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Fulltext Unmet needs for contraception in married women in a tribal area of India

Patil SS, Abdul Rashid K, Narayan KA

Malaysian Journal of Public Health Medicine, 2010;10(2):44-51.
MyJurnal

Background and Objectives: Unmet need for contraception is the gap between women's reproductive intentions and their contraceptive behavior. This community based interventional study was carried out to determine the unmet needs for contraception, the reasons for this and to assess the impact of interventional measures on acceptance of contraception.
Subjects and Methods: This study was conducted in 52 villages in the state of Maharashtra, India, among 363 married women selected by cluster sampling. Data was collected using an interview guide. An intervention was done for the women who had an unmet need and an assessment of the change was done subsequently. Data was analyzed by using SPSS.
Results The prevalence of contraceptive usage was 59.2% and the prevalence of unmet need for contraception was 44% (160). The unmet need for spacing births was 53.8%, 38.7% for limiting births and 7.5% women were dissatisfied with the current contraceptive method. The reasons ranged from side effects to contraceptives to source of obtaining contraceptives. Age of the respondents, education and number of living children showed statistically significant association with unmet needs. Post intervention, the contraceptive prevalence rate increased significantly 85.7% and there was a significant reduction in the unmet needs for spacing and limiting births, equally there was a significant reduction of dissatisfaction with using contraception.
Conclusion: Improvement in the use of contraception and addressing the unmet need for contraception requires community involvement and ongoing, sustained efforts by health workers to ensure quality care to the beneficiaries.

Matched MeSH terms: Contraception Behavior
Population policies in Southeast Asia and Australia: the international relevance of domestic affairs

Jones GW

J Aust Popul Assoc, 1984;1:109-20.
PMID: 12267174
Matched MeSH terms: Contraception Behavior
Fulltext Peers as recruiters: family planning communications of West Malaysian acceptors

Verbrugge LM

J Health Soc Behav, 1978 Mar;19(1):51-68.
PMID: 649939 DOI: 10.2307/2136322
Matched MeSH terms: Contraception Behavior*
Fulltext Socioeconomic Correlates of Contraceptive Use among the Ethnic Tribal Women of Bangladesh: Does Sex Preference Matter?

Kamal SM, Hassan CH

J Family Reprod Health, 2013 Jun;7(2):73-86.
PMID: 24971107

Objective: To examine the relationship between socioeconomic factors affecting contraceptive use among tribal women of Bangladesh with focusing on son preference over daughter.
Materials and methods: The study used data gathered through a cross sectional survey on four tribal communities resided in the Rangamati Hill District of the Chittagong Hill Tracts, Bangladesh. A multistage random sampling procedure was applied to collect data from 865 currently married women of whom 806 women were currently married, non-pregnant and had at least one living child, which are the basis of this study. The information was recorded in a pre-structured questionnaire. Simple cross tabulation, chi-square tests and logistic regression analyses were performed to analyzing data.
Results: The contraceptive prevalence rate among the study tribal women was 73%. The multivariate analyses yielded quantitatively important and reliable estimates of likelihood of contraceptive use. Findings revealed that after controlling for other variables, the likelihood of contraceptive use was found not to be significant among women with at least one son than those who had only daughters, indicating no preference of son over daughter. Multivariate logistic regression analysis suggests that home visitations by family planning workers, tribal identity, place of residence, husband's education, and type of family, television ownership, electricity connection in the household and number of times married are important determinants of any contraceptive method use among the tribal women.
Conclusion. The contraceptive use rate among the disadvantaged tribal women was more than that of the national level. Door-step delivery services of modern methods should be reached and available targeting the poor and remote zones.
Keywords: Bangladesh, Contraceptive use, Ethnic tribal women, Sex preference, Logistic regression

Matched MeSH terms: Contraception Behavior
Determinants of waiting time to third pregnancy using censored linear regression

Awang H

J Biosoc Sci, 2003 Jan;35(1):59-70.
PMID: 12537156

The intervals between pregnancies have important effects on fertility and maternal and infant health outcomes. This study uses linear regression with censored observation to assess the determinants of the waiting time to third pregnancy. The analysis is applied to data from the Second Malaysian Family Life Survey consisting of 1172 women who had their second delivery ending in a live birth. Contraceptive use, age of the woman, duration of breast-feeding, length of previous pregnancy interval and education of the woman all affect the waiting time to third pregnancy significantly.

