Analysis the contraception usage and unmet needs of education and reproductive health in Hubei province, China

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The use of contraceptives less unwanted pregnancy and sexually transmitted infections(STIs) including HIV. And cause traditional attitudes towards sex, marriage and family have changed. It leads to a lack of caution about sex and pre-marital sex is more acceptable. Hence, the number of miscarriages caused by unwanted pregnancies has increased. People is going to settle many of sexual and reproductive health matters. Methods: This study, was conducted of about 103 counties in Hubei Province from August 2014 to July 2016, which used frequencies, percentage, mean, chi-square, logistic regression to analysis this data that collected from 17555 respondents. (IBM-SPSS v 25.0) Results: The results in this article describe more men (62.6%) received family planning services education than women (37.4%). And people who did not participate in family planning services education, 17.0% and 21.9% did not know about vasectomy and withdrew as a method of male contraception, respectively. Striking, up to 23.9% and 22.8% of people with or without participating in family planning services education had experienced contraceptive failure (pregnancy for example) in couple. Age, educational, occupational status and the number of living children were strongly associated with contraceptive failure within participating in family planning services education. Only age, place of residence and number of living children were significant associated with contraceptive failure without participating in family planning services education. The figure showed greatly unmet needs of education and reproductive health whether or not to accept family planning services education Conclusion: There is a huge difference in Knowledge and use of contraceptives, as well as unmet educational and reproductive health needs between those who participated in family planning services education and those who did not. That means people who participate in family planning services education got more about sexual and reproductive health education and understand the important of the family planning services. Therefore, it is necessary to provide family planning services for more people and regions to obtain a good understanding of contraceptives, sexual intercourse and unintended pregnancy. Sexual & Reproductive Medicine contraceptives abortion STIs Family planning services reproductive health knowledge Plain English Summary The use of contraceptives less unwanted pregnancy and sexually transmitted infections(STIs) including HIV. And traditional attitudes towards sex, marriage and family have changed. The number of miscarriages caused by unwanted pregnancies has increased. People is going to settle many of sexual and reproductive health matters. A cross-sectional study was conducted of about 102 counties in Hubei Province from August 2014 to July 2016. 17555 respondents aged 18-49 (female) and 20-60 (male) filled the questionnaire The results in this article describe up to 23.9% and 22.8% of people with or without participating in family planning services education had experienced contraceptive failure (pregnancy for example) in couple. Age, educational, occupational status and the number of living children were strongly associated with contraceptive failure within participating in family planning services education. Only age, place of residence and number of living children were significant associated with contraceptive failure without participating in family planning services education. The figure showed greatly unmet needs of education and reproductive health whether or not to accept family planning services education In conclusion : People who participate in family planning services education got more about sexual and reproductive health education and understand the important of the family planning services. Therefore, it is necessary to provide family planning services for more people and regions to obtain a good understanding of contraceptives, sexual intercourse and unintended pregnancy. Introduction The one-child policy has been in effect since 1980, family planning services mainly restricted to IUD and sterilization (tubal ligation) to control the population in china [ 1 ]. Indeed, family planning services settled many of sexual and reproductive health matters. Some studies show that early sex and subsequent unsafe behavior can increase the risk of STIs [ 6 – 8 ]. And the World Health Organization (WHO) also estimated that roughly 1 million people are infected with any of four curable sexually transmitted infections every day(including chlamydia, gonorrhea, syphilis, and trichomoniasis) [ 9 ]. However, in recent decades, contraceptives have developed rapidly, which are divided into modern contraceptives (including Sterilization, Intrauterine devices, Oral contraceptives, Emergency contraceptive pills, etc.) and non-modern contraceptives (including Withdrawal, Lactational amenorrhea Abstinence etc.) [ 2 ]. Contraceptive methods are aimed to overcome biological advances in technology that allow couples to have sex whenever they want and most important is to protect the health of mother and child. Moreover, the use of contraceptives is not only less unwanted pregnancy and less STIs including HIV, but is also to improve family income and the status of women [ 3 – 5 ]. We believe that the people who are in the reproductive age need a good understanding of sexual intercourse and unintended pregnancy. Similarly it is also necessary to strengthen education on sexual and reproductive health. With the development of economy and the popularization of internet and social media, young people are becoming more open-minded in China [ 10 ]. And cause traditional attitudes towards sex, marriage and family have changed [ 11 ]. It leads to a lack of caution about sex and pre-marital sex is more acceptable [ 12 ]. Hence, the number of miscarriages caused by unwanted pregnancies has increased. According to the latest available figures, 13 million induced abortions were conducted in China in 2008 [ 13 ]. Furthermore, unmarried women accounted for 30%-35% of all induced abortions in china [ 15 – 17 ] and it is also estimate that there were 35 abortions per 1000 women aged 15–44 years worldwide each year and some 25% of pregnancies ended in abortion in globally in 2010–14[ 14 ]. However, the number would be even higher than it is now if not using use contraceptives. Thus, Knowledge of contraceptives and the choice of effective contraceptives are greatly important. China introduced the universal two-child policy in 2015. Family planning services also play an important role in new policy cause people who have undergone ligation maybe want to get second baby. Then it can provide counseling of restoring fertility and technical services for them. The same family planning service can also provide the knowledge of pre and postnatal care, sexual health matters, parenting rights and regular reproductive health examination. Because people's knowledge of contraceptives and how to choose suitable contraceptives is still relatively weak. This study is focused on to the knowledge, behavior and use of contraceptives and unmet needs of family planning services among people of reproductive age with or without accepted family planning services education in Hubei province, China. 2 Materials And Methods Study Population A cross-sectional study was conducted of about 102 counties in Hubei Province from August 2014 to July 2016. 17555 respondents aged 18-49 (female) and 20-60 (male) filled the questionnaire, which have lived in the area for at least six months and provide informed consent. Five towns (streets) were selected from each county in Hubei Province, and two village (resident) groups were selected from each township: a total of 20 sample points were selected from each village (resident) group, and the sample size was determined according to the number of people in each township. Fourteen investigators (five peer educators from local communities, five medical staff from health districts and four junior researchers from the Hubei Provincial Family Planning Institute) were interviewed in different regions. The survey investigators had to summarize and provide sexual and reproductive health education including family planning counseling each time to respondents Statistical analyses This study was to analysis knowledge and use of contraceptives and unmet needs of education and reproductive health, as well as the factors of failure of contraception among with or without accepting family planning services education by frequencies, percentage, mean, chi-square, logistic regression. The data collected were from a 37-question questionnaire filled out by 17555 people. Statistical analysis was performed using IBM-SPSS v 25.0 Ethical consideration Ethics approval was provided by the Hubei Family Planning and Reproductive Institute of Tongji Medical College and field authorizations were delivered by the local authorities. During the data collection training phase, the researchers obtained the informed consent of all participants. This information provided by the participants only be used for scientific research and we kept it confidential 3 Result 3.1 Sociodemographic Characteristics of Respondents A total of 17555 people