CONTRACEPTIVE METHOD MIX
1.3.3 COMPARISON OF INJECTABLE CONTRACEPTIVE USERS WITH DISCONTINUED USERS AND THOSE WHO HAD NEVER USED THE
1.3.3.1 Comparing Demographic Characteristics
1.3.3 COMPARISON OF INJECTABLE CONTRACEPTIVE USERS WITH
Table 1.3.3 Comparative demographic characteristics according to IPC user status
*
byCIvl1, religious,traditional or customary ceremony**
partner recently died or left***
of those married orina stable relationshipDemographic Characteristic Current Previous Never
Users Users Used
N=187 N=244 N=417
Age (years)
Mean (SD) 26.1 (5.9) 28.6 (7.2) 25.1 (8.4)
Range 17-49 17-48 15-48
Education level grade 8 or above (%) 75.3 58.7 64.5
Employment status (%)
Employed (formal or informal) 8.6 9.5 8.0
Housewife/pensioner 10.7 16.9 11.6
Students/scholars 19.7 11.9 32.9
Unemployed 61.0 61.7 47.4
Average household income of ZAR1 000 per month or<(%) 91.6 92.4 92.2
Average household size 8.5 8.3 7.9
Range of household size 2-25 2-18 2-25
Marital status (%)
Married* 13.4 19.7 17.3
Stable relationship 77.5 64.3 52.8
Single, casual relationships 7.0 6.6 8.9
No relationship 2.1 ** 9.4 8.4
Never had a relationship
- -
12.7Proportion with partners residing with respondent*** 11.8 20.0 9.8 Proportion with migrant partners (i.e. living outside the 76.3 59.0 69.2 district)***
Proportion of migrant partners who did not return home for a 61.1 81.0 79.9 month or longer
. . . . ..
A logistic regression analysis which explores associations between current use of IPCs and demographic variables is described later in this chapter (sub-section 1.3.3.3).
1.3.3.2 Comparing Reproductive and Contraceptive History Pregnancy History
Forty percent of those who had never used the injectable method had never been pregnant. Ofthose who had never used IPCs and who had ever been sexually active, 31.3% had never been pregnant. By comparison, very few of the current IPC users and previous users had never been pregnant (3.2% and 4.1% respectively) (Table 1.3.4).
Table 1.3.4 Comparative reproductive history by IPC user status
* The ropeISa traditional contraceptive method obtained from a faith healer or a traditional healer . According to a male traditional leader who participated in the group discussions,a few threads from a mule's tail are used to make a rope. The woman ties this rope around her waist to prevent pregnancy.
Reproductive History Current Previous Users Never Used
Users N=244 N=417
N=187 Pregnancy history
%never pregnant 3.2 4.1 40.0
%never pregnant (of those ever sexually active) - - 31.3
Number pregnant at time of interview - 25 23
Number unsure if pregnant at time of interview - 7 8
Age at first pregnancy (years)
Mean (SD) 19.2(2.8) 18.8 (2.7) 19.6 (3.3)
Range 12-30 12-31 13-31
%<20 years who were or had been pregnant 96.2 82.4 24.4
(p=0.000)
% first pregnant< 16 years (of those ever pregnant) 7.2 9.8 12.5
%first pregnant<20 years (of those ever pregnant) 60.2 63.8 53.1 Parity
Mean number ofliving children (total sample) 1.9 2.2 1.4
Mean number of living children (of those ever 2.0 2.4 2.3
pregnant)
Maximum number ofliving children 7 10 10
% with one child (of total sample) 48.7 38.9 25.2
% with more than one child 44.9 54.1 29.7
Contraceptive history
Ever used a contraceptive method (%) 100 100 18.2
Ever used a contraceptive method (% of those ever 100 100 21.5 sexually active)
Age at first contraceptive use (years)
Mean (SD) 22.3 (4.9) 22.0 (5.2) 20.1 (3.3)
Range 16-42 14-41 15-34
First contraceptive method used n=187 n=244 n=74
IPC 90.4 94.3 -
OC 9.1 5.7 71.6
Male condom 0.5 0 2.7
Female condom 0 0 1.4
IUD 0 0 2.7
Tuballigation 0 0 1.4
Thigh sex 0 0 10.8
Withdrawal 0 0 2.7
Rope* 0 0 1.4
Quinine 0 0 2.7
Essence of life 0 0 1.4
Other . . - - 1.4
109
Most of those who were in the group that had never used IPCs and who had never been pregnant were under 20 years (60.5%). By contrast, few who had been pregnant were under 20 (13.6%) (Figure 1.3.4).