Matched MeSH terms: Contraception Behavior
Fulltext Comparison of body weight among hormonal and non-hormonal users in a Malaysian cohort

Ibrahim H, Tengku Ismail TA, Hashim N

J Taibah Univ Med Sci, 2019 Feb;14(1):25-30.
PMID: 31435386 DOI: 10.1016/j.jtumed.2018.11.012

Objectives: Weight gain remains an issue for contraceptive users due to the high prevalence of obesity. This retrospective study compares the weight gain between hormonal and non-hormonal contraceptive users in government health clinics in Kota Bharu, Kelantan, Malaysia.
Methods: A total of 380 women who had used the same contraceptive method for at least twelve months were recruited in this study. Covariance analysis was done to compare the weight gain between hormonal and non-hormonal contraceptive users, while studying the same confounders [age, household income, number of pregnancies, and baseline body mass index (BMI)].
Results: Hormonal methods were more commonly used. The mean weight gain among hormonal users (adjusted mean 2.85, 95% CI 2.45, 3.24) was significantly higher than non-hormonal users (adjusted mean 0.46, 95% CI -0.73, 1.65; p-value <0.001), after controlling for age, household income, number of pregnancies, and baseline BMI.
Conclusion: The possibility of weight gain following the use of hormonal methods should be investigated and non-hormonal methods should be considered to prevent weight gain.

Matched MeSH terms: Contraception Behavior
Integrated population-development program performance: the Malaysian Felda experience

Fong CO

J Dev Areas, 1985 Jan;19(2):149-70.
PMID: 12313937
Matched MeSH terms: Contraception Behavior
Four perspectives of women's health. Workshop participants talk about women's health issues in four countries. [Malaysia]

Kaur P

JOICFP News, 1994 Jan.
PMID: 12318571
Matched MeSH terms: Contraception Behavior*
Fulltext Who are the women wishing to opt for contraception?

Mushtaq K, Ashraf M, Thaver IH

J Pak Med Assoc, 2020 Dec;70(12(B)):2460-2463.
PMID: 33475564 DOI: 10.47391/JPMA.770

This descriptive cross-sectional research study was conducted to determine the characteristics of the women who intend to use a modern family planning method. For this 154 women were selected in a small village and faceto- face interviews were conducted. The findings indicate that 86 (56%) women intended to use a contraceptive method. The regression model showed that women who had the knowledge about different methods, those who had previously ever used family planning method and those who had never used any traditional method are more likely to adopt modern contraceptive methods.

Matched MeSH terms: Contraception Behavior
Utilization of Private Sector Family Planning Services in Malaysia

Lai SL, Tey NP, Mahmud A, Ismail N

Int Q Community Health Educ, 2021 Jul;41(4):395-403.
PMID: 33167794 DOI: 10.1177/0272684X20972864

BACKGROUND: The private sector is playing an increasingly important role in family planning services globally. The active participation of private providers is associated with a higher contraceptive prevalence rate.
OBJECTIVES: To examine the differentials and determinants of the utilization of private providers for family planning services.
METHOD: This study used the 2014 Malaysian Population and Family Survey data. Cross-tabulations and logistic regression were performed on 1,817 current users of modern methods.
RESULTS: Overall, 26% of modern method users obtained their supplies from private clinics/pharmacies and 15.2% from other sources, such as drug stores and sundry shops. The odds of utilizing the private sector for family planning services differ significantly across regions and socio-economic groups. The odds of obtaining supply from the private clinics/pharmacies were higher among the Chinese and urban women (AOR > 1), and it was lower among those from the eastern region (AOR = 0.47, 95% CI = 0.30-0.73). Non-Bumiputera, urban, higher educated, and working women, and those whose husbands decided on family planning had higher odds of obtaining the supply from the other sources (AOR > 1).
CONCLUSION: The private sector complements and supplements the public sector in providing family planning services to the public.

