Aparna Jain PhD MPH Laura Reichenbach PhD ICFP 2015 January 2016 Background Research questions Are the current measurement approaches of contraceptive need no need unmet need and met need the most appropriate ID: 513417
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Slide1
Unmet Need: Is it the right indicator for FP programming with Youth in Ouagadougou partnership countries?
Aparna Jain, PhD, MPHLaura Reichenbach, PhD
ICFP 2015
January 2016Slide2
BackgroundSlide3
Research questions
Are the current measurement approaches of contraceptive need (no need, unmet need, and met need) the most appropriate indicators
for family planning programming among youth aged 15 to 24?
How does age and marital status influence contraceptive need among youth in Ouagadougou partnership countries?Slide4
MethodsSlide5
Data
Demographic and Health SurveysBenin 2011-2012Burkina Faso 2010
Cote D’Ivoire 2011-2012Guinea 2012Mali 2012-2013
Niger 2012
Senegal 2010-2011Slide6
Sample size
Youth 15-24 years old Benin:5,800Burkina
Faso: 6,623Cote D’Ivoire: 3,976
Guinea: 3,661
Mali: 3,736
Niger: 3,822
Senegal: 6,648Slide7
Methods
Outcome variable: Contraceptive needUnmet need
Met needNo need
Explanatory variables: Marital status
Never married
Currently married/in union
Formerly married
Respondent age (15-19, 20-24)
Covariates: education, wealth, parity, residenceSlide8
Methods
Bivariate analysis:Assess effect of marital status & age on contraceptive needMultivariate logistic regression:Model I: no need (1) compared to some need (unmet need + met need, 0)
Model II: unmet need (1) compared to met need (0); respondents with no need excludedSlide9
ResultsSlide10
Need for Contraception by Marital Status
NO NEED
UNMET NEED
MET NEED
Benin
Unmarried
72.2
10.9
16.9
Married
56.8
33.9
9.3
Burkina
Faso
Unmarried
84.44.710.8Married 63.323.413.3Cote D’IvoireUnmarried62.616.221.2Married 53.831.015.3GuineaUnmarried76.210.313.5Married70.425.54.1MaliUnmarried84.68.66.8Married66.824.19.1NigerUnmarried98.30.930.74Married71.916.311.8SenegalUnmarried95.82.81.4Married61.330.68.1Slide11
Need for Contraception by Age
NO NEED
UNMET NEED
MET NEED
Benin
15-19
73.3
12.3
14.4
20-24
59.0
27.2
13.8
Burkina Faso
15-19
83.8
9.9
6.320-2461.220.618.2Cote D’Ivoire15-1968.116.415.220-2449.627.223.3Guinea15-1979.814.75.520-2464.821.613.6Mali15-1979.714.55.820-2466.422.710.9Niger15-1987.28.44.420-2469.5
16.8
13.7
Senegal
15-19
88.7
9.1
2.220-2473.320.26.5Slide12
MARRIED
(ref: unmarried)
15 –
19 YEAR OLDS
(ref: 20 – 24 year olds)
OR
95% CI
OR
95% CI
Benin
1.07
(0.84-1.37)
1.35
(1.17-1.56)
Burkina Faso
0.65
(0.48-0.89)
1.28
(1.06-1.54)Cote D’Ivoire1.01(0.80-1.26)1.73(1.39-2.15)Guinea1.66(1.27-2.19)1.41(1.13-1.77)Mali0.52(0.33-0.83)1.03(0.83-1.27)Niger0.09(0.04-0.20)1.05(0.82-1.35)Senegal0.16(0.10-0.24)0.76(0.61-0.95)Model I: No Need for ContraceptionModel adjusted for education, wealth, parity, residence Slide13
Model IIa
: Unmet Need for Contraception(excludes those with no need)
MARRIED
(ref: unmarried)
15 –
19 YEAR OLDS
(ref: 20 – 24 year olds)
OR
95% CI
OR
95% CI
Benin
2.27
(1.57-3.27)
0.87
(0.67-1.13)
Burkina Faso
1.76
(1.09-2.87)2.66(1.94-3.66)Cote D’Ivoire2.10(1.43-3.08)1.15(0.80-1.66)Guinea6.92(4.22-11.34)2.64(1.78-3.92)Mali2.64(1.78-3.92)1.26(0.82-1.96)Niger2.37(0.42-13.4)1.25(0.80-1.94)Senegal1.77(1.07-2.92)1.13(0.66-1.92)Model adjusted for education, wealth, parity, residence Slide14
Model IIb
: Met Need for Contraception(excludes those with no need)
UNMARRIED
(ref: unmarried)
OR
95% CI
Benin
2.08
(1.44-3.01)
Burkina Faso
1.66
(1.03-2.67)
Cote D’Ivoire
1.76
(1.21-2.57)
Guinea
5.28
(3.30-8.45)
Mali1.73(0.96-3.10)Niger2.02(0.34-11.97)Senegal1.66(1.01-2.72)Model adjusted for education, wealth, parity, residence Slide15
DiscussionSlide16
Discussion
NO
NEED
UNMET NEED
MET NEED
15
- 19
0.68
0.16
0.16
20
- 24
0.50
0.27
0.23
25 - 29
0.51
0.26
0.2330 - 340.570.220.2135 - 390.560.230.2140 - 440.570.230.1945 - 500.800.110.09Cote D’Ivoire DHS 2011-2012Slide17
Discussion
As youth transition into different life stages, their need and use of contraception changes 6 of 7 countries 15-19
year olds have no need for contraception compared to 20-24 years old (significant in 4 countries)
7 countries unmarried youth who are sexually active are
more likely to use contraception than married
women (significant in 5 countries)
7 countries sexually
active married youth were most likely to have an unmet need
(significant in 6 countries)
Slide18
Discussion
Family planning programming for youth needs to consider:Age
Sexual initiationMarital status
One size does not fit all!Slide19