filled in the questionnaire, of whom13382 (76.2%) were participating in family planning services education and 4173 (23.8%) were not. Most of the study participants belonged to the Han ethnic group. In addition to, more men (62.6%) had received family planning services education than women (37.4%). There was no significant difference in educational attainment between those who attended family planning services education and those who did not. In terms of educational experience, almost all those who received family planning service education (95.4%) and those who did not (93.7%) had a junior high school diploma or above. The majority of those who take part in family planning services education (56.1%) and those who did not (49.8%) come from countryside. As far as work is concerned most of the people who either participate in family planning services education or who did not participate in family planning services education had jobs. (Table 1 ). Table 1 Descriptive statistics of population characteristics among with or without participating in family planning services education Variable Had accepted in family planning services education n (%) P -value Yes (13382) No(4173) Age < 25 823(6.2) 380(9.1) 0.000 25 ~ 35 5250(39.2) 1809(43.4) 35 ~ 45 5564(41.6) 1475(35.3) ≥ 45 1745(13.0) 509(12.2) Gender Male 8378(62.6) 2821(67.6) 0.000 Female 5004(37.4) 1352(32.4) Ethnicity Han 12788(95.6) 3965(95.0) 0.124 Other 593(4.4) 209(5.0) Educational level Junior middle school or below 5822(43.6) 1866(44.72) 0.000 Senior middle or secondary 4383(32.7) 1201(28.78) College or above 3177(23.7) 1106(26.5) Place of residence Countryside 7509(56.1) 2076(49.8) 0.000 City town 4419(33.0) 1466(35.1) Transitional area 1454(10.9) 631(15.1) Occupational status Yes 12742(95.1) 3916(93.9) 0.000 No 658(4.9) 257(6.1) Number of living children Nil 764(5.7) 437(10.5) 0.000 One 9662(72.2) 3004(72.0) Two or more 2956(22.1) 3916(17.5) N refers to total number of respondents; % refers to percentage; p refers to the p-value at p ≤ 0.05 3.2 Knowledge About Male Contraceptives The majority (77.2%) of all respondents participated in family planning services education and those (67.6%) who did not participate in family planning services education knew about condom as a contraceptive method. Only a small percentage (5.5% and 15.0% )of those who participate in family planning services education are unaware of vasectomy or withdrawal as a method of male contraception whereas, among those who did not participate in family planning services education, 17.0% and 21.9% of all people did not know about vasectomy and withdrew as a method of male contraception, respectively. More than half of the respondents who with (65.9%) or without (57.1%) participating in family planning services education think condom was the best contraceptive method. Yet up to 22.5% of people who did not participate in family planning services education did not know the best method of male contraception. (Table 2 ) Table 2 Differences in the Knowledge of male contraceptives among with or without participating in family planning services education Knowledge Had accepted in family planning services education n (%) P -value Yes (13382) No(4173) Do you know condom as contraceptive method? Yes 13055(97.6) 3963(95.0) 0.000 NO 327(2.4) 210(5.0) Do you know vasectomy as contraceptive method? Yes 12648(94.5) 3463(83.0) 0.000 NO 734(5.5) 710(17.0) Do you know withdrawal as contraceptive method? Yes 11382(85.0) 3261(78.2) 0.000 NO 2000(15.0) 912(21.9) Which of the following do you think is the best contraceptive method? condom 8821(65.9) 2382(57.1) 0.000 vasectomy 2659(19.9) 614(14.7) withdrawal 226(1.7) 108(2.6) Have no opinion 1302(9.7) 941(22.5) Others 374(2.8) 128(3.1) N refers to total number of respondents; % refers to percentage; p refers to the p-value at p ≤ 0.05 About the knowledge of the characteristics of male contraceptives, approximately two-thirds of the respondents who take part in family planning services education (77.2%) and those who did not (67.7%) think safe and effective should be the characteristics of male contraceptives. Regarding Less harmful to body and Operation should be simple, about half of the respondents who accepted family planning services education (62.8%;54.6%) and those who did not (58.8%;46.9%) think that also should be the characteristics of male contraceptives. However, still 11.4% of people who did not participate in family planning services education have no opinion for the characteristics of male contraceptives compared with those (5.8%) who participated in family planning services education. Additional, a part of the people who participate in family planning services education (25.7%) and those who did not (20.7%) indicated that vasectomy affects physical labor whereas both of them(24.4% with or 20.5% without participating in family planning services education) also revealed that side effects and complication is the most severe disadvantage of vasectomy. Moreover, up to 25.8% of people who did not participate in family planning education didn’t know the most severe disadvantage of vasectomy compared with those (16.3%) who participated in family planning services education (Table 3 ) Table 3 Differences in the knowledge of the characteristics of male contraceptives among with or without participating in family planning services education Knowledge Had accepted in family planning services education n (%) P-value Yes(13382) No (4173) What characteristics do you think male contraceptive methods should have ༟ Safe and effective 10336(77.2) 2822(67.7) 0.000 Less harmful to body 8407(62.8) 2452(58.8) Operation should be simple 7311(54.6) 1956(46.9) Should restore fertility 4104(30.7) 1126(27.0) Should be low cost 2740(20.5) 786(18.8) Have no opinion 775(5.8) 498(11.9) Others 193(1.4) 77(1.8) Which one do you think is the most severe about the disadvantages of vasectomy? Affect sexual life 1521(11.4) 435(11.0) 0.000 Affect physical labor 3443(25.7) 865(20.7) Hard to restore fertility 1994(14.9) 552(13.0) Painful procedure 443(3.3) 195(4.6) Side effects and complication 3263(24.4) 859(20.5) High cost 32(0.2) 13(0.3) Have no opinion 2180(16.3) 1077(25.8) Others 506(3.8) 177(4.2) N refers to total number of respondents; % refers to percentage; p refers to the p-value at p ≤ 0.05 According to Table 2 and Table 3 showed a significant difference in knowledge of male contraceptive between those who received family planning services education and those who did not. 3.3 The Types Of Contraception Method Currently Used About 69.8% and 64.8% of the respondents among with or without received family planning services education reported that they currently use female contraceptives. Whereas, there was an obvious difference between taking in family planning services education and did not taking in family planning services education in not using contraception, respectively 11.6% and 16.7%. Additional respondents who were not using contraception, more than one third (36.8%; 37.7%) have no interest in contraception among with or without accepted in family planning services education. Some of people who participated in family planning services education (25.0%) and those who did not (28.5%) were in the pregnancy period. 3.4 Factors Of Failure Of Contraception Despite there was no difference between participating in family planning services education and non-participating in family planning services education even in contraceptive failure, but yet up to 23.9% and 22.8% of people with or without accepting in family planning services education had experienced contraceptive failure (pregnancy for example) in couple (Table 4 ). Table 5 shows reported age p = 0.000 (OR 1.015; 95% CI: 1.010–1.020), educational p = 0.004 (OR 1.076; 95% CI:1.024–1.131),occupational status p = 0.003 (AOR 1.357; 95% CI: 1.106–1.665) and the number of living children p = 0.030 (AOR 1.088; 95% CI: 1.008–1.175) were strongly associated with on contraceptive failure within participating in family planning services education. while age p = 0.000 (OR 1.028; 95% CI: 1.018–1.037), place of residence p = 0.000 (OR 0.202; 95% CI: 1.090–1.326) and number of living children p = 0.000 (OR 1.376; 95% CI: 1.195–1.563) were significant associated with contraceptive failure without participating in family planning services education. Table 4 Differences in the types of contraception method currently used among with or without participating in family planning services education Behavior Had accepted in family planning services education n (%) P -value Yes(13382) No(4173) Current form of contraceptive practicing ? Male contraception 2492(18.6) 770(18.5) 0.810 Female contraception 9339(69.8) 2705(64.8) 0.000 No contraception 1551(11.6) 697(16.7) 0.000 What is your reason to not using contraception? No interest to contraception 570(38.6) 263(37.7) 0.000 Pregnancy period 388(25.0) 199(28.5) 0.000 Other reasons 593(38.2) 236(33.8) 0.000 experienced contraceptive failure 3203(23.9) 950(22.8) 0.120 N refers to total number of respondents; % refers to percentage; p refers to the p-value at p ≤ 0.05 Table 5 The factors of contraceptive failure was analyzed by logistic regression among with or without participating in family planning services education Variables Participating in family planning services Not participating in family planning services education (contraceptive failure) education (contraceptive failure) OR (95% CI) p-value OR (95% CI) p-value Age 1.015(1.010,1.020) 0.000 1.028(1.018,1.037) 0.000 < 25 25 ~ 35 35 ~ 45 ≥45 Gender 1.030(0.949,1.118) 0.479 1.072(0.919,1.250) 0.377 Male Female Ethnicity 0.867(0.710,1.059) 0.162 0.873(0.619,1.231) 0.439 Han Other Educational level 1.076(1.024,1.131) 0.004 1.045(0.957,1.141) 0.324 Junior middle school or below Senior middle College or above Place of residence 1.010(0.957,1.071) 0.728 0.202(1.090,1.326) 0.000 Countryside City town Occupational status 1.357(1.106,1.665) 0.003 0.776(0.583,1.036) 0.085 Yes No Number of Living Children 1.088(1.008,1.175) 0.030 1.376(1.195,1.563) 0.000 Nil One Two or more AOR refers to Adjusted Odd Ratio; CI refers Confidence Interval and p refers to the p-value at p ≤ 0.05. 