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Healthcare system indicators associated with modern contraceptive use in Ghana, Kenya, and Nigeria: evidence from the Performance Monitoring and Accountability 2020 data.
Reproductive Health ( IF 3.4 ) Pub Date : 2019-10-26 , DOI: 10.1186/s12978-019-0816-4
Ibitola Asaolu 1 , Velia Leybas Nuño 1 , Kacey Ernst 2 , Douglas Taren 1 , John Ehiri 1
Affiliation  

BACKGROUND Public health literature is replete with evidence on individual and interpersonal indicators of modern contraceptive use. There is, however, limited knowledge regarding healthcare system indicators of modern contraceptive use. This study assessed how the healthcare system influences use of modern contraceptive among women in Ghana, Kenya, and two large population states in Nigeria. METHODS This study used data from Phase 1 of the Performance Monitoring and Accountability 2020. The analytical sample was limited to women with a need for contraception, defined as women of reproductive age (15 to 49 years) who wish to delay or limit childbirth. Therefore, this analysis consisted of 1066, 1285, and 1955 women from Nigeria, Ghana, and Kenya respectively. Indicators of healthcare assessed include user-fees, visit by health worker, type of health facility, multiple perinatal services, adolescent reproductive healthcare, density of healthcare workers, and regularity of contraceptive services. All analyses were conducted with SAS (9.4), with statistical significance set at p < 5%. RESULTS The prevalence of modern contraceptive was 22.7, 33.2, and 68.9% in Nigeria, Ghana, and Kenya respectively. The odds of modern contraceptive use were higher among Nigerian women who lived within areas that provide adolescent reproductive healthcare (OR = 2.05; 95% C.I. = 1.05-3.99) and Kenyan women residing in locales with polyclinic or hospitals (OR = 1.91; 1.27-2.88). Also, the odds of contraceptive use were higher among Kenyan women who lived in areas with user-fee for contraceptive services (OR = 1.40; 1.07-1.85), but lower among Ghanaian women residing in such areas (OR = 0.46; 0.23-0.92). Lastly, the odds of modern contraceptive use were higher among women visited by a health-worker visit among women in Ghana (OR = 1.63; 1.11-2.42) and Nigeria (OR = 2.97; 1.56-5.67) than those without a visit. CONCLUSION This study found an association between country-specific indicators of healthcare and modern contraceptive use. Evidence from this study can inform policy makers, health workers, and healthcare organizations on specific healthcare factors to target in meeting the need for contraception in Ghana, Kenya, and Nigeria.

中文翻译:

加纳,肯尼亚和尼日利亚与现代避孕药具使用相关的医疗保健系统指标:《 2020年绩效监测和问责制》数据的证据。

背景技术公共卫生文献中充斥着关于现代避孕药具使用的个人和人际关系指标的证据。但是,有关现代避孕药具的医疗系统指标的知识有限。这项研究评估了医疗系统如何影响加纳,肯尼亚和尼日利亚两个人口大国的妇女使用现代避孕药具。方法本研究使用了《 2020年绩效监测与责任》第一阶段的数据。分析样本仅限于需要避孕的妇女,即育龄妇女(15至49岁),她们希望推迟或限制分娩。因此,该分析分别由来自尼日利亚,加纳和肯尼亚的1066、1285和1955名女性组成。评估的医疗保健指标包括用户费用,医护人员的就诊,卫生设施的类型,多种围产期服务,青春期生殖保健,医护人员的密度以及避孕服务的定期性。所有分析均采用SAS(9.4)进行,统计学显着性设置为p <5%。结果在尼日利亚,加纳和肯尼亚,现代避孕药具的流行率分别为22.7%,33.2%和68.9%。生活在提供青春期生殖保健的地区的尼日利亚妇女(OR = 2.05; 95%CI = 1.05-3.99)和居住在综合诊所或医院的肯尼亚妇女(OR = 1.91; 1.27- 2.88)。此外,生活在有使用避孕服务使用者费用地区的肯尼亚妇女使用避孕药具的几率更高(OR = 1.40; 1.07-1.85),但居住在这些地区的加纳妇女中使用避孕药具的几率较低(OR = 0.46; 0。23-0.92)。最后,在加纳(OR = 1.63; 1.11-2.42)和尼日利亚(OR = 2.97; 1.56-5.67)中,通过卫生工作者访问的妇女中,使用现代避孕方法的妇女的比例高于没有访问的妇女。结论本研究发现特定国家的医疗保健指标与现代避孕药具之间存在关联。这项研究的证据可为决策者,卫生工作者和医疗保健组织提供有关特定医疗保健因素的信息,以针对加纳,肯尼亚和尼日利亚的避孕需求为目标。结论本研究发现特定国家的医疗保健指标与现代避孕药具之间存在关联。这项研究的证据可为决策者,卫生工作者和医疗保健组织提供有关特定医疗保健因素的信息,以针对加纳,肯尼亚和尼日利亚的避孕需求为目标。结论本研究发现特定国家的医疗保健指标与现代避孕药具之间存在关联。这项研究的证据可为决策者,卫生工作者和医疗保健组织提供有关特定医疗保健因素的信息,以针对加纳,肯尼亚和尼日利亚的避孕需求为目标。
更新日期:2019-10-26
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