Family Planning Beliefs and Their Association with Contraceptive Use Dynamics

Results from a Longitudinal Study in Uganda

Bibliographic Data

ID10795649
AuthorsLinnea A Zimmerman (0000-0002-0118-0889, Department of Population, Family and Reproductive Health Johns Hopkins Bloomberg School of Public Health Baltimore USA, corresponding author), Dana O Sarnak (0000-0003-3976-4860, Department of Population, Family and Reproductive Health Johns Hopkins Bloomberg School of Public Health Baltimore USA, corresponding author), Cary Karp (0000-0002-4050-7602, Department of Population, Family and Reproductive Health Johns Hopkins Bloomberg School of Public Health Baltimore USA, corresponding author), Shannon N Wood (0000-0003-4389-3526, Department of Population, Family and Reproductive Health Johns Hopkins Bloomberg School of Public Health Baltimore USA, corresponding author), Claire Moreau (0000-0002-8637-6249, Department of Population, Family and Reproductive Health Johns Hopkins Bloomberg School of Public Health Baltimore USA, corresponding author), Simon Peter Sebina Kibira (0000-0002-7385-423X, Department of Community Health and Behavioural Sciences School of Public Health Makerere University Kampala Uganda, corresponding author), Fredrick Makumbi (0000-0002-6460-7325, Department of Epidemiology and Biostatistics School of Public Health Makerere University Kampala Uganda, corresponding author)
Year2021
Volume52
Issue3
Pages241-258
Publication date2021-09-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueStudies in Family Planning (JOURNAL)
Journal identifiersISSN: 0039-3665 • E-ISSN: 1728-4465
PublisherWiley (PUBLISHER • GB)
DOI10.1111/sifp.12153
PMID34015142
OpenAlexW3162909995
LanguageEN
Citations received10
References cited41

Norms and beliefs toward contraception, both positive and negative, motivate contraceptive use; however, they have seldom been explored longitudinally in low‐ and middle‐income countries, limiting our understanding of their influence on contraceptive dynamics. We used PMA2020 Uganda national longitudinal data of reproductive aged women in 2018 (baseline) and 2019 (follow‐up) to explore discontinuation and switching among modern contraceptive users at baseline (n = 688) and contraceptive use at follow‐up among nonusers at baseline (n = 1,377). Multivariable simple and multinomial logistic regressions assessed the association of individual and community‐level contraceptive beliefs with contraceptive uptake, discontinuation and switching. One‐quarter of nonusers at baseline were using contraception at follow‐up, while 37 percent of users at baseline had discontinued and 28 percent had switched methods at follow‐up. The odds of contraceptive uptake were lower among women who strongly agreed that contraception impacted future fertility or caused conflict within a couple, relative to those who strongly disagreed (adjusted odds ratio (aOR): 0.7 and aOR: 0.6, respectively), but higher among women who strongly agreed that contraception preserved beauty (aOR: 1.6). Women who strongly agreed that it was acceptable to use contraception before having children were less likely to discontinue their method than those who strongly disagreed (adjusted relative risk ratio (aRRR): 0.5), though living in a community where more women agreed with this statement was associated with higher discontinuation (aRRR: 6.0). Family planning programs that promote positive beliefs toward family planning could improve contraceptive uptake and continuation. More research is needed to understand how contraceptive beliefs shape contraceptive decisions across the life course

Association (psychology · Developing country · Economic growth · Economics · Environmental health · Family planning · Fertility · Geography · Longitudinal study · Population · Research methodology · Sociology · Adolescent Sexual and Reproductive Health · Demographic Trends and Gender Preferences · Demography · Global Maternal and Child Health · Medicine · Psychology