Differentials of modern contraceptive methods use by food security status among married women of reproductive age in Wolaita Zone, South Ethiopia
Archives of Public Health volume 73, Article number: 38 (2015)
In spite of the massive spending and extensive family-planning promotion, many poor people in the third world remain reluctant to use modern contraceptive method. Mostly when they use modern contraceptives, their continuation rates are often low. Reproductive health can improve women’s nutrition; in return better nutrition can improve reproductive health. Thus addressing the connection between nutrition and reproductive health is critical to ensure population growth that does not overwhelm world resources.
A community based cross-sectional study was conducted from March 15–30, 2014 in Soddo Zuria Woreda, Southern Ethiopia. A total of 651 currently married women of reproductive age group were selected using multistage sampling. Probability proportional to the size allocation method was employed to determine the number of households. Multivariable logistic regression was used to assess the association between family planning use and food security status after adjusting for other covariates.
Use of modern contraceptive method was significantly low among food insecure women (29.7 %) compared to those who were food secure (52.0 %), (P < 0.001). Women from food secure households were nearly twice likely to use modern contraceptive methods (AOR: 1.69 (CI: 1.03, 2.66)). Similarly, those who had antenatal care (ANC) visit (AOR: 4.56 (CI: 2.45, 7.05)); exposure to media (AOR: 4.92 (CI: 1.84, 13.79)) and those who discussed about contraceptive methods with their partner (AOR: 3.07 (CI: 1.86, 5.22)) were more likely to use modern contraceptive methods. Conversely, women who delivered their last child at home were less likely to use modern contraceptive methods (AOR: 0.08 (CI: 0.03, 0.13)).
Food insecurity is negatively associated with modern contraceptive method use. Thus food insecurity should be considered as one of the barriers in designing family planning services and needs special arrangement.
At the beginning of twenty-first century, world population was estimated to be almost 6.1 billion. According to the United Nation (UN) projection, the world’s population will reach 11 billion by 2020. This continued world population growth has become an urgent global problem. This growth rate is mostly occurring in developing countries where fertility rate is very high .
Despite impressive reductions in child mortality and improvements in life expectancy, women’s reproductive health in developing countries particularly Sub-Saharan Africa lags behind leaving birth rates to remain high. Women in the region have on average 5.1 children . Each year, there are an estimated 80 million unintended pregnancies, and 42 million of these pregnancies end in abortion. The primary reason for abortion is to end an unplanned pregnancy. To reduce the number of unintended pregnancies and the number of abortions, women must have access to contraceptive information and services. Studies around the world revealed that, in regions where women had given high-quality contraceptive services, the number of abortions would have been decreased .
Family planning is a viable solution to control such a fast growing population and its associated consequences. In addition to spacing and limiting the number of children, it improves the maternal and child health: it empowers women and enhances economic development . Family planning is also one of the human rights. In this regard Article 16 of the Teheran Proclamation issued by the United Nations Conference on Human Rights in 1968 states that "…Parents have a basic human right to determine freely and responsibly the number and spacing of their children".
In spite of the massive spending and extensive family planning promotion over three decades, many poor people in the third world remain reluctant to use modern contraception in the early twenty-first century. Attitudes and the need for children among the poor are often quite different from that of family-planning enthusiasts, who are mostly middle class individuals. Mostly when poor people use modern contraceptive methods, their continuation rate of modern contraceptive methods use is often low. Poverty and adverse social conditions including lack of information and access to other methods of birth control, threats of discontinued social benefits, and economic constraints also set the conditions for abuses in family-planning programs .
Ethiopia has been deemed a population-climate “hotspot” place where rapid growth and a changing climate pose grave threats to food security and human well-being. One in ten Ethiopians is chronically food insecure, and nearly one in five go hungry in drought years. With almost half of its people under the age of 15 and an average fertility rate of nearly five (4.8) children per woman, Ethiopia’s population is the fifth fastest growing in the world . In Ethiopia most of the modern contraceptive methods that are the results of current technologies are available, and around 97.1 % of the communities are aware of those methods. Modern contraceptive methods that are commonly used in the country are injectables (20.8 %), implants (3.4 %), pill (2.1 %), female sterilization (0.5 %), intrauterine device (IUD) (0.3 %), male condom (0.2 %) and other methods are rarely used .
A closer look at Ethiopia shows that neither the Malthusians nor the Boserupians quite get it right concerning the relation between population and food supply. The connections between population and food security are extraordinarily complex. The country is characterized by highly troubling Global Hunger Index (29.8 i.e. 80th out of 84 countries)  and poor family planning utilization (only 29 % of married women)  which leads to rapid population growth that does not match with available resource . Numbers matter, but so do other dynamics, such as migration and age structure. Context is paramount: the right policies are essential to encouraging and reaping the benefits from positive demographic trends, but those policies must be tailored to local circumstances .
Women’s health is crucial to food security and nutrition. Agriculture and food security programmes should be uniquely positioned to respond to women’s productive and reproductive needs. Reproductive health services can improve women’s and children’s nutrition, and better nutrition can improve reproductive health. Population growth directly challenges food security, particularly in sub-Saharan Africa, and food security and agricultural programmes can be an effective means to deliver reproductive health services, and integrate family planning with sustainable agriculture .
Addressing the connection between food security and reproductive health is critical to ensure population growth that does not overwhelm the world’s resources. Program for Appropriate Technology in Health (PATH’s) Integrated Population and Costal Resource Management Project exemplifies a cost-effective intervention which integrated sustainable fishing practices with improved access to family planning, enabled coastal communities with a history of rapid population growth, extensive malnutrition, and overwhelmed municipal fisheries to take control of their reproductive health and natural resources for the sustainability of community life .
Nearly everywhere, wealthier women are more likely to use modern contraceptives than poorer women. The disparities in use between rich and poor are most pronounced in countries with low contraceptive use such as in Uganda. In countries such as Honduras, contraceptive use overall may rise, but the poor still lag behind .
The influence of food insecurity on the utilization of family planning services is not well-explained directly, with little studies demonstrating the effect of socioeconomic status , standard of living , asset index [16–18] and income [16, 19] on family planning outcome.
There are also incompatible findings from some studies. A study conducted in Butajira District, South Central Ethiopia identified variables like ecology/residence, household food shortage, and educational status and house hold livelihood as determinants of family planning utilization. The study found that married women who were members of food self deficient households were about 1.58 times more likely to use family planning compared to their counterparts in food self sufficient households though the association turned statistically insignificant when other variables are included . Contrary to expectations, spousal communication about family planning and geographic accessibility to service facilities were found to be less critical in determining contraceptive use .
Although an overwhelming amount of researches have been given to food security issues and to reproductive health, scanty attention has been given to the relationship between the two. Indeed, there has been some attempt to illuminate how women’s reproductive health status influences household food security, but no enough work has been done in the reverse direction to explicate the relationship between the various aspects of food security and childbearing and family planning utilization. Similarly, there were no studies on the relationship between household food insecurity and family planning utilization particularly in the study area. Thus, this study is designed to comprehend the relationships between food security and reproductive health needs.
Study Area and Setting
A comparative community based cross sectional study was conducted from March 15–30, 2014 in Soddo Zuria Woreda, Wolaita Zone Southern Ethiopia 380 km south of Addis Ababa (The capital of Ethiopia). The study comprised 15 randomly selected Kebeles from 34 rural kebeles (smallest administrative unit in Ethiopia) as there were no urban kebele in the study setting. This Zone is characterized by small landholdings supporting high populations’ and high fertility rates .
A sample of 651 married women of reproductive age was included in the study. The sample size was determined using a formula for estimation of two population proportion using Epinfo software with the assumptions of 95 % confidence level, expected proportion of current use of family planning among food secure married women (50 %), power (80 %), the ratio of food secure to food insecure(r = 1), Odds ratio (OR) = 2, a design effect of 2 for cluster sampling and a non-response rate of 10 %.
The study subjects were randomly selected from fifteen randomly selected kebeles out of the 34 kebeles. The probability proportional to the size allocation method was employed to determine the number of households to be included from each of the kebeles. The selection of each sampling unit was done by applying systematic sampling method based on the list of households with currently married women available in the database of kebele administration. The data base contains list of households (locally called “Aba Wora”) in the kebele administration that is regularly updated by the administrative bodies through health extension workers of the kebele. The initial household was randomly selected by lottery method using number between one and the sampling interval for each kebeles. Since it was only one woman that was needed per household, in case where there was more than one woman in a given household, a lottery method was employed to identify the women to be interviewed.
Method of data collection
The questionnaire for determinants of modern contraceptive method was adapted from Ethiopia Demographic Health Survey (EDHS, 2011) English version and further developed by using peer reviewed published literatures to include other determinants of family planning method. Questionnaires constituted information on respondent’s socio demographic and economic variables, food security status, reproductive health, and contraceptive information.
To assure the quality of data, the final English version of the questionnaire was translated by two language experts into the local language of the respondents (Wolaitegna language) and back translated to English in order to keep its consistency. Pre-test was conducted on 5 % of the sample to determine the applicability of the question to be asked on adjacent woreda i.e. Damot Gale Woreda Delbo Kebele before the actual data collection. Correction and modification were done on the instrument after pretest.
