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Gaddy H, Ingholt MM. Did the 1918 influenza pandemic cause a 1920 baby boom? Demographic evidence from neutral Europe. POPULATION STUDIES 2024; 78:269-287. [PMID: 37011659 DOI: 10.1080/00324728.2023.2192041] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 11/22/2022] [Indexed: 04/05/2023]
Abstract
In 1919-20, the European countries that were neutral in the First World War saw a small baby bust followed by a small baby boom. The sparse literature on this topic attributes the 1919 bust to individuals postponing conceptions during the peak of the 1918-20 influenza pandemic and the 1920 boom to recuperation of those conceptions. Using data from six large neutral countries of Europe, we present novel evidence contradicting that narrative. In fact, the subnational populations and maternal birth cohorts whose fertility was initially hit hardest by the pandemic were still experiencing below-average fertility in 1920. Demographic evidence, economic evidence, and a review of post-pandemic fertility trends outside Europe suggest that the 1920 baby boom in neutral Europe was caused by the end of the First World War, not by the end of the pandemic.
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Odimegwu C, Muchemwa M, Akinyemi JO. Systematic review of multilevel models involving contextual characteristics in African demographic research. JOURNAL OF POPULATION RESEARCH 2023. [DOI: 10.1007/s12546-023-09305-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
Abstract
AbstractMultilevel modelling has become a popular analytical approach for many demographic and health outcomes. The objective of this paper is to systematically review studies which used multilevel modelling in demographic research in Africa in terms of the outcomes analysed, common findings, theoretical rationale, questions addressed, methodological approaches, study design and data sources. The review was conducted by searching electronic databases such as Ebsco hosts, Science Direct, ProQuest, Scopus, PubMed and Google scholar for articles published between 2010 and 2021. Search terms such as neighbourhood, social, ecological and environmental context were used. The systematic review consisted of 35 articles, with 34 being peer-reviewed journal articles and 1 technical report. Based on the systematic review community-level factors are important in explaining various demographic outcomes. The community-level factors such as distance to the health facility, geographical region, place of residence, high illiteracy rates and the availability of maternal antenatal care services influenced several child health outcomes. The interpretation of results in the reviewed studies mainly focused on fixed effects rather than random effects. It is observed that data on cultural practices, values and beliefs, are needed to enrich the robust evidence generated from multilevel models.
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Fuseini AG, Rawson H, Ley L, Kerr D. Patient dignity and dignified care: A qualitative description of hospitalised older adults perspectives. J Clin Nurs 2023; 32:1286-1302. [PMID: 35322497 DOI: 10.1111/jocn.16286] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 02/23/2022] [Accepted: 02/25/2022] [Indexed: 02/04/2023]
Abstract
AIMS AND OBJECTIVES The aim of this study was to explore older adults' perspectives about dignity and dignified nursing care during acute hospitalisation in Ghana. BACKGROUND Maintaining hospitalised older adults' dignity is an essential component of nursing care and one of the most important determinants of wellbeing. To date, no study has been published on older adults' perspectives of dignified nursing care in the African context. STUDY DESIGN A qualitative descriptive research design. METHODS Twenty hospitalised older adults were purposively selected from the medical and surgical wards of a teaching hospital in Ghana. Data were gathered through semi-structured interviews between April and August, 2021, and analysed using reflexive thematic analysis techniques. The SRQR checklist was used to document reporting of the study. RESULTS The following four themes were identified: Effective nurse-patient communication, Maintaining patients' privacy, Respectful and compassionate care provision and Providing quality and safe care. Dignity was preserved when patients were treated with respect and compassion, provided privacy, and had close family members involved in physical care. Identified barriers to dignity included inadequate information about their health condition, poor communication by the nurses, lack of autonomy, poorly designed healthcare infrastructure and inadequate privacy. CONCLUSIONS Several enablers and barriers to dignified nursing care have been identified that have been discussed in previous studies. The unique factors identified in the Ghanaian context were family members' involvement in physical care influenced by cultural and religious beliefs, environmental barriers to privacy and dignity and inadequate involvement in decision making. RELEVANCE TO CLINICAL PRACTICE Nurses must treat older patients with respect, educate them about the health condition, involve them in care decisions, and identify their preferences regarding provision of hygiene needs, particularly in consideration of religious and cultural beliefs, including involvement of family members. Future planning of healthcare infrastructure needs to consider the importance of private cubicles with disability-accessible ensuite bathrooms for patients' comfort and privacy.
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Affiliation(s)
| | - Helen Rawson
- Monash Nursing and Midwifery, Monash University, Melbourne, Vic., Australia
| | - Lenore Ley
- School of Nursing and Midwifery, Deakin University, Melbourne, Vic., Australia.,Centre for Quality and Patient Safety, Institute for Health Transformation, School of Nursing and Midwifery, Deakin University, Geelong, Vic., Australia
| | - Debra Kerr
- Centre for Quality and Patient Safety, Institute for Health Transformation, School of Nursing and Midwifery, Deakin University, Geelong, Vic., Australia
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Okezue OC, Agbo EC, John JN, John DO. Patient involvement in medical decisions: a survey of shared decision making during physical therapy consultations. Physiother Theory Pract 2023; 39:878-886. [PMID: 35072594 DOI: 10.1080/09593985.2022.2029653] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Shared decision making (SDM) is widely affirmed as an ethical principle in healthcare; underpinned by both evidence of its positive outcomes among patients and strong inducements for its adoption by health professionals. This study investigated patients' involvement in SDM, determined its association with their personal characteristics and identified factors influencing their participation. METHOD A cross-sectional survey was executed among 148 consenting patients, who were recruited using convenience sampling technique and invited to complete self-report questionnaires on SDM. Data were analyzed via descriptive and inferential statistics. RESULTS Only 14 patients (9.5%) were involved in SDM whilst most patients (88.5%) had passive roles during consultation. SDM involvement had significant associations with age (p = .006) and educational status (p = .021). Most patients (67.6%) identified 'Doubt towards SDM,' as a factor that could hinder this collaborative process. Similarly, majority of the patients acknowledged the relevance of the influential factors: 'Physiotherapist's support' (83.7%) and 'Adequate health Information' (75%), toward promoting involvement in SDM. CONCLUSION Patient involvement in SDM was low in this study. Older and less/uneducated patients exhibited an increased tendency of noninvolvement. Key influential factors that either facilitate or hinder patients' involvement in SDM were revealed. There is a need to curtail drawbacks to SDM and promote its execution in physical therapy as well as general clinical practice.
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Affiliation(s)
- Obinna Chinedu Okezue
- Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, University of Nigeria Enugu Campus, Enugu, Nigeria
| | - Emeka Collins Agbo
- Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, University of Nigeria Enugu Campus, Enugu, Nigeria
| | - Jeneviv Nene John
- Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, University of Nigeria Enugu Campus, Enugu, Nigeria
| | - Davidson Okwudili John
- Department of Physiotherapy, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria
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Niang K, Fall A, Ndiaye S, Sarr M, Ba K, Masquelier B. Enhancing the value of death registration with verbal autopsy data: a pilot study in the Senegalese urban population in 2019. Arch Public Health 2023; 81:45. [PMID: 36991465 DOI: 10.1186/s13690-023-01067-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 03/20/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND There is no source of data on causes of death in Senegal that covers both community and hospital deaths. Yet the death registration system in the Dakar region is relatively complete (>80%) and could be expanded to provide information on the diseases and injuries that led to death. METHODS In this pilot study, we recorded all deaths that occurred over 2 months and were reported in the 72 civil registration offices in the Dakar region. We selected the deaths of residents of the region and administered a verbal autopsy to a relative of the deceased to identify the underlying causes of death. Causes of death were assigned using the InterVA5 model. RESULTS The age structure of deaths registered at the civil registry differed from that of the census, with a proportion of infant deaths about twice as high as in the census. The main causes of death were prematurity and obstetric asphyxia in newborns. Meningitis and encephalitis, severe malnutrition, and acute respiratory infections were the leading causes from 1 month to 15 years of age. Cardiovascular diseases accounted for 27% of deaths in adults aged 15-64 and 45% of deaths among adults above age 65, while neoplasms accounted for 20% and 12% of deaths in these two age groups, respectively. CONCLUSIONS This study demonstrates that the epidemiological transition is at an advanced stage in urban areas of Dakar, and underlines the importance of conducting regular studies based on verbal autopsies of deaths reported in civil registration offices.
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Affiliation(s)
- Khadim Niang
- Department of Public Health and Social Medicine, University of Gaston Berger, Saint-Louis, Senegal
| | - Atoumane Fall
- Agence Nationale de la Statistique et de la Démographie (ANSD), Dakar, Senegal
| | - Samba Ndiaye
- Agence Nationale de la Statistique et de la Démographie (ANSD), Dakar, Senegal
| | - Maguette Sarr
- Agence Nationale de la Statistique et de la Démographie (ANSD), Dakar, Senegal
| | - Khady Ba
- Agence Nationale de la Statistique et de la Démographie (ANSD), Dakar, Senegal
| | - Bruno Masquelier
- Center for Demographic Research, Louvain University, Louvain-la-Neuve, Belgium.