3.5 Education And Reproductive Health Unmet Needs According to Table 6 there shows a huge difference in the education and reproductive health unmet needs between accepting in family planning services education and did not. But refer to education about pre and postnatal care, contraceptive methods, sexual health matters, sexually transmitted diseases(STDs) and prevention, parenting rights Showed greatly unmet needs Whether or not to accept family planning services education. Similarly involved reproductive health about free premarital health and regular reproductive health examination, Guidance of healthy pregnancy and access and technical services of contraceptives for free also Showed greatly unmet needs Whether or not to accept family planning services education Table 6 Differences in the education and reproductive health unmet needs among with or without participating in family planning services education Unmet (%) Had accepted in family planning services education n (%) P -value Yes NO Education unmet needs Prenatal and postnatal care education 9851(73.61) 2507(60.08) 0.000 Knowledge on contraceptive methods 9286(69.39) 2508(60.10) Knowledge on reproduction health 9444(70.57 2697(64.63) Knowledge on STDs and prevention 8427(62.97) 2320(55.60) Knowledge on parenting rights 6003(44.86) 7379(55.14) Reproductive health unmet needs Free premarital health examination 9277(69.32) 2469(59.17) 0.000 Regular reproductive health examination 10221(76.38) 2855(68.42) Guidance of healthy pregnancy / healthy baby 6990(52.23) 1983(47.52) Free access and availability of contraceptives 7946(59.4) 2141(48.7) Free technical services for contraceptive use 6945(51.90) 1885(45.20) Others 406(3.03) 106(2.54) N refers to total number of respondents; % refers to percentage; p refers to the p-value at p ≤ 0.05 Discussion Historically, as early as 1973, China was concerned about the social and economic, China launched a nationwide family planning service [ 18 , 19 ]. However, In 1979 china had begun most strictly implement the one-child policy which controlled population growth in order to economic growth [ 20 ] and intended to protect both the health of mothers and children. Furthermore, family planning services provided free contraceptives to protect women's reproductive health from sexually transmitted infections. More recently, the number of married women who either use contraception or who have an unmet need for family planning is projected to grow from 900 million in 2010 to 962 million in 2015 and will increase in most developing countries [ 21 ] Here the findings revealed that most of the respondents knew about the knowledge of male contraceptives. But those who accepted education about family planning services knew more about the knowledge of male contraceptives (including ways, advantages, disadvantages) than those who did not. (Table 2 , 3 ). That maybe People who have received family planning services are consulting for more information about contraceptives Although male contraceptive using so simple, about 69.8% and 64.8% of the respondents among with or without received family planning services education reported that they currently using female contraceptives far more than using male contraception (Table 4 ). Our data are in line with many previous studies: women dominated in family planning [ 22 – 25 ]. Furthermore, Ventura et al reported 89% of reproductive aged women are currently using some form of contraception [ 26 ] Strikingly, respondents who were not using contraception, more than one of third (36.8%;37.7%) have no interest for contraception among with or without accepted in family planning services education. It may be because someone does not want to use contraceptives that the number of unwanted pregnancies and abortion increases [ 2 ]. People need to be educated about the dangers of abortion through family planning services. Yet up to 23.9% and 22.8% of people with or without accepting in family planning services education had experienced contraceptive failure in couple (Table 4 ). The failure rates are higher than other studies. Such as other studies indicate that the most effective methods of contraception include Long Acting Reversible Contraceptive(LARC) methods and sterilization which have a failure rate less than 1% (27,28). Pills, the transdermal patch, injectables, and the vaginal ring also have effective when used correctly but the failure rate up to 7% when user error (29–33). Similar with combined methods, condom efficacy is limited and the failure rates approach 13% (34, 35). Table 5 shows reported ages, education, occupational status and having no living children had a significant effect on contraceptive failure within participating in family planning services education. while only age, place of residence, occupational status had an effected on contraceptive failure without participating in family planning services education. Different age, educational, occupation affected the understanding and choice of contraceptives. We also found that a greatly unmet needs of the education and reproductive health whether or not to accept family planning services education. In 2010,146 million (130–166 million) women worldwide aged 15–49 years who were married or in a union had an unmet need for family planning [ 21 ]. It should be noted that several studies suggested that have a huge unmet need of education and reproductive health [ 36 – 40 ] Conclusions This study revealed that there is a huge difference in Knowledge and use of contraceptives, as well as unmet educational and reproductive health needs between those who participate in family planning services education and those who did not. That means people who participate in family planning services education got more about sexual and reproductive health education and understand the important of the family planning services. Therefore, it is necessary to provide family planning services for more people and regions to obtain a good understanding of contraceptives, sexual intercourse and unintended pregnancy Limitation This study only involved knowledge (types of contraceptives and their advantages and disadvantages) about male contraceptives and not about female that leading to incomplete analysis of the results Abbreviations STDs sexually transmitted diseases STIs sexually transmitted infections Declarations Strengths Our study conducted a systematic and comprehensive sampling of about 102 counties in Hubei Province, China. We cannot guarantee that all our results are applicable the whole of china. But maybe our findings are transferable to similar situations throughout Hubei Province. Additional we were doing questionnaires at the same time provided sexual and reproductive health education including family planning counseling for people Consent for publication Not applicable Availability of data and materials The datasets during and/or analysed during the current study available from the corresponding author on reasonable request. Competing of interest There are no conflicts of interest Acknowledgements Not applicable References 10.1016/j. contraception Wang C. History of the Chinese Family Planning program: 1970–2010. Contraception. 2012;85(6):563-569. doi: 10.1016/j. contraception . 2011.10.013. Hubacher D, Trussell J. A definition of modern contraceptive methods. Contraception. 2015;92(5):420–1. doi: 10.1016/j . contraception. 2015.08.008. Cleland J, Conde-Agudelo A, Peterson H, Ross J, Tsui A. Contraception and health. Lancet. 2012;380(9837):149–56. doi: 10.1016/S0140-6736(12)60609-6 . Schwartz S, Papworth E, Thiam-Niangoin M, et al. 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The risk of pregnancy after vasectomy [published correction appears in Obstet Gynecol. 2004 Jul;104(1):200]. Obstet Gynecol. 2004;103(5 Pt 1):848-850. doi: 10.1097/01.AOG.0000123246.11511.e4 . Trussel J, Aiken A. Contraceptive Efficacy. In: Hatcher RA, Nelson AL, Trussell J, Cwiak C, Cason P, Policar MS. etal, eds. Contraceptive Technology. New York: ArdentMedia; 2018. Ahrendt HJ, Nisand I, Bastianelli C, et al. Efficacy, acceptability and tolerability of the combined contraceptive ring, NuvaRing, compared with an oral contraceptive containing 30 microg of ethinyl estradiol and 3 mg of drospirenone. Contraception. 2006;74(6):451–7. doi: 10.1016/j.contraception.2006.07.004 . Creinin MD, Meyn LA, Borgatta L, et al. Multicenter comparison of the contraceptive ring and patch: a randomized controlled trial. Obstet Gynecol. 