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Socio-economic and education related inequities in use of modern contraceptive in seven sub-regions in Uganda
BACKGROUND: Advocacy for equity in health service utilization and access, including Family Planning (FP) continues to be a cornerstone in increasing universal health coverage. Inequities in Family planning are highlighted by the differences in reproductive health outcomes or in the distribution of r...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9972732/ https://www.ncbi.nlm.nih.gov/pubmed/36855140 http://dx.doi.org/10.1186/s12913-023-09150-y |
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author | Makumbi, Fredrick E Nabukeera, Sarah Tumwesigye, Nazarius Mbona Namanda, Cissie Atuyambe, Lynn Mukose, Aggrey Ssali, Sarah Ssenyonga, Ronald Tweheyo, Ritah Gidudu, Andrew Sekimpi, Carole Hashim, Catherine Verde Nicholson, Martha Ddungu, Peter |
author_facet | Makumbi, Fredrick E Nabukeera, Sarah Tumwesigye, Nazarius Mbona Namanda, Cissie Atuyambe, Lynn Mukose, Aggrey Ssali, Sarah Ssenyonga, Ronald Tweheyo, Ritah Gidudu, Andrew Sekimpi, Carole Hashim, Catherine Verde Nicholson, Martha Ddungu, Peter |
author_sort | Makumbi, Fredrick E |
collection | PubMed |
description | BACKGROUND: Advocacy for equity in health service utilization and access, including Family Planning (FP) continues to be a cornerstone in increasing universal health coverage. Inequities in Family planning are highlighted by the differences in reproductive health outcomes or in the distribution of resources among different population groups. In this study we examine inequities in use of modern contraceptives with respect to Socio-economic and Education dimensions in seven sub-regions in Uganda. METHODS: The data were obtained from a baseline cross-sectional study in seven statistical regions where a program entitled “Reducing High Fertility Rates and Improving Sexual Reproductive Health Outcomes in Uganda, (RISE)” is implemented in Uganda. There was a total of 3,607 respondents, half of whom were women of reproductive age (15-49 years) and the other half men (18-54 years). Equity in family planning utilization was assessed by geography, wealth/economic and social-demographics. The use of modern family planning was measured as; using or not using modern FP. Concentration indices were used to measure the degree of Inequality in the use of modern contraceptives. Prevalence Ratios to compare use of modern FP were computed using modified Poisson regression run in STATA V15. RESULTS: Three-quarters (75.6%) of the participants in rural areas were married compared to only 63% in the urban. Overall use of modern contraceptives was 34.2% [CI:30.9, 37.6], without significant variation by rural/urban settings. Women in the higher socio-economic status (SES) were more advantaged in use of modern contraceptives compared to lower SES women. The overall Erreygers Concentration Index, as a measure of inequity, was 0.172, p<0.001. Overall, inequity in use of modern contraceptives by education was highest in favor of women with higher education (ECI=0.146, p=0.0001), and the concentration of use of modern contraceptives in women with higher education was significant in the rural but not urban areas CONCLUSION: Inequities in the use of modern contraceptives still exist in favor of women with more education or higher socio-economic status, mainly in the rural settings. Focused programmatic interventions in rural settings should be delivered if universal Family Planning uptake is to be improved. |
format | Online Article Text |
id | pubmed-9972732 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-99727322023-03-01 Socio-economic and education related inequities in use of modern contraceptive in seven sub-regions in Uganda Makumbi, Fredrick E Nabukeera, Sarah Tumwesigye, Nazarius Mbona Namanda, Cissie Atuyambe, Lynn Mukose, Aggrey Ssali, Sarah Ssenyonga, Ronald Tweheyo, Ritah Gidudu, Andrew Sekimpi, Carole Hashim, Catherine Verde Nicholson, Martha Ddungu, Peter BMC Health Serv Res Research BACKGROUND: Advocacy for equity in health service utilization and access, including Family Planning (FP) continues to be a cornerstone in increasing universal health coverage. Inequities in Family planning are highlighted by the differences in reproductive health outcomes or in the distribution of resources among different population groups. In this study we examine inequities in use of modern contraceptives with respect to Socio-economic and Education dimensions in seven sub-regions in Uganda. METHODS: The data were obtained from a baseline cross-sectional study in seven statistical regions where a program entitled “Reducing High Fertility Rates and Improving Sexual Reproductive Health Outcomes in Uganda, (RISE)” is implemented in Uganda. There was a total of 3,607 respondents, half of whom were women of reproductive age (15-49 years) and the other half men (18-54 years). Equity in family planning utilization was assessed by geography, wealth/economic and social-demographics. The use of modern family planning was measured as; using or not using modern FP. Concentration indices were used to measure the degree of Inequality in the use of modern contraceptives. Prevalence Ratios to compare use of modern FP were computed using modified Poisson regression run in STATA V15. RESULTS: Three-quarters (75.6%) of the participants in rural areas were married compared to only 63% in the urban. Overall use of modern contraceptives was 34.2% [CI:30.9, 37.6], without significant variation by rural/urban settings. Women in the higher socio-economic status (SES) were more advantaged in use of modern contraceptives compared to lower SES women. The overall Erreygers Concentration Index, as a measure of inequity, was 0.172, p<0.001. Overall, inequity in use of modern contraceptives by education was highest in favor of women with higher education (ECI=0.146, p=0.0001), and the concentration of use of modern contraceptives in women with higher education was significant in the rural but not urban areas CONCLUSION: Inequities in the use of modern contraceptives still exist in favor of women with more education or higher socio-economic status, mainly in the rural settings. Focused programmatic interventions in rural settings should be delivered if universal Family Planning uptake is to be improved. BioMed Central 2023-02-28 /pmc/articles/PMC9972732/ /pubmed/36855140 http://dx.doi.org/10.1186/s12913-023-09150-y Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/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/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://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. |
spellingShingle | Research Makumbi, Fredrick E Nabukeera, Sarah Tumwesigye, Nazarius Mbona Namanda, Cissie Atuyambe, Lynn Mukose, Aggrey Ssali, Sarah Ssenyonga, Ronald Tweheyo, Ritah Gidudu, Andrew Sekimpi, Carole Hashim, Catherine Verde Nicholson, Martha Ddungu, Peter Socio-economic and education related inequities in use of modern contraceptive in seven sub-regions in Uganda |
title | Socio-economic and education related inequities in use of modern contraceptive in seven sub-regions in Uganda |
title_full | Socio-economic and education related inequities in use of modern contraceptive in seven sub-regions in Uganda |
title_fullStr | Socio-economic and education related inequities in use of modern contraceptive in seven sub-regions in Uganda |
title_full_unstemmed | Socio-economic and education related inequities in use of modern contraceptive in seven sub-regions in Uganda |
title_short | Socio-economic and education related inequities in use of modern contraceptive in seven sub-regions in Uganda |
title_sort | socio-economic and education related inequities in use of modern contraceptive in seven sub-regions in uganda |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9972732/ https://www.ncbi.nlm.nih.gov/pubmed/36855140 http://dx.doi.org/10.1186/s12913-023-09150-y |
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