Two days training on the objective of the study, data collection tools and interview techniques were given for fifteen Clinical Nurses as data collectors and five BSc nurses as supervisors recruited from health centers. The interview was conducted in a place where the woman felt free to express her feelings and ideas. Moreover, in occasions where the sampled women were not accessed for absence, up to three attempts were endeavored for interviewing to lessen the non response rate. The questionnaires were checked by the supervisors on daily basis for completeness.
Knowledge of modern contraception was measured for at least one modern contraceptive method i.e. if three of the knowledge assessing questions were answered correctly (whether the mother had heard of any modern contraceptive method, knows the importance of modern contraceptive method and knows where to get it). Similarly attitude toward modern contraceptive method was measured using six attitude assessment questions on a five point Likert scale with score values ranging from 1 (strongly disagree) to 5 (strongly agree) adapted from EDHS and other peer reviewed literatures. Respondents that have attitude score greater than the average score for six attitude assessing score using Likert scale were considered as having favorable attitude. Exposure to mass media was measured based on the response of respondents for exposure to at least one media in the last six months. Discontinuation of modern contraceptive method was a unit variable measured by asking about interruption of any modern contraceptive method (MCM) for at least three months after initiation.
The tool for assessment of food security status was adapted from Food and Nutrition Technical Assistance (FANTA) household food insecurity access scale (HFIAS) developed for use in developing country settings, and it is a tool that asks respondents about three domains of food insecurity: (1) experiencing anxiety and uncertainty about the household food supply; (2) altering quality of the diet; (3) reducing quantity of food consumed . The tool consists of nine questions that ask about changes households made in their diet or food consumption patterns due to limited resources to acquire food in the preceding 30 days.
Based on the responses given to the nine questions and frequency of occurrence over the past 30 days, households were given a score that ranges from 0 to 27. A higher HFIAS score is indicative of poorer access to food and greater household food insecurity. For this analysis, households were classified into two groups based on overall distribution of the HFIAS in the sample. The lower the score, the most food secured a household was. Based on the answer to nine occurrence questions and 27 frequency questions; women who responded no to all occurrence questions and those who responded ‘yes’ to the first occurrence question i.e. “In the past four weeks, did you worry that your household would not have enough food?” and responded only ‘rarely’ to frequency questions were classified as food secured.
The data template format was prepared in Epidata version 3.1 and the data was entered into the software with caution. The completeness of the data were checked. Errors related to inconsistency were verified using data cleansing method. The data were exported to statistical package for social sciences (SPSS) version 20(Illinois Chicago), categorized and sorted to facilitate its analysis.
Descriptive statistics were computed for household food insecurity, socio-demographic characteristics and family planning use. Food-insecure and food-secure households were compared with the logistic regression and chi-square test for proportions through different characteristics of respondents. Some of reproductive health related characteristics of respondents; namely Antenatal care (ANC) follow up, place of delivery of the last child and previous history of child death, were also compared between the two groups. Logistic regression, specifically binary was used to identify factors that were associated with family planning utilization to select variables for multiple logistic regressions. Variables with p-value of < 0.25 on binary logistic regression were taken into multivariable logistic regression models to assess the association between independent variables and the outcome variable (modern family planning practice).
Crude and adjusted odds ratios with their corresponding 95 % confidence intervals were computed. A P-value ≤ 0.05 was considered statistically significant in this study. Efforts were made to assess whether the necessary assumptions for the application of multiple logistic regression are fulfilled. In this regard, the Hosmer and Lemeshow's goodness-of-fit test was done to check the fitness of the model. Interaction between different predictor variables was checked.
Ethical clearance was obtained from the Ethical Review Committee of Jimma University College of Public Health and Medical Science and letter of permission was obtained from Wolaita Zone Health Office and Soddo Zuria Woreda health office. Informed oral consent was also obtained from each study subject prior to interview and the purpose of the study explained to the respondents.
A total 651 women were involved in the study giving a response rate of 100 %. Concerning socio-demographic characteristics of the respondents a little over half of the respondents had no education 339(52.1 %).Occupationally more than half of the study subjects 386(59.3 %) were housewives and farmers’ women accounts for 161(24.7 %) of the study subjects. The prevalence of household food insecurity was 60.5 % (Table 1).
Regarding their reproductive health experiences, 15.6 % of food secure mothers and 18.7 % of food insecure mothers reported to have at least one experience of unintended pregnancy and this is relatively lower when compared with national level which is 25 %. Regarding ANC follow up 72.4 % of food secure mothers and 56.7 % of food insecure have ANC visit for their last pregnancy. Nearly three fourth, 73.9 % of mothers reported to have delivered their last child at home, which accounts 65.9 % of food secure mothers and 79.2 % of food insecure. The history of child death was also asked and the respondents reported that 12.4 % of food secure and 16.8 % of food insecure have at least one experience of child death (Table 2).
On behalf of contraceptive characteristics about 38.6 % of women from the study subjects were currently using modern contraceptive method in the study area and it is 52.0 % among women from food secure households and 29.7 % among women from food insecure households. The most common reason for mothers not using modern family planning is a need for more children 28.5 % followed by religious prohibition 20.3 %. About 96.9 % of women from food secure households and 86.8 % of food insecure had knowledge of modern contraceptive method. Information about exposure to mass media shows that 95.6 % of women from food secure households and 82.5 % of women from food insecure households had history of exposure to at least one media within the last six months (Table 3).
On bivariate analysis some of the respondent’s characteristics show variation between food secure and food insecure households. The proportion of women marrying before 18 years of age is higher for food insecure households, p = 0.002. On the other hand the proportion of women having unintended pregnancy was insignificantly different between the two groups: 15.6 % among food secure and 18.7 % among food insecure, (P = 0.16). Majority of women from food secure households (72.4 %) had at least one ANC visit compared to women from food insecure households which was 56.7 % (P < 0.001). The proportion of women who have delivered their last child at a health institution was significantly smaller among food insecure households (20.5 %) as compared to women from food secure households (34.4 %) with (P < 0.001). The proportion of women using modern contraceptive method was significantly different among women from food secure (52.0 %) and food insecure (29.7 %) households (p < 0.001) and among ever users of modern contraceptive method discontinuation rate is higher for women from food insecure households (50.5 %) compared to food secure households (36.9 %) with (P = 0.003) (Table 4).
Concerning the association between modern contraceptive utilization and respondents characteristics, the results from binary logistic regression showed that household food security (P < 0.001), ANC visit (P < 0.001), place of delivery (P < 0.001), knowledge of modern contraceptive method (P < 0.001), attitude toward modern contraceptive method (P- < 0.001), exposure to media (P < 0.001), discussion with partner (P < 0.001) and total number of birth (P < 0.001) were significantly associated with modern contraceptive method (Table 5).
After adjusting all the other variables in the multivariable logistic regression model household food insecurity, delivery place of the last child, religion of the respondent, media exposure, antenatal care (ANC) follow up and discussion with husband about modern contraceptive methods (MCM) of the respondents were independently associated with modern contraceptive use. Women from food secure households were 1.7 times more likely to use MCM compared to women from food insecure households [adjusted odds ratio (AOR): 1.69, (confidence interval (CI): 1.03, 2.66). Mothers who had at least one ANC follow up were nearly five times more likely to use MCM when compared to women who have no any ANC visit [AOR: 4.56, (CI: 2.45, 7.05)]. Concerning place of delivery, the likelihood of using MCM decrease by 92 % for those women who delivered their last child at home compared to institutional delivery, [AOR: 0.08 (CI: 0.03, 0.13)]. Exposure to mass media has also significant effect on MCM utilization. Women who were exposed to at least one media in the last six months were about 5 times more likely to use MCM than those who have no any history of exposure [AOR: 4.92, (CI: 1.84, 13.79)]. Discussion between couples is also positively associated with modern contraceptive method utilization [AOR: 3.07, (CI: 1.86, 5.22)] (Table 6)
In Ethiopia only three in every ten (29 %) of currently married women were using contraceptive method. About 93 % of these methods were modern methods i.e. 27 % out of 29 %. About twenty-five percent of currently married women have an unmet need for family planning services . In this study the prevalence of modern contraceptive method use is relatively higher than the national and regional contraceptive prevalence level. It is also relatively higher than the prevalence in rural area of Butajira from previous study done on determinants of low family planning use and high unmet need . Similarly, from our study other maternal health services like ANC and institutional delivery are also higher than the national level.
The result of this study showed that women from food secure households were about 1.7 times more likely to use modern contraception than women from food insecure households. Although there were no studies that show the relation between food insecurity and modern contraceptive use some previous studies show that poorer women were less likely to use modern contraceptive method and women with higher income are more likely to use contraception compared to the poor women . In study done on utilization of family planning services by married Sudanese women of reproductive age; women with a higher socioeconomic status were found to be more likely to use modern methods of family planning than their counterparts . In addition to this when poor people use modern contraceptives, their continuation rates are also often low . Among ever users of modern contraceptive in this study larger number of women from food insecure households, about 50.5 %, had discontinued using modern contraceptive method as compared to women from food secure households which is only 36.9 % had discontinued using modern contraceptive method.