Matched MeSH terms: Contraception Behavior
Fulltext Migrant Women's Access to Sexual and Reproductive Health Services in Malaysia: A Qualitative Study

Loganathan T, Chan ZX, de Smalen AW, Pocock NS

Int J Environ Res Public Health, 2020 07 26;17(15).
PMID: 32722563 DOI: 10.3390/ijerph17155376

Providing sexual and reproductive health (SRH) services to migrant workers is key to fulfilling sustainable developmental goals. This study aims to explore key informants' views on the provision of SRH services for migrant women in Malaysia, exploring the provision of SRH education, contraception, abortion, antenatal and delivery, as well as the management of gender-based violence. In-depth interviews of 44 stakeholders were conducted from July 2018 to July 2019. Data were thematically analysed. Migrant workers that fall pregnant are unable to work legally and are subject to deportation. Despite this, we found that insufficient SRH information and contraceptive access are provided, as these are seen to encourage promiscuity. Pregnancy, rather than sexually transmitted infection prevention, is a core concern among migrant women, the latter of which is not adequately addressed by private providers. Abortions are often seen as the only option for pregnant migrants. Unsafe abortions occur which are linked to financial constraints and cultural disapproval, despite surgical abortions being legal in Malaysia. Pregnant migrants often delay care-seeking, and this may explain poor obstetric outcomes. Although health facilities for gender-based violence are available, non-citizen women face additional barriers in terms of discrimination and scrutiny by authorities. Migrant women face extremely limited options for SRH services in Malaysia and these should be expanded.

Matched MeSH terms: Contraception Behavior/ethnology; Contraception Behavior/statistics & numerical data*
Contraceptive choice and acceptability: the future for STI risk in Kelantan, Malaysia

Shiely F, Saifuddin MS

Int J STD AIDS, 2014 Mar;25(3):219-27.
PMID: 23970646 DOI: 10.1177/0956462413497699

More than 150 million women become pregnant in developing countries annually and an estimated 287,000 die from pregnancy-related causes. Contraception is vital to prevent unnecessary maternal deaths, as well as sexually transmitted infections. The objective of this study was to investigate preferred contraceptive methods and the factors that influence contraceptive choice among women in Kelantan, Malaysia. A cross-sectional study using interview-based questionnaires was conducted, during July and August 2009, in local family planning clinics in Kelantan. The questionnaire was administered to adult women (age 20-50). Prevalence of unplanned pregnancies was high (48%). Contraceptive preference was Depo contraceptive injection (32%), oral contraceptive pills (27%), intrauterine devices (15%) and contraceptive implants (12%); 9% used condoms. Only 2% used contraception to protect against sexually transmitted infections or HIV/AIDS. Younger women (OR 0.90; 95% CI 0.807-0.993) were more likely to use contraception. In conclusion, non-interrupted contraceptive methods were preferred. More than 60% would stop using contraception if it interrupted intercourse. From both a public health and infectious disease perspective, this is extremely worrying.

Matched MeSH terms: Contraception Behavior*
Fulltext HPV positivity and its' influencing factors among invasive cervical cancer women in Malaysia

Sharifa Ezat Wan Puteh, Norin Rahayu Samsuddin, Sharifah Noor Akmal Syed Hussain, Shamsul Azhar Shah, Syed Mohamed Aljunid

