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      Modern contraceptive utilization and its associated factors among married women in Senegal: a multilevel analysis

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          Abstract

          Background

          Utilization of modern contraceptives is still low in low-and middle-income countries, although fertility and population growth rates are high. In Senegal, modern contraceptive utilization is low, with few studies focusing on its associated factors. This study examined modern contraceptive use and its associated factors among married women in Senegal.

          Methods

          Data from the 2017 Continuous Demographic and Health Survey (C-DHS) on 11,394 married women was analysed. We examined the associations between the demographic and socioeconomic characteristics of women and their partners and modern contraceptive use using multilevel logistic regression models. Adjusted odds ratios with 95% confidence intervals (CI) were estimated.

          Results

          The utilization of modern contraceptives among married women was 26.3%. Individual level factors associated with modern contraceptive use were women’s age (45–49 years-aOR = 0.44, 0.30–0.63), women’s educational level (higher-aOR = 1.88, 1.28–2.76) husband’s educational level (higher-aOR = 1.43, 1.10–1.85)), number of living children (5 or more children-aOR = 33.14, 19.20–57.22), ideal number of children (2 children-aOR = 1.95, 1.13–3.35), desire to have more children (wants no more-aOR = 2.46, 2.06–2.94), ethnicity (Diola-aOR = 0.70, 0.50–0.99), media exposure (yes-aOR = 1.44, 1.16–1.79)), wealth index (richer-aOR = 1.31, 1.03–1.67) and decision making power of women (decision making two-aOR = 1.20, 1.02–1.41). Whereas, region (Matam-aOR = 0.35, 0.23–0.53), place of residence (rural-aOR = 0.76, 0.63–0.93), community literacy level (high-aOR = 1.31, 1.01–1.71) and community knowledge level of modern contraceptives (high-aOR = 1.37, 1.13–1.67) were found as significant community level factors.

          Conclusions

          The findings indicate that both individual and community level factors are significantly associated with modern contraceptive use among married women in Senegal. Interventions should focus on enhancing literacy levels of women, their husbands and communities. Furthermore, strengthening awareness and attitude towards family planning should be given priority, especially in rural areas and regions with low resources.

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          Most cited references46

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          A Caution Regarding Rules of Thumb for Variance Inflation Factors

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            Intermediate and advanced topics in multilevel logistic regression analysis

            Multilevel data occur frequently in health services, population and public health, and epidemiologic research. In such research, binary outcomes are common. Multilevel logistic regression models allow one to account for the clustering of subjects within clusters of higher‐level units when estimating the effect of subject and cluster characteristics on subject outcomes. A search of the PubMed database demonstrated that the use of multilevel or hierarchical regression models is increasing rapidly. However, our impression is that many analysts simply use multilevel regression models to account for the nuisance of within‐cluster homogeneity that is induced by clustering. In this article, we describe a suite of analyses that can complement the fitting of multilevel logistic regression models. These ancillary analyses permit analysts to estimate the marginal or population‐average effect of covariates measured at the subject and cluster level, in contrast to the within‐cluster or cluster‐specific effects arising from the original multilevel logistic regression model. We describe the interval odds ratio and the proportion of opposed odds ratios, which are summary measures of effect for cluster‐level covariates. We describe the variance partition coefficient and the median odds ratio which are measures of components of variance and heterogeneity in outcomes. These measures allow one to quantify the magnitude of the general contextual effect. We describe an R 2 measure that allows analysts to quantify the proportion of variation explained by different multilevel logistic regression models. We illustrate the application and interpretation of these measures by analyzing mortality in patients hospitalized with a diagnosis of acute myocardial infarction. © 2017 The Authors. Statistics in Medicine published by John Wiley & Sons Ltd.
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              Maternal deaths averted by contraceptive use: an analysis of 172 countries.

              Family planning is one of the four pillars of the Safe Motherhood Initiative to reduce maternal death in developing countries. We aimed to estimate the effect of contraceptive use on maternal mortality and the expected reduction in maternal mortality if the unmet need for contraception were met, at country, regional, and world levels. We extracted relevant data from the Maternal Mortality Estimation Inter-Agency Group (MMEIG) database, the UN World Contraceptive Use 2010 database, and the UN World Population Prospects 2010 database, and applied a counterfactual modelling approach (model I), replicating the MMEIG (WHO) maternal mortality estimation method, to estimate maternal deaths averted by contraceptive use in 172 countries. We used a second model (model II) to make the same estimate for 167 countries and to estimate the effect of satisfying unmet need for contraception. We did sensitivity analyses and compared agreement between the models. We estimate, using model I, that 342,203 women died of maternal causes in 2008, but that contraceptive use averted 272,040 (uncertainty interval 127,937-407,134) maternal deaths (44% reduction), so without contraceptive use, the number of maternal deaths would have been 1·8 times higher than the 2008 total. Satisfying unmet need for contraception could prevent another 104,000 maternal deaths per year (29% reduction). Numbers of unwanted pregnancies and unmet contraceptive need are still high in many developing countries. We provide evidence that use of contraception is a substantial and effective primary prevention strategy to reduce maternal mortality in developing countries. Bill and Melinda Gates Foundation. Copyright © 2012 Elsevier Ltd. All rights reserved.
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                Author and article information

                Contributors
                betregiorgiszegeye27@gmail.com
                brightahinkorah@gmail.com
                didri040@uottawa.ca
                olorunsaiyec@arcadia.edu
                adjei@uni-bremen.de
                sanni.yaya@uOttawa.ca
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                28 January 2021
                28 January 2021
                2021
                : 21
                : 231
                Affiliations
                [1 ]HaSET Maternal and Child Health Research Program, Shewarobit Field Office, Shewarobit, Ethiopia
                [2 ]GRID grid.117476.2, ISNI 0000 0004 1936 7611, School of Public Health, Faculty of Health, , University of Technology Sydney, ; Ultimo, Australia
                [3 ]GRID grid.28046.38, ISNI 0000 0001 2182 2255, Interdisciplinary School of Health Sciences, , University of Ottawa, ; Ottawa, Ontario Canada
                [4 ]GRID grid.252353.0, ISNI 0000 0001 0583 8943, Department of Public Health, , Arcadia University, ; Glenside, PA USA
                [5 ]GRID grid.418465.a, ISNI 0000 0000 9750 3253, Leibniz Institute for Prevention Research and Epidemiology, BIPS, ; Bremen, Germany
                [6 ]GRID grid.28046.38, ISNI 0000 0001 2182 2255, School of International Development and Global Studies, , University of Ottawa, ; 120 University Private, Ottawa, ON K1N 6N5 Canada
                [7 ]GRID grid.7445.2, ISNI 0000 0001 2113 8111, The George Institute for Global Health, Imperial College London, ; London, UK
                Author information
                http://orcid.org/0000-0002-4876-6043
                Article
                10252
                10.1186/s12889-021-10252-7
                7845035
                33509144
                a2f19a41-282c-40a8-bbf3-62eff5cdba98
                © The Author(s) 2021

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 25 June 2020
                : 17 January 2021
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2021

                Public health
                contraceptive utilization,modern contraceptive,senegal; sexual and reproductive health

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