This finding has important implication especially in Ethiopia, which is one of the world’s most food insecure countries with problems along all key dimensions of food security where one in ten Ethiopians is chronically food insecure. With almost half its people under the age of 15 and an average fertility rate of nearly five (4.8) children per woman, Ethiopia’s population is the fifth fastest growing in the world . The combined effect of high prevalence of food insecurity and a youthful population with potential for population momentum poses arguments on the need for devising appropriate intervention strategies to promote use of modern family planning methods especially in food insecure areas to curb the synergistic negative consequences of both problems.
The study also found that women who have discussion with their husband were about 3 times more likely to use modern contraceptive method. Spousal discussion about family planning and contraceptive practice was documented to be crucial for the wider acceptance of contraceptive practice and lessening partners’ fertility intention in developing countries [23, 24]. A study done on awareness and determinants of family planning practice in Jimma, Ethiopia indicated that the percentage of women who used modern contraceptives was higher among those who had discussed family planning with their husbands than among those who had not ; in agreement with the study done in Butajira that showed a positive association between couple’s discussion on family planning and contraception .
Utilization of other health services like previous attendance of ANC, post natal care (PNC), and delivery at health institution and attendance of immunization services were found to have statistically significant association to the current use of modern contraception. In this study ANC follow up and institutional delivery were found to be statistically significant. Regarding ANC follow up and modern contraceptive method use the women who have at least one ANC follow up are more likely to use modern contraceptive method compared to those who have no any ANC follow and women who delivered at home were also less likely to use modern contraceptive compared to those that delivered at health institution. It may be that women who deliver at health institutions receive more exposure to family planning information compared to those who deliver at home. Information about public exposure to messages through a particular medium allows policy makers to ensure the use of the most effective means of communication for various target groups in the population and it is one of the enabling factors for proper utilization of modern contraceptive method . In this study women that have exposure to media were about five times more likely to use modern contraceptive method. In study done in Wolaita Soddo Town south west Ethiopia women who have radio and television were about three times more likely to use contraceptive method as compared to those who have not .
The study on family planning knowledge and current use of contraception among the Mru indigenous women in Bangladesh also shows that women who have exposure to mass media were six times more likely to use contraceptive methods . Study done on factors influencing contraceptive use among young women in urban squatter settlements of Karachi, Pakistan stated that women were more likely to use contraceptives when messages of family planning were delivered through media .
In Ethiopia national health policy gives a high priority to the democratization and decentralization of the health service systems and one of targets of the Ministry of Health, with respect to improving maternal and child health, is to increase the contraceptive prevalence rate (CPR) to 66 percent by 2015 . This study showed that households’ food insecurity significantly affects modern contraceptive method use and its continuation. Hence any program whether governmental or non-governmental that wants to improve modern contraceptive method use and its continuation should consider food security status of the area while planning for family planning service and should cooperatively work with agricultural offices.
Strong emphasis should be given to active involvement of women in productive activities like Productive Safety Net Program that is being practiced in the country with the aim of enabling the rural poor facing chronic food insecurity to resist shocks, create assets and become food self sufficient. Woreda Health Office should also give emphasis to modern contraceptive use related reproductive health services like ANC and place of delivery. ANC follow up and institutional deliveries show significant improvement in modern contraceptive method use. Therefore improving the rate of ANC follow up and institutional delivery may highly improve utilization of modern contraceptive method. Awareness creation on the importance of discussing on reproductive health issue for both mothers and their husbands and encouraging women in discussions about modern contraceptive methods with health professional should be encouraged.
Strength and limitation
There were no non respondent from the sample and all of the probably selected individuals were interviewed. The study was comparative in nature and efforts were made to show the difference in different characteristics of the respondents in the two groups. By controlling for confounders as much as possible the difference in MCM utilization among the two groups was assessed. We admit a number of limitations in our study. Although we used standardized tool to assess food security status there may be possibility of some misclassification. Household Food Insecurity Access Scale measures acute food insecurity as it asks food access within the last one month. In addition, our analysis was based on cross-sectional data whereas data capturing seasonal trends are needed to fully understand the relationship between modern contraceptive use and household food insecurity. The cross-sectional nature of the data also limits our ability to draw any causal conclusions i.e. failure to use modern contraceptive that leads to large family size resulting in food insecurity may be the case.
Overall, the study showed that food insecurity is a significant barrier to use of modern contraceptive methods. Not only family planning method use, but also women from food insecure households were less likely to practice other reproductive services like antenatal care and institutional delivery. Food security interventions should integrate appropriate strategies for enhancing use of modern contraceptive methods in food insecured areas.
Food and Agricultural Organization
Human immunodeficiency virus/ Acquired immunodeficiency syndrome
Modern family planning
Southern Nations Nationalities and Peoples Representative
World Health Organization
Program for appropriate technology in health
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We would like to thank Jimma University, College of Public Health & Medical Sciences for funding this research. We extend our deepest gratitude to supervisors, data collectors and respondents who participated on this study. We would also like to thank Soddo Zuria Woreda administration office. Finally our gratitude also goes to Mr. Hailesilasie Beyene, from Jimma University, an English language expert who reviewed the article for language edition.
The authors declare that they have no competing interests.
