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Prevalence and factors associated with unmet need for family planning among women of reproductive age (15–49) in the Democratic Republic of Congo: A multilevel mixed-effects analysis

The Democratic Republic of Congo (DRC) has experienced high levels of unmet need for family planning (UNFP) for many years, alongside high fertility, maternal and infant mortality rates. Previous research addressed the UNFP in DRC, but analyses were limited to the individual-level and to specific re...

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Autores principales: Mosuse, Marie Alice, Gadeyne, Sylvie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9543979/
https://www.ncbi.nlm.nih.gov/pubmed/36206283
http://dx.doi.org/10.1371/journal.pone.0275869
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author Mosuse, Marie Alice
Gadeyne, Sylvie
author_facet Mosuse, Marie Alice
Gadeyne, Sylvie
author_sort Mosuse, Marie Alice
collection PubMed
description The Democratic Republic of Congo (DRC) has experienced high levels of unmet need for family planning (UNFP) for many years, alongside high fertility, maternal and infant mortality rates. Previous research addressed the UNFP in DRC, but analyses were limited to the individual-level and to specific regions. This study aims to determine the individual- and community-level factors associated with UNFP among married women of reproductive age in DRC. Using data from the 2014 DRC Demographic and Health Survey, a two-level mixed-effect logistic model examined i) the associations between UNFP and individual- and community level factors, and ii) the extent to which individual variability in UNFP is due to the variability observed at the community-level, given the individual characteristics. A total of 10,415 women in 539 clusters were included. Prevalence of unmet need for limiting was 8.13%, and 23.81% for spacing. Compared to adolescents (15–24), young (25–34) (aOR = 0.75, CI: 0.63–0.90) and middle-aged (35–49) (aOR = 0.65, CI: 0.51–0.82) women were less likely to have unmet need for family planning. The odds of having unmet need increased significantly with number of living children [1–2 children (aOR = 2.46, CI: 1.81–3.35), 7+ children (aOR = 6.46, CI: 4.28–9.73)] and among women in a female-headed household (aOR = 1.22, CI: 1.04–1.42). Women from provinces Equateur (aOR = 1.82, CI: 1.24–2.68), Nord-Kivu (aOR = 1.66, CI: 1.10–2.55) and Orientale (aOR = 1.60, CI: 1.10–2.32) were more likely to have unmet need, compared to women from Kinshasa. Women from communities with medium (aOR = 1.32, CI: 1.01–1.72) and high (aOR = 1.46, CI: 0.98–2.18) proportion of women in wealthy households, and medium (aOR = 1.32, CI: 1.01–1.72) and high (aOR = 1.46, CI: 0.98–2.18) proportion of women with low ideal family size (≤6) were more likely to have unmet need, compared to those from communities with low proportion of wealthy households and high ideal family size, respectively. Policies should consider strengthening family planning programs in provinces Equateur, Orientale, and Nord-Kivu, and in wealthier communities and communities with a higher ideal family size. Family planning programs should target adolescents and young women.
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spelling pubmed-95439792022-10-08 Prevalence and factors associated with unmet need for family planning among women of reproductive age (15–49) in the Democratic Republic of Congo: A multilevel mixed-effects analysis Mosuse, Marie Alice Gadeyne, Sylvie PLoS One Research Article The Democratic Republic of Congo (DRC) has experienced high levels of unmet need for family planning (UNFP) for many years, alongside high fertility, maternal and infant mortality rates. Previous research addressed the UNFP in DRC, but analyses were limited to the individual-level and to specific regions. This study aims to determine the individual- and community-level factors associated with UNFP among married women of reproductive age in DRC. Using data from the 2014 DRC Demographic and Health Survey, a two-level mixed-effect logistic model examined i) the associations between UNFP and individual- and community level factors, and ii) the extent to which individual variability in UNFP is due to the variability observed at the community-level, given the individual characteristics. A total of 10,415 women in 539 clusters were included. Prevalence of unmet need for limiting was 8.13%, and 23.81% for spacing. Compared to adolescents (15–24), young (25–34) (aOR = 0.75, CI: 0.63–0.90) and middle-aged (35–49) (aOR = 0.65, CI: 0.51–0.82) women were less likely to have unmet need for family planning. The odds of having unmet need increased significantly with number of living children [1–2 children (aOR = 2.46, CI: 1.81–3.35), 7+ children (aOR = 6.46, CI: 4.28–9.73)] and among women in a female-headed household (aOR = 1.22, CI: 1.04–1.42). Women from provinces Equateur (aOR = 1.82, CI: 1.24–2.68), Nord-Kivu (aOR = 1.66, CI: 1.10–2.55) and Orientale (aOR = 1.60, CI: 1.10–2.32) were more likely to have unmet need, compared to women from Kinshasa. Women from communities with medium (aOR = 1.32, CI: 1.01–1.72) and high (aOR = 1.46, CI: 0.98–2.18) proportion of women in wealthy households, and medium (aOR = 1.32, CI: 1.01–1.72) and high (aOR = 1.46, CI: 0.98–2.18) proportion of women with low ideal family size (≤6) were more likely to have unmet need, compared to those from communities with low proportion of wealthy households and high ideal family size, respectively. Policies should consider strengthening family planning programs in provinces Equateur, Orientale, and Nord-Kivu, and in wealthier communities and communities with a higher ideal family size. Family planning programs should target adolescents and young women. Public Library of Science 2022-10-07 /pmc/articles/PMC9543979/ /pubmed/36206283 http://dx.doi.org/10.1371/journal.pone.0275869 Text en © 2022 Mosuse, Gadeyne https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Mosuse, Marie Alice
Gadeyne, Sylvie
Prevalence and factors associated with unmet need for family planning among women of reproductive age (15–49) in the Democratic Republic of Congo: A multilevel mixed-effects analysis
title Prevalence and factors associated with unmet need for family planning among women of reproductive age (15–49) in the Democratic Republic of Congo: A multilevel mixed-effects analysis
title_full Prevalence and factors associated with unmet need for family planning among women of reproductive age (15–49) in the Democratic Republic of Congo: A multilevel mixed-effects analysis
title_fullStr Prevalence and factors associated with unmet need for family planning among women of reproductive age (15–49) in the Democratic Republic of Congo: A multilevel mixed-effects analysis
title_full_unstemmed Prevalence and factors associated with unmet need for family planning among women of reproductive age (15–49) in the Democratic Republic of Congo: A multilevel mixed-effects analysis
title_short Prevalence and factors associated with unmet need for family planning among women of reproductive age (15–49) in the Democratic Republic of Congo: A multilevel mixed-effects analysis
title_sort prevalence and factors associated with unmet need for family planning among women of reproductive age (15–49) in the democratic republic of congo: a multilevel mixed-effects analysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9543979/
https://www.ncbi.nlm.nih.gov/pubmed/36206283
http://dx.doi.org/10.1371/journal.pone.0275869
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