use of family planning (FP) methods and partner awareness of contraceptive use. The predictors of CCU were explored using logistic regressions. We used the findings to develop a guide which we applied in-depth interviews and focus group discussions with attendants at the same facility. Qualitative data analysis was conducted using a framework approach.
We interviewed 300 women, 48 % of whom were aged between 26–33 years. The injectable was the most widely used method (56 %). The prevalence of CCU was 34 %. In multivariate analysis, single women were more likely to practice CCU than married or co-habiting women (Adjusted OR = 12.12, 95 % C.I. 4.73–31.1). Muslim and traditionalist women were similarly more likely to practice CCU than non-Muslim, non-traditionalist (Adjusted OR = 4.56, 2.29–9.06). Women who preferred to have their first or next child in 4 or more years from the time of the interview were more likely to be in CCU than women who intended to have children within 4 years of the interview (2.57; 1.37–4.83). Single women saw in covert use a statement of their social autonomy. To succeed in CCU, women wished that clinic attendance cards would not be given to them to keep at home. Though many participants saw in CCU a source of anxiety, they expected health workers to consider it and uphold confidentiality in the provision of services.
Covert contraceptive use was high in this municipality and being single was the strongest predictor of the practice. Providers of FP services should reflect on how to adequately address the challenges faced by women who practice CCU.
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DOI: 10.1186/s12905-016-0310-x
PubMed: 27266263
PubMed Central: 4893877
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F. Baiden<affiliation><nlm:aff id="Aff1">Epidemiology Unit, Ensign College of Public Health, Kpong, ER Ghana</nlm:aff><wicri:noCountry code="subfield">ER Ghana</wicri:noCountry></affiliation><affiliation><nlm:aff id="Aff2">Faculty of Public Health and Allied Sciences, Catholic University College of Ghana, Fiapre, BAR Ghana</nlm:aff><wicri:noCountry code="subfield">BAR Ghana</wicri:noCountry></affiliation><affiliation><nlm:aff id="Aff2">Faculty of Public Health and Allied Sciences, Catholic University College of Ghana, Fiapre, BAR Ghana</nlm:aff><wicri:noCountry code="subfield">BAR Ghana</wicri:noCountry></affiliation><affiliation><nlm:aff id="Aff2">Faculty of Public Health and Allied Sciences, Catholic University College of Ghana, Fiapre, BAR Ghana</nlm:aff><wicri:noCountry code="subfield">BAR Ghana</wicri:noCountry></affiliation><affiliation><nlm:aff id="Aff2">Faculty of Public Health and Allied Sciences, Catholic University College of Ghana, Fiapre, BAR Ghana</nlm:aff><wicri:noCountry code="subfield">BAR Ghana</wicri:noCountry></affiliation><affiliation><nlm:aff id="Aff4">Municipal Health Directorate, Ghana Health Service, Sunyani, BAR Ghana</nlm:aff><wicri:noCountry code="subfield">BAR Ghana</wicri:noCountry></affiliation>Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Covert contraceptive use among women attending a reproductive health clinic in a municipality in Ghana</title><author><name sortKey="Baiden, F" sort="Baiden, F" uniqKey="Baiden F" first="F." last="Baiden">F. Baiden</name><affiliation><nlm:aff id="Aff1">Epidemiology Unit, Ensign College of Public Health, Kpong, ER Ghana</nlm:aff><wicri:noCountry code="subfield">ER Ghana</wicri:noCountry></affiliation><affiliation><nlm:aff id="Aff2">Faculty of Public Health and Allied Sciences, Catholic University College of Ghana, Fiapre, BAR Ghana</nlm:aff><wicri:noCountry code="subfield">BAR Ghana</wicri:noCountry></affiliation></author><author><name sortKey="Mensah, G P" sort="Mensah, G P" uniqKey="Mensah G" first="G. P." last="Mensah">G. P. Mensah</name><affiliation><nlm:aff id="Aff2">Faculty of Public Health and Allied Sciences, Catholic University College of Ghana, Fiapre, BAR Ghana</nlm:aff><wicri:noCountry code="subfield">BAR Ghana</wicri:noCountry></affiliation></author><author><name sortKey="Akoto, N