MF conceived and designed the study, performed analysis and interpretation of data and critically reviewed the manuscript. TB and AT assisted with the design conception, analysis, interpretation of data and draft the manuscript and critically reviewed the article. YA assisted in analysis, interpretation and in drafting and reviewing of the manuscript. All authors read and approved the final manuscript.
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Feyisso, M., Belachew, T., Tesfay, A. et al. Differentials of modern contraceptive methods use by food security status among married women of reproductive age in Wolaita Zone, South Ethiopia. Arch Public Health 73, 38 (2015). https://doi.org/10.1186/s13690-015-0089-5
Utafiti wa idadi ya wanawake walioolewa katika umri wa kuzaa katika eneo la Wolaita, Ethiopia Kusini, ulionyesha kuwa idadi ya wanawake walioolewa katika eneo la Wolaita, Ethiopia Kusini, wana umri wa kuzaa, na idadi ya wanawake walioolewa katika eneo la Wolaita, Ethiopia Kusini, wana umri wa kuzaa. Hasa wanapotumia njia za kisasa za kuzuia mimba, mara nyingi viwango vyao vya kuendelea ni vya chini. Afya ya uzazi inaweza kuboresha lishe ya wanawake; kwa kubadilishana lishe bora inaweza kuboresha afya ya uzazi. Kwa hivyo kushughulikia uhusiano kati ya lishe na afya ya uzazi ni muhimu kuhakikisha ukuaji wa idadi ya watu ambao haujazidisha rasilimali za ulimwengu. Utafiti wa jamii ulifanywa kuanzia Machi 15 hadi 30, 2014 huko Soddo Zuria Woreda, Kusini mwa Ethiopia. Wanawake 651 waliooa katika umri wa uzazi walichaguliwa kwa kutumia sampuli ya hatua nyingi. Uwezekano uwiano na ukubwa wa utaratibu wa mgawanyo ilitumika kuamua idadi ya nyumba. Multivariable logistic regression ilitumiwa kutathmini uhusiano kati ya matumizi ya mipango ya familia na hali ya usalama wa chakula baada ya kurekebisha kwa covariates nyingine. Matumizi ya njia za kisasa za kuzuia mimba yalikuwa ya chini sana miongoni mwa wanawake wasio na usalama wa chakula (29.7%) ikilinganishwa na wale ambao walikuwa na usalama wa chakula (52.0%) (P < 0.001). Wanawake kutoka kwa kaya zilizo na usalama wa chakula walikuwa karibu mara mbili ya uwezekano wa kutumia mbinu za kisasa za kuzuia mimba (AOR: 1.69 (CI: 1.03, 2.66)). Kwa mfano, wale waliopata matibabu ya kabla ya kujifungua (AOR 4.56 (CI: 2.45; 7.05), waliopata mawasiliano na vyombo vya habari (AOR 4.92 (CI: 1.84; 13.79)), na wale waliozungumza na mwenzi wao kuhusu mbinu za kuzuia mimba (AOR 3.07 (CI: 1.82; 5.22), walikuwa na uwezekano mkubwa zaidi wa kutumia mbinu za kisasa za kuzuia mimba. Kwa upande mwingine, wanawake ambao walizaa mtoto wao wa mwisho nyumbani walikuwa na uwezekano mdogo wa kutumia njia za kisasa za kuzuia mimba (AOR: 0.08 (CI: 0.03, 0.03)). Ukosefu wa usalama wa chakula unahusiana vibaya na matumizi ya njia za kisasa za kuzuia mimba. Kwa hivyo ukosefu wa usalama wa chakula unapaswa kuzingatiwa kama moja ya vizuizi katika kubuni huduma za upangaji wa familia na inahitaji mpangilio maalum. Mwanzoni mwa karne ya 21, idadi ya watu duniani ilikadiriwa kuwa karibu bilioni 6.1. Kulingana na makadirio ya Umoja wa Mataifa, idadi ya watu duniani itafikia bilioni 11 kufikia mwaka 2020. Ongezeko hilo la idadi ya watu ulimwenguni limekuwa tatizo la haraka la ulimwengu. Kiwango hiki cha ukuaji kinatokea hasa katika nchi zinazoendelea ambapo kiwango cha uzazi ni cha juu sana. Licha ya kupungua kwa vifo vya watoto na kuboresha muda wa kuishi, afya ya uzazi ya wanawake katika nchi zinazoendelea, hasa Afrika Kusini mwa Jangwa la Sahara, inasimama nyuma na kuacha viwango vya kuzaliwa kubaki juu. Wanawake katika mkoa huo wana wastani wa watoto 5.1. Kila mwaka, inakadiriwa kwamba kuna mimba milioni 80 zisizotarajiwa, na milioni 42 kati ya hizo huishia kwa utoaji-mimba. Sababu kuu ya utoaji-mimba ni kukomesha mimba isiyopangwa. Ili kupunguza idadi ya mimba zisizotarajiwa na idadi ya utoaji mimba, wanawake lazima wawe na upatikanaji wa habari na huduma za kuzuia mimba. Uchunguzi uliofanywa ulimwenguni pote ulionyesha kwamba katika maeneo ambapo wanawake walikuwa wametoa huduma za kuzuia mimba zenye ubora wa juu, idadi ya utoaji mimba ingekuwa imepungua. Mpango wa familia ni suluhisho linalofaa la kudhibiti ongezeko hilo la haraka la idadi ya watu na matokeo yanayohusiana nalo. Pamoja na kupunguza idadi ya watoto, inaboresha afya ya mama na mtoto, inawapa nguvu wanawake na inaongeza maendeleo ya kiuchumi. Mpango wa familia pia ni mojawapo ya haki za kibinadamu. "Katika Mkataba wa Tehran wa mwaka 1968 wa Umoja wa Mataifa kuhusu Haki za Binadamu, nchi hiyo ilitangaza kuwa ""Wazazi wana haki ya msingi ya kuamua kwa uhuru na kwa uwajibikaji idadi ya watoto wao na umbali kati yao.""" Licha ya matumizi makubwa ya fedha na kukuza mipango ya familia kwa miaka 30 iliyopita, watu wengi maskini katika nchi za ulimwengu wa tatu bado wanakataa kutumia njia za kisasa za kuzuia mimba. Mtazamo na uhitaji wa watoto miongoni mwa maskini mara nyingi ni tofauti kabisa na ule wa wapenzi wa mipango ya familia, ambao kwa kawaida ni watu wa tabaka la kati. Kwa sababu ya hali hiyo, watu maskini wanaotumia njia za kisasa za kuzuia mimba wanaendelea kutumia njia hizo kwa muda mrefu. Umaskini na hali mbaya za kijamii, ikiwa ni pamoja na ukosefu wa habari na upatikanaji wa njia nyingine za kudhibiti kuzaliwa, vitisho vya kukomeshwa kwa faida za kijamii, na vikwazo vya kiuchumi, pia huunda hali za unyanyasaji katika programu za mipango ya familia. Ethiopia imekuwa ikionwa kama eneo la "mahali pa joto" ambapo ukuaji wa haraka na mabadiliko ya hali ya hewa yanaweka vitisho vikubwa kwa usalama wa chakula na ustawi wa binadamu. "Mmoja kati ya watu kumi nchini Ethiopia anaugua ukosefu wa chakula, na karibu mmoja kati ya watano anaugua njaa katika miaka ya ukame.""" Kwa kuwa karibu nusu ya watu wake ni chini ya umri wa miaka 15 na kiwango cha wastani cha uzazi ni karibu watoto watano kwa kila mwanamke, idadi ya watu wa Ethiopia ni ya tano kwa kasi zaidi ulimwenguni. Katika nchi ya Ethiopia, njia za kisasa za kuzuia mimba zinapatikana na karibu asilimia 97.1 ya jamii zinajua kuhusu njia hizo. Njia za kawaida za kuzuia mimba ni sindano (20.8%, implant (3.4%, pill (2.1%), sterilization ya wanawake (0.5%, IUD (0.3%, condom ya kiume (0.2%) na mbinu nyingine hazitumiwi sana. Kwa kuzingatia kwa karibu Ethiopia, inaonekana kwamba wala Malthusians wala Boserupans kabisa kupata haki kuhusu uhusiano kati ya idadi ya watu na ugavi wa chakula. Uhusiano kati ya idadi ya watu na usalama wa chakula ni tata sana. Nchi hiyo ina sifa ya kusumbua sana Global Hunger Index (29.8 i.e. Kwa sababu ya idadi ya wanawake walioolewa, idadi ya wanawake wanaofanya kazi katika mipango ya familia ni ya chini (ni asilimia 29 tu ya wanawake walioolewa) na kwa sababu hiyo idadi ya watu inaongezeka kwa kasi na hailingani na rasilimali zinazopatikana. Idadi ni muhimu, lakini ndivyo ilivyo na mienendo mingine, kama vile uhamiaji na muundo wa umri. """Mazingira ni muhimu: sera sahihi ni muhimu kwa kuhimiza na kuvuna faida kutoka kwa mwenendo mzuri wa idadi ya watu, lakini sera hizo lazima ziwe na hali ya ndani." Afya ya wanawake ni muhimu kwa usalama wa chakula na lishe. Programu za kilimo na usalama wa chakula zinapaswa kuwa na nafasi ya kipekee ya kukabiliana na mahitaji ya uzalishaji na uzazi wa wanawake. Huduma za afya ya uzazi zinaweza kuboresha lishe ya wanawake na watoto, na lishe bora inaweza kuboresha afya ya uzazi. Ongezeko la idadi ya watu ni changamoto ya moja kwa moja kwa usalama wa chakula, hasa katika