Current Practices of Contraceptive Use Among Palestine Refugee Mothers of Young Children Attending UNRWA Clinics, A Follow Up Study 2015
Bibliographic record
Abstract
Background: UNRWA introduced family planning services in 1994 as an integral part of its expanded maternal and child health care program. The main objective of UNRWA’s family planning program is to promote the health of mothers, children and subsequently their families. Objective: The ultimate objective of this follow-up study was to assess the current situation regarding contraceptive practices among the target population after five years from the 2010 follow-up study and to identify future program needs leading to the development of action-oriented activities. Methods: A cross-sectional survey was conducted by trained nurses from June - December 2015. Participants were Palestine refugee mothers who attended well-baby clinics with their youngest child (aged 2 months through 5 years) at all UNRWA health centers. A sample size of 10478 participants was calculated based on contraceptive use prevalence in 2010, using Epi Info sample size calculation. Mothers were interviewed and retrospective data from health records was used as supplement. All participants provided verbal informed consent. The study protocol approved and cleared by UNRWA health department ethical committee. A multiple logistic regression was performed to test if maternal age and parity predicted contraceptive use. Chi- square was used to analyze the relationship between previous contraceptive use and birth interval, birth weight, and gestational age. Results: Data was obtained from 9860 mothers, with a mean age of 29.8 years. Of them, 59.3% were using modern contraceptives at the time of the survey, 17.7% were using traditional methods, and 23.0% were not using any contraceptive method. The most common modern contraceptive was intrauterine device (37.4%), and UNRWA was the main provider for 82.6% of women currently using modern contraceptives. The most common reasons for not using contraceptives were child wish (21.7%), pregnancy (18.6%) and husband opposition (19.7%). Using women with 6 pregnancies (P<0.001; OR 1.6, [CI 1.28 ± 1.99]). Women with at least 1 male child are significantly more likely to use contraceptives (P<0.001; OR 1.39 [CI 1.24 ± 1.56]). Maternal age over 35 was not a significant predictor for modern contraceptive use. Chi-square used to test the association of modern contraceptive use prior to pregnancy with birth weight, the result showed statistically significant 23.88 (P<0.001) while gestational age was not a significant in the child born of that pregnancy. Conclusions: It is encouraging that mothers seeking modern contraceptives rely on UNRWA to provide family planning services. We found that mothers with higher parity are more likely to use modern contraceptives, which comply with UNRWA recommendations. As expected, modern contraceptives lead to better birth spacing. However, mothers above 35 years of age are not more likely to use modern contraceptives. These mothers may be at higher risk for negative maternal and infant health outcomes. UNRWA family planning services could focus more on counseling this group of mothers.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".