O" sort="Akoto, N O" uniqKey="Akoto N" first="N. O." last="Akoto">N. O. Akoto</name><affiliation><nlm:aff id="Aff2">Faculty of Public Health and Allied Sciences, Catholic University College of Ghana, Fiapre, BAR Ghana</nlm:aff><wicri:noCountry code="subfield">BAR Ghana</wicri:noCountry></affiliation></author><author><name sortKey="Delvaux, T" sort="Delvaux, T" uniqKey="Delvaux T" first="T." last="Delvaux">T. Delvaux</name><affiliation wicri:level="1"><nlm:aff id="Aff3">Unit of HIV/AIDS Policy, Institute of Tropical Medicine, Antwerpen, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Unit of HIV/AIDS Policy, Institute of Tropical Medicine, Antwerpen</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff5">Public Health Department, Institute of Tropical Medicine, Antwerp, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Public Health Department, Institute of Tropical Medicine, Antwerp</wicri:regionArea></affiliation></author><author><name sortKey="Appiah, P C" sort="Appiah, P C" uniqKey="Appiah P" first="P. C." last="Appiah">P. C. Appiah</name><affiliation><nlm:aff id="Aff4">Municipal Health Directorate, Ghana Health Service, Sunyani, BAR Ghana</nlm:aff><wicri:noCountry code="subfield">BAR Ghana</wicri:noCountry></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">27266263</idno><idno type="pmc">4893877</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4893877</idno><idno type="RBID">PMC:4893877</idno><idno type="doi">10.1186/s12905-016-0310-x</idno><date when="2016">2016</date><idno type="wicri:Area/Pmc/Corpus">000144</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000144</idno><idno type="wicri:Area/Pmc/Curation">000143</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000143</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Covert contraceptive use among women attending a reproductive health clinic in a municipality in Ghana</title><author><name sortKey="Baiden, F" sort="Baiden, F" uniqKey="Baiden F" first="F." last="Baiden">F. Baiden</name><affiliation><nlm:aff id="Aff1">Epidemiology Unit, Ensign College of Public Health, Kpong, ER Ghana</nlm:aff><wicri:noCountry code="subfield">ER Ghana</wicri:noCountry></affiliation><affiliation><nlm:aff id="Aff2">Faculty of Public Health and Allied Sciences, Catholic University College of Ghana, Fiapre, BAR Ghana</nlm:aff><wicri:noCountry code="subfield">BAR Ghana</wicri:noCountry></affiliation></author><author><name sortKey="Mensah, G P" sort="Mensah, G P" uniqKey="Mensah G" first="G. P." last="Mensah">G. P. Mensah</name><affiliation><nlm:aff id="Aff2">Faculty of Public Health and Allied Sciences, Catholic University College of Ghana, Fiapre, BAR Ghana</nlm:aff><wicri:noCountry code="subfield">BAR Ghana</wicri:noCountry></affiliation></author><author><name sortKey="Akoto, N O" sort="Akoto, N O" uniqKey="Akoto N" first="N. O." last="Akoto">N. O. Akoto</name><affiliation><nlm:aff id="Aff2">Faculty of Public Health and Allied Sciences, Catholic University College of Ghana, Fiapre, BAR Ghana</nlm:aff><wicri:noCountry code="subfield">BAR Ghana</wicri:noCountry></affiliation></author><author><name sortKey="Delvaux, T" sort="Delvaux, T" uniqKey="Delvaux T" first="T." last="Delvaux">T. Delvaux</name><affiliation wicri:level="1"><nlm:aff id="Aff3">Unit of HIV/AIDS Policy, Institute of Tropical Medicine, Antwerpen, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Unit of HIV/AIDS Policy, Institute of Tropical Medicine, Antwerpen</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff5">Public Health Department, Institute of Tropical Medicine, Antwerp, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Public Health Department, Institute of Tropical Medicine, Antwerp</wicri:regionArea></affiliation></author><author><name sortKey="Appiah, P C" sort="Appiah, P C" uniqKey="Appiah P" first="P. C." last="Appiah">P. C. Appiah</name><affiliation><nlm:aff id="Aff4">Municipal Health Directorate, Ghana Health Service, Sunyani, BAR Ghana</nlm:aff><wicri:noCountry code="subfield">BAR Ghana</wicri:noCountry></affiliation></author></analytic><series><title level="j">BMC Women's Health</title><idno type="eISSN">1472-6874</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Covert contraceptive use (CCU) in sub-Saharan Africa is an indication of women’s inability to exercise autonomy in their reproductive choices. The aim of this study was to assess the prevalence and determinants of CCU among a sample of FP clients in a municipality of Ghana.