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Jean Simon D, Paul B, Kiragu A, Olorunsaiye CZ, Joseph F, Joseph G, N'Gou MD. Prevalence and factors associated with condom use among sexually active young women in Haiti: evidence from the 2016/17 Haiti demographic and health survey. BMC Womens Health 2023; 23:146. [PMID: 36991441 PMCID: PMC10061838 DOI: 10.1186/s12905-023-02295-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 03/21/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND Young women in Haiti remain vulnerable to sexually transmitted infections and unintended pregnancy. However, little is known about condom use among this population. This study examined the prevalence and the factors associated with condom use among sexually active young women in Haiti. METHODS Data from the 2016/17 Haiti demographic and health survey were used. The prevalence and the factors associated with condom use among sexually active young women in Haiti were assessed using descriptive statistics and binary logistic regression model. RESULTS The prevalence of condom use was 15.4% (95% CI 14.0-16.8). Being teenage (AOR = 1.34; 95% CI: 1.04-1.74), living in urban areas (AOR = 1.41; 95% CI = 1.04-1.90), having higher education level (AOR = 2.39; 95% CI: 1.44-4.00), being in the middle or rich category of household wealth index (AOR = 2.32; 95% CI: 1.53-3.53 and AOR = 2.93; 95% CI: 1.90-4.52), having correct knowledge of ovulatory cycle (AOR = 1.65; 95% CI: 1.30-2.10), having 2-3 lifetime sexual partners and one lifetime sexual partner (AOR = 2.04; 95% CI: 1.36-3.06 and AOR = 2.07; 95% CI: 1.35-3.17) had significantly higher odds of using condom. In addition, sexually active young women whose last partner was their boyfriend (AOR = 4.38; 95% CI: 2.82-6.81), and those whose last partner was a friend/casual acquaintance/commercial sex worker (AOR = 5.29; 95% CI: 2.18-12.85) were associated with increased likelihood of using condom compared with their counterparts whose partner was their spouse. CONCLUSION The Haitian government as well as institutions involved in sexual health should consider these factors when designing sexual and reproductive health interventions targeting young women. More specifically, to increase condom use and reduce risky sexual behaviors, they should combine efforts to raise awareness and induce sexual behavioral changes at two levels. In the education system, they should reinforce sexual education in primary and secondary schools while paying special attention to rural areas. In the whole society, it is important to deepen efforts toward increased awareness on family planning and condom use, through mass media and local organizations including religious ones. Priority should be given to the poorer households, young people and women, and rural areas, in order to maximize reduction in early and unintended pregnancy, and sexually transmitted infections. Interventions should include a condom price subsidy and a campaign to destigmatize condom use which is actually a "male affair".
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Affiliation(s)
- David Jean Simon
- Bureau d'Etudes et de Recherche en Statistiques Appliquées, Suivi et Evaluation (BERSA-SE), Port-au-Prince, Haiti
| | - Bénédique Paul
- Department of Agro-socio-economics, Chibas, Université Quisqueya, Port-au-Prince, Haiti.
- Groupe d'Etude sur les Sciences de la Durabilité, Université Quisqueya, Port-au-Prince, Haiti.
| | - Ann Kiragu
- Department of Law and Political and Social Sciences, University of Sorbonne Paris Nord, Paris, France
| | | | - Fanor Joseph
- Bureau d'Etudes et de Recherche en Statistiques Appliquées, Suivi et Evaluation (BERSA-SE), Port-au-Prince, Haiti
- Doctoral School of Social and Human Sciences, University of Antananarivo, Antananarivo, Madagascar
| | - Ghislaine Joseph
- Centre de Recherche Cultures Arts Sociétés (CELAT), University of Laval, Quebec, Canada
| | - M'Boh Delphin N'Gou
- Centre de Recherche de l'Institut de Démographie de l'Université de Paris (CRIDUP), Paris 1 Pantheon Sorbonne University, Paris, France
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Nyirenda M, Sukazi S, Buthelezi C, Hanass-Hancock J. “A frightening experience, especially at our age”: Examining the neglect and abuse of older persons in HIV prevention and care programs. Front Public Health 2023; 11:1061339. [PMID: 36992889 PMCID: PMC10040649 DOI: 10.3389/fpubh.2023.1061339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 02/10/2023] [Indexed: 03/14/2023] Open
Abstract
BackgroundAs the global population ages and the HIV pandemic matures, a growing number of older persons aged ≥50 years are becoming increasingly vulnerable to acquiring HIV. Unfortunately, older persons are often neglected and left out of sexual health programs and services. This study explored the experiences of older persons living with and without HIV in accessing prevention and care services and how those experiences translate into the neglect and abuse of older persons. The study also explored older people's perspectives on community responses to HIV in older people.MethodsThis qualitative analysis used data from 37 individuals who participated in focus group discussions conducted in 2017/2018 across two communities in Durban, South Africa. Using an interview guide and thematic content analysis, salient themes regarding attitudes to HIV in older persons and factors of access to HIV prevention and cares services for older persons were analyzed.ResultsThe study participant's mean age was 59.6 years. Major themes emerging from the data included factors impacting HIV prevention and transmission in older people; community responses to HIV contributing to the abuse of older people, and structural drivers of abuse in older people living with HIV (OPLHIV). Knowledge about HIV and how to protect themselves from HIV was limited among participants. Older persons were frightened to acquire HIV at an older age as they feared judgment and discrimination for getting HIV at that age. OPLHIV reported frequently experiencing community stigma and poor staff attitudes and practices at health facilities, such as a triage health delivery system that fueled community stigma. Participants also experienced neglect, verbal and emotional abuse at healthcare facilities.ConclusionAlthough there were no reports of physical and sexual abuse of older persons in this study, this study shows that despite decades of HIV programs in the country, HIV-related stigma, discrimination, and disrespect of older persons remain pervasive in the community and at health facilities. As an increasing number of people age and live longer with HIV, the neglect and outright abuse of older persons need urgent policy and program interventions.
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Affiliation(s)
- Makandwe Nyirenda
- Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa
- College of Health Sciences, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
- *Correspondence: Makandwe Nyirenda
| | - Sizakele Sukazi
- HIV Prevention Research Unit, South African Medical Research Council, Durban, South Africa
| | - Cebo Buthelezi
- HIV Prevention Research Unit, South African Medical Research Council, Durban, South Africa
| | - Jill Hanass-Hancock
- Gender and Health Research Unit, South African Medical Research Council, Durban, South Africa
- College of Health Sciences, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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Covid-19 Recovery and Growth: Promoting Technology Innovation in Healthcare Sector on Hygiene and Safe Medication Practices in Low-Resourced Nigerian Societies. SCIENTIFIC AFRICAN 2023; 19:e01542. [PMID: 36624773 PMCID: PMC9812470 DOI: 10.1016/j.sciaf.2023.e01542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 12/14/2022] [Accepted: 01/03/2023] [Indexed: 01/06/2023] Open
Abstract
Introduction Globally, the healthcare sector is primarily designated to provide timely, efficient and effective medical services. In African countries like Nigeria, the inequality in the healthcare sector is worsened by the limited coverage of healthcare delivery. This has evolved to an unprecedented effect on the provision of healthcare services in low-resource societies. In the post COVID-19 era, recovery and growth from the pandemic become more demanding with an emphasis on promoting innovative technology in the healthcare sector on hygiene and safe medication practices. Method Data was sourced from mixed research method. Questionnaires, focus group discussions, and in-depth interviews were used to deduce data from 142 healthcare providers, users, and social workers. Participants were randomly selected from three healthcare institutions in Nsukka, Enugu state. Result Findings revealed that although greater positive perception (66.7%) holds on promoting innovative technology in the healthcare sector; concerns on negative perceptions (33.3%) were; the choice of medication, cultural health behavior and non-adherence to health guidelines. Major factors militating against innovative technology in healthcare sector were corruption in healthcare system, patients' economic level and poor healthcare delivery. Findings depict that age (χ²cal= 84.0, p=0.000<0.05) and income (χ²cal= 53.7, p=0.000<0.05) of patients were found to be significant in the utilization of innovative technology in healthcare. Evidence-based interventions on innovative healthcare systems on hygiene and safe medication practices were; intensive community health education at the grass-root, implementation of health policies, and tutors' improved healthcare knowledge. Participants showed little knowledge of social workers' engagement in health institutions. Conclusion Equity in healthcare is a core concern in Sustainable Development Goals. Achieving equal distribution of health services between urban and rural societies in recovery from covid-19 pandemic and growth of the healthcare sector is pegged on promoting innovative technology in hygiene and safe medication practices. The study recommends that social workers' engagement with health providers and users in low-resourced societies could help propagate awareness and self-care management of health challenges through digital information technology in Nigeria.
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Smith-Greenaway E, Lin Y. Is the mortality-fertility nexus gendered? A research note on sex differences in the impact of sibling mortality on fertility preferences. POPULATION STUDIES 2023; 77:141-151. [PMID: 36748425 DOI: 10.1080/00324728.2023.2168036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Research guided by demographic transition theory has shown that exposure to mortality influences women's fertility preferences and behaviours. Despite the myriad contexts, methodological approaches, and linkages featured in past studies, they have shared a focus on women, leaving questions on the gendered salience of mortality exposures for adults' fertility-related outcomes unanswered. In this research note, we analyse data from three African countries with distinct fertility profiles (Nigeria, Zambia, and Zimbabwe) to examine associations between sibling mortality exposure and ideal family size among women, men, and couples. We also investigate the stability of these associations over time. The associations between adults' sibling mortality exposure and their own and their spouses' ideal family sizes vary across countries. However, the gendered nature of the results in every country and evidence of cross-spousal effects uniformly demonstrate the need to incorporate sex differences into the study of the mortality-fertility link.
