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      Intimate partner violence and current modern contraceptive use among married women in Uganda: a cross-sectional study

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          Abstract

          Introduction

          This paper examined the relationship between Intimate Partner Violence (IPV) and current modern contraceptive use (MCU) among married women in Uganda.

          Methods

          We used the 2011 Uganda Demographic and Health Survey (UDHS) data, selecting a weighted sample of 1,307 married women from the domestic violence module. Chi-squared tests and multivariate complementary log-log (clog-log) regressions were used to examine the relationship between IPV and current MCU, controlling for women's socio-demographic factors.

          Results

          Significant predictors of current MCU (25.3%) among married women were: women's reported ability to ask a partner to use a condom, number of living children and wealth index. The odds of current MCU were higher among women who could ask their partners to use a condom (aOR = 1.87, 95% CI: 1.26-2.78), had more than one child (aOR = 2.05, 95% CI: 1.07,3.93) and were from better wealth indices for example the richest (aOR = 2.52, 95% CI: 1.25-5.08). IPV was not associated with current MCU independently and after adjusting for women's socio-demographic factors.

          Conclusion

          In Uganda's context, IPV was not associated with current MCU. Interventions to promote MCU should enhance women's capacity to negotiate MCU within union and target women of lower socio-economic status.

          Most cited references28

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          Persistent high fertility in Uganda: young people recount obstacles and enabling factors to use of contraceptives

          Background High fertility among young people aged 15-24 years is a public health concern in Uganda. Unwanted pregnancy, unsafe induced abortions and associated high morbidity and mortality among young women may be attributed to low contraceptive use. This study aims at exploring reasons for low contraceptive use among young people. Methods In 16 focus group discussions, the views of young people about obstacles and enabling factors to contraceptive use in Mityana and Mubende districts, Uganda were explored. The groups were homogeneously composed by married and unmarried men and women, between the ages of 15-24. The data obtained was analyzed using qualitative content analysis. Results Young men and women described multiple obstacles to contraceptive use. The obstacles were categorized as misconceptions and fears related to contraception, gender power relations, socio-cultural expectations and contradictions, short term planning, and health service barriers. Additionally, young people recounted several enabling factors that included female strategies to overcome obstacles, changing perceptions to contraceptive use, and changing attitude towards a small family size. Conclusions Our findings suggest changing perceptions and behavior shift towards contraceptive use and a small family size although obstacles still exist. Personalized strategies to young women and men are needed to motivate and assist young people plan their future families, adopt and sustain use of contraceptives. Reducing obstacles and reinforcing enabling factors through education, culturally sensitive behavior change strategies have the potential to enhance contraceptives use. Alternative models of contraceptive service delivery to young people are proposed.
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            Women's empowerment and choice of contraceptive methods in selected African countries.

            It is generally believed that women's lack of decision-making power may restrict their use of modern contraceptives. However, few studies have examined the different dimensions of women's empowerment and contraceptive use in African countries. Data came from the latest round of Demographic and Health Surveys conducted between 2006 and 2008 in Namibia, Zambia, Ghana and Uganda. Responses from married or cohabiting women aged 15-49 were analyzed for six dimensions of empowerment and the current use of female-only methods or couple methods. Bivariate and multivariate multinomial regressions were used to identify associations between the empowerment dimensions and method use. Positive associations were found between the overall empowerment score and method use in all countries (relative risk ratios, 1.1-1.3). In multivariate analysis, household economic decision making was associated with the use of either female-only or couple methods (1.1 for all), as was agreement on fertility preferences (1.3-1.6) and the ability to negotiate sexual activity (1.1-1.2). In Namibia, women's negative attitudes toward domestic violence were correlated with the use of couple methods (1.1). Intervention programs aimed at increasing contraceptive use may need to involve different approaches, including promoting couples' discussion of fertility preferences and family planning, improving women's self-efficacy in negotiating sexual activity and increasing their economic independence.
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              Controlling behavior, power relations within intimate relationships and intimate partner physical and sexual violence against women in Nigeria

              Background Controlling behavior is more common and can be equally or more threatening than physical or sexual violence. This study sought to determine the role of husband/partner controlling behavior and power relations within intimate relationships in the lifetime risk of physical and sexual violence in Nigeria. Methods This study used secondary data from a cross-sectional nationally-representative survey collected by face-to-face interviews from women aged 15 - 49 years in the 2008 Nigeria Demographic and Health Survey. Utilizing a stratified two-stage cluster sample design, data was collected frrm 19 216 eligible with the DHS domestic violence module, which is based on the Conflict Tactics Scale (CTS). Multivariate logistic regression analysis was used to determine the role of husband/partner controlling behavior in the risk of ever experiencing physical and sexual violence among 2877 women aged 15 - 49 years who were currently or formerly married or cohabiting with a male partner. Results Women who reported controlling behavior by husband/partner had a higher likelihood of experiencing physical violence (RR = 3.04; 95% CI: 2.50 - 3.69), and women resident in rural areas and working in low status occupations had increased likelihood of experiencing physical IPV. Controlling behavior by husband/partner was associated with higher likelihood of experiencing physical violence (RR = 4.01; 95% CI: 2.54 - 6.34). In addition, women who justified wife beating and earned more than their husband/partner were at higher likelihood of experiencing physical and sexual violence. In contrast, women who had decision-making autonomy had lower likelihood of experiencing physical and sexual violence. Conclusion Controlling behavior by husband/partner significantly increases the likelihood of physical and sexual IPV, thus acting as a precursor to violence. Findings emphasize the need to adopt a proactive integrated approach to controlling behavior and intimate partner violence within the society.
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                Author and article information

                Journal
                Pan Afr Med J
                Pan Afr Med J
                PAMJ
                The Pan African Medical Journal
                The African Field Epidemiology Network
                1937-8688
                30 May 2018
                2018
                : 30
                : 85
                Affiliations
                [1 ]Department of Population Studies, School of Statistics and Planning, College of Business and Management Sciences, Makerere University, Kampala, Uganda
                [2 ]Demography and Population Studies, Schools of Social Sciences and Public Health, University of the Witwatersrand, Johannesburg, South Africa
                Author notes
                [& ]Corresponding author: Stephen Ojiambo Wandera, Department of Population Studies, School of Statistics and Planning, College of Business and Management Sciences, Makerere University, Kampala, Uganda
                Article
                PAMJ-30-85
                10.11604/pamj.2018.30.85.12722
                6191265
                30344869
                e8c661c0-2dab-4ca9-9e87-b1df31e9d65e
                © Stephen Ojiambo Wandera et al.

                The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 11 May 2017
                : 20 February 2018
                Categories
                Research

                Medicine
                intimate partner violence,modern contraceptive use,sub-saharan africa (ssa)
                Medicine
                intimate partner violence, modern contraceptive use, sub-saharan africa (ssa)

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