Int J Public Health Res, 2011;1(1):13-22.
MyJurnal

Accepted 10 August 2011.
Introduction Cervical cancer (CC) is the second most prevalent female cancer in Malaysia. Almost 70% of its’ causal factors are attributable to oncogenic human papillomavirus (HPV) types 16, 18 and other risk factors. HPV genotypes distributions are also noted to differ by geographical area.
Methods This was cross sectional study conducted in 2007, to determine the influencing factors of HPV positivity and prevalence of HPV infections among patients with cervical cancer in Universiti Kebangsaan Malaysia Medical Centre (UKMMC). Patients’ paraffin-embedded cervical tissues kept in the Pathology Department from 1999 to 2007 were randomly selected. A total of 81 medical records with complete information were chosen as samples and patients were contacted for consent. Tissue samples were further derived for PCR DNA for HPV genotyping. Analyses included descriptive statistics; bivariate χ2 test and correlation were used to determine relationship between factors and HPV positivity. Significance level of less than 0.05 was taken as statistically significant.
Results Mean age of cancer diagnosis was at 52 ± 12.2 years. Women of Chinese ethnicity was the highest ethnicity to be HPV positive at 65.4% and squamous cell carcinoma was more commonly found (59.3%) compared with other types of cancers. The prevalence of HPV positivity was 92.6% with type 16 being the most common (74.1%), followed by type 33 (30.9%) and 18 (22.2%). Multiple HPV infections were a common finding at 54.3%. Factors thought to influence positivity i.e. age of intercourse, number of sexual partners, number of parity, smoking status of patients and their partners, oral contraceptive usage, presence of chronic illnesses and cancer stage were not significantly associated with HPV positivity. Increased CC severity level was not associated with increased number of HPV infections (Pearson correlation 0.58; p =0.607).
Conclusions High HPV positivity at 92.6% was found among ICC patients. Factors thought to influence HPV positivity were not significant. The top three HPV genotypes were type 16 followed by type 33 and 18. However, local women HPV serotypes findings need to be replicated in a larger population sample.

Matched MeSH terms: Contraception Behavior
Fulltext Factors associated with postpartum family planning in a cohort of Kelantanese women with previous caesarean delivery in Malaysia

Hafizah I, Tengku Alina TI, Suhaily MH, Zaharah S

IIUM Medical Journal Malaysia, 2020;19(1):85-97.
MyJurnal

This community-based, cross-sectional study aimed to identify the factors associated with
postpartum family planning use among a cohort of women with recent caesarean delivery in a state with the
lowest contraceptive use in Malaysia. Materials and Methods: A total of 281 women aged between 18-49
years old who had caesarean delivery in government tertiary centres in Kelantan from January until April
2017 were enrolled in this study. The study was conducted from January until April 2018. Women were
selected through stratified random sampling with probability proportional to size. Data were collected
through a validated structured questionnaire. The main outcome was binary (postpartum family planning use
or non-use). The factors included socio-demographic details, reproductive history, previous contraceptive
use, contraceptive health education received, knowledge, and social support. Simple and multiple logistic
regression were conducted to identify significant determinants of postpartum family planning use. Results:
The factors associated with postpartum family planning use included a secondary and below education level
of women (AOR= 2.37, 95% CI (1.05, 5.34)), previous contraceptive use (AOR= 9.82, 95% CI (4.81, 20.06)),
individual health education (AOR= 4.19, 95% CI (1.23, 14.30)), higher knowledge score (AOR= 1.12, 95% CI
(1.03, 1.23)), and higher social support score (AOR= 1.09, 95% CI (1.03, 1.16)). Conclusions: here remains a
need to enhance personalised contraceptive counselling in the primary care setting as well as to promote
longer acting reversible contraceptive methods.

Matched MeSH terms: Contraception Behavior
Fulltext Barriers of modern contraceptive practices among Asian women: a mini literature review

Najafi-Sharjabad F, Zainiyah Syed Yahya S, Abdul Rahman H, Hanafiah Juni M, Abdul Manaf R

Glob J Health Sci, 2013 Sep;5(5):181-92.
PMID: 23985120 DOI: 10.5539/gjhs.v5n5p181

Family planning has been cited as essential to the achievement of Millennium Development Goals (MDG). Family planning has a direct impact on women's health and consequence of each pregnancy. The use of modern contraception among Asian women is less than global average. In Asia a majority of unintended pregnancies are due to using traditional contraceptive or no methods which lead to induced unsafe abortion. Cultural attitudes, lack of knowledge of methods and reproduction, socio demographic factors, and health service barriers are the main obstacles to modern contraceptive practice among Asian women. Culturally sensitive family planning program, reforming health system, and reproductive health education through mass media to create awareness of the benefits of planned parenthood are effective strategies to improve modern contraceptive practice among Asian women.