</p></sec><sec><title>Methods</title><p>We conducted a mixed method study among women attending a public reproductive health clinic in Sunyani, a city of over 250,000 inhabitants in Ghana. An initial survey inquired into sociodemographic characteristics, use of family planning (FP) methods and partner awareness of contraceptive use. The predictors of CCU were explored using logistic regressions. We used the findings to develop a guide which we applied in-depth interviews and focus group discussions with attendants at the same facility. Qualitative data analysis was conducted using a framework approach.</p></sec><sec><title>Results</title><p>We interviewed 300 women, 48 % of whom were aged between 26–33 years. The injectable was the most widely used method (56 %). The prevalence of CCU was 34 %. In multivariate analysis, single women were more likely to practice CCU than married or co-habiting women (Adjusted OR = 12.12, 95 % C.I. 4.73–31.1). Muslim and traditionalist women were similarly more likely to practice CCU than non-Muslim, non-traditionalist (Adjusted OR = 4.56, 2.29–9.06). Women who preferred to have their first or next child in 4 or more years from the time of the interview were more likely to be in CCU than women who intended to have children within 4 years of the interview (2.57; 1.37–4.83). Single women saw in covert use a statement of their social autonomy. To succeed in CCU, women wished that clinic attendance cards would not be given to them to keep at home. Though many participants saw in CCU a source of anxiety, they expected health workers to consider it and uphold confidentiality in the provision of services.</p></sec><sec><title>Conclusions</title><p>Covert contraceptive use was high in this municipality and being single was the strongest predictor of the practice. 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<front><journal-meta><journal-id journal-id-type="nlm-ta">BMC Womens Health</journal-id><journal-id journal-id-type="iso-abbrev">BMC Womens Health</journal-id><journal-title-group><journal-title>BMC Women's Health</journal-title></journal-title-group><issn pub-type="epub">1472-6874</issn><publisher><publisher-name>BioMed Central</publisher-name><publisher-loc>London</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">27266263</article-id><article-id pub-id-type="pmc">4893877</article-id><article-id pub-id-type="publisher-id">310</article-id><article-id pub-id-type="doi">10.1186/s12905-016-0310-x</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title>Covert contraceptive use among women attending a reproductive health clinic in a municipality in Ghana</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Baiden</surname><given-names>F.</given-names></name><address><email>baidenf@gmail.com</email></address><xref ref-type="aff" rid="Aff1"></xref><xref ref-type="aff" rid="Aff2"></xref></contrib><contrib contrib-type="author"><name><surname>Mensah</surname><given-names>G. P.</given-names></name><xref ref-type="aff" rid="Aff2"></xref></contrib><contrib contrib-type="author"><name><surname>Akoto</surname><given-names>N. O.</given-names></name><xref ref-type="aff" rid="Aff2"></xref></contrib><contrib contrib-type="author"><name><surname>Delvaux</surname><given-names>T.</given-names></name><xref ref-type="aff" rid="Aff3"></xref><xref ref-type="aff" rid="Aff5"></xref></contrib><contrib contrib-type="author"><name><surname>Appiah</surname><given-names>P. C.