Afrika Kusini mwa Jangwa la Sahara, na mipango ya usalama wa chakula na kilimo inaweza kuwa njia bora ya kutoa huduma za afya ya uzazi, na kuunganisha mipango ya familia na kilimo endelevu. "Kushughulikia uhusiano kati ya usalama wa chakula na afya ya uzazi ni muhimu kuhakikisha ukuaji wa idadi ya watu ambao haujaza rasilimali za ulimwengu. """ Programu ya Teknolojia ya Sawa katika Afya (PATH) Integrated Population na Coastal Resource Management Project ni mfano wa uingiliaji wa gharama nafuu ambao uliunganisha mazoea ya uvuvi endelevu na upatikanaji bora wa mipango ya familia, iliwezesha jamii za pwani na historia ya ukuaji wa haraka wa idadi ya watu, utapiamlo mkubwa, na uvuvi wa manispaa uliojaa kuchukua udhibiti wa afya yao ya uzazi na rasilimali za asili kwa ajili ya uendelevu wa maisha ya jamii. Karibu kila mahali, wanawake matajiri zaidi huelekea kutumia njia za kisasa za kuzuia mimba kuliko wanawake maskini. Tofauti za matumizi kati ya matajiri na maskini ni kubwa zaidi katika nchi zenye matumizi ya chini ya njia za kuzuia mimba kama vile Uganda. Katika nchi kama vile Honduras, matumizi ya njia za kuzuia mimba kwa ujumla yanaweza kuongezeka, lakini maskini bado wanashindwa. "Uchunguzi wa ""Usaidizi wa Chakula"" katika matumizi ya huduma za mipango ya familia haujulikani vizuri, na masomo machache yanaonyesha athari ya hali ya kijamii na kiuchumi, kiwango cha maisha, index ya mali [16] na mapato [16] juu ya matokeo ya mipango ya familia." Pia kuna matokeo yasiyofaa kutoka kwa masomo fulani. Utafiti uliofanywa katika wilaya ya Butajira, kusini mwa Ethiopia uligundua mabadiliko kama mazingira, ukosefu wa chakula, hali ya elimu na maisha ya nyumba kama sababu za kuamua matumizi ya mipango ya familia. Utafiti huo uligundua kuwa wanawake walioolewa ambao walikuwa wanachama wa nyumba zenye uhaba wa chakula walikuwa na uwezekano wa kutumia mipango ya familia mara 1.58 ikilinganishwa na wenzao katika nyumba zenye uhitaji wa chakula, ingawa uhusiano huo uligeuka kuwa wa kihistoria wakati vigezo vingine viliingizwa. Kinyume na matarajio, mawasiliano ya mwenzi kuhusu mipango ya familia na upatikanaji wa kijiografia kwa vifaa vya huduma iligunduliwa kuwa muhimu zaidi katika kuamua matumizi ya njia za kuzuia mimba. Ingawa idadi kubwa ya utafiti imewekwa kwa masuala ya usalama wa chakula na afya ya uzazi, umakini mdogo umewekwa kwa uhusiano kati ya hizo mbili. Kwa kweli, kumekuwa na jaribio la kuangazia jinsi hali ya afya ya uzazi ya wanawake inavyoathiri usalama wa chakula cha kaya, lakini hakuna kazi ya kutosha iliyofanywa katika mwelekeo wa kinyume ili kuelezea uhusiano kati ya mambo mbalimbali ya usalama wa chakula na uzazi na matumizi ya mipango ya familia. Vivyo hivyo, hakukuwa na masomo juu ya uhusiano kati ya ukosefu wa usalama wa chakula wa kaya na matumizi ya mipango ya familia hasa katika eneo la utafiti. Kwa hivyo, utafiti huu umebuniwa kuelewa uhusiano kati ya usalama wa chakula na mahitaji ya afya ya uzazi. Utafiti wa jamii ulifanywa mnamo Machi 15, 2014 huko Soddo Zuria, eneo la Wolaita Kusini mwa Ethiopia, kilomita 380 kusini mwa Addis Ababa. Utafiti huo ulijumuisha watu 15 waliochaguliwa kwa nasibu kutoka kwa watu 34 wa vijijini (kifungu kidogo cha utawala nchini Ethiopia) kwani hakukuwa na watu wa mijini katika mazingira ya utafiti. Eneo hili ni sifa ya mashamba madogo ya ardhi kuunga mkono idadi kubwa ya watu <unk> na viwango vya juu vya uzazi. Uchunguzi huo ulihusisha wanawake 651 waliooa na wenye umri wa kuzaa. Kwa mfano, kwa mfano, kwa mfano, kwa mfano, kwa mfano, kwa mfano, kwa mfano, kwa mfano, kwa mfano, kwa mfano, kwa mfano, kwa mfano, kwa mfano, kwa mfano, kwa mfano, kwa mfano, kwa mfano, kwa mfano, kwa mfano, kwa mfano, kwa mfano, kwa mfano, kwa mfano, kwa mfano, kwa mfano, kwa mfano. Kwa mfano, watu waliochaguliwa kwa nasibu kutoka kwa watu 15 waliochaguliwa kwa nasibu kutoka kwa watu 34 waliochaguliwa kwa nasibu. Uwezekano unaolingana na njia ya ugawaji wa ukubwa ulitumiwa kuamua idadi ya kaya ambazo zitahusishwa kutoka kwa kila kebeles. Uchaguzi wa kila kitengo cha sampuli ulifanywa kwa kutumia njia ya sampuli ya utaratibu kulingana na orodha ya kaya zilizo na wanawake waliooa sasa zinazopatikana katika hifadhidata ya utawala wa kebele. Hifadhidata hiyo ina orodha ya nyumba (kwa lugha ya kienyeji huitwa <unk>Aba Wora<unk>) katika utawala wa kebele ambayo inasasishwa mara kwa mara na mashirika ya utawala kupitia wafanyikazi wa upanuzi wa afya wa kebele. Nyumba ya awali ilikuwa randomly kuchaguliwa kwa njia ya bahati nasibu kwa kutumia idadi kati ya moja na vipindi vya sampuli kwa kila kebeles. Kwa kuwa ni mwanamke mmoja tu aliyehitajika kwa kila nyumba, katika kesi ambapo kulikuwa na wanawake zaidi ya mmoja katika nyumba fulani, mbinu ya bahati nasibu ilitumiwa kutambua wanawake wa kuhojiwa. "Kulingana na utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa ""Ethopia.""" Mafunzo yalifanyiza habari juu ya vigezo vya kijamii na vya kiuchumi vya walioulizwa, hali ya usalama wa chakula, afya ya uzazi, na habari ya kuzuia mimba. Ili kuhakikisha ubora wa data, toleo la mwisho la Kiingereza la swali lilitafsiriwa na wataalamu wawili wa lugha katika lugha ya ndani ya waliohojiwa (lugha ya Wolaitegna) na kutafsiriwa tena kwa Kiingereza ili kudumisha uthabiti wake. Majaribio ya awali yalifanywa kwa asilimia 5 ya sampuli ili kuamua matumizi ya swali la kuulizwa kwenye woreda jirani yaani. Damot Gale Woreda Delbo Kebele kabla ya ukusanyaji halisi wa data. Marekebisho na marekebisho yalifanywa kwenye chombo baada ya pretest. Mafunzo ya siku mbili juu ya lengo la utafiti, zana za ukusanyaji wa data na mbinu za mahojiano zilitolewa kwa wauguzi kumi na tano wa kliniki kama wakusanyaji wa data na wauguzi watano wa BSc kama wasimamizi waliochaguliwa kutoka vituo vya afya. Mahojiano hayo yalifanywa mahali ambapo mwanamke huyo alihisi huru kueleza hisia na mawazo yake. Zaidi ya hayo, katika matukio ambapo wanawake sampuli hawakuwa kuwasiliana kwa ajili ya kutokuwepo, hadi majaribio tatu walikuwa walijitahidi kwa mahojiano ya kupunguza kiwango cha kutokuwa na majibu. Mafunzo yalikaguliwa na wasimamizi kila siku ili kuhakikisha kwamba yanafaa. Ujuzi wa njia ya kisasa ya kuzuia mimba ulipimwa kwa angalau njia moja ya kisasa ya kuzuia mimba yaani. Katika maswali matatu ya uchunguzi wa ujuzi, mama anajua jinsi ya kutumia njia ya kisasa ya kuzuia mimba na jinsi ya kuitumia. Uwezo wa kupima tabia ya mtu kwa njia ya kisasa ya kuzuia mimba ulipimwa kwa kutumia maswali sita ya tathmini ya tabia kwenye kiwango cha Likert cha pointi tano na alama za alama kuanzia 1 (hakikishi kabisa) hadi 5 (hakikishi kabisa) zilizobadilishwa kutoka kwa EDHS na fasihi nyingine iliyochunguzwa na wenzao. "Wanafunzi ambao wana alama ya mtazamo kubwa kuliko alama ya wastani ya alama sita za tathmini ya mtazamo kwa kutumia kiwango cha Likert walichukuliwa kuwa na mtazamo mzuri. """ Ufikiaji wa vyombo vya habari ulipimwa kulingana na majibu ya waliohojiwa kwa kufunuliwa kwa angalau vyombo vya habari moja katika miezi sita iliyopita. Kuondolewa kwa njia ya kisasa ya kuzuia mimba ilikuwa kipimo cha kitengo kilichopimwa kwa kuuliza juu ya kukatishwa kwa njia yoyote ya kisasa ya kuzuia mimba (MCM) kwa angalau miezi mitatu baada ya kuanza. Mfano wa kipimo cha usalama wa chakula ni kipimo cha usalama wa chakula cha familia (HFIAS) ambacho kinachotumiwa katika nchi zinazoendelea, na kinawauliza watu kuhusu mambo matatu ya ukosefu wa usalama wa chakula: (1) kuwa na wasiwasi na kutokuwa