2008;111(2 Pt 1):267–77. doi: 10.1097/01.AOG.0000298338.58511.d1 . Lopez LM, Grimes DA, Gallo MF, Stockton LL, Schulz KF. Skin patch and vaginal ring versus combined oral contraceptives for contraception. Cochrane Database Syst Rev. 2013;2013(4):CD003552. doi: 10.1002/14651858.CD003552.pub4 . Published 2013 Apr 30. Zieman M, Guillebaud J, Weisberg E, Shangold GA, Fisher AC, Creasy GW. Contraceptive efficacy and cycle control with the Ortho Evra/Evra transdermal system: the analysis of pooled data. Fertil Steril. 2002;77(2 Suppl 2):13–8. doi: 10.1016/s0015-0282(01)03275-7 . Warner L, Steiner MJ. Male condoms. In: Hatcher RA, Nelson AL, Trussell J, Cwiak C, Cason P, Policar MS,etal, eds.ContraceptiveTechnology.NewYork:ArdentMedia;2018. Rosenberg MJ, Waugh MS. Latex condom breakage and slippage in a controlled clinical trial. Contraception. 1997;56(1):17–21. doi: 10.1016/s0010-7824(97)00069-3 . Hall KS, Manu A, Morhe E, et al. Bad girl and unmet family planning need among Sub-Saharan African adolescents: the role of sexual and reproductive health stigma. Qual Res Med Healthc. 2018;2(1):55–64. doi: 10.4081/qrmh.2018.7062 . 10.1186/s12905-015-0281-3 Wulifan JK, Brenner S, Jahn A, De Allegri M. A scoping review on determinants of unmet need for family planning among women of reproductive age in low and middle income countries. BMC Womens Health . 2016;16:2. Published 2016 Jan 15. doi: 10.1186/s12905-015-0281-3 . 10.1186/s12913-018-3722-5 Munakampe MN, Zulu JM, Michelo C. Contraception and abortion knowledge, attitudes and practices among adolescents from low and middle-income countries: a systematic review [published correction appears in BMC Health Serv Res. 2019 Jul 2;19(1):441]. BMC Health Serv Res . 2018;18(1):909. Published 2018 Nov 29. doi: 10.1186/s12913-018-3722-5 . 10.1186/s12905-015-0209-y Mota K, Reddy S, Getachew B. Unmet need of long-acting and permanent family planning methods among women in the reproductive age group in shashemene town, Oromia region, Ethiopia: a cross sectional study. BMC Womens Health . 2015;15:51. Published 2015 Jul 15. doi: 10.1186/s12905-015-0209-y . 10.11604/pamj.supp.2016.25.2.9712 Negash W, Dessalegn M, Yitayew B, Demsie M, Wagnew M, Nyagero J. Reproductive health service utilization and associated factors: the case of north Shewa zone youth, Amhara region, Ethiopia. Pan Afr Med J. 2016;25(Suppl 2):3. Published 2016 Nov 26. doi: 10.11604/pamj.supp.2016.25.2.9712 . Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-37378","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research","associatedPublications":[],"authors":[{"id":740665,"identity":"c36001fd-cc0d-43d6-8b77-8b59539e178c","order_by":0,"name":"peng meilin","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA0ElEQVRIiWNgGAWjYBACNvbmww8+GNgw88sfPkCcFj6eY2mGMyrS2CVnsCUQp0VOIsdAmufMYX6DGzwGRDqMIcHAmLctTdrgds/HG28Y7OR0GwhqOZDwcG6bjbHknbObLecwJBubHSCkhbHhgMHbtrRkvgO526R5GA4kbiOohZmxQYK37XB9w4GcZ0RqYWNmkAR6n1ngRg4bkVp42NhAgcws2XPM2HKOARF+kZ///jMkKtmbH954U2EnR1ALCpAgNmqQtZCqYxSMglEwCkYEAACf8UMoMqsxeQAAAABJRU5ErkJggg==","orcid":"https://orcid.org/0000-0001-6439-9047","institution":"Huazhongkejidaxue","correspondingAuthor":true,"prefix":"","firstName":"peng","middleName":"","lastName":"meilin","suffix":""},{"id":740666,"identity":"7ac6c10c-8e9b-468f-9218-8822f2b7516e","order_by":1,"name":"kai zhao","email":"","orcid":"","institution":"Huazhong University of Science and Technology Tongji Medical College","correspondingAuthor":false,"prefix":"","firstName":"kai","middleName":"","lastName":"zhao","suffix":""},{"id":740667,"identity":"426e9270-cf38-4d39-a02d-cec922772bcc","order_by":2,"name":"Huiping Zhang","email":"","orcid":"","institution":"Huazhong University of Science and Technology Tongji Medical College","correspondingAuthor":false,"prefix":"","firstName":"Huiping","middleName":"","lastName":"Zhang","suffix":""},{"id":740668,"identity":"f464d523-f52d-4f2b-b245-3f4b54edaa0e","order_by":3,"name":"kunming Tian","email":"","orcid":"","institution":"Huazhong University of Science and Technology Tongji Medical College","correspondingAuthor":false,"prefix":"","firstName":"kunming","middleName":"","lastName":"Tian","suffix":""},{"id":740669,"identity":"b7e8888c-7fb6-4ec5-bbf3-532539931383","order_by":4,"name":"Yiwei Fang","email":"","orcid":"","institution":"Huazhong University of Science and Technology Tongji Medical College","correspondingAuthor":false,"prefix":"","firstName":"Yiwei","middleName":"","lastName":"Fang","suffix":""},{"id":740670,"identity":"e4719026-4132-4985-9a96-d110ee2262a7","order_by":5,"name":"yuan Zhang","email":"","orcid":"","institution":"Huazhong University of Science and Technology Tongji Medical College","correspondingAuthor":false,"prefix":"","firstName":"yuan","middleName":"","lastName":"Zhang","suffix":""}],"badges":[],"createdAt":"2020-06-22 05:47:02","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-37378/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-37378/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":13547441,"identity":"9626c697-f75a-4c28-a2c5-dc58f7ead1bd","added_by":"auto","created_at":"2021-09-17 02:13:45","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":649884,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-37378/v1/034a6ea1-347f-4d64-b2e6-be45822d94d7.pdf"}],"financialInterests":"","formattedTitle":"Analysis the contraception usage and unmet needs of education and reproductive health in Hubei province, China","fulltext":[{"header":"Plain English Summary","content":"\u003cp\u003eThe use of contraceptives less unwanted pregnancy and sexually transmitted infections(STIs) including HIV. And traditional attitudes towards sex, marriage and family have changed. The number of miscarriages caused by unwanted pregnancies has increased. People is going to settle many of sexual and reproductive health matters.\u003c/p\u003e\n\u003cp\u003eA cross-sectional study was conducted of about 102 counties in Hubei Province from August 2014 to July 2016. 17555 respondents aged 18-49 (female) and 20-60 (male) filled the questionnaire\u003c/p\u003e\n\u003cp\u003eThe results in this article describe up to 23.9% and 22.8% of people with or without participating in family planning services education had experienced contraceptive failure (pregnancy for example) in couple. Age, educational, occupational status and the number of living children were strongly associated with contraceptive failure within participating in family planning services education. Only age, place of residence and number of living children were significant associated with contraceptive failure without participating in family planning services education. The figure showed greatly unmet needs of education and reproductive health whether or not to accept family planning services education\u003c/p\u003e\n\u003cp\u003eIn conclusion\u003cstrong\u003e: \u003c/strong\u003ePeople who participate in family planning services education got more about sexual and reproductive health education and understand the important of the family planning services. Therefore, it is necessary to provide family planning services for more people and regions to obtain a good understanding of contraceptives, sexual intercourse and unintended pregnancy.\u003c/p\u003e"},{"header":"Introduction","content":" \u003cp\u003eThe one-child policy has been in effect since 1980, family planning services mainly restricted to IUD and sterilization (tubal ligation) to control the population in china [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Indeed, family planning services settled many of sexual and reproductive health matters. Some studies show that early sex and subsequent unsafe behavior can increase the risk of STIs [\u003cspan additionalcitationids=\"CR7\" citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. And the World Health Organization (WHO) also estimated that roughly 1\u0026nbsp;million people are infected with any of four curable sexually transmitted infections every day(including chlamydia, gonorrhea, syphilis, and trichomoniasis) [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. However, in recent decades, contraceptives have developed rapidly, which are divided into modern contraceptives (including Sterilization, Intrauterine devices, Oral contraceptives, Emergency contraceptive pills, etc.) and non-modern contraceptives (including Withdrawal, Lactational amenorrhea Abstinence etc.) [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Contraceptive methods are aimed to overcome biological advances in technology that allow couples to have sex whenever they want and most important is to protect the health of mother and child. Moreover, the use of contraceptives is not only less unwanted pregnancy and less STIs including HIV, but is also to improve family income and the status of women [\u003cspan additionalcitationids=\"CR4\" citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. We believe that the people who are in the reproductive age need a good understanding of sexual intercourse and unintended pregnancy. Similarly it is also necessary to strengthen education on sexual and reproductive health.