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Solanke BL, Kupoluyi JA, Awoleye AF, Adewole OE, Babalola OB. Women's ability to negotiate safer sex with partners by contraceptive status among a nationally representative sample of married women in Nigeria. Contracept Reprod Med 2023; 8:17. [PMID: 36855163 PMCID: PMC9976491 DOI: 10.1186/s40834-023-00214-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 01/10/2023] [Indexed: 03/02/2023] Open
Abstract
BACKGROUND Existing studies established that safer sex negotiation influences contraceptive use, and women who are able to negotiate safer sex were expected to be contraceptive users. However, it is not certain that all contraceptive users have the ability to negotiate safer sex. Likewise, there is no evidence that all non-users are not able to negotiate safer sex with partners. The study assesses the prevalence of women's ability to negotiate safer sex and examines the determinants of women's ability to negotiate safer sex among contraceptive users and non-users. METHODS The comparative cross-sectional research design was adopted. Data were extracted from the 2018 Nigeria Demographic and Health Survey. The study analyzed a sample of 2,765 contraceptive users and 20,304 non-users. The outcome variable was women's ability to negotiate safer sex with partners. The explanatory variables examined are eight socio-demographic characteristics (age, child marriage, education, parity, media exposure, religion, work status, and experience of female genital mutilation), six relational characteristics (healthcare autonomy, financial autonomy, household wealth quintile, partners' education, ownership of assets, and type of marriage). Attitude to wife-beating, male controlling behavior, place of residence, and geo-political zone of residence were included as control variables. Multivariable regression models were estimated. RESULTS Findings showed that 6.2% of women who were not able to negotiate safer sex were contraceptive users, while 15.9% of women who were able to negotiate safer sex were contraceptive users. Among non-users, the significant determinants were child marriage, education, parity, mass media exposure, religion, work status, healthcare autonomy, financial autonomy, household wealth, partner education, type of marriage, geo-political zone, attitude to wife-beating, and male controlling behavior. Regarding contraceptive users, the significant determinants were parity, religion, the experience of female genital mutilation, financial autonomy, partner education, type of marriage, and the geo-political zone of residence. CONCLUSION The ability to negotiate safer sex differs among contraceptive users and non-users. Also, the determinants of the ability to negotiate safer sex differ among contraceptive users and non-users. While existing strategies may continue to focus on women not using contraceptives, new strategies promoting reproductive autonomy are required among contraceptive users.
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Affiliation(s)
- Bola Lukman Solanke
- Department of Demography and Social Statistics, Obafemi Awolowo University, Ile-Ife, Nigeria.
| | - Joseph Ayodeji Kupoluyi
- grid.10824.3f0000 0001 2183 9444Department of Demography and Social Statistics, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Abayomi Folorunso Awoleye
- grid.10824.3f0000 0001 2183 9444Department of Demography and Social Statistics, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Olusola Esther Adewole
- grid.10824.3f0000 0001 2183 9444Department of Sociology and Anthropology, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Oyeyemi Bukola Babalola
- grid.10824.3f0000 0001 2183 9444Department of Psychology, Obafemi Awolowo University, Ile-Ife, Nigeria
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Mihret Fetene S, Debebe Negash W, Shewarega ES, Asmamaw DB, Belay DG, Teklu RE, Aragaw FM, Alemu TG, Eshetu HB, Fentie EA. Determinants of full immunization coverage among children 12-23 months of age from deviant mothers/caregivers in Ethiopia: A multilevel analysis using 2016 demographic and health survey. Front Public Health 2023; 11:1085279. [PMID: 36926180 PMCID: PMC10011448 DOI: 10.3389/fpubh.2023.1085279] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 02/07/2023] [Indexed: 03/08/2023] Open
Abstract
Background Despite remarkable improvements in child health services utilization, childhood immunization has been poorly implemented in Ethiopia. However, evidence on the coverage of immunization among children from mothers/caregivers with no education (non-educated mothers were the most identified risk for underutilization of services) are scarce. Therefore, this study aimed to assess the determinants of full immunization coverage among children 12-23 months of age from deviant mothers/caregivers in Ethiopia. Methods We analyzed data from the 2016 Ethiopia Demographic and Health Survey (EDHS) on a sample of 1,170 children 12-23 months of age identified from deviant mothers/caregivers (mothers/caregivers with no education) through a two-stage stratified sampling. A multilevel mixed-effect binary logistic regression analysis was used to identify the individual and community level determinants of full immunization coverage among children 12-23 months of age with their deviant mothers/caregivers. In the final model, a p-value of < 0.05 and adjusted odds ratio (AOR) with 95% confidence interval (CI) were used to select statistically significant determinants of full immunization coverage. Results The overall full immunization coverage among children 12-23 months of age identified from deviant mothers/caregivers was 27.4% (95%CI: 25.0, 31.0) in Ethiopia. Deviant mothers/caregivers who are employed (AOR = 1.69, 95%CI: 1.68, 2.45), being in the rich household wealth status (AOR = 2.54, 95%CI: 1.53, 4.22), residing in city (AOR = 5.69, 95%CI: 2.39, 13.61), having one to three (AOR: 3.28, 95% CI: 2.12-5.07) and four and more ANC follow-up during the recent pregnancy (AOR: 3.91, 95% CI: 2.45, 6.24) were the determinants that increased full immunization coverage among children 12-23 months of age. Conclusions Full immunization coverage among children 12-23 months of age from non-educated mothers/caregivers was low and far behind the national target of coverage. Therefore, a system-wide intervention should be used to enhance employability, wealth status, and key maternal health services like ANC follow-up among non-educated mothers/caregivers to increase their children's full immunization coverage.
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Affiliation(s)
- Samrawit Mihret Fetene
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Wubshet Debebe Negash
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Ever Siyoum Shewarega
- Department of Reproductive Health, School of Public Health, College of Medicine and Health Sciences, Dilla University, Dilla, Ethiopia
| | - Desale Bihonegn Asmamaw
- Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Daniel Gashaneh Belay
- Department of Human Anatomy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Rediet Eristu Teklu
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Fantu Mamo Aragaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tewodros Getaneh Alemu
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Habitu Birhan Eshetu
- Department of Health Promotion and Health Behavior, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Elsa Awoke Fentie
- Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Alazbih NM, Kaya AH, Mengistu MY, Gelaye KA. Determinants of time to first marriage and birth intervals among women of child bearing age in Dabat Health and demographic surveillance system site, Northwest Ethiopia. PLoS One 2023; 18:e0281997. [PMID: 36827293 PMCID: PMC9956046 DOI: 10.1371/journal.pone.0281997] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 02/07/2023] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND Event histories such as marriage and birth have been used to study fertility behavior of women. Understanding the timing of these events provide insight to reproductive patterns of the population. Thus, the aim of this study was to assess the timing of marriage and durations of birth intervals and their associated factors, and and to examine their effects on the current fertility among women in Dabat health and demographic surveillance system site, Northwest Ethiopia. METHODS A community based cross-sectional survey was carried out in the beginning of 2020 among 1649 women of reproductive age group. Data were collected using structured and interviewer administered questionnaire. The parametric survival analysis was employed to estimate the relationships among socioeconomic and demographic variables with outcome variables, the timing of age at first marriage and duration of birth intervals. RESULTS This study confirmed that median age at first marriage was the lowest estimated at 15 years which was below the national and regional average. The result of the study also revealed that married women waited almost a median duration of three years for their first, second, third and fourth child which was increased to nearly four years for three years preceding the survey. The parametric survival analysis showed woman's education, occupation, and current age were the predictors of age at first marriage. divorce experience, women empowerment and marriage cohort were the determinant factors of first birth interval; women education, child death, and ideal number of children were the predictors of second and third birth intervals; and media exposure and child death experience of women were predictors of fourth birth interval. CONCLUSION The study indicated that median age at first marriage was the lowest though the successive birth intervals were longer. The survival analysis identified women's education, occupation, child death and ideal number of children affected the timing of age at first marriage and duration of birth intervals. Hence, encouraging women for higher education and giving opportunity to women in employments may contribute for delaying age at first marriage and increasing the duration of birth intervals which in turn slowing down the fertility of women.
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Affiliation(s)
| | | | - Mezgebu Yitayal Mengistu
- Department of Health System and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kassahun Alemu Gelaye
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Belachew TB, Negash WD, Bitew DA, Asmamaw DB. Modern contraceptive utilisation and its associated factors among reproductive age women in high fertility regions of Ethiopia: a multilevel analysis of Ethiopia Demographic and Health Survey. BMJ Open 2023; 13:e066432. [PMID: 36787981 PMCID: PMC9930559 DOI: 10.1136/bmjopen-2022-066432] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
OBJECTIVE This study is aimed to assess the magnitude of modern contraceptives utilisation and associated factors among reproductive age women in high fertility regions of Ethiopia. DESIGN Cross-sectional study. SETTING High fertility regions of Ethiopian. PARTICIPANTS A total weighted sample of 3822 married reproductive age women. METHODS In this study, data were obtained from the recent Ethiopian Demographic and Health Surveys. A total weighted sample of 3822 women of reproductive age was included. A multilevel mixed-effect binary logistic regression model was fitted to identify the significant associated factors of modern contraceptive utilisation. Statistical significance was determined using adjusted OR (AOR) with 95% CI. RESULTS The overall modern contraceptive utilisation was 29.75% (95% CI 28.2% to 31.2%). Among the factors associated with utilisation were women's age 25-34 years (AOR 1.3; 95% CI 1.01 to 1.66) and ≥35 (AOR 1.71; 95% CI 1.37 to 2.70), husband's occupation (AOR 1.49; 95% CI 1.03 to 1.99), number of alive children: 1-4 (AOR 2.20; 95% CI 1.47 to 3.30), 5-8 (AOR 1.74; 95% CI 1.09 to 2.77), husband's desired number of children (AOR 0.77; 95% CI 0.61 to 0 .96), residency (AOR 2.37; 95% CI 1.20 to 4.67), community media exposure (AOR 1.77; 95% CI 1.01 to 3.08), region (AOR 0.13; 95% CI 0.03 to 0.52) and religion (AOR 0.49; 95% CI 0.36 to 0.66) were significantly associated with modern contraceptive utilisation. CONCLUSION Modern contraceptives utilisation in high fertility regions of Ethiopia was low. Women age, husband occupation, number of living children, husband's desired number of children, residency, community media exposure, region and religion were significantly associated with modern contraceptive utilisation. Therefore, to improve the utilisation of modern contraceptives, public health policy makers should consider creating awareness through mass media, male involvement in family planning, as well as family planning programmes, should be encouraged in rural areas.