Matched MeSH terms: Contraception Behavior/ethnology*
Fulltext Contraceptive use among women with chronic medical conditions and factors associated with its non-use in Malaysia

Manaf RA, Ismail IZ, Latiff LA

Glob J Health Sci, 2012 Sep;4(5):91-9.
PMID: 22980381 DOI: 10.5539/gjhs.v4n5p91

INTRODUCTION: Women with chronic medical conditions are at higher risk of adverse pregnancy outcomes, which may be minimized through optimal preconception care and appropriate contraceptive use. This study aimed to describe contraceptive use among women with chronic medical conditions and factors associated with its non-use.
METHODS: This study used cross-sectional data from a family planning survey among women with chronic medical conditions conducted in three health facilities in a southern state of Malaysia. A total of 450 married women in reproductive age (18-50 year) with intact uterus, and do not plan to conceive were analysed for contraceptive use. Both univariate and multivariate analysis was conducted to identify factors associated with contraceptive non-use among the study participants.
RESULTS: A total of 312 (69.3%) of the study participants did not use contraceptive. Contraceptive non-use was highest among the diabetics (71.2%), connective tissue disease patients (68.6%) and hypertensive patients (65.3%). Only 26.3% of women with heart disease did not use contraceptive. In the multivariate analysis, contraceptive non-use was significantly more common among women who received their medical treatment in the health clinics as compared to those who received treatment in the hospital (adjusted odds ratio [OR]=1.75, 95% confidence interval [CI]: 1.09, 2.79), being in older age group of 41-50 year (adjusted OR=2.31, 95% CI: 1.19, 4.48), having children (adjusted OR=4.57, 95% CI: 1.66, 12.57) and having lower education (adjusted OR=2.87, 95% CI: 1.43, 5.77).
CONCLUSION: About two-third of women with chronic medical conditions who needed contraceptive did not use them despite the higher risk of pregnancy related complications. The high unmet need warrant an effective health promotion programme to encourage the uptake of contraceptives especially targeting women of older age group, low education and those who received their medical treatment at health clinics.
Study site: Outpatient clinic, three hospitals; 8 health clinics, Malaysia

Matched MeSH terms: Contraception Behavior/statistics & numerical data*
Family planning availability and contraceptive practice

Rodríguez G

Fam Plann Perspect, 1979 Jan-Feb;11(1):51-70.
PMID: 421882

Analysis of World Fertility Survey data from five countries--Colombia, Costa Rica, Korea, Malaysia and Nepal--shows that the availability of contraceptive services and supplies is a major determinant of use. In Nepal, where few women know where to obtain supplies, only two percent are contracepting. In Costa Rica, where almost all married women know an outlet nearby, 53 percent use effective methods.

Matched MeSH terms: Contraception Behavior*
Profiles of women presenting for abortions in Singapore: focus on teenage abortions and late abortions

Lim L, Wong H, Yong E, Singh K

Eur J Obstet Gynecol Reprod Biol, 2012 Feb;160(2):219-22.
PMID: 22137571 DOI: 10.1016/j.ejogrb.2011.11.017

