Contraceptive Use Across Cultures: A Cross-Cultural Comparison of Contraceptive Use in Women Seeking Care at Sun Yat-sen University Hospital, China and Monduli District Hospital, Tanzania
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OBJECTIVE: The purpose of this study was to determine and compare contraceptive choices in women in China and Tanzania and to assess the factors associated with their contraceptive choice. STUDY DESIGN: A prospective cohort trial was performed at Sun Yat-sen University in Guangzhou, China (06/2013 - 08/2013) and the Monduli District Hospital in Monduli, Tanzania (08/2015 - 09/2015). Women were approached during either an inpatient or outpatient visit with an Obstetrics/Gynecology practitioner and asked to complete a survey in their native language (Mandarin or Kiswahili) after obtaining verbal consent. The survey included demographic and social data, socioeconomic status (SES), obstetric history, and contraceptive choice. Data were analyzed using Student’s T-test and Chi-square test for continuous and categorical data, respectively. A P<0.05 was considered statistically significant. RESULTS: During the study period, a total of 128 Chinese women and 61 Tanzanian women completed the survey. Most women chose to use condoms with very few women using long acting reversible contraceptives. However, in the Tanzania population, other popular methods of contraception included LARCs such as implants as well as injections. In addition, elective abortion rates were significantly higher in Chinese women than Tanzanian women (P <0.05). Chinese women <21 and >35 years of age used some form of contraception compared with women in the 21-35 year old range who were more likely to not use contraception, while very few Tanzanian women in the <21 had ever used contraceptives. In addition, those in higher socioeconomic classes/with higher education were less likely to use contraceptives in the Chinese population, but more likely to use contraceptives in the Tanzanian population. CONCLUSION: Contraceptive use in China and Tanzania was clearly influenced by many factors. The high rate of condom use compared to longer, more sustainable methods of contraception highlight a need for better contraception education in both developing countries.