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Affiliation(s)
| | | | - Desalegn Anmut Bitew
- Department of Reproductive Health, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Desale Bihonegn Asmamaw
- Department of Reproductive Health, Institute of Public Health, University of Gondar, Gondar, Ethiopia
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Predictors of Knowledge, Attitude, and Practice (KAP) Towards Family Planning (FP) Among Pregnant Women in Fiji. Matern Child Health J 2023; 27:795-804. [PMID: 36781695 PMCID: PMC10115692 DOI: 10.1007/s10995-023-03618-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2023] [Indexed: 02/15/2023]
Abstract
OBJECTIVE This study aimed to determine the predictors of Knowledge, Attitude and Practice (KAP) towards Family Planning (FP) among pregnant Fijian women. METHODS A cross-sectional study was conducted over two months in 2019 with adult pregnant women attending the Antenatal Clinic (ANC) at Ba Mission Hospital (BMH), Fiji. Data was collected using a self-administrated questionnaire. Statistical analysis included correlation tests and regression analysis in determining predictors of KAP. RESULTS 240 pregnant women participated in this study with a mean age of 26.02 (± SD = 4.13). The results showed a moderate level of knowledge (mean 14.95, SD ± 3.15), positive attitude (mean 20.56, SD ± 5.68), and good practice (mean 4.97, SD ± 1.73). Linear regression identified that women with more than seven children had a knowledge score of 3.65, lower than null parity (t value = -2.577, p = 0.011). Women aged 20 to 24 had a 6.47 lower attitude score than women aged 18 to 19 (t value = -2.142, p = 0.033). Women in defacto relationships had a 2.12 lower attitude score compared to the married category (t value = -2.128, p = 0.034). Fijian women of Indian descent had a 1.98 lower attitude score than the I Taukei women (t value = -2.639, p = 0.009). Women aged 30-34 had 2.41 lower practice scores than those aged 18-19 (t value = -2.462, p = 0.015). CONCLUSION This study found a medium knowledge of FP among pregnant women. These findings support a recommendation for further research to implement effective strategies.
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Langa N. Dependency Theory: An Evaluation of the Period-Based Changes in the Utilization of Maternal Health Care and Neonatal Mortality in Tanzania Between 1991 and 2016. INTERNATIONAL JOURNAL OF SOCIAL DETERMINANTS OF HEALTH AND HEALTH SERVICES 2023; 53:27551938231156033. [PMID: 36775927 DOI: 10.1177/27551938231156033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
While efforts have been made to increase maternal health care (MHC) utilization and decrease neonatal mortality in Tanzania, much remains to be known about the effect of dependency (particularly on reproductive policy changes) on the use of MHC and neonatal health over time among varying socioeconomic groups. This study applied dependency theory to cross-sectional secondary data (collected by the Tanzania Demographic Health Surveys between 1991 and 2016) to investigate period-based changes in MHC and neonatal mortalities in Tanzania. Results from the data analysis found that while neonatal mortalities were decreasing in Tanzania (from 1991 to 2016), the odds of neonatal mortality were still greater in 2016. Also, a decline in the recommended skilled delivery assistance and 4 + antenatal care visits occurred in the data period. A significant increase in socioeconomic inequality around MHC use and neonatal mortality occurred during the study period as well. Policy recommendations to reduce these inequalities and move toward meeting Sustainability Development Goals for maternal and neonatal health in Tanzania are discussed.
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Affiliation(s)
- Neema Langa
- Department of Sociology/African American Studies, 14743University of Houston, Houston, TX, USA
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Ajaero CK, Ebimgbo S, Ezeibe C, Ugwu C, Nzeadibe C, Osabede N. Life Satisfaction in South Africa: The Influence of Inter-Provincial Migration Status. PSYCHOLOGICAL STUDIES 2023. [DOI: 10.1007/s12646-022-00697-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
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Boateng D, Oppong FB, Senkyire EK, Logo DD. Socioeconomic factors associated with the number of children ever born by married Ghanaian females: a cross-sectional analysis. BMJ Open 2023; 13:e067348. [PMID: 36754565 PMCID: PMC9923263 DOI: 10.1136/bmjopen-2022-067348] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
Abstract
OBJECTIVE Most studies in Ghana on determinants of children ever born (CEB) are often conducted among all females of reproductive age and do not adequately report patterns among married females. Considering the importance of marriage to fertility in the Ghanaian context, this study seeks to explore the association of socioeconomic characteristics of married Ghanaian women with CEB. DESIGN Data from the 2017 Ghana Maternal Health Survey were used. Three separate models were considered: linear regression model using CEB and two logistic regression models. Bivariate and multivariate analyses were considered for all models. SETTING The study was conducted in all 10 administrative regions of Ghana. PARTICIPANTS Married females aged between 15 and 49 years. PRIMARY AND SECONDARY OUTCOME MEASURES Socioeconomic factors associated with married females' CEB. RESULTS In all three models, place of residence, zone, wealth index, age, age at marriage, media exposure, level of education, number of abortions and age at first sex were all significantly (p<0.05) associated with CEB. Married females with higher education had lower odds of one or more births and lower odds of giving birth to three or more children. Also, married females from households with the highest wealth index had fewer CEB, lower odds of one or more births and lower odds of giving birth to three or more children. CONCLUSION Socioeconomic characteristics of married females in Ghana, including education and wealth status had a significant influence on the number of CEBs. We recommend governments' intervention to help bridge the gaps in access to education and income-generating opportunities. The mass media must be used to propagate and counsel married females on the potential of high fertility and its consequences.
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Affiliation(s)
- Dennis Boateng
- Biostatistics, Global Statistical Institute, Techiman, Ghana
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Rojas-Botero ML, Borrero-Ramírez YE, Cáceres-Manrique FDM. [Social inequalities in under-five mortality: a systematic review]. Rev Salud Publica (Bogota) 2023; 22:220-237. [PMID: 36753114 DOI: 10.15446/rsap.v22n2.86964] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 05/10/2020] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE To identify the characteristics of the published studies on social inequalities in under-five mortality, their theoretical perspectives, axes of inequality, methods and results. METHOD We carried out a systematic literature review. We consulted four electronic databases and Google Scholar, for studies published between 2010 and 2018. RESULTS We analyzed 126 articles. In 62.7%, territory was studied as the axis of inequality, followed by socioeconomic determinants (27.8%). Neonatal, infant and under-five mortality was analyzed as an output in health in 19.0%, 49.2% and 32.3%, respectively. It predominated ecological (62.7%) and longitudinal (50.0%) studies. Significant reductions in mortality rates were found, however, the decline was not homogeneous among subpopulations. CONCLUSIONS The literature reports a marked decrease in under-five mortality; however, the gaps between different axes of inequality continue and in some cases they have increased. Gaps varied according to time, place, axis of inequality and type of mortality analyzed.
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Affiliation(s)
- Maylen L Rojas-Botero
- MR: Profesional en Gerencia de Sistemas de Información en Salud, M.Sc. Epidemiología. Ph.D.(c) Epidemiología. Universidad de Antioquia, Facultad Nacional de Salud Pública. Medellín, Colombia.
| | - Yadira E Borrero-Ramírez
- YB: MD. Esp. Teoría Métodos de Investigación. M.Sc. Sociología. Ph.D. Salud Pública. Posdoctorado en Salud Colectiva. Universidad de Antioquia, Facultad Nacional de Salud Pública.
| | - Flor de María Cáceres-Manrique
- FC: Enfermera. Esp.; M.Sc. Epidemiología. Esp. Docencia Universitaria. Ph.D. Salud Pública. Universidad Industrial de Santander, Facultad de Salud, Escuela de Medicina, Departamento de Salud Pública. Bucaramanga, Colombia.
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Atama CS, Ebimgbo SO, Uzoma CC, Iwuagwu TE, Asadu N. Socio-economic status of women and fertility outcome in Benue State, North-Central, Nigeria. Health Care Women Int 2023; 44:126-144. [PMID: 34156918 DOI: 10.1080/07399332.2021.1929990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Nigeria still records high fertility despite launching programs to reduce fertility rate. We therefore surveyed the influence of socio-economic status of women on their fertility outcome in Benue State, North-Central, Nigeria. Data from 1049 childbearing women were collected using questionnaires. The data were analyzed using logistic regression and chi-square statistics. Significant relationship exists between education, income, occupation, age, marital status and fertility outcome at p < .05. To achieve global health development and be amongst the best performers in global quality of life measures, women's empowerment programs are encouraged to enhance their autonomy in decision making with reference to reproduction.