\u003c/p\u003e \u003cp\u003eWith the development of economy and the popularization of internet and social media, young people are becoming more open-minded in China [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. And cause traditional attitudes towards sex, marriage and family have changed [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. It leads to a lack of caution about sex and pre-marital sex is more acceptable [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Hence, the number of miscarriages caused by unwanted pregnancies has increased. According to the latest available figures, 13\u0026nbsp;million induced abortions were conducted in China in 2008 [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Furthermore, unmarried women accounted for 30%-35% of all induced abortions in china [\u003cspan additionalcitationids=\"CR16\" citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e] and it is also estimate that there were 35 abortions per 1000 women aged 15\u0026ndash;44\u0026nbsp;years worldwide each year and some 25% of pregnancies ended in abortion in globally in 2010\u0026ndash;14[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. However, the number would be even higher than it is now if not using use contraceptives. Thus, Knowledge of contraceptives and the choice of effective contraceptives are greatly important.\u003c/p\u003e \u003cp\u003eChina introduced the universal two-child policy in 2015. Family planning services also play an important role in new policy cause people who have undergone ligation maybe want to get second baby. Then it can provide counseling of restoring fertility and technical services for them. The same family planning service can also provide the knowledge of pre and postnatal care, sexual health matters, parenting rights and regular reproductive health examination. Because people's knowledge of contraceptives and how to choose suitable contraceptives is still relatively weak. This study is focused on to the knowledge, behavior and use of contraceptives and unmet needs of family planning services among people of reproductive age with or without accepted family planning services education in Hubei province, China.\u003c/p\u003e "},{"header":"2 Materials And Methods ","content":"\u003cp\u003e\u003cstrong\u003eStudy Population\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA cross-sectional study was conducted of about 102 counties in Hubei Province from August 2014 to July 2016. 17555 respondents aged 18-49 (female) and 20-60 (male) filled the questionnaire, which have lived in the area for at least six months and provide informed consent. Five towns (streets) were selected from each county in Hubei Province, and two village (resident) groups were selected from each township: a total of 20 sample points were selected from each village (resident) group, and the sample size was determined according to the number of people in each township. Fourteen investigators (five peer educators from local communities, five medical staff from health districts and four junior researchers from the Hubei Provincial Family Planning Institute) were interviewed in different regions. The survey investigators had to summarize and provide sexual and reproductive health education including family planning counseling each time to respondents\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical analyses\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was to analysis knowledge and use of contraceptives and unmet needs of education and reproductive health, as well as the factors of failure of contraception among with or without accepting family planning services education by frequencies, percentage, mean, chi-square, logistic regression. The data collected were from a 37-question questionnaire filled out by 17555 people. Statistical analysis was performed using IBM-SPSS v 25.0\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical consideration\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthics approval was provided by the Hubei Family Planning and Reproductive Institute of Tongji Medical College and field authorizations were delivered by the local authorities. During the data collection training phase, the researchers obtained the informed consent of all participants. This information provided by the participants only be used for scientific research and we kept it confidential\u003c/p\u003e"},{"header":"3 Result","content":" \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003e3.1 Sociodemographic Characteristics of Respondents\u003c/h2\u003e \u003cp\u003eA total of 17555 people filled in the questionnaire, of whom13382 (76.2%) were participating in family planning services education and 4173 (23.8%) were not. Most of the study participants belonged to the Han ethnic group. In addition to, more men (62.6%) had received family planning services education than women (37.4%). There was no significant difference in educational attainment between those who attended family planning services education and those who did not. In terms of educational experience, almost all those who received family planning service education (95.4%) and those who did not (93.7%) had a junior high school diploma or above. The majority of those who take part in family planning services education (56.1%) and those who did not (49.8%) come from countryside. As far as work is concerned most of the people who either participate in family planning services education or who did not participate in family planning services education had jobs. (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDescriptive statistics of population characteristics among with or without participating in family planning services education\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eHad accepted in family planning services education n (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eYes (13382)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eNo(4173)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u0026lt;\u0026thinsp;25 823(6.2) 380(9.1) 0.000\u003c/p\u003e \u003cp\u003e25\u0026thinsp;~\u0026thinsp;35 5250(39.2) 1809(43.4)\u003c/p\u003e \u003cp\u003e35\u0026thinsp;~\u0026thinsp;45 5564(41.6) 1475(35.3)\u003c/p\u003e \u003cp\u003e\u0026ge;\u0026thinsp;45 1745(13.0) 509(12.2)\u003c/p\u003e \u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e \u003cp\u003eMale 8378(62.6) 2821(67.6) 0.000\u003c/p\u003e\u003cp\u003eFemale 5004(37.4) 1352(32.4)\u003c/p\u003e\u003cp\u003e\u003cb\u003eEthnicity\u003c/b\u003e\u003c/p\u003e\u003cp\u003eHan 12788(95.6) 3965(95.0) 0.124\u003c/p\u003e\u003cp\u003eOther 593(4.4) 209(5.0)\u003c/p\u003e\u003cp\u003e\u003cb\u003eEducational level\u003c/b\u003e\u003c/p\u003e \u003cp\u003eJunior middle school or below 5822(43.6) 1866(44.72) 0.000\u003c/p\u003e\u003cp\u003eSenior middle or secondary 4383(32.7) 1201(28.78)\u003c/p\u003e\u003cp\u003eCollege or above 3177(23.7) 1106(26.5)\u003c/p\u003e\u003cp\u003e\u003cb\u003ePlace of residence\u003c/b\u003e\u003c/p\u003e\u003cp\u003eCountryside 7509(56.1) 2076(49.8) 0.000\u003c/p\u003e\u003cp\u003eCity town 4419(33.0) 1466(35.1)\u003c/p\u003e\u003cp\u003eTransitional area 1454(10.9) 631(15.1)\u003c/p\u003e\u003cp\u003e\u003cb\u003eOccupational status\u003c/b\u003e\u003c/p\u003e\u003cp\u003eYes 12742(95.1) 3916(93.9) 0.000\u003c/p\u003e\u003cp\u003eNo 658(4.9) 257(6.1)\u003c/p\u003e\u003cp\u003e\u003cb\u003eNumber of living children\u003c/b\u003e\u003c/p\u003e\u003cp\u003eNil 764(5.7) 437(10.5) 0.000\u003c/p\u003e\u003cp\u003eOne 9662(72.2) 3004(72.0)\u003c/p\u003e\u003cp\u003eTwo or more 2956(22.1) 3916(17.5)\u003c/p\u003e\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eN refers to total number of respondents; % refers to percentage; p refers to the p-value at p\u0026thinsp;\u0026le;\u0026thinsp;0.05\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \n\u003ch2\u003e3.2 Knowledge About Male Contraceptives\u003c/h2\u003e\n \u003cp\u003eThe majority (77.2%) of all respondents participated in family planning services education and those (67.6%) who did not participate in family planning services education knew about condom as a contraceptive method. Only a small percentage (5.5% and 15.0% )of those who participate in family planning services education are unaware of vasectomy or withdrawal as a method of male contraception whereas, among those who did not participate in family planning services education, 17.0% and 21.9% of all people did not know about vasectomy and withdrew as a method of male contraception, respectively. More than half of the respondents who with (65.9%) or without (57.1%) participating in family planning services education think condom was the best contraceptive method. Yet up to 22.5% of people who did not participate in family planning services education did not know the best method of male contraception. (Table \u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDifferences in the Knowledge of male contraceptives among with or without participating in family planning services education\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eKnowledge\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eHad accepted in family planning services education n (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eYes (13382)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eNo(4173)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eDo you know condom\u003c/p\u003e \u003cp\u003eas contraceptive method? Yes 13055(97.6) 3963(95.0) 0.000\u003c/p\u003e \u003cp\u003eNO 327(2.4) 210(5.0)\u003c/p\u003e \u003cp\u003eDo you know vasectomy\u003c/p\u003e \u003cp\u003eas contraceptive method? Yes 12648(94.5) 3463(83.0) 0.000\u003c/p\u003e \u003cp\u003eNO 734(5.5) 710(17.0)\u003c/p\u003e \u003cp\u003eDo you know withdrawal\u003c/p\u003e \u003cp\u003eas contraceptive method? Yes 11382(85.0) 3261(78.2) 0.000\u003c/p\u003e \u003cp\u003eNO 2000(15.0) 912(21.9)\u003c/p\u003e \u003cp\u003eWhich of the following do you\u003c/p\u003e \u003cp\u003ethink is the best contraceptive method?