na uhakika kuhusu ugavi wa chakula cha nyumbani; (2) kubadilisha ubora wa chakula; na (3) kupunguza kiasi cha chakula kinachotumiwa. Mfano wa utafiti huo ni maswali tisa yanayoulizwa kuhusu mabadiliko ya chakula au tabia ya matumizi ya chakula kwa sababu ya mapato madogo ya kupata chakula katika siku 30 zilizopita. Kwa mujibu wa majibu ya maswali hayo tisa na mara nyingi ya matukio hayo katika siku 30 zilizopita, makazi hayo yalipewa alama kuanzia 0 hadi 27. Alama ya juu ya HFIAS inaonyesha upatikanaji duni wa chakula na ukosefu mkubwa wa usalama wa chakula wa kaya. Kwa ajili ya uchambuzi huu, nyumba walikuwa classified katika makundi mawili kulingana na usambazaji wa jumla ya HFIAS katika sampuli. Kadiri alama ilivyokuwa ya chini, ndivyo familia ilivyokuwa na chakula kingi zaidi. "Kwa mujibu wa majibu ya maswali tisa ya ""kuonekana"" na maswali 27 ya ""mzuri"" wanawake waliojibu ""hapana"" kwa maswali yote ya ""kuonekana"" na wale waliojibu ""ndiyo"" kwa swali la kwanza la ""kuonekana"" yaani ""mzuri.""" <unk> Katika wiki nne zilizopita, je, ulijali kwamba nyumba yako haingekuwa na chakula cha kutosha? <unk> na kujibu tu <unk> mara chache <unk> kwa maswali ya mzunguko yaliorodheshwa kama chakula salama. Mfano wa data ulitengenezwa katika Epidata 3.1 na data iliingizwa katika programu kwa tahadhari. Ukamilifu wa data ulichunguzwa. Makosa yanayohusiana na kutopatana yalithibitishwa kwa kutumia njia ya kusafisha data. Takwimu hizo zilisafirishwa kwenye kifurushi cha takwimu kwa sayansi ya kijamii (SPSS) toleo la 20 (Illinois Chicago), na kugawanywa na kupangwa ili kuwezesha uchambuzi wake. Takwimu za ufafanuzi zilihesabiwa kwa ukosefu wa usalama wa chakula wa kaya, sifa za kijamii na za idadi ya watu na matumizi ya mipango ya familia. Kwa mfano, idadi ya watu walioathirika na ukosefu wa usalama wa chakula ililinganishwa na kiwango cha ki-square na kiwango cha logistical regression, na idadi ya watu walioathiriwa na ukosefu wa usalama wa chakula ililinganishwa na kiwango cha ki-square. Baadhi ya sifa zinazohusiana na afya ya uzazi za waliohojiwa, yaani, utunzaji wa kabla ya kuzaliwa (ANC), mahali pa kuzaliwa kwa mtoto wa mwisho na historia ya zamani ya kifo cha mtoto, pia zililinganishwa kati ya makundi mawili. Logistic regression ni njia ya kugundua sababu za matumizi ya mipango ya familia na kuamua aina ya mabadiliko ya mabadiliko ya mabadiliko ya mabadiliko ya mabadiliko ya mabadiliko ya mabadiliko. Vipimo vya p-thamani ya 0.25 kwenye regression ya binary logistic vilichukuliwa katika mifano ya regression ya multivariable ya logistic ili kutathmini uhusiano kati ya vigezo vya kujitegemea na vigezo vya matokeo (mazoea ya kisasa ya mipango ya familia). Kwa mfano, kwa mfano, kiwango cha kawaida cha uwezekano wa kuaminika na kiwango cha uhakika cha 95%. P-thamani ya 0.05 ilionwa kuwa muhimu kwa takwimu katika utafiti huu. Jitihada zilifanywa kutathmini kama dhana muhimu kwa ajili ya matumizi ya regression nyingi logistic ni kukamilika. Katika suala hili, Hosmer na Lemeshow ya wema-ya-fit mtihani ulifanywa kuangalia fitness ya mfano. Maingiliano kati ya vigezo tofauti vya utabiri yalithibitishwa. Uhalali wa maadili ulipatikana kutoka kwa Kamati ya Mapitio ya Maadili ya Chuo Kikuu cha Jimma cha Afya ya Umma na Sayansi ya Matibabu na barua ya ruhusa ilipatikana kutoka kwa Ofisi ya Afya ya Eneo la Wolaita na Ofisi ya Afya ya Soddo Zuria Woreda. Kujiunga na utafiti huo kwa njia ya mdomo na kwa ufahamu ulifanywa kabla ya mahojiano na lengo la utafiti huo lilielezwa kwa washiriki. Wanawake 651 walihusika katika utafiti huo na kiwango cha majibu kilikuwa asilimia 100. Kwa mujibu wa takwimu za utafiti, zaidi ya nusu ya watu waliohojiwa walikuwa hawana elimu, na zaidi ya nusu ya watu waliohojiwa walikuwa wanawake, na zaidi ya nusu walikuwa wanawake wa nyumbani na wakulima, na asilimia 161,7 ya watu hao walikuwa wanawake. Ugonjwa wa ukosefu wa usalama wa chakula katika nyumba ni asilimia 60.5 (tazama: Kwa mujibu wa ripoti ya mwaka huu, asilimia 15.6 ya wanawake wenye afya ya uzazi na asilimia 18.7 ya wanawake wasio na afya ya uzazi wameripoti kuwa wamepata mimba isiyo ya kawaida, na asilimia hiyo ni ya chini ikilinganishwa na kiwango cha kitaifa cha asilimia 25. Kwa mujibu wa ripoti hiyo, asilimia 72.4 ya akina mama wanaotarajia kupata chakula na asilimia 56.7 ya akina mama wanaotarajia kupata chakula, wametembelea kituo cha uchunguzi wa afya cha afya cha afya ya watoto. Takriban asilimia tatu ya akina mama walioripoti kuwa wamezaa mtoto wao wa mwisho nyumbani, asilimia 65.9 ya akina mama walio na usalama wa chakula na asilimia 79.2 ya wale wasio na usalama wa chakula. Katika utafiti huo, asilimia 12.4 ya watu walio na usalama wa chakula na asilimia 16.8 ya watu walio na ukosefu wa usalama wa chakula walijaribu kuua watoto. Kwa mujibu wa ripoti hiyo, asilimia 38.6 ya wanawake wanaotumia njia za kisasa za kuzuia mimba katika eneo hilo, asilimia 52.0 ni wanawake wanaotumia njia za kisasa za kuzuia mimba na asilimia 29.7 ni wanawake wanaotumia njia za kisasa za kuzuia mimba. Sababu ya kawaida kwa akina mama kutotumia mipango ya kisasa ya familia ni haja ya kuwa na watoto zaidi (28.5%), ikifuatiwa na marufuku ya kidini (20%). Asilimia 96,9 ya wanawake kutoka kwa familia zilizo na usalama wa chakula na asilimia 86,8 ya wale wasio na usalama wa chakula wana ujuzi wa njia ya kisasa ya kuzuia mimba. Takwimu za kuambukizwa kwa vyombo vya habari zinaonyesha kwamba asilimia 95,6 ya wanawake kutoka kwa kaya zenye usalama wa chakula na asilimia 82,5 ya wanawake kutoka kwa kaya zisizo na usalama wa chakula walikuwa na historia ya kuambukizwa kwa angalau vyombo vya habari katika miezi sita iliyopita. Katika uchambuzi wa bivariate baadhi ya sifa za waliohojiwa zinaonyesha tofauti kati ya kaya zenye usalama wa chakula na zisizo na usalama wa chakula. Idadi ya wanawake wanaooa kabla ya umri wa miaka 18 ni ya juu zaidi kwa kaya zisizo na usalama wa chakula (p = 0.002). Kwa upande mwingine, idadi ya wanawake walio na mimba zisizotarajiwa ilikuwa tofauti kidogo kati ya makundi mawili: 15.6% kati ya usalama wa chakula na 18.7% kati ya ukosefu wa usalama wa chakula (P = 0.16). Wanawake wengi kutoka kwa kaya zilizo salama ya chakula (72.4%) walikuwa na angalau ziara moja ya ANC ikilinganishwa na wanawake kutoka kwa kaya zisizo salama za chakula (56.7%) (P < 0.001). Idadi ya wanawake waliozaa mtoto wao wa mwisho katika taasisi ya afya ilikuwa ndogo sana kati ya kaya zisizo na usalama wa chakula (20.5%) ikilinganishwa na wanawake kutoka kwa kaya zilizo na usalama wa chakula (34.4%) na (P < 0.001). Idadi ya wanawake wanaotumia njia za kisasa za kuzuia mimba ni tofauti sana kati ya wanawake kutoka kwa kaya zenye usalama wa chakula (52.0%) na wanawake kutoka kwa kaya zisizo na usalama wa chakula (29.7%) (p < 0.001) na kati ya watumiaji wa kawaida wa njia za kisasa za kuzuia mimba, kiwango cha kuacha ni cha juu kwa wanawake kutoka kwa kaya zisizo na usalama wa chakula (50.5%) ikilinganishwa na wanawake kutoka kwa kaya zenye usalama wa chakula (36.9%) (p = 0.003). Kwa mujibu wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti. Baada ya kurekebisha vigezo vingine vyote katika mfano wa kurudi nyuma kwa vifaa vya multivariable, ukosefu wa usalama wa chakula wa kaya, mahali pa kuzaa mtoto wa mwisho, dini ya mtoaji, kufunuliwa kwa vyombo vya habari, utunzaji wa kabla ya kuzaliwa (ANC), na majadiliano na mume kuhusu mbinu za kisasa za kuzuia mimba (MCM) ya mtoaji, zilihusishwa kwa kujitegemea na