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Affiliation(s)
- Chiemezie S Atama
- Department of Sociology & Anthropology, University of Nigeria, Nsukka, Nigeria
| | - Samuel O Ebimgbo
- Department of Social Work, University of Nigeria, Nsukka, Nigeria
| | - Chigasa C Uzoma
- National Centre for Energy Research and Development, University of Nigeria, Nsukka, Nigeria
| | - Tochi E Iwuagwu
- Department of Human Kinetics and Health Education, University of Nigeria, Nsukka, Nigeria
| | - Ngozi Asadu
- Department of Sociology & Anthropology, University of Nigeria, Nsukka, Nigeria
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Asrese ET, Adem YF. Contraceptive utilization and associated factors among polygamous and monogamous women in Worebabo Woreda, South Wollo Zone, Ethiopia: a comparative cross sectional study. BMC Womens Health 2023; 23:39. [PMID: 36710331 PMCID: PMC9885600 DOI: 10.1186/s12905-023-02180-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 01/16/2023] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND In Ethiopia high population growth and unintended pregnancies are posing pressures where the economy is incapable of holding overpopulation. Despite this problem, utilization of modern contraception is low in rural areas of the country, especially in the areas where polygamy is common. Therefore, this study was conducted to assess contraceptive utilization and associated factors among polygamous and monogamous women in, Ethiopia. METHOD A community-based comparative cross-sectional and phenomenological study design was employed from July 1 to September 30, 2021, on the total sample size of 774 selected married women of the reproductive age group by using a multistage sampling method and a purposive sampling method were used for the qualitative part of the study. A pre-tested interview with a structured questionnaire was used to collect data and key informants were interviewed using semi-structured questionnaire. Associated factors were analyzed by using bivariable and multivariable binary logistic regression models. The odds ratio, with a 95% confidence level, was used to declare a statistically significant association. RESULT A total of 703 married women of the reproductive age groups were interviewed, yielding a 90.89% response rate; among these married women, 352 and 351 were in monogamous and polygamous relationships. The proportion of women who use modern contraceptives was 161 (45.7%) in monogamous relationship, and 151 (43.0%) in polygamous relationships. Overall, utilization of modern contraceptives was significantly associated with educational status (AOR = 2.143, CI:1.428-3.216), religion (AOR = 1.704, CI: 1.144-2.539), undesired fertility (AOR = 3.17,CI:1.939-5.183), who decides on the number of children (AOR = 3.054, CI:1.93-4.832), getting clear information by Health care provider (AOR = 4.624, CI:3.132-6.828), family pressure (AOR = 1.855, CI:1.351-2.75), fear of social stigma (AOR = 2.482, CI:1.666-3.699), and accepts myths about contraceptives (AOR = 1.878, CI:1.278-2.761). CONCLUSION This study identified that utilization of modern contraception was low in the study area. The district health office and concerned stakeholders should implement interventions that scale up contraceptive use, need family involvement in decision making, addressing myths around contraceptives, helping women to get education, and training of health care providers.
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Affiliation(s)
- Eueail Teferi Asrese
- Department of Public Health, Dessie College of Health Sciences, P.O.Box: 1212, Dessie, Ethiopia
| | - Yonas Fissha Adem
- Department of Public Health, Dessie College of Health Sciences, P.O.Box: 1212, Dessie, Ethiopia
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Chumo I, Kabaria C, Shankland A, Igonya E, Mberu B. Complementarity of formal and informal actors and their networks in support of vulnerable populations in informal settlements: Governance diaries approach. Front Public Health 2023; 10:1043602. [PMID: 36777785 PMCID: PMC9911518 DOI: 10.3389/fpubh.2022.1043602] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 11/07/2022] [Indexed: 01/28/2023] Open
Abstract
Introduction Beyond several interests and speculations on the relationship between formal and informal actors and their networks in support of vulnerable populations, most studies do not conclusively establish whether the two types of support are substitutes or complements. While informal care and formal care may be substitutes in general, they are complements among the vulnerable groups. Despite how some studies have described complementarity, further insights on the synergy between formal and informal actors and networks are needed to pinpoint how to maximize policy and interventions to alleviate the challenges facing vulnerable groups in informal settlements. Methods We conducted an ethnography using governance diaries with 24 participants in Korogocho and Viwandani informal settlements in Nairobi, Kenya. The governance diaries approach involved conducting bi-weekly governance in-depth interviews (IDIs) with study participants for 4 months, complemented with observations, reflections, participant diaries and informal discussions. We used framework analysis approach. Findings Informal actors identified include family, neighbors, friends, community groups and community members, and their direct networks. Formal actors on the other hand included government institutions, individuals and authorities that make policies and rules and their desired and possible networks. Both the formal and informal actors and their networks had complementary roles that were beneficial to the vulnerable populations living and working in informal settlements. The complementarities between formal and informal actors and networks in supporting vulnerable groups were portrayed in roles and responsibilities to the vulnerable groups; rules, regulations and governance in supporting vulnerable groups; knowledge, skills and dynamic workforces among formal and informal actors and their networks; information flow on health and wellbeing to the vulnerable populations; transition of actors in supporting vulnerable groups; availability, access and involvement of formal and informal actors and networks to support vulnerable groups. The complementarities allowed for maximum support of the vulnerable populations than otherwise. Conclusion We conclude that informal social support is needed regardless of the availability of formal social support. Moreover, a combination of formal and informal actors and related networks are essential to support vulnerable persons. Formal actors should establish, support, or maintain the informal actors and related networks through goodwill and sundry incentives as a vital dimension of building with local community structures and enhancing inclusion, participation and ownership of policy and program interventions by marginalized and vulnerable groups.
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Affiliation(s)
- Ivy Chumo
- African Population and Health Research Center (APHRC), Nairobi, Kenya
| | - Caroline Kabaria
- African Population and Health Research Center (APHRC), Nairobi, Kenya
| | - Alex Shankland
- Institute of Development Studies (IDS), Brighton, United Kingdom
| | - Emmy Igonya
- African Population and Health Research Center (APHRC), Nairobi, Kenya
| | - Blessing Mberu
- African Population and Health Research Center (APHRC), Nairobi, Kenya
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Olowolafe TA, Adebowale AS, Fagbamigbe AF, Bolarinwa OA, Akinyemi JO. Shifts in age pattern, timing of childbearing and trend in fertility level across six regions of Nigeria: Nigeria Demographic and Health Surveys from 2003-2018. PLoS One 2023; 18:e0279365. [PMID: 36662682 PMCID: PMC9858060 DOI: 10.1371/journal.pone.0279365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 12/05/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Nigeria's population is projected to increase from 200 million in 2019 to 450 million in 2050 if the fertility level remains at the current level. Thus, we examined the shifts in the age pattern of fertility, timing of childbearing and trend in fertility levels from 2003 and 2018 across six regions of Nigeria. METHOD This study utilised the 2003, 2008, 2013, and 2018 Nigeria Demographic and Health Survey datasets. Each survey was a cross-sectional population-based design, and a two-stage cluster sampling technique was used to select women aged 15-49 years. The changes in the timing of childbearing were examined by calculating the corresponding mean ages at the birth of different birth orders for each birth order separately to adjust the Quantum effect for births. The Gompertz Relational Model was used to examine the age pattern of fertility and refined fertility level. RESULT In Nigeria, it was observed that there was a minimal decline in mean children ever born (CEB) between 2003 and 2018 across all maternal age groups except aged 20-24 years. The pattern of mean CEB by the age of mothers was the same across the Nigeria regions except in North West. Nigeria's mean number of CEB to women aged 40-49 in 2003, 2008, 2013 and 2018 surveys was 6.7, 6.6, 6.3 and 6.1, respectively. The mean age (years) at first birth marginally increased from 21.3 in 2003 to 22.5 in 2018. In 2003, the mean age at first birth was highest in South East (24.3) and lowest in North East (19.4); while South West had the highest (24.4) and both North East and North West had the lowest (20.2) in 2018. Similar age patterns of fertility existed between 2003 and 2018 across the regions. Nigeria's estimated total fertility level for 2003, 2008, 2013 and 2018 was 6.1, 6.1, 5.9 and 5.7, respectively. CONCLUSION The findings showed a reducing but slow fertility declines in Nigeria. The decline varied substantially across the regions. For a downward change in the level of fertility, policies that will constrict the spread of fertility distribution across the region in Nigeria must urgently be put in place.
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Affiliation(s)
- Tubosun A. Olowolafe
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, University of Ibadan, Ibadan, Nigeria
- Department of Public Health, Lead City University, Ibadan, Nigeria
| | - Ayo S. Adebowale
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, University of Ibadan, Ibadan, Nigeria
| | - Adeniyi F. Fagbamigbe
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, University of Ibadan, Ibadan, Nigeria
| | - Obasanjo Afolabi Bolarinwa
- Department of Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa
- Department of Global Public Health, Canterbury Christ Church University, Canterbury, United Kingdom
| | - Joshua O. Akinyemi
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, University of Ibadan, Ibadan, Nigeria
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Tsegaye Negash B. Fertility intention among married women in Ethiopia: a multilevel analysis of Ethiopian demographic health survey 2016. Contracept Reprod Med 2023; 8:6. [PMID: 36650577 PMCID: PMC9847042 DOI: 10.1186/s40834-022-00201-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 11/15/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Fertility intention is the central aspect of countries which determine their population demography. Therefore, proportion and factors associated with fertility intention should be studied at different level of community for designing of appropriate policies, strategies, and programs. Despite its importance, information is scarce about proportion and predictors of fertility intention among women of reproductive age in Ethiopia, in 2016. METHODS A secondary data analysis was done on 2016 Ethiopian Demographic and Health Survey/EDHS/ in this study. A total of 1423 fecund, married, and sexually active women were included this study. Multilevel mixed-effect logistic regression model was done to show association between fertility desire and explanatory variables. Adjusted Odds Ratio with 95% Confidence Interval (CI) was computed to assess the strength and significance of association. RESULTS Prevalence of fertility intention was 63.5% (95%CI:62.2%,64.8%) in Ethiopia, in 2016. The response rate of this study was 100%. The odd of fertility desire was higher among women of age 20-34 years (AOR=2.5,95%CI:1.5,4.0), women of age 35-49 years (AOR= 9,95%CI:12.2,45.4), Muslim followers (AOR=5.4,95%CI:3.6,7.9), other religions followers (AOR= 1.8,95%CI:1.2,3.0), women who did not want to use modern contraceptive (AOR=3.1,95%CI:2.2,4.3). However, the likelihood of fertility intention was low among women who owned mobile phone (AOR=0.6,95%CI:0.4,0.87), and women with more than one partner (AOR=0.5,95%CI:0.41,0.8). At the community level factors like: Community education status (AOR= 1.67,95%CI:1.26,2.2) and region were factors strongly linked to fertility intention. CONCLUSIONS In this study, prevalence of fertility desire was higher compared to other countries. Participants age, religion, intention to use modern contraceptive, own mobile, and having multiple partners were individual factors associated with fertility preference. Furthermore, educational status and region were community factor associated significantly with intention of fertility. Hence, expansion of mobile networking and family planning messages through mobile. Furthermore, religious teaching should be enhanced to control family size among followers. Finally, the Ethiopian government should also work strongly to improve community education.