\u003c/p\u003e \u003cp\u003econdom 8821(65.9) 2382(57.1) 0.000\u003c/p\u003e \u003cp\u003evasectomy 2659(19.9) 614(14.7)\u003c/p\u003e \u003cp\u003ewithdrawal 226(1.7) 108(2.6)\u003c/p\u003e \u003cp\u003eHave no opinion 1302(9.7) 941(22.5)\u003c/p\u003e \u003cp\u003eOthers 374(2.8) 128(3.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eN refers to total number of respondents; % refers to percentage; p refers to the p-value at p\u0026thinsp;\u0026le;\u0026thinsp;0.05\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eAbout the knowledge of the characteristics of male contraceptives, approximately two-thirds of the respondents who take part in family planning services education (77.2%) and those who did not (67.7%) think safe and effective should be the characteristics of male contraceptives. Regarding Less harmful to body and Operation should be simple, about half of the respondents who accepted family planning services education (62.8%;54.6%) and those who did not (58.8%;46.9%) think that also should be the characteristics of male contraceptives. However, still 11.4% of people who did not participate in family planning services education have no opinion for the characteristics of male contraceptives compared with those (5.8%) who participated in family planning services education. Additional, a part of the people who participate in family planning services education (25.7%) and those who did not (20.7%) indicated that vasectomy affects physical labor whereas both of them(24.4% with or 20.5% without participating in family planning services education) also revealed that side effects and complication is the most severe disadvantage of vasectomy. Moreover, up to 25.8% of people who did not participate in family planning education didn\u0026rsquo;t know the most severe disadvantage of vasectomy compared with those (16.3%) who participated in family planning services education (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDifferences in the knowledge of the characteristics of male contraceptives among with or without participating in family planning services education\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eKnowledge\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eHad accepted in family planning services education n (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eP-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eYes(13382)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eNo (4173)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWhat characteristics do you think male\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003econtraceptive methods should have\u003c/b\u003e༟\u003c/p\u003e \u003cp\u003eSafe and effective 10336(77.2) 2822(67.7) 0.000\u003c/p\u003e \u003cp\u003eLess harmful to body 8407(62.8) 2452(58.8)\u003c/p\u003e \u003cp\u003eOperation should be simple 7311(54.6) 1956(46.9)\u003c/p\u003e \u003cp\u003eShould restore fertility 4104(30.7) 1126(27.0)\u003c/p\u003e \u003cp\u003eShould be low cost 2740(20.5) 786(18.8)\u003c/p\u003e \u003cp\u003eHave no opinion 775(5.8) 498(11.9)\u003c/p\u003e \u003cp\u003eOthers 193(1.4) 77(1.8)\u003c/p\u003e\u003cp\u003e\u003cb\u003eWhich one do you think is the most severe\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cspan type=\"BoldItalic\" class=\"BoldItalic\" name=\"Emphasis\"\u003eabout\u003c/span\u003e \u003cb\u003ethe disadvantages of vasectomy?\u003c/b\u003e\u003c/p\u003e\u003cp\u003eAffect sexual life 1521(11.4) 435(11.0) 0.000\u003c/p\u003e\u003cp\u003eAffect physical labor 3443(25.7) 865(20.7)\u003c/p\u003e \u003cp\u003eHard to restore fertility 1994(14.9) 552(13.0)\u003c/p\u003e \u003cp\u003ePainful procedure 443(3.3) 195(4.6)\u003c/p\u003e \u003cp\u003eSide effects and complication 3263(24.4) 859(20.5)\u003c/p\u003e \u003cp\u003eHigh cost 32(0.2) 13(0.3)\u003c/p\u003e \u003cp\u003eHave no opinion 2180(16.3) 1077(25.8)\u003c/p\u003e \u003cp\u003eOthers 506(3.8) 177(4.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eN refers to total number of respondents; % refers to percentage; p refers to the p-value at p\u0026thinsp;\u0026le;\u0026thinsp;0.05\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eAccording to Table \u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e and Table \u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e showed a significant difference in knowledge of male contraceptive between those who received family planning services education and those who did not.\u003c/p\u003e \n\u003ch2\u003e3.3 The Types Of Contraception Method Currently Used\u003c/h2\u003e\n \u003cp\u003eAbout 69.8% and 64.8% of the respondents among with or without received family planning services education reported that they currently use female contraceptives. Whereas, there was an obvious difference between taking in family planning services education and did not taking in family planning services education in not using contraception, respectively 11.6% and 16.7%. Additional respondents who were not using contraception, more than one third (36.8%; 37.7%) have no interest in contraception among with or without accepted in family planning services education. Some of people who participated in family planning services education (25.0%) and those who did not (28.5%) were in the pregnancy period.\u003c/p\u003e \n\u003ch2\u003e3.4 Factors Of Failure Of Contraception\u003c/h2\u003e\n \u003cp\u003eDespite there was no difference between participating in family planning services education and non-participating in family planning services education even in contraceptive failure, but yet up to 23.9% and 22.8% of people with or without accepting in family planning services education had experienced contraceptive failure (pregnancy for example) in couple (Table\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e). Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e shows reported age p\u0026thinsp;=\u0026thinsp;0.000 (OR 1.015; 95% CI: 1.010\u0026ndash;1.020), educational p\u0026thinsp;=\u0026thinsp;0.004 (OR 1.076; 95% CI:1.024\u0026ndash;1.131),occupational status p\u0026thinsp;=\u0026thinsp;0.003 (AOR 1.357; 95% CI: 1.106\u0026ndash;1.665) and the number of living children p\u0026thinsp;=\u0026thinsp;0.030 (AOR 1.088; 95% CI: 1.008\u0026ndash;1.175) were strongly associated with on contraceptive failure within participating in family planning services education. while age p\u0026thinsp;=\u0026thinsp;0.000 (OR 1.028; 95% CI: 1.018\u0026ndash;1.037), place of residence p\u0026thinsp;=\u0026thinsp;0.000 (OR 0.202; 95% CI: 1.090\u0026ndash;1.326) and number of living children p\u0026thinsp;=\u0026thinsp;0.000 (OR 1.376; 95% CI: 1.195\u0026ndash;1.563) were significant associated with contraceptive failure without participating in family planning services education.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDifferences in the types of contraception method currently used among with or without participating in family planning services education\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eBehavior\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eHad accepted in family planning services education n (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eYes(13382)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eNo(4173)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCurrent form of contraceptive\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003epracticing\u003c/b\u003e ?\u003c/p\u003e \u003cp\u003eMale contraception 2492(18.6) 770(18.5) 0.810\u003c/p\u003e \u003cp\u003eFemale contraception 9339(69.8) 2705(64.8) 0.000\u003c/p\u003e \u003cp\u003eNo contraception 1551(11.6) 697(16.7) 0.000\u003c/p\u003e \u003cp\u003e\u003cb\u003eWhat is your reason to not using\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003econtraception?\u003c/b\u003e\u003c/p\u003e \u003cp\u003eNo interest to contraception 570(38.6) 263(37.7) 0.000\u003c/p\u003e \u003cp\u003ePregnancy period 388(25.0) 199(28.5) 0.000\u003c/p\u003e \u003cp\u003eOther reasons 593(38.2) 236(33.8) 0.000\u003c/p\u003e \u003cp\u003e\u003cb\u003eexperienced contraceptive failure\u003c/b\u003e 3203(23.9) 950(22.8) 0.120\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eN refers to total number of respondents; % refers to percentage; p refers to the p-value at p\u0026thinsp;\u0026le;\u0026thinsp;0.05\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe factors of contraceptive failure was analyzed by logistic regression among with or without participating in family planning services education\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"1\"\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables Participating in family planning services Not participating in family planning services\u003c/p\u003e \u003cp\u003eeducation (contraceptive failure) education (contraceptive failure)\u003c/p\u003e \u003cp\u003eOR (95% CI) p-value OR (95% CI) p-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge\u003c/b\u003e 1.015(1.010,1.020) 0.000 1.028(1.018,1.037) 0.000\u003c/p\u003e \u003cp\u003e\u0026lt;\u0026thinsp;25\u003c/p\u003e \u003cp\u003e 25\u0026thinsp;~\u0026thinsp;35\u003c/p\u003e \u003cp\u003e35\u0026thinsp;~\u0026thinsp;45\u003c/p\u003e \u003cp\u003e\u0026ge;45\u003c/p\u003e \u003cp\u003e\u003cb\u003eGender\u003c/b\u003e 1.030(0.949,1.118) 0.479 1.072(0.919,1.250) 0.377\u003c/p\u003e\u003cp\u003eMale\u003c/p\u003e\u003cp\u003eFemale\u003c/p\u003e\u003cp\u003e\u003cb\u003eEthnicity\u003c/b\u003e 0.867(0.710,1.059) 0.162 0.873(0.619,1.231) 0.439\u003c/p\u003e\u003cp\u003eHan\u003c/p\u003e\u003cp\u003eOther\u003c/p\u003e\u003cp\u003e\u003cb\u003eEducational level\u003c/b\u003e 1.076(1.024,1.131) 0.004 1.045(0.957,1.141) 0.324\u003c/p\u003e\u003cp\u003eJunior middle school or below \u003c/p\u003e\u003cp\u003eSenior middle\u003c/p\u003e\u003cp\u003eCollege or above\u003c/p\u003e\u003cp\u003e\u003cb\u003ePlace of residence\u003c/b\u003e 1.010(0.957,1.071) 0.728 0.202(1.090,1.326) 0.000\u003c/p\u003e\u003cp\u003eCountryside\u003c/p\u003e\u003cp\u003eCity town\u003c/p\u003e\u003cp\u003e\u003cb\u003eOccupational status\u003c/b\u003e 1.357(1.106,1.665) 0.003 0.776(0.583,1.036) 0.085\u003c/p\u003e\u003cp\u003eYes\u003c/p\u003e\u003cp\u003eNo\u003c/p\u003e\u003cp\u003e\u003cb\u003eNumber of Living Children\u003c/b\u003e 1.088(1.008,1.175) 0.030 1.376(1.195,1.563) 0.000\u003c/p\u003e\u003cp\u003eNil\u003c/p\u003e\u003cp\u003eOne\u003c/p\u003e\u003cp\u003eTwo or more\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAOR refers to Adjusted Odd Ratio; CI refers Confidence Interval and p refers to the p-value at p\u0026thinsp;\u0026le;\u0026thinsp;0.05.