matumizi ya kisasa ya kuzuia mimba. Wanawake kutoka kwa familia zilizo na usalama wa chakula walikuwa na uwezekano wa mara 1.7 zaidi wa kutumia MCM ikilinganishwa na wanawake kutoka kwa familia zisizo na usalama wa chakula [adjusted odds ratio (AOR) 1.69 (interval ya uaminifu (CI) 1.032.66). Kwa wanawake ambao walikuwa na angalau moja ya ANC kufuatilia walikuwa karibu mara tano zaidi ya uwezekano wa kutumia MCM ikilinganishwa na wanawake ambao hawana ANC ziara [AOR: 4.55, IC: 2.45]. Kwa upande wa mahali pa kujifungua, uwezekano wa kutumia MCM hupungua kwa 92% kwa wanawake ambao walifungua mtoto wao wa mwisho nyumbani ikilinganishwa na kujifungua kwa taasisi (AOR: 0.08; CI: 0.03; 0.13). Kufunuliwa kwa vyombo vya habari pia kuna athari kubwa juu ya matumizi ya MCM. Wanawake ambao wamekuwa na angalau moja ya vyombo vya habari katika miezi sita iliyopita walikuwa karibu mara tano zaidi ya kutumia MCM kuliko wale ambao hawana historia ya mfiduo [AOR: 4.92 (CI: 1.84; 13.79). Kwa mujibu wa ripoti ya utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti wa utafiti. Zaidi ya asilimia 93 ya njia hizo zilikuwa za kisasa. 27 kwa asilimia 29 Karibu asilimia ishirini na tano ya wanawake waliooa sasa wana mahitaji yasiyotimizwa ya huduma za kupanga familia. Katika utafiti huu, kiwango cha matumizi ya njia za kisasa za kuzuia mimba ni cha juu zaidi kuliko kiwango cha kitaifa na kikanda cha kuenea kwa njia za kuzuia mimba. Pia ni ya juu zaidi kuliko kuenea katika eneo la vijijini la Butajira kutoka kwa utafiti wa awali uliofanywa juu ya sababu za matumizi ya chini ya mipango ya familia na mahitaji ya juu yasiyotimizwa. Kwa mujibu wa utafiti huo, huduma za afya za mama kama vile utoaji wa watoto na utoaji wa watoto katika taasisi za matibabu pia ni za juu kuliko kiwango cha kitaifa. Utafiti huo ulionyesha kuwa wanawake kutoka kwa familia zenye usalama wa chakula walikuwa na uwezekano wa kutumia njia za kisasa za kuzuia mimba mara 1.7 zaidi kuliko wanawake kutoka kwa familia zenye ukosefu wa usalama wa chakula. Ingawa hakuna utafiti ulioonyesha uhusiano kati ya ukosefu wa usalama wa chakula na matumizi ya njia za kisasa za kuzuia mimba, baadhi ya masomo ya awali yanaonyesha kwamba wanawake maskini walikuwa na uwezekano mdogo wa kutumia njia za kisasa za kuzuia mimba na wanawake wenye mapato ya juu walikuwa na uwezekano mkubwa wa kutumia njia za kuzuia mimba ikilinganishwa na wanawake maskini. Katika utafiti uliofanywa juu ya matumizi ya huduma za mipango ya familia na wanawake wa Sudan walioolewa wa umri wa kuzaa; wanawake wenye hali ya juu ya kijamii na kiuchumi waligunduliwa kuwa na uwezekano mkubwa wa kutumia mbinu za kisasa za mipango ya familia kuliko wenzao. Kwa kuongezea hii wakati watu maskini hutumia njia za kisasa za kuzuia mimba, viwango vyao vya kuendelea pia mara nyingi ni vya chini. Katika idadi ya wanawake wanaotumia njia za kuzuia mimba za kisasa, asilimia 50.5 walikuwa wameacha kutumia njia za kuzuia mimba za kisasa, ikilinganishwa na asilimia 36.9 tu ya wanawake wanaotumia njia za kuzuia mimba za kisasa. Utafiti huo una athari kubwa hasa nchini Ethiopia, ambayo ni moja ya nchi zenye ukosefu mkubwa wa usalama wa chakula duniani, na ina matatizo katika vipimo vyote muhimu vya usalama wa chakula, ambapo mmoja kati ya Wateo kumi ana ukosefu wa usalama wa chakula. Kwa kuwa karibu nusu ya watu wake ni chini ya umri wa miaka 15 na kiwango cha wastani cha uzazi ni karibu watoto watano kwa kila mwanamke, idadi ya watu wa Ethiopia ni ya tano kwa kasi zaidi ulimwenguni. Matokeo ya pamoja ya kuenea kwa ukosefu wa usalama wa chakula na idadi ya vijana na uwezekano wa kuongezeka kwa idadi ya watu, inatoa hoja juu ya haja ya kubuni mikakati sahihi ya kuingilia kati ili kukuza matumizi ya mbinu za kisasa za kupanga familia, haswa katika maeneo ya ukosefu wa usalama wa chakula, ili kuzuia athari mbaya za synergistic za shida zote mbili. Utafiti huo pia uligundua kuwa wanawake ambao wanajadili na waume zao walikuwa karibu mara tatu zaidi ya kutumia njia ya kisasa ya kuzuia mimba. Majadiliano ya ndoa juu ya mipango ya familia na mazoea ya kuzuia mimba yaliandikwa kuwa muhimu kwa kukubalika kwa mazoea ya kuzuia mimba na kupunguza nia ya uzazi wa wenzi katika nchi zinazoendelea [23, 24]. Utafiti uliofanywa kuhusu ufahamu na mambo yanayoamua mazoea ya kupanga familia huko Jimma, Ethiopia ulionyesha kuwa asilimia ya wanawake waliotumia njia za kisasa za kuzuia mimba ilikuwa kubwa zaidi miongoni mwa wale ambao walikuwa wamejadili mipango ya familia na waume zao kuliko wale ambao hawakuwa wamefanya hivyo; kwa makubaliano na utafiti uliofanywa huko Butajira ambao ulionyesha uhusiano mzuri kati ya majadiliano ya wanandoa juu ya mipango ya familia na kuzuia mimba. Matumizi ya huduma nyingine za afya kama vile kuhudhuria kabla ya ANC, huduma ya baada ya kuzaliwa (PNC), na kuzaa katika taasisi ya afya na kuhudhuria huduma za chanjo ziligunduliwa kuwa na uhusiano muhimu wa takwimu na matumizi ya sasa ya njia za kuzuia mimba za kisasa. Katika utafiti huu, uchunguzi wa ANC na utoaji wa taasisi uligunduliwa kuwa muhimu kwa takwimu. Kwa mujibu wa utafiti wa utafiti wa utafiti wa Ugonjwa wa Ugonjwa wa Ugonjwa wa Ugonjwa wa Ugonjwa wa Ugonjwa wa Ugonjwa wa Ugonjwa wa Ugonjwa wa Ugonjwa wa Ugonjwa wa Ugonjwa wa Ugonjwa wa Ugonjwa wa Ugonjwa wa Ugonjwa wa Ugonjwa wa Ugonjwa wa Ugonjwa wa Ugonjwa wa Ugonjwa wa Ugonjwa wa Ugonjwa wa Ugonjwa wa Ugonjwa wa Ugonjwa wa Ugonjwa. Wanawake wanaozaa katika taasisi za afya wanaweza kupata habari zaidi za mipango ya familia kuliko wale wanaozaa nyumbani. Taarifa kuhusu ufikiaji wa umma kwa ujumbe kupitia njia fulani inaruhusu watengenezaji wa sera kuhakikisha matumizi ya njia bora zaidi za mawasiliano kwa makundi mbalimbali ya lengo katika idadi ya watu na ni moja ya sababu za kuwezesha matumizi sahihi ya njia ya kisasa ya kuzuia mimba. Wanawake ambao wamekuwa wakikabiliwa na vyombo vya habari walikuwa na uwezekano wa mara tano zaidi wa kutumia njia ya kisasa ya kuzuia mimba. Katika utafiti uliofanywa katika mji wa Wolaita Soddo kusini magharibi mwa Ethiopia, wanawake ambao wana redio na televisheni walikuwa karibu mara tatu zaidi ya kutumia njia ya kuzuia mimba ikilinganishwa na wale ambao hawana. Utafiti wa ujuzi wa mipango ya familia na matumizi ya sasa ya njia za kuzuia mimba miongoni mwa wanawake wa asili wa Mru nchini Bangladesh pia unaonyesha kuwa wanawake ambao wamekuwa na mawasiliano na vyombo vya habari walikuwa na uwezekano wa mara sita zaidi wa kutumia njia za kuzuia mimba. Utafiti uliofanywa juu ya sababu zinazoathiri matumizi ya njia za kuzuia mimba miongoni mwa wanawake vijana katika makazi ya mijini ya Karachi, Pakistan, ulisema kuwa wanawake walikuwa na uwezekano mkubwa wa kutumia njia za kuzuia mimba wakati ujumbe wa mipango ya familia ulipopelekwa kupitia vyombo vya habari. "Katika sera ya afya ya kitaifa ya Ethiopia, ""kutoa kipaumbele cha juu kwa demokrasia na kutokuwa na mamlaka ya huduma za afya"" na moja ya malengo ya Wizara ya Afya, kuhusiana na kuboresha afya ya mama na mtoto, ni kuongeza kiwango cha kuenea kwa njia za kuzuia mimba kwa asilimia 66 ifikapo mwaka 2015." Utafiti huu ulionyesha kwamba ukosefu wa usalama wa chakula wa kaya huathiri sana matumizi ya njia ya kisasa ya kuzuia mimba na kuendelea kwake. Kwa hiyo, mpango wowote, iwe ni wa serikali au wa kiserikali, ambao unataka kuboresha matumizi ya njia za kisasa za kuzuia mimba na kuendelea kwake, unapaswa kuzingatia hali ya usalama wa chakula wa eneo hilo wakati