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Affiliation(s)
- Berhan Tsegaye Negash
- grid.192268.60000 0000 8953 2273Department of Midwifery, Collage of Health Science and Medicine, Hawassa University, Hawassa, Ethiopia
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Phiri M, Musonda E, Shasha L, Kanyamuna V, Lemba M. Individual and Community-level factors associated with early marriage in Zambia: a mixed effect analysis. BMC Womens Health 2023; 23:21. [PMID: 36650478 PMCID: PMC9843915 DOI: 10.1186/s12905-023-02168-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 01/09/2023] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Child marriage has long been a public health concern around the world, because it has the potential to deprive adolescent girls of their sexual reproductive health rights and limits their ability to reach their full potential in life. The prevalence of child marriage has been consistently higher in sub-Saharan Africa than elsewhere. However, fewer studies have explored the influence of both individual and community-level influences on early marriage in sub-Saharan Africa. This study, therefore, examined individual and community-level factors associated with child marriages in Zambia. METHODS Data came from the Zambia Demographic and Health Surveys (ZDHS) conducted in 2007, 2013-14 and 2018. A pooled weighted sample of 9990 women aged 20-29 years was used in the analysis. Stata software version 17 was used to perform statistical analysis, taking into account complex survey design. The association between individual- and community- level factors and early marital behavior was assessed using multilevel logistic regression models. RESULTS The prevalence of child marriage among women aged 20-29 was 44.4 percent (95% CI: 42.1, 46.7) in 2018, declining from 51.5 percent (95% CI: 48.9, 54.0) in 2007. Women with secondary or higher level of education [aOR = 0.36, 95% CI = 0.26-0.49] and [aOR = 0.07, 95% CI = 0.03-0.18] and those whose age at first birth was (15-19 year) or (20-29 years) were associated with less likelihood of experiencing child marriage. Communities with a high percentage of women who gave birth at a young age [aOR = 1.36, 95% CI = 1.15-1.62] were more likely to experience child marriage. Individual and community-level characteristics accounted for 35% of the overall variations in communities' likelihood of experiencing early marriage. Even after controlling for both individual and community-level influences, the intra-class correlation revealed that around 4.5 percent of the overall variations remained unexplained. CONCLUSION Prevalence of child marriage has reduced over the years but is still high in Zambia. Both individual and community- level factors influenced child marriage in Zambia. There is a need to strengthen strategies that keep girls in school to delay their exposure to early sexual debut and child marriage. Designing of reproductive health interventions in the country should consider integration of community factors such as economic insecurity and access to reproductive health information.
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Affiliation(s)
- Million Phiri
- grid.12984.360000 0000 8914 5257Department of Population Studies, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia ,grid.11951.3d0000 0004 1937 1135Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Emmanuel Musonda
- grid.12984.360000 0000 8914 5257Department of Population Studies, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia
| | - Liness Shasha
- grid.12984.360000 0000 8914 5257Department of Population Studies, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia
| | - Vincent Kanyamuna
- grid.12984.360000 0000 8914 5257Department of Development Studies, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia
| | - Musonda Lemba
- grid.12984.360000 0000 8914 5257Department of Population Studies, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia
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Obiyan MO, Olaleye AO, Oyinlola FF, Folayan MO. Factors associated with pregnancy and induced abortion among street-involved female adolescents in two Nigerian urban cities: a mixed-method study. BMC Health Serv Res 2023; 23:25. [PMID: 36627625 PMCID: PMC9832642 DOI: 10.1186/s12913-022-09014-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 12/27/2022] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVES This study determined the correlates of unwanted pregnancy and induced abortion among sexually active female street-involved adolescents (SIAs) aged 10-19 years in two urban cities in South-west, Nigeria. METHODS The data for this study were extracted from a larger mixed-method survey dataset on the sexual and reproductive health (SRH) of 1505 street-involved young people aged 10 to 24 years. For the quantitative data, the explanatory variables were age, history of school attendance, employment status, religion, living arrangement and city of residence. The study outcomes were a history of pregnancy and a history of induced abortion of last pregnancy. Binomial regression analysis was performed to determine the association between the explanatory and outcome variables. For the qualitative data generated through focus group discussions and in-depth-interviews, inductive and deductive approaches were used in conducting a thematic analysis to explore the perspectives and experiences of SIA on pregnancy and induced abortion. RESULTS Of the 424 female SIAs, 270 (63.7%) reported having had sex. Sixty-four (23.7%) respondents had a history of pregnancy, of which 38 (59.4%) gave a history of induced abortion of the last pregnancy. A history of school attendance significantly reduced the likelihood of being pregnant (AOR: 0.42, 95% C.I: 0.19-0.91), while 15-19-years-old SIAs who were pregnant were significantly less likely to abort (AOR: 0.13, 95% C.I: 0.02-0.77). Qualitative reports indicated that unintended pregnancy and induced abortion was a common experience among the sexually active SIAs. Many participants were aware of the methods of, and places to induce abortion. CONCLUSION A large proportion of SIAs are sexually active with a high incidence of unintended pregnancy and a high rate of unsafe abortion. Access of female SIAs to education can reduce the risk of unintended pregnancy. Attention needs to be paid to how SIAs can have access to contraception.
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Affiliation(s)
- Mary O Obiyan
- Department of Demography and Social Statistics, Obafemi Awolowo University, Ile-Ife, Nigeria.
| | - Atinuke O Olaleye
- Department of Obstetrics and Gynecology, Babcock University, Ilishan, Nigeria
| | - Funmilola F Oyinlola
- Department of Demography and Social Statistics, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Morenike O Folayan
- Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, Nigeria
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Patil A, Tyagi N, Prasad J. Age at marriage and first birth interval: A systematic review and meta-analysis. INDIAN JOURNAL OF HEALTH SCIENCES AND BIOMEDICAL RESEARCH (KLEU) 2023. [DOI: 10.4103/kleuhsj.kleuhsj_418_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Wright KO, Akinyinka MR, Fagbemi T, Aderibigbe A, Banke-Thomas A, Wusu O. Contraceptive use and fertility control in rural and urban communities of Lagos Nigeria. Niger Postgrad Med J 2023; 30:31-39. [PMID: 36814161 DOI: 10.4103/npmj.npmj_268_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
Background It is predicted that the population of sub-Saharan Africa will be thrice its size by the end of the 21st century. Our study compared patterns, incentives and disincentives for the uptake of contraceptives in rural and urban communities of Lagos, Nigeria. Materials and Methods This is a population-based cross-sectional study on 1445 women of reproductive ages 15-49 years using a cluster sampling technique and a pre-tested, interviewer-administered electronic questionnaire in 2020. Data were analysed using the Statistical Package for the Social Sciences (SPSS) software version 26.0 and ethical approval was obtained for the study. Results About 32.4% of the respondents were rural dwellers and 67.6% were urban residents. The overall mean age was 31.7 ± 7.8 years. In terms of pattern, slightly over half (53.3%) of all respondents had ever used family planning (FP), including modern contraceptives and slightly less than a third (30.8%) currently use FP methods in both rural and urban communities, respectively. Predominant disincentives for non-use of FP include a desire to retain fertility, lack of further need, unbearable side effects and lack of spousal support. The odds of being an urban dweller currently using a method of contraceptive method is 4.169 times higher for earners above ₦60,000, which is twice the minimum wage compared to those without income (adjusted odd's ratio: 4.169, 95% confidence interval: 1.395-12.462). Conclusion Sustained effort is required to improve contraceptive uptake, FP service delivery and demand satisfaction for modern contraceptives to enable the achievement of demographic dividends and gains.
