Women’s socio-demographic and cultural factors influencing unmet need for family planning in rural areas of The Gambia: Evidence from a population-based analytical cross-sectional study

Unmet need for Family planning

Socio-cultural and proximate factors

Yes (n=142)

No (n=422)

Total (N=564)

Chi-square

p-value

n (%)

n (%)

n (%)

Societies support on use of contraceptive methods

Yes

57 (23.8)

183 (76.3)

240 (100.0)

2.332

0.312

No

72 (27.9)

186 (72.1)

258 (100.0)

I don't know

13 (19.7)

53 (80.3)

66 (100.0)

Traditional /cultural beliefs against contraceptive usage

Yes

81 (24.1)

255 (75.9)

336 (100.0)

1.134

0.567

No

48 (28.1)

123 (71.9)

171 (100.0)

I don't know

13 (22.8)

44 (77.2)

57 (100.0)

Partner support on the use of contraceptive methods

Yes

22 (13.3)

143 (86.7)

165 (100.0)

18.087

<0.001*

No

75 (28.7)

186 (71.3)

261 (100.0)

I don't know

45 (32.6)

93 (67.4)

138 (100.0)

Who decides on contraceptive uptake (n=438)

Partner alone

39 (26.5)

108 (73.5)

147 (100.0)

20.944

<0.001*

Wife alone

18 (15.3)

100 (84.7)

118 (100.0)

Both wife and partner

14 (11.2)

111 (88.8)

125 (100.0)

Healthcare providers

7 (33.3)

14 (66.7)

21 (100.0)

Not using contraceptives

11 (40.7)

16 (59.3)

27 (100.0)

Contraceptives harmful or has side effects (n=438)

Yes

48 (18.6)

210 (81.4)

258 (100.0)

0.274†

No

41 (23.4)

134 (76.6)

175 (100.0)

I don't know

0 (0.0)

5 (100.0)

5 (100.0)

Contraceptives are beneficial (n=438)

Yes

81 (20.4)

316 (79.6)

397 (100.0)

0.018

0.893

No

8 (19.5)

33 (80.5)

41 (100.0)

Know about Contraceptives

Yes

89 (20.3)

349 (79.7)

438 (100.0)

24.558

<0.001*

No

53 (42.1)

73 (57.9)

126 (100.0)

Heard of Contraceptives

Yes

130 (24.1)

410 (75.9)

540 (100.0)

8.199

0.004*

No

12 (50.0)

12 (50.0)

24 (100.0)

Contraceptives are affordable

Yes

41 (136)

261 (86.4)

302 (100.0)

46.446

<0.001*

No

101 (38.5)

161 (61.5)

262 (100.0)

Sexually active

Yes

138 (24.7)

420 (75.3)

558 (100.0)

0.038†*

No

4 (66.7)

2 (33.3)

6 (100.0)

Frequency of sex

Every time (everyday)

0 (0.0)

11 (100.0)

11 (100.0)

0.062†

Most times (>once per week)

78 (23.7)

251 (76.3)

329 (100.0)

Occasionally (at least twice per month)

33 (26.4)

92 (73.6)

125 (100.0)

Rarely

28 (29.8)

66 (70.2)

94 (100.0)

Never

3 (60.0)

2 (40.0)

5 (100.0)

Used contraceptive before

Yes

30 (10.9)

246 (89.1)

276 (100.0)

58.735

<0.001*

No

112 (38.9)

176 (61.1)

288(100.0)

Frequency of using contraceptives

Every time

1 (12.5)

7 (87.5)

8 (100.0)

<0.001†*

Most times

3 (7.5)

37 (92.5)

40 (100.0)

Occasionally

6 (4.5)

127 (95.5)

133 (100.0)

Rarely

19 (21.6)

69 (78.4)

88 (100.0)

Never

113 (38.3)

182 (61.7)

295 (100.0)

Getting contraceptives when due

Yes

20 (9.0)

201 (91.0)

221 (100.0)

50.173

<0.001*

No

122 (35.6)

221 (64.4)

343 (100.0)

Discuss FP with partner

Yes

37 (16.4)

189 (83.6)

226 (100.0)

15.522

<0.001*

No

105 (31.1)

233 (68.9)

338 (100.0)

Reasons for not discussing with partners (n=338)

He does not approve of it

40 (29.9)

94 (70.1)

134 (100.0)

7.028

0.071

It is against cultural norms

36 (39.1)

56 (60.9)

92 (100.0)

He will regard me as a player

6 (15.8)

32 (84.2)

38 (100.0)

It’s against my religious beliefs

23 (31.1)

51 (68.9)

74 (100.0)

Preference of FP service provider

Female service providers for women

63 (27.9)

163 (72.1)

226 (100.0)

0.361†

Male service providers for men

13 (19.4)

54 (80.6)

67 (100.0)

Community Based Distributors

0 (0.0)

5 (100.0)

5 (100.0)

No sex preference

66 (24.8)

200 (75.2)

266 (100.0)

Person to contact about contraceptives

Husband/partner

22 (33.3)

44 (66.7)

66 (100.0)

0.478†

Relatives

11 (31.4)

24 (68.6)

35 (100.0)

Male friends

1 (10.0)

9 (90.0)

10 (100.0)

Female friends

26 (23.4)

85 (76.6)

111 (100.0)

Healthcare providers

80 (24.1)

252 (75.9)

332 (100.0)

my parents (mother)

2 (20.0)

8 (80.0)

10 (100.0)

Who decides on the number of children to have

Husband/partner

58 (27.9)

150 (72.1)

208 (100.0)

0.088†

Myself

42 (23.0)

141 (77.0)

183 (100.0)

Family/close relatives

1 (12.5)

7 (87.5)

8 (100.0)

Parents

8 (57.1)

6 (42.9)

14 (100.0)

Not in any relationship/marriage

2 (18.2)

9 (81.8)

11 (100.0)

God decides

31 (22.1)

109 (77.9)

140 (100.0)

Ever informed your partner of using contraceptives

Yes

32 (16.1)

167 (83.9)

199 (100.0)

13.508

<0.001*

No

110 (30.1)

255 (69.9)

365 (100.0)

What you do when you don’t have Contraceptives from clinics

Purchase from the pharmacy

31 (15.7)

167 (84.3)

198 (100.0)

<0.001†*

Use of alternative methods

1 (3.4)

28 (96.6)

29 (100.0)

Do not use any methods

74 (35.6)

134 (64.4)

208 (100.0)

Asked my partner to use protection

2 (28.6)

5 (71.4)

7 (100.0)

I wait for new supplies

34 (28.1)

87 (71.9)

121 (100.0)