سیاست‌های مشوق باروری و نقش آن در الگوی استفاده از روش‌های پیشگیری از بارداری در زنان سنین باروری شهر سنندج، سال 1395

نوع مقاله: اصیل پژوهشی

نویسندگان

1 دانشیار گروه جمعیت و سلامت، مؤسسه مطالعات و مدیریت جامع و تخصصی جمعیت کشور، تهران، ایران.

2 کارشناس ارشد جمعیت‌شناسی، دانشکده علوم اجتماعی علامه طباطبایی، دانشگاه علامه طباطبایی، تهران، ایران.

چکیده

مقدمه: در پاسخ به روند سریع کاهش باروری در ایران در دهه‌های اخیر، سیاست‌های مشوق باروری در اردیبهشت ماه سال 1393 ابلاغ گردید و تغییرات مهمی در محدود‌کردن برنامه‌های تنظیم خانواده در کشور رخ داده است، در حالی‌که مشخص نیست این سیاست‌ها چه تأثیری در الگوی استفاده از روش‌های پیشگیری از بارداری داشته است. مطالعه حاضر با هدف تعیین نقش سیاست‌های مشوق باروری در الگوی استفاده از روش‌های پیشگیری از بارداری و همچنین نگرش زنان در خصوص تغییر در دسترسی، کیفیت، هزینه و ترویج روش‌های پیشگیری از بارداری پس از معرفی سیاست‌های فوق انجام شد.
روش‌کار: این مطالعه توصیفی- تحلیلی و مقایسه‌ای، یک پیمایش مبتنی بر جمعیت است که در تابستان 1395 در بین 454 زن 49-15 ساله همسردار در شهرستان سنندج انجام شد. گردآوری داده‌ها با استفاده از پرسشنامه محقق‌ساخته انجام گرفت. آخرین روش پیشگیری در پیمایش سنندج (نمونه: 454 زن) با داده‌های متناظر در پیمایش جمعیت و سلامت استان کردستان (نمونه: 260 زن) در سال 1389 مقایسه گردید. همچنین نگرش زنان سنندج در خصوص تغییرات در عرضه، کیفیت و هزینه روش‌های پیشگیری از بارداری بررسی شده و عوامل مرتبط با نگرش زنان با استفاده از آزمون‌های تی تست و کای دو مورد تحلیل قرار گرفت. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته‌ها: این بررسی نشان داد که در دوره 95-1389، شیوع روش‌های مدرن از 2/81% به 7/64% کاهش یافته بود، درحالی‌که شیوع روش منقطع از 19% به 36% افزایش و برعکس لوله ‌بستن زنان از 4/24% به 4% کاهش یافته بود. همچنین استفاده از IUD و کاندوم افزایش واضحی را نشان می‌داد (به ترتیب از 19% به 3/26% و از 11% به 1/15%). در پیمایش 1395، دسترسی، کیفیت و ترویج و اطلاع‌رسانی روش‌های پیشگیری کاهش یافته و هزینه‌ تهیه روش‌های پیشگیری از نگاه زنان سنین باروری نسبت به 2 سال قبل، افزایش یافته بود. زنان از طبقات اجتماعی اقتصادی پایین‌تر، نگرانی بیشتری از افزایش هزینه و کاهش کیفیت روش‌های پیشگیری داشتند.
نتیجه‌گیری: الگوی روش‌های پیشگیری از بارداری از روش‌های مطمئن به روش‌های غیرمطمئن تغییر کرده است. عواقب بهداشتی نامطلوب محدودیت تنظیم خانواده متعاقب سیاست‌های جدید بر اقشار آسیب‌پذیر جامعه بیشتر خواهد بود که نیازمند توجه سیاست‌گذاران سلامت و مداخلات مناسب می‌باشد.

کلیدواژه‌ها


عنوان مقاله [English]

Pronatalist Policies and its Role in Pattern of Contraceptive Methods among Women in Reproductive Age in Sanandaj City, 2016

نویسندگان [English]

  • Farideh Khalajabadi Farahani 1
  • Shahram Khazani 2
1 Associate professor, Department of Population and Health, National Population Studies & Comprehensive Management Institute, Tehran, Iran.
2 M.Sc. in Demography, Allameh Tabatabaie School of Social Sciences, Allameh Tabatabaie University, Tehran, Iran.
چکیده [English]

Introduction: In response to rapid fertility reduction over the recent decades in Iran, pronatalist policies was introduced in 2014 and significant changes has occurred in the family planning programs in the country, while it is not clear enough what influences these policies have had on pattern of using contraceptive methods. This study was performed with aim to determine the role of pronatalist policies in the pattern of using contraceptive methods, as well as the attitudes of women towards changes in the access, quality, cost and advocacy of contraceptive methods after introduction of these polices.
Methods: This descriptive-analytic and comparison study is a population-based survey which was conducted among 454 married women aged 15-49 years in Sanandaj in 2016. Data collection was performed using a researcher-made questionnaire. Last contraception used (n=454) was compared to corresponding method used in the Demographic Health Survey of Kordestan (n=260) in 2010. The women’s attitude towards changes in the provision, quality and cost of contraceptive methods were evaluated and the factors associated to the women’s attitude were also assessed using t-test and Chi-square test. P<0.05 was considered statistically significant.
Results: Over the period of 2010-2016, the prevalence of modern methods was reduced from 81.2% to 64.7%, while the prevalence of withdrawal method increased from 19% to 36%. A reduction was shown in the prevalence of women's tubal ligation (from 24.4% to 4%). The prevalence of using IUD and condom was clearly increased from 19% to 26.3% and from 11% to 15.1%, respectively. In 2016 survey, a reduction was reported in the access, quality, and advocacy and informing of contraceptive methods and the cost of providing contraceptive methods had increased compared to two years ago from the viewpoints of women at reproductive age. Women from lower socio-economic status were more concerned of rising cost and reduced quality of contraceptive methods.
Conclusion: The pattern of contraceptive methods has been changed from safe to unsafe methods. Adverse health consequences of restriction of family planning due to new population policies will be greater for vulnerable groups of the society that needs more attention by health policymakers and appropriate interventions.

کلیدواژه‌ها [English]

  • Contraceptive methods
  • Iran
  • Pronatalist population policies
  • Sanandaj
  • Women
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