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Affiliation(s)
- Kikelomo Ololade Wright
- Department of Community Health and Primary Health Care, Lagos State University College of Medicine; Department of Community Health and Primary Health Care, Lagos State University Teaching Hospital; Centre for Reproductive Health Research and Innovation, Lagos State University College of Medicine, Lagos, Nigeria
| | - Modupe Rebekah Akinyinka
- Department of Community Health and Primary Health Care, Lagos State University College of Medicine; Department of Community Health and Primary Health Care, Lagos State University Teaching Hospital, Lagos, Nigeria
| | - Temiloluwa Fagbemi
- Centre for Reproductive Health Research and Innovation, Lagos State University College of Medicine, Lagos, Nigeria
| | - Adedayo Aderibigbe
- Department of Community Health and Primary Health Care, Lagos State University Teaching Hospital; Centre for Reproductive Health Research and Innovation, Lagos State University College of Medicine, Lagos, Nigeria
| | - Aduragbemi Banke-Thomas
- Centre for Reproductive Health Research and Innovation, Lagos State University College of Medicine, Lagos, Nigeria; Centre for Vulnerable Children and Families, Institute for Life Course Development, University of Greenwich, London, United Kingdom
| | - Onipede Wusu
- Department of Sociology, Faculty of Social Sciences, Lagos State University, Lagos, Nigeria
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Bolarinwa OA, Ahinkorah BO, Seidu AA, Mohammed A, Effiong FB, Hagan JE, Ayodeji Makinde O. Predictors of young maternal age at first birth among women of reproductive age in Nigeria. PLoS One 2023; 18:e0279404. [PMID: 36638089 PMCID: PMC9838863 DOI: 10.1371/journal.pone.0279404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 12/07/2022] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Adverse obstetric outcomes have been commonly associated with early childbearing in many low-and middle-income countries. Despite this evidence, scholarly information on early childbearing in the sub-Saharan African region, especially Nigeria, is limited. This study examines the predictors of young maternal age at first birth among women of reproductive age in Nigeria using multi-level analysis. METHODS Data from the most recent Nigeria Demographic and Health Survey conducted in 2018 were analyzed. A total of 29,949 women of reproductive age (15-49 years) were considered for the study. Descriptive statistics using weighted percentage and chi-square test of independence (χ2) were first used to describe the variables of interest. This procedure was followed by a multilevel analysis of factors associated with young maternal age at first birth in Nigeria at p<0.05 level of significance. RESULTS Approximately 36.80% of the sample population had their first birth before the age of 18. Mothers residing in the North-East region [aOR = 1.26; 95% (CI = 1.13-1.42)] and practicing Islam [aOR = 1.17; 95% (CI = 1.05-1.29] were more likely to have their first birth before the age of 18 than those in the North-Central region and those practicing Christianity. Living in communities with medium literacy level [aOR = 0.90; 95% (CI = 0.82-0.99)] and high literacy level [aOR = 0.71; 95% (CI = 0.62-0.81)], being within richest wealth index [aOR = 0.61; 95% (CI = 0.53-0.71)] and being Yoruba [aOR = 0.46; 95% (CI = 0.39-0.56)] were associated with lower odds of young maternal age at first birth. CONCLUSION More than one-third of women of reproductive age in Nigeria had given birth to their first child before 18 years. Thus, there is a need for the Nigerian government and other stakeholders, including Non-Governmental Organisations and Civil Society Organisations to formulate and implement policy interventions targeted at reducing early childbearing among women of reproductive age in Nigeria.
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Affiliation(s)
- Obasanjo Afolabi Bolarinwa
- Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
- Institute for Advanced Studies in the Humanities, University of Edinburgh, Edinburgh, United Kingdom
| | | | - Abdul-Aziz Seidu
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
- Centre for Gender and Advocacy, Takoradi Technical University, Takoradi, Ghana
| | - Aliu Mohammed
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana
| | - Fortune Benjamin Effiong
- Department of Clinical Chemistry and Immunology, Faculty of Medical Laboratory Science, University of Calabar, Calabar, Nigeria
| | - John Elvis Hagan
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana
- Neurocognition and Action-Biomechanics-Research Group, Faculty of Psychology and Sport Sciences, Bielefeld University, Bielefeld, Germany
- * E-mail:
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Factors associated with reporting good maternal health-related knowledge among rural mothers of Yemen. J Biosoc Sci 2023; 55:150-168. [PMID: 34839844 DOI: 10.1017/s0021932021000663] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Increasing women's knowledge about maternal health is an important step towards empowering them and making them aware of their rights and health status, allowing them to seek appropriate health care. In Yemen, the ongoing conflict has hampered the delivery of health information to women in public health facilities. This study examined rural women's knowledge of, and attitude towards, maternal and child health in Yemen and identified the factors associated with good maternal health knowledge. The study was conducted between August and November 2018. A sample of 400 women aged 15-49 years who had delivered in the 6 months prior to the survey were systematically selected from selected public health facilities in Abyan and Lahj. Women were interviewed using a structured questionnaire to gather data on their demographic and economic characteristics, obstetric history and responses to health knowledge and attitude questions. Women's knowledge level was assessed as poor or good using the mean score as a cut-off. Chi-squared test and multiple logistic regression analysis were used to identify statistically significant factors associated with good maternal health knowledge. The percentage of women who had good knowledge was 44.8% (95% CI: 39.8-49.8). Women's attitude towards maternal health was negative in the areas of early ANC attendance, managing dietary regime and weight during pregnancy, facility delivery, PNC visits, cord care and mother and child health management. Women with primary education, whose husbands had received no formal education, who had their first ANC visit from the second trimester of pregnancy and who had fewer than four ANC visits were more likely to have poor health knowledge. Conversely, those with higher household income and only one child were more likely to have good maternal health knowledge. Overall, women's knowledge on maternal and child health care in rural areas of Yemen was low. Strategies are needed to increase rural women's knowledge on maternal and child health in this conflict-affected setting.
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Anbesu EW, Alemayehu M, Asgedom DK, Jeleta FY. Women’s decision-making power regarding family planning use and associated factors in Ethiopia: A systematic review and meta-analysis. SAGE Open Med 2023; 11:20503121231162722. [PMID: 37008684 PMCID: PMC10052484 DOI: 10.1177/20503121231162722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 02/21/2023] [Indexed: 03/30/2023] Open
Abstract
Objective: Although emphasis is placed on women’s decision-making power regarding family planning use in Ethiopia, the utilization of contraceptives is low. There are studies conducted in different parts of the country on women’s decision-making power regarding family planning use; however, there are inconsistent findings. Thus, this study aimed to determine the pooled prevalence of women’s decision-making power regarding family planning use and associated factors in Ethiopia. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed to develop the systematic review and meta-analysis. All observational studies were retrieved from online databases, including PubMed, CINAHL, Google Scholar, African Journal Online and gray literature. The data search was performed from 1 December to 16 May 2022. The quality of the studies was critically assessed using the Joanna Briggs Institute checklist. Heterogeneity among studies was examined using the I2 statistic. RevMan version 5.3 and STATA version 14 software were used for analysis. Results: A total of 852 studies were retrieved, and 8 studies were included in the final meta-analysis. The pooled prevalence of women’s decision-making power regarding family planning use was 57 (95% confidence interval: 37, 77). Good knowledge of family planning methods (odds ratio: 2.46, 95% confidence interval: 1.65, 3.67), a positive attitude toward family planning methods (odds ratio: 2.04, 95% confidence interval: 1.3, 3.2), and having primary or higher education (odds ratio: 9.76, 95% confidence interval: 4.36, 21.99) were associated with increased odds of women’s decision-making power regarding family planning use. Conclusion: Nearly three in five married women made decisions regarding family planning use in Ethiopia. Women with good knowledge of family planning methods, a positive attitude toward family planning methods, and women having primary or higher education were associated with increased odds of women’s decision-making power regarding family planning use.
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Affiliation(s)
- Etsay Woldu Anbesu
- Department of Public Health, College of Medical and Health Sciences, Samara University, Samara, Ethiopia
- Etsay Woldu Anbesu, Department of Public Health, College of Medical and Health Sciences, Samara University, Samara, 132, Ethiopia.
| | - Mussie Alemayehu
- School of Public Health, College of Health Science, Mekelle University, Mekelle, Tigray, Ethiopia
| | - Dejen Kahsay Asgedom
- Department of Public Health, College of Medical and Health Sciences, Samara University, Samara, Ethiopia
| | - Fikru Yigezu Jeleta
- Department of Nursing, College of Medical and Health Sciences, Samara University, Samara, Ethiopia
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Sisay G, Mulat T. Antenatal Care Dropout and Associated Factors in Ethiopia: A Systematic Review and Meta-Analysis. Health Serv Res Manag Epidemiol 2023; 10:23333928231165743. [PMID: 37021289 PMCID: PMC10068991 DOI: 10.1177/23333928231165743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
Abstract
Background The prevalence and determinants of antenatal care (ANC) dropout in Ethiopia were studied. However, the results were inconsistent and showed considerable variation. Hence, this meta-analysis aimed at estimating the overall prevalence of ANC dropout and its predictors in Ethiopia. Methods A comprehensive search of published studies was done using different international databases such as such as PubMed, DOJA, Embase, Cochrane Library, Google Scholar, and the institutional repository of Ethiopian universities were used to search for relevant studies. Data were extracted using Microsoft Excel spreadsheet, and exported to STATA v17 for analysis. A random effect model was used to estimate the overall national prevalence of ANC dropout. Fixed effects model were used to compute the pooled adjusted odd ratios (AOR) with the corresponding 95% confidence intervals (CIs). I2 test was used to assess heterogeneity of the included studies. Egger's tests was used to check for the presence of publication bias. Results A total of 7 studies were included in this systematic review and meta-analysis with 11,839 study participants. The overall pooled prevalence of ANC in Ethiopia was found to be 41.37% (95% CI =35.04, 47.70). Distance from the health care facility (AOR = 2.93, 95% CI = 2.75, 3.11), pregnancy complication signs (AOR = 2.97, 95% CI = 2.77, 3.16), place of residence (AOR = 1.79, 95% CI = 1.31, 2.26), educational level (AOR = 1.79, 95%CI = 1.37, 2.21), and age group (30-49) (AOR = 0.61, 95% CI = 0.45, 0.78) were significantly associated with ANC dropout. Conclusion Based on this review and meta-analysis, 41% of Ethiopian women dropped out of ANC visits before the minimum recommended visit (4 times). Hence, to reduce the number of ANC dropouts, it is important to counsel and educate women during their first prenatal care. Issues of urban–rural disparities and noted hotspot areas for ANC dropout should be given further attention.