wa kupanga huduma ya mipango ya familia na unapaswa kufanya kazi kwa ushirikiano na ofisi za kilimo. "Kama ilivyoelezwa, ""muhimu wa kuimarisha ushiriki wa wanawake katika shughuli za uzalishaji kama vile programu ya ""Productive Safety Net"" ambayo inafanywa nchini humo kwa lengo la kuwawezesha maskini wa vijijini wanaokabiliwa na ukosefu wa usalama wa chakula kukabiliana na mshtuko, kuunda mali na kuwa na chakula cha kujitegemea." Ofisi ya Afya ya Woreda inapaswa pia kutoa msisitizo kwa matumizi ya kisasa ya kuzuia mimba inayohusiana na huduma za afya ya uzazi kama vile ANC na mahali pa kujifungua. Ufuatiliaji wa ANC na uzazi wa taasisi unaonyesha uboreshaji mkubwa katika matumizi ya njia ya kisasa ya kuzuia mimba. Kwa hiyo kuboresha kiwango cha kufuatilia ANC na utoaji wa taasisi inaweza kuboresha sana matumizi ya mbinu ya kisasa ya kuzuia mimba. Kuongeza uelewa juu ya umuhimu wa kujadili suala la afya ya uzazi kwa mama na waume zao na kuwahimiza wanawake katika majadiliano juu ya mbinu za kisasa za kuzuia mimba na wataalamu wa afya. Nguvu na kikomo Hakukuwa na non-mjibu kutoka sampuli na wote wa watu uwezekano kuchaguliwa walikuwa mahojiano. Utafiti huo ulikuwa wa kulinganisha na juhudi zilifanywa kuonyesha tofauti katika sifa tofauti za waliohojiwa katika vikundi viwili. Kwa kudhibiti kwa ajili ya confounders kama iwezekanavyo, tofauti katika matumizi ya MCM kati ya makundi mawili ilitathminiwa. Tunakubali kwamba kuna mapungufu kadhaa katika utafiti wetu. Ingawa tulitumia chombo cha kawaida kutathmini hali ya usalama wa chakula kunaweza kuwa na uwezekano wa baadhi ya uainishaji mbaya. Kiwango cha Upatikanaji wa Usalama wa Chakula cha Nyumba hupima ukosefu mkubwa wa usalama wa chakula kwani inauliza upatikanaji wa chakula ndani ya mwezi mmoja uliopita. Kwa kuongezea, uchambuzi wetu ulitegemea data ya msalaba, wakati data inayokamata mwenendo wa msimu inahitajika kuelewa kikamilifu uhusiano kati ya matumizi ya kisasa ya uzazi na ukosefu wa usalama wa chakula wa kaya. Uwezo wa data ya msalaba pia hupunguza uwezo wetu wa kutoa hitimisho lolote la kisababishi, yaani. Kutotumia njia za kisasa za kuzuia mimba kunaweza kusababisha idadi kubwa ya familia na kusababisha ukosefu wa usalama wa chakula. Kwa ujumla, utafiti huo ulionyesha kwamba ukosefu wa usalama wa chakula ni kizuizi kikubwa kwa matumizi ya mbinu za kisasa za kuzuia mimba. Kwa mujibu wa ripoti hiyo, wanawake kutoka familia zenye uhaba wa chakula wana uwezekano mdogo wa kutumia huduma nyingine za uzazi kama vile utunzaji wa kabla ya kujifungua na kujifungua katika taasisi. Hatua za usalama wa chakula zinapaswa kuunganisha mikakati sahihi ya kuongeza matumizi ya mbinu za kisasa za kuzuia mimba katika maeneo yasiyo na usalama wa chakula. "Mfumo wa Umoja wa Mataifa wa Chakula na Kilimo (FAO) unaoongoza katika ""Mipango ya Utaratibu wa Familia ya Kisasa"" (Mipango ya Utaratibu wa Familia ya Kisasa) na ""Mipango ya Utaratibu wa Utaratibu wa Utaratibu wa Utaratibu wa Utaratibu wa Utaratibu wa Utaratibu wa Utaratibu wa Utaratibu wa Utaratibu wa Utaratibu wa Utaratibu wa Utaratibu wa Utaratibu wa Utaratibu wa Utaratibu wa Utaratibu wa Utaratibu wa Utaratibu wa Utaratibu wa Utaratibu.""" Uendelevu wa mazingira kwa kupunguza kasi ya ukuaji wa idadi ya watu. Psychol. (Mwanamke mwenye akili mbaya) Kudumisha. Dev. (Mwanamume wa Mungu) 2002b; 209 <unk>238. Bremner J. Idadi ya watu na usalama wa chakula: Africas chalenge [Internet]. Mwaka 2012 "Kama ilivyoelezwa katika taarifa ya ""Publications Report 2012: Population, Food Security, Africa, Part 1,"" ilitumwa na: www.philanthropy.org." Mambo ya Kuhusu Kupanga Familia [Internet]. Durham, North Carolina: Utangazaji kwa ajili ya Mabadiliko Project; 2013. "Kama ilivyoelezwa katika makala ya ""Mfumo wa Usimamizi wa Familia"" ya Fahdusi S. S. S., ""Uhitaji wa Usimamizi wa Familia miongoni mwa Wanawake wa Vijijini nchini Bangladesh.""" Dhaka MedColl. 2010;19(1):115. Taifa la Umoja. Hakuna Kichwa. <unk>Tangazo la Tehran.<unk> Hatua ya Umoja wa Mataifa F. Hum. Haki. New York, Marekani, 1974 Bandarage A. <unk>Utaratibu wa Familia.<unk> [Intaneti]. Maelezo mapya. Historia. Mawazo. Encyclopedia.com; 2005. Encyclopedia.com: Encyclopedia.com: Encyclopedia.com. "Kama ilivyoelezwa katika ukurasa wa ""Encyclopedia of Family Planning"" (http: en.encyclopedia.org) na ""Family Planning"" (http: en.encyclopedia.org) ni muhimu sana." Mazur L. Taming Njaa nchini Ethiopia: Jukumu la Dynamics ya Idadi ya Watu _ New Security Beat. Wilson Cent. [Intaneti]. "Kama ilivyoelezwa katika taarifa ya ""Taming: Hunger in Ethiopia: The Role of Population Dynamics: Key Facts and Findings"" ya gazeti la habari la SecurityBeat." Kiwango cha Njaa Duniani [Internet]. Mwaka 2009 "Kama ilivyoelezwa katika ukurasa wa ""Mafunzo ya Utafiti"" (http: www.gci.org) na ""Mafunzo ya Utafiti"" (http: www.gci.org) na ""Mafunzo ya Utafiti"" (http: www.gci.org)." CSA IM Ethiopia: Uchunguzi wa Idadi ya Watu na Afya 2011 Addis Ababa, Kenya: CSA IM, 2012 TGE. Serikali ya Mpito ya EthiopiaSera ya Kitaifa ya Idadi ya Watu wa Ethiopia. Addis Ababa: TGE; 1993. Usalama wa Chakula, Maendeleo ya Vijijini ya Kudumu na Kilimo. Inapatikana kutoka: http: www.unmillenniumproject.org/reports/tf_hunger.htm Reichlin L. Embracing the Link: Today's Reproductive Health Choices and Tomorrow's Food Security. "Blog ya ""Ukosefu wa Chakula"" ya 2013" "Kama ilivyoelezwa katika makala ya ""Mtazamo wa Afya ya Ulimwenguni"" ya Aspen Institute, ""Mtazamo wa Afya ya Ulimwenguni"" ni ""Mtazamo wa Afya ya Ulimwenguni"" na ""Mtazamo wa Afya ya Ulimwenguni"" ni ""Mtazamo wa Afya ya Ulimwenguni.""" Donna Clifton, Toshiko Kaneda Mpango wa Familia Ulimwenguni Pote. 2008 Data Sheet Watu wengi. 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""Uhusika wa Wanaume katika Mpango wa Familia: Maombi ya Mfano wa Transtheoretical katika Wolaita Soddo Town Kusini mwa Ethiopia.""" 2010;2:4(2)50 Islam MR, Thorvaldsen G. Maarifa ya kupanga familia na matumizi ya sasa ya uzazi kati ya wanawake wa asili wa Mru nchini Bangladesh: uchambuzi wa multivariate. Kufungua upatikanaji J Contract. 2012;3:916. Hijazi HH. Sababu zinazoathiri matumizi ya njia za kuzuia mimba miongoni mwa wanawake wa umri wa kuzaa katika Jordan Kaskazini: Mfumo wa Hatua za Sera ya Afya. Chuo Kikuu cha Jimbo la Oregon; 2012. p. 1<unk>202. Tunapenda kumshukuru Chuo Kikuu cha Jimma, Chuo cha Afya ya Umma na Sayansi za Matibabu kwa kufadhili utafiti huu. Tunashukuru sana kwa wasimamizi, wakusanyaji wa data na waliohojiwa ambao walishiriki katika utafiti huu. Tunapenda pia kumshukuru ofisi ya utawala ya Soddo Zuria Woreda. Mwishowe tunamshukuru pia Mheshimiwa Hailesilasie Beyene, kutoka Chuo Kikuu cha Jimma, mtaalamu wa lugha ya Kiingereza ambaye alikagua makala hiyo kwa ajili ya toleo la lugha. Waandishi wanatangaza kwamba hawana maslahi yanayopingana. Mfumo wa utafiti ulibuniwa na kubuniwa, ulifanya uchambuzi na tafsiri ya data na ukaguzi muhimu wa hati. T.B. na T.A. walisaidia katika kubuni, kuchambua, kutafsiri data na kuunda hati na kukagua makala hiyo. Alisaidia katika uchambuzi, tafsiri na katika kuandaa na kukagua hati. Waandishi wote walisoma na kuidhinisha hati ya mwisho. Kuhusu makala hii Namba makala hii Feyisso, M., Belachew, T., Tesfay, A. et al. Uwezekano wa kutumia njia za kuzuia mimba za kisasa kwa kiwango cha usalama wa chakula miongoni mwa wanawake walioolewa katika umri wa kuzaa katika eneo la Wolaita, kusini mwa Ethiopia. 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