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \n\u003ch2\u003e3.5 Education And Reproductive Health Unmet Needs\u003c/h2\u003e\n \u003cp\u003eAccording to Table \u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e there shows a huge difference in the education and reproductive health unmet needs between accepting in family planning services education and did not. But refer to education about pre and postnatal care, contraceptive methods, sexual health matters, sexually transmitted diseases(STDs) and prevention, parenting rights Showed greatly unmet needs Whether or not to accept family planning services education. Similarly involved reproductive health about free premarital health and regular reproductive health examination, Guidance of healthy pregnancy and access and technical services of contraceptives for free also Showed greatly unmet needs Whether or not to accept family planning services education\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDifferences in the education and reproductive health unmet needs among with or without participating in family planning services education\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eUnmet (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eHad accepted in family planning services education n (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eYes\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eNO\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEducation unmet needs\u003c/b\u003e\u003c/p\u003e \u003cp\u003ePrenatal and postnatal care education 9851(73.61) 2507(60.08) 0.000\u003c/p\u003e \u003cp\u003eKnowledge on contraceptive methods 9286(69.39) 2508(60.10)\u003c/p\u003e \u003cp\u003eKnowledge on reproduction health 9444(70.57 2697(64.63)\u003c/p\u003e \u003cp\u003eKnowledge on STDs and prevention 8427(62.97) 2320(55.60)\u003c/p\u003e \u003cp\u003eKnowledge on parenting rights 6003(44.86) 7379(55.14)\u003c/p\u003e \u003cp\u003e\u003cb\u003eReproductive health unmet needs\u003c/b\u003e\u003c/p\u003e \u003cp\u003eFree premarital health examination 9277(69.32) 2469(59.17) 0.000\u003c/p\u003e \u003cp\u003eRegular reproductive health examination 10221(76.38) 2855(68.42)\u003c/p\u003e \u003cp\u003eGuidance of healthy pregnancy / healthy baby 6990(52.23) 1983(47.52)\u003c/p\u003e \u003cp\u003eFree access and availability of contraceptives 7946(59.4) 2141(48.7)\u003c/p\u003e \u003cp\u003eFree technical services for contraceptive use 6945(51.90) 1885(45.20)\u003c/p\u003e \u003cp\u003eOthers 406(3.03) 106(2.54)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eN refers to total number of respondents; % refers to percentage; p refers to the p-value at p\u0026thinsp;\u0026le;\u0026thinsp;0.05\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e "},{"header":"Discussion","content":" \u003cp\u003eHistorically, as early as 1973, China was concerned about the social and economic, China launched a nationwide family planning service [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. However, In 1979 china had begun most strictly implement the one-child policy which controlled population growth in order to economic growth [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e] and intended to protect both the health of mothers and children. Furthermore, family planning services provided free contraceptives to protect women's reproductive health from sexually transmitted infections. More recently, the number of married women who either use contraception or who have an unmet need for family planning is projected to grow from 900\u0026nbsp;million in 2010 to 962\u0026nbsp;million in 2015 and will increase in most developing countries [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eHere the findings revealed that most of the respondents knew about the knowledge of male contraceptives. But those who accepted education about family planning services knew more about the knowledge of male contraceptives (including ways, advantages, disadvantages) than those who did not. (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e,\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). That maybe People who have received family planning services are consulting for more information about contraceptives\u003c/p\u003e \u003cp\u003eAlthough male contraceptive using so simple, about 69.8% and 64.8% of the respondents among with or without received family planning services education reported that they currently using female contraceptives far more than using male contraception (Table \u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e). Our data are in line with many previous studies: women dominated in family planning [\u003cspan additionalcitationids=\"CR23 CR24\" citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. Furthermore, Ventura et al reported 89% of reproductive aged women are currently using some form of contraception [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e] Strikingly, respondents who were not using contraception, more than one of third (36.8%;37.7%) have no interest for contraception among with or without accepted in family planning services education. It may be because someone does not want to use contraceptives that the number of unwanted pregnancies and abortion increases [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. People need to be educated about the dangers of abortion through family planning services.\u003c/p\u003e \u003cp\u003eYet up to 23.9% and 22.8% of people with or without accepting in family planning services education had experienced contraceptive failure in couple (Table\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e). The failure rates are higher than other studies. Such as other studies indicate that the most effective methods of contraception include Long Acting Reversible Contraceptive(LARC) methods and sterilization which have a failure rate less than 1% (27,28). Pills, the transdermal patch, injectables, and the vaginal ring also have effective when used correctly but the failure rate up to 7% when user error (29\u0026ndash;33). Similar with combined methods, condom efficacy is limited and the failure rates approach 13% (34, 35). Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e shows reported ages, education, occupational status and having no living children had a significant effect on contraceptive failure within participating in family planning services education. while only age, place of residence, occupational status had an effected on contraceptive failure without participating in family planning services education. Different age, educational, occupation affected the understanding and choice of contraceptives. We also found that a greatly unmet needs of the education and reproductive health whether or not to accept family planning services education. In 2010,146\u0026nbsp;million (130\u0026ndash;166\u0026nbsp;million) women worldwide aged 15\u0026ndash;49\u0026nbsp;years who were married or in a union had an unmet need for family planning [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. It should be noted that several studies suggested that have a huge unmet need of education and reproductive health [\u003cspan additionalcitationids=\"CR37 CR38 CR39\" citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e]\u003c/p\u003e "},{"header":"Conclusions","content":" \u003cp\u003eThis study revealed that there is a huge difference in Knowledge and use of contraceptives, as well as unmet educational and reproductive health needs between those who participate in family planning services education and those who did not. That means people who participate in family planning services education got more about sexual and reproductive health education and understand the important of the family planning services. Therefore, it is necessary to provide family planning services for more people and regions to obtain a good understanding of contraceptives, sexual intercourse and unintended pregnancy\u003c/p\u003e "},{"header":"Limitation","content":" \u003cp\u003eThis study only involved knowledge (types of contraceptives and their