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Affiliation(s)
- Gizaw Sisay
- Department of Public Health, College of Medicine and Health Science, Dilla University, Dilla, Ethiopia
- Gizaw Sisay Belay, Department of Public Health, College of Medicine and Health Science, Dilla University, Po. box 419, Dilla, Ethiopia.
| | - Tsion Mulat
- Department of Public Health, College of Medicine and Health Science, Dilla University, Dilla, Ethiopia
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Abstract
Women's ability to negotiate for safer sex has effects on their sexual and reproductive health. This study investigated the association between safer sex negotiation and parity among women in sub-Saharan Africa. The data were sourced from the Demographic and Health Surveys of 28 sub-Saharan African countries conducted from 2010 to 2019. A total of 215,397 women aged 15-49 were included in the study. Multilevel logistic analysis was conducted to examine the association between safer sex negotiation and parity among women in sub-Saharan Africa. The results were presented as adjusted odds ratios (aOR) and the significance level set at p<0.05. The overall prevalences of safer sex negotiation and high parity among women in sub-Saharan Africa were 82.7% and 52.1%, respectively. The prevalence of high parity ranged from 32.3% in Chad to 72.1% in Lesotho. The lowest prevalence of safer sex negotiation was in Chad (16.8%) while the highest prevalence was recorded in Rwanda (99.7%). Women who had the capacity to negotiate for safer sex were less likely to have high parity compared with those who had no capacity to negotiate for safer sex (aOR = 0.78, CI: 0.75-0.81). Other factors that were associated with high parity were age, educational level, marital status, exposure to media, contraceptive use, religion, wealth quintile, sex of household head, and place of residence. The study identified significant association between safer sex negotiation and high parity among women of reproductive age in sub-Saharan Africa. It is worth noting that women's ability to negotiate for safer sex could reduce high parity among women in sub-Saharan Africa. Therefore, policies and programmes aimed at birth control or reducing high parity among women could be targeted at improving their capacity to negotiate for safer sex through education.
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Association of spousal violence and women's empowerment status among the rural women of sub-Saharan Africa. J Biosoc Sci 2023; 55:55-73. [PMID: 34743765 DOI: 10.1017/s0021932021000602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Spousal violence (SV) is a global problem for women and its elimination is one of the prime targets of Sustainable Development Goal-5. Data from the Demographic and Health Surveys of seventeen countries, representing two sub-Saharan Africa (SSA) regions (East and Southern Africa [ESA] and West and Central Africa [WCA]), were used to examine the relationship between all types of SV and women's empowerment status among rural married women aged 15-49 years. Multivariate logistic regression analysis was used to explore adjusted associations, and a relative index of inequality (RII) and slope index of inequality (SII) were used to measure the inequality in experiencing SV by rural women based on their overall empowerment position. Within the period 2015-2019, the reported rate of SV was higher in the ESA (physical SV: 33.55%; sexual SV: 16.96%; any type of SV: 46.14%) than the WCA countries (physical SV: 27.80%; sexual SV: 7.63%; any type of SV: 40.83%), except for emotional SV (WCA: 31.28% vs ESA: 29.35%). In terms of overall empowerment status, rural WCA women were slightly ahead of their counterparts in the ESA region (46.09% and 44.64%, respectively). For both ESA and WCA countries, women who didn't justify violence and who had access to health care (except physical SV in WCA) showed negative but significant association with all types of SV in the adjusted analysis. Conversely, economic empowerment significantly increased the odds of experiencing physical and any type of SV in both regions. The significant risk ratios obtained from RII, for any SV were 0.83 and 1.09, and the β-coefficients from SII were -0.082 and 0.037 units, respectively, in ESA and WCA. Multi-sectoral microfinance-based intervening programmes and policies should be implemented regionally to empower women, especially in the economic, socio-culture, health care accessibility dimensions, and this will eventually reduce all types of spousal violence in rural SSA.
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Ndagijimana E, Biracyaza E, Nzayirambaho M. Risky sexual behaviors and their associated factors within high school students from Collège Saint André in Kigali, Rwanda: An institution-based cross-sectional study. FRONTIERS IN REPRODUCTIVE HEALTH 2023; 5:1029465. [PMID: 36936133 PMCID: PMC10020213 DOI: 10.3389/frph.2023.1029465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 01/27/2023] [Indexed: 03/06/2023] Open
Abstract
Background Risky sexual behaviors (RSBs) remain public health concerns in adolescents from sub-Saharan Africa (SSA), and these practices may increase vulnerability to reproductive health problems if no early healthcare strategies are implemented. While previous studies reported that adolescents are engaged in these RSBs due to diverse influences such as the teenage stage, urbanization, and change in the environment they experience, there is a shortage of studies on RSB among adolescents in SSA. This study assessed the magnitude of RSBs and the RSB-associated factors among in-school adolescents. Methods School-based cross-sectional study was conducted among 263 Saint Andre school students in Kigali, Rwanda, from July 3, 2020, to September 30, 2020. Systematic random sampling techniques were employed. All data were entered into Epi-Data and analyzed using SPSS version 25. Chi-square tests and multivariable logistic regression analyses were applied to determine factors associated with risky sexual behaviors. Confidence intervals (CIs) of 95% and 5% for statistical significance were maintained. Results Of 263 participants, 109 (41%) experienced RSB in their lifetime. Among them, 66 respondents (60.55%) utilized contraceptive methods to prevent sexual and reproductive problems that can be caused by unprotected sexual intercourse. The students who experienced domestic violence had increased odds of experiencing RSB [odds ratio (OR) = 4.22; 95% CI: 1.6-11.23] than their counterparts. Those in grade 11 (OR = 2.68; 95% CI: 1.06-6.78) and grade 12 (OR = 4.39; 95% CI: 1.82-10.56) were more likely to practice RSB than those in grade 10. Alcohol users were almost more likely to experience RSB (OR = 3.9; 95% CI: 1.97-5.5) than their counterparts. Those who lived away from their biological parents had higher likelihood of experiencing RSB (OR = 2.5; 95% CI: 1.14-4.42) than those who lived with one or both parents. Students who experienced peer pressure were more likely to engage in RSB (OR = 3.9; 95% CI: 2.01-7.51) than their counterparts. Conclusion Promoting specific intervention programs built upon the factors associated with RSB among high school students needs to be prioritized.
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Affiliation(s)
- Emmanuel Ndagijimana
- Department of Epidemiology and Biostatistics, School of Public Health, University of Rwanda, Kigali, Rwanda
- Correspondence: Emmanuel Biracyaza Emmanuel Ndagijimana
| | - Emmanuel Biracyaza
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
- Correspondence: Emmanuel Biracyaza Emmanuel Ndagijimana
| | - Manasse Nzayirambaho
- Department of Epidemiology and Biostatistics, School of Public Health, University of Rwanda, Kigali, Rwanda
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Logie CH, Okumu M, Loutet M, Berry I, Lukone SO, Kisubi N, Mwima S, Kyambadde P. Mixed-methods findings from the Ngutulu Kagwero (agents of change) participatory comic pilot study on post-rape clinical care and sexual violence prevention with refugee youth in a humanitarian setting in Uganda. Glob Public Health 2023; 18:2092178. [PMID: 35770702 DOI: 10.1080/17441692.2022.2092178] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 06/13/2022] [Indexed: 11/04/2022]
Abstract
There is a dearth of evidence-based post-rape clinical care interventions tailored for refugee adolescents and youth in low-income humanitarian settings. Comics, a low-cost, low-literacy and youth-friendly method, integrate visual images with text to spark emotion and share health-promoting information. We evaluated a participatory comic intervention to increase post-exposure prophylaxis (PEP) knowledge and acceptance, and prevent sexual and gender-based violence, in Bidi Bidi refugee settlement, Uganda. Following a formative qualitative phase, we conducted a pre-test post-test pilot study with refugee youth (aged 16-24 years) (n = 120). Surveys were conducted before (t0), after (t1), and two-months following (t2) workshops. Among participants (mean age: 19.7 years, standard deviation: 2.4; n = 60 men, n = 60 women), we found significant increases from t0 to t1, and from t0 to t2 in: (a) PEP knowledge and acceptance, (b) bystander efficacy, and (c) resilient coping. We also found significant decreases from t0 to t1, and from t0 to t2 in sexual violence stigma and depression. Qualitative feedback revealed knowledge and skills acquisition to engage with post-rape care and violence prevention, and increased empathy to support survivors. Survivor-informed participatory comic books are a promising approach to advance HIV prevention through increased PEP acceptance and reduced sexual violence stigma with refugee youth.Trial registration: ClinicalTrials.gov identifier: NCT04656522.
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Affiliation(s)
- Carmen H Logie
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
- Women's College Research Institute, Women's College Hospital, Toronto, Canada
- United Nations University Institute for Water, Environment & Health (UNU-INWEH), Hamilton, Canada
| | - Moses Okumu
- School of Social Work, University of Illinois Urbana Champaign, Urbana, IL, USA
- Department of Social Work, Uganda Christian University, Mukono, Uganda
| | - Miranda Loutet
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Isha Berry
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | | | - Nelson Kisubi
- Uganda Refugee and Disaster Management Council, Yumbe, Uganda
| | - Simon Mwima
- School of Social Work, University of Illinois Urbana Champaign, Urbana, IL, USA
- National AIDS Coordinating Program, Ugandan Ministry of Health, Kampala, Uganda
| | - Peter Kyambadde
- National AIDS Coordinating Program, Ugandan Ministry of Health, Kampala, Uganda
- Most at Risk Population Initiative (MARPI), Mulago Hospital, Kampala, Uganda
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Sahile A, Bekele D, Ayele H. Determining factors of neonatal mortