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Correlates of mistimed and unwanted pregnancy among women in the Democratic Republic of Congo.

Authors
  • Adhikari, Tara Ballav1, 2
  • Acharya, Pawan1
  • Rijal, Anupa1, 3
  • Mapatano, Mala Ali4
  • Aro, Arja R5
  • 1 Nepal Health Frontiers, Maharajgunj, Kathmandu, Nepal. , (Nepal)
  • 2 Department of Public Health, Aarhus University, Aarhus, Denmark. , (Denmark)
  • 3 Department of Regional Health Research, University of Southern Denmark, Denmark. , (Denmark)
  • 4 School of Public Health, University of Kinshasa, Democratic Republic of Congo. , (Congo - Kinshasa)
  • 5 Faculty of Health Sciences, Unit for Health Promotion Research, University of Southern Denmark, Esbjerg, Denmark. , (Denmark)
Type
Published Article
Journal
Journal of Biosocial Science
Publisher
Cambridge University Press
Publication Date
May 01, 2020
Volume
52
Issue
3
Pages
382–399
Identifiers
DOI: 10.1017/S0021932019000518
PMID: 31409440
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Unwanted and mistimed pregnancies impose threats on the health and well-being of the mother and child and limit the acquisition of optimal sexual and reproductive health services, especially in resource-constrained settings like the Democratic Republic of Congo (DRC). This study aimed to determine the prevalence and correlates of mistimed and unwanted pregnancies among women in the DRC. Data were drawn from the 2013-14 DRC Demographic Health Survey (EDS-RDC II). Bivariate and multivariate logistic regression analysis was performed to identify correlates of mistimed and unwanted pregnancies. Sequential logistic regression modelling including distal (place of residence), intermediate (socio-demographic and socioeconomic factors) and proximal (reproductive health and family planning) factors was performed using multivariate analysis. More than a quarter (28%) of pregnancies were reported as unintended (23% mistimed and 5% unwanted). Women who wanted no more children (aOR 1.21; CI: 1.01, 1.44) had less than 24 months of birth spacing (aOR 2.14; CI: 1.80, 2.54) and those who intended to use a family planning method (aOR 1.24; CI: 1.01, 1.52) reported more often that their last pregnancy was mistimed. Women with five or more children (aOR 2.13; CI: 1.30, 3.49), those wanting no more children (aOR 13.07; CI: 9.59, 17.81) and those with more than 48 months of birth spacing (aOR 2.31; CI: 1.26, 4.23) were more likely to report their last pregnancy as unwanted. The high rate of unintended pregnancies in the DRC shows the urgency to act on the fertility behaviour of women. The associated intermediate factors for mistimed and unwanted pregnancy indicate the need to accelerate family planning programmes, particularly for women of high parity and those who want no more children. Likewise, health promotion measures at the grassroots level to ensure women's empowerment and increase women's autonomy in health care are necessary to address the social factors associated with mistimed pregnancy.

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