Figure 1.3.4 Pregnancy history of women who had never used IPCs Never used IPCs
n=417
40% never pregnant (31.3% of sex active ~)
• 60.5% < 20 years
60% pregnant at some time
• 13.6%<20 years
Just over two thirds (68.2%) ofthose who had never used an IPC and who had never been pregnant,had had a relationship at some time. Those who had never been pregnant and had never had a relationship (31.8%), were particularly young -- 84.9% were under 20 years and 58.5% were 15,16 or 17 years old (9 were 15 years, 12 were 16 years and 10 were 17 years old).
Figure 1.3.5 shows that many of the non-users who were under 20 had never been pregnant (74.8%) in contrast to the very few under 20s in the IPC user group (3.8%) and the discontinued user group (11.8%) who had never been pregnant.
Figure 1.3.5 Percentage never pregnant, within age group, by IPC user status
80
-
cca 7060 cC) 50
e
Q. 40
~
Q)
>Q) 30
c
?fl. 20 10
O +",~-'--,J~'-'-,--""'"--".---'--r-...,--.---,
<20 20-24 25-29 30-34 35-39 40-44 45-49 Age (years)
IPC users
• Previous users
o
Never usedMany of the IPC users and discontinued users were first pregnant before they turned 20 (60.2% and 63.4% respectively),compared to only 53.1% ofthe ever sexually active non- users (Table 1.3.4). Mean age at first pregnancy was similar for the 3 user categories (Table 1.3.4).
Relatively few respondents reported that they had ever had difficultyin conceiving:
• 0.5% of current IPC users
• 0.8% of previous IPC users
• 3.9% ofthose who had never used the injectable.
Slightly more women were unsure about whether or not they had a fertility problem:
• 1.2% of current IPC users
• 0.8% of previous IPC users
• 7.3% ofthose who had never used the injectable.
111
Parity
More IPC users had only one child than the other user categories (Table 1.3.4 and Figure 1.3.6), and many of those who had never used the injectable had no children.
Figure 1.3.6 Distribution of number of children by IPC user category 60
50 40
~ 30 20 10
o
+,",,- -'-r-'"o
1 2 3 4 5+mIPCusers
• Previous users
oNever used
Number of children
Whilst many current and discontinued IPC users in the under 20 year age group had only one child, fewer teenagers who had never used the injectable had one child (Figure 1.3.7).
Bearing in mind however that many non-users,particularly those under 20 years, had never been pregnant (Figure 1.3.6).
Figure 1.3.7 Percentage with one child by age and IPC user category 100
::s
80... -=
~ 60- -= -
.~ 40~ 20
e
0
BiIIPC users
• Previous users
o
Never used<20 20-24 25-29 30-34 35-39 40-44 45-49
Age group (years)
Contraceptive History
Very few of those who had never used the injectable had ever used any method of
contraception (18.2%)(Table 1.3.4). Excluding those who had never been sexually active, 21.5% of those who had never used an IPC had ever used any contraceptive method -- most often the oral hormonal contraceptive method which was the first method used by 71.6%. The oral contraceptive was the first method for far fewer current IPC users and discontinued IPC users (Table 1.3.4). A greater mix of first contraceptive methods is evident for those never having used the injectable method, including a wide range of traditional methods - thigh sex,withdrawal, rope (Table 1.3.4) and substances not
registered with the Medicines Control Council as contraceptives (quinine, essence of life).
Mean age at first contraceptive use was similar for the 3 user categories, and, particularly for users and discontinued users,was higher than mean age at first pregnancy (Table 1.3.4).