advantages and disadvantages) about male contraceptives and not about female that leading to incomplete analysis of the results\u003c/p\u003e "},{"header":"Abbreviations","content":" \u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSTDs\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003esexually transmitted diseases\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSTIs\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003esexually transmitted infections\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e "},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eStrengths\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOur study conducted a systematic and comprehensive sampling of about 102 counties in Hubei Province, China. We cannot guarantee that all our results are applicable the whole of china. But maybe our findings are transferable to similar situations throughout Hubei Province. Additional we were doing questionnaires at the same time provided sexual and reproductive health education including family planning counseling for people\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets during and/or analysed during the current study available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting of interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThere are no conflicts of interest\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e \u003cdiv class=\"BibBookDOI\"\u003e10.1016/j. contraception\u003c/div\u003e \u003cspan\u003eWang C. 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Contraception. 2006;74(6):451\u0026ndash;7. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.contraception.2006.07.004\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eCreinin MD, Meyn LA, Borgatta L, et al. Multicenter comparison of the contraceptive ring and patch: a randomized controlled trial. Obstet Gynecol. 2008;111(2 Pt 1):267\u0026ndash;77. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1097/01.AOG.0000298338.58511.d1\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eLopez LM, Grimes DA, Gallo MF, Stockton LL, Schulz KF. Skin patch and vaginal ring versus combined oral contraceptives for contraception. Cochrane Database Syst Rev. 2013;2013(4):CD003552. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1002/14651858.CD003552.pub4\u003c/span\u003e\u003c/span\u003e. Published 2013 Apr 30.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eZieman M, Guillebaud J, Weisberg E, Shangold GA, Fisher AC, Creasy GW. Contraceptive efficacy and cycle control with the Ortho Evra/Evra transdermal system: the analysis of pooled data. Fertil Steril. 2002;77(2 Suppl 2):13\u0026ndash;8. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/s0015-0282(01)03275-7\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eWarner L, Steiner MJ. Male condoms. In: Hatcher RA, Nelson AL, Trussell J, Cwiak C, Cason P, Policar MS,etal, eds.ContraceptiveTechnology.NewYork:ArdentMedia;2018.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eRosenberg MJ, Waugh MS. Latex condom breakage and slippage in a controlled clinical trial. Contraception. 1997;56(1):17\u0026ndash;21. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/s0010-7824(97)00069-3\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eHall KS, Manu A, Morhe E, et al. \u003cem\u003eBad girl\u003c/em\u003e and unmet family planning need among Sub-Saharan African adolescents: the role of sexual and reproductive health stigma. Qual Res Med Healthc. 2018;2(1):55\u0026ndash;64. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.4081/qrmh.2018.7062\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cdiv class=\"BibBookDOI\"\u003e10.1186/s12905-015-0281-3\u003c/div\u003e \u003cspan\u003eWulifan JK, Brenner S, Jahn A, De Allegri M. A scoping review on determinants of unmet need for family planning among women of reproductive age in low and middle income countries. \u003cem\u003eBMC Womens Health\u003c/em\u003e. 2016;16:2. Published 2016 Jan 15. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1186/s12905-015-0281-3\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cdiv class=\"BibBookDOI\"\u003e10.1186/s12913-018-3722-5\u003c/div\u003e \u003cspan\u003eMunakampe MN, Zulu JM, Michelo C. Contraception and abortion knowledge, attitudes and practices among adolescents from low and middle-income countries: a systematic review [published correction appears in BMC Health Serv Res. 2019 Jul 2;19(1):441]. \u003cem\u003eBMC Health Serv Res\u003c/em\u003e. 2018;18(1):909. Published 2018 Nov 29. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1186/s12913-018-3722-5\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cdiv class=\"BibBookDOI\"\u003e10.1186/s12905-015-0209-y\u003c/div\u003e \u003cspan\u003eMota K, Reddy S, Getachew B. Unmet need of long-acting and permanent family planning methods among women in the reproductive age group in shashemene town, Oromia region, Ethiopia: a cross sectional study. \u003cem\u003eBMC Womens Health\u003c/em\u003e. 2015;15:51. Published 2015 Jul 15. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1186/s12905-015-0209-y\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cdiv class=\"BibBookDOI\"\u003e10.11604/pamj.supp.2016.25.2.9712\u003c/div\u003e \u003cspan\u003eNegash W, Dessalegn M, Yitayew B, Demsie M, Wagnew M, Nyagero J. Reproductive health service utilization and associated factors: the case of north Shewa zone youth, Amhara region, Ethiopia. Pan Afr Med J. 2016;25(Suppl 2):3. Published 2016 Nov 26. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.11604/pamj.supp.2016.25.2.9712\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e \u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"contraceptives, abortion, STIs, Family planning services, reproductive health, knowledge","lastPublishedDoi":"10.21203/rs.3.rs-37378/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-37378/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003ebackground\u003c/strong\u003e: In recent years, contraceptives have developed rapidly, which are divided into modern contraceptives and non-modern contraceptives. The use of contraceptives less unwanted pregnancy and sexually transmitted infections(STIs) including HIV. And cause traditional attitudes towards sex, marriage and family have changed. It leads to a lack of caution about sex and pre-marital sex is more acceptable. Hence, the number of miscarriages caused by unwanted pregnancies has increased. People is going to settle many of sexual and reproductive health matters. \u003c/p\u003e\u003cp\u003e\u003cstrong\u003eMethods: \u003c/strong\u003eThis study, was conducted of about 103 counties in Hubei Province from August 2014 to July 2016, which used frequencies, percentage, mean, chi-square, logistic regression to analysis this data that collected from 17555 respondents. (IBM-SPSS v 25.0)\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eThe results in this article describe more men (62.6%) received family planning services education than women (37.4%). And people who did not participate in family planning services education, 17.0% and 21.9% did not know about vasectomy and withdrew as a method of male contraception, respectively.\u0026nbsp;Striking, up to 23.9% and 22.8% of people with or without participating in family planning services education had experienced contraceptive failure (pregnancy for example) in couple. Age, educational, occupational status and the number of living children were strongly associated with contraceptive failure within participating in family planning services education. Only age, place of residence and number of living children were significant associated with contraceptive failure without participating in family planning services education. The figure showed greatly unmet needs of education and reproductive health whether or not to accept family planning services education\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eConclusion: \u003c/strong\u003eThere is a huge difference in Knowledge and use of contraceptives, as well as unmet educational and reproductive health needs between those who participated in family planning services education and those who did not. That means people who participate in family planning services education got more about sexual and reproductive health education and understand the important of the family planning services. Therefore, it is necessary to provide family planning services for more people and regions to obtain a good understanding of contraceptives, sexual intercourse and unintended pregnancy.\u003c/p\u003e","manuscriptTitle":"Analysis the contraception usage and unmet needs of education and reproductive health in Hubei province, China","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2020-07-01 13:55:32","doi":"10.21203/rs.3.rs-37378/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"001ce6d0-3954-419c-ab1c-6d999dcbb092","owner":[],"postedDate":"July 1st, 2020","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":137141,"name":"Sexual \u0026 Reproductive Medicine"}],"tags":[],"updatedAt":"2020-07-27T18:54:46+00:00","versionOfRecord":[],"versionCreatedAt":"2020-07-01 13:55:32","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-37378","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-37378","identity":"rs-37378","version":["v1"]},"buildId":"J0_U0BvcaRcwD8yVFaRlm","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}