OBJECTIVE: Teenage abortions predispose women to adverse pregnancy outcomes in subsequent pregnancies such as anemia, stillbirths, preterm deliveries and low birth weight babies. We aim to profile the women presenting for abortions in our institution and determine risk factors for late presentation for abortions.
STUDY DESIGN: In this retrospective cohort study, all women who underwent an abortion at the National University Hospital, Singapore, from 2005 to 2009 were recruited. Data was obtained from a prepared questionnaire during the mandatory pre-abortion counseling sessions. Profiles of women aged <20 years were compared with those ≥ 20 years old using Chi-square test if the assumptions for Chi-square test were met; otherwise, Fisher's exact test was carried out. Logistic regression was used to investigate the risk factors for second trimester termination of pregnancy.
RESULTS: 2109 women presented for induced abortions, of which 1998 had single abortion throughout the course of the study. The mean age of women with single abortion was 29.1 years (sd 7). In the group of women with single abortion, 182 (9.1%) were teenage abortions. In contrast to women ≥ 20 years of age, pregnant teenagers were more likely not to have used any contraception (51.1% vs. 25.2%) and more likely to present late for abortions (39.6% vs. 15.9%). Other risk factors for late presentation for abortions include Malay ethnicity, singlehood, nulliparity and lack of prior usage of contraception.
CONCLUSION: Teenagers are more likely to have no prior contraceptive usage and to present late for abortions. Lack of proper sexual education and awareness of contraceptive measures may have a major contributory factor to such a trend in teenage abortions. Recommendations have been made in order to curb this societal problem.

Matched MeSH terms: Contraception Behavior/ethnology
Determinants of birth-interval length in the Philippines, Malaysia, and Indonesia: a hazard-model analysis

Trussell J, Martin LG, Feldman R, Palmore JA, Concepcion M, Abu Bakar D

Demography, 1985 May;22(2):145-68.
PMID: 3996687
Matched MeSH terms: Contraception Behavior
[Family planning programs and birth control in the third world]

Wohlschlagl H

Demogr Inf, 1991;?:17-34, 153.
PMID: 12343122

PIP: The population explosion has been abating since the 2nd half of the 1960s. The birth rate of the 3rd World dropped from 45/1000 during 1950-55 to 31/1000 during 1985-90. From the 1st half of the 1960s to the 1st half of the 1980s the total fertility of such countries dropped from 6.1 to 4.2 children/woman. In Taiwan, Singapore, Hong Kong, South Korea, and Malaysia living standards improved as a result of industrialization, and fertility decreased significantly. In Sri Lanka, China, North Vietnam, and Thailand the drop of fertility is explained by cultural and religious factors. In 1982 about 78% of the population of developing countries lived in 39 states that followed an official policy aimed at reducing the population. Another 16% lived in countries supporting the concept of a desired family size. However, World Bank data showed that in the mid-1980s in 27 developing countries no state family planning (FP) programs existed. India adopted an official FP program in 1952, Pakistan followed suit in 1960, South Korea in 1961, and China in 1962. In Latin America a split policy manifested itself: in Brazil birth control was rejected, only Colombia had a FP policy. In 1986 the governments of 68 of 131 developing countries representing 3.1 billion people considered the number of children per woman too high. 31 of these countries followed concrete population control policies. On the other hand, in 1986 24 countries of Africa with 40% of the continent's population took no measures to influence population growth. In Latin America and the Caribbean 18 of 33 countries were idle, except for Mexico that had a massive state FP program. These programs also improve maternal and child health with birth spacing of at least 2 years, and the prevention of pregnancies of too young women or those over 40. The evaluation of rapidly spreading FP programs in the 1970s was carried out by the World Fertility Survey in 41 countries. The impact of FP programs was more substantial than socioeconomic factors. Contraceptive use increased in Mexico from 13% in 1973 to 41% in 1978 among women of fertile age. According to 1984 and 1988 UN data modern methods of contraception were used by 70% of women in China, 60-65% in Southeast Asia, Costa Rica, and Puerto Rico. In contrast, less than 5% used them in most countries of Africa, 15-20% in West Asia, 25-30% in South Asia, and 40% in Latin America. The pill was the most popular method. From the early 1980s in South and East Asia 1/5 of women got sterilized after attaining the desired family size. Less than 10% of women used IUDs in developing countries. FP programs have benefited from higher education levels and economic incentives and sanctions and exemplified in Singapore, China, South Korea, Thailand, and Taiwan.

Matched MeSH terms: Contraception Behavior*

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