</given-names></name><xref ref-type="aff" rid="Aff4"></xref></contrib><aff id="Aff1"><label></label>Epidemiology Unit, Ensign College of Public Health, Kpong, ER Ghana</aff><aff id="Aff2"><label></label>Faculty of Public Health and Allied Sciences, Catholic University College of Ghana, Fiapre, BAR Ghana</aff><aff id="Aff3"><label></label>Unit of HIV/AIDS Policy, Institute of Tropical Medicine, Antwerpen, Belgium</aff><aff id="Aff4"><label></label>Municipal Health Directorate, Ghana Health Service, Sunyani, BAR Ghana</aff><aff id="Aff5"><label></label>Public Health Department, Institute of Tropical Medicine, Antwerp, Belgium</aff></contrib-group><pub-date pub-type="epub"><day>6</day><month>6</month><year>2016</year></pub-date><pub-date pub-type="pmc-release"><day>6</day><month>6</month><year>2016</year></pub-date><pub-date pub-type="collection"><year>2016</year></pub-date><volume>16</volume><elocation-id>31</elocation-id><history><date date-type="received"><day>19</day><month>4</month><year>2015</year></date><date date-type="accepted"><day>4</day><month>6</month><year>2016</year></date></history><permissions><copyright-statement>© Baiden et al. 2016</copyright-statement><license license-type="OpenAccess"><license-p><bold>Open Access</bold>This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">http://creativecommons.org/licenses/by/4.0/</ext-link>), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/publicdomain/zero/1.0/">http://creativecommons.org/publicdomain/zero/1.0/</ext-link>) applies to the data made available in this article, unless otherwise stated.</license-p></license></permissions><abstract id="Abs1"><sec><title>Background</title><p>Covert contraceptive use (CCU) in sub-Saharan Africa is an indication of women’s inability to exercise autonomy in their reproductive choices. The aim of this study was to assess the prevalence and determinants of CCU among a sample of FP clients in a municipality of Ghana.</p></sec><sec><title>Methods</title><p>We conducted a mixed method study among women attending a public reproductive health clinic in Sunyani, a city of over 250,000 inhabitants in Ghana. An initial survey inquired into sociodemographic characteristics, use of family planning (FP) methods and partner awareness of contraceptive use. The predictors of CCU were explored using logistic regressions. We used the findings to develop a guide which we applied in-depth interviews and focus group discussions with attendants at the same facility. Qualitative data analysis was conducted using a framework approach.</p></sec><sec><title>Results</title><p>We interviewed 300 women, 48 % of whom were aged between 26–33 years. The injectable was the most widely used method (56 %). The prevalence of CCU was 34 %. In multivariate analysis, single women were more likely to practice CCU than married or co-habiting women (Adjusted OR = 12.12, 95 % C.I. 4.73–31.1). Muslim and traditionalist women were similarly more likely to practice CCU than non-Muslim, non-traditionalist (Adjusted OR = 4.56, 2.29–9.06). Women who preferred to have their first or next child in 4 or more years from the time of the interview were more likely to be in CCU than women who intended to have children within 4 years of the interview (2.57; 1.37–4.83). Single women saw in covert use a statement of their social autonomy. To succeed in CCU, women wished that clinic attendance cards would not be given to them to keep at home. Though many participants saw in CCU a source of anxiety, they expected health workers to consider it and uphold confidentiality in the provision of services.</p></sec><sec><title>Conclusions</title><p>Covert contraceptive use was high in this municipality and being single was the strongest predictor of the practice. Providers of FP services should reflect on how to adequately address the challenges faced by women who practice CCU.</p></sec></abstract><kwd-group xml:lang="en"><title>Keywords</title><kwd>Covert</kwd><kwd>Secret</kwd><kwd>Contraceptive</kwd><kwd>Method</kwd><kwd>Family planning</kwd><kwd>Ghana Africa</kwd></kwd-group><custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name><meta-value>© The Author(s) 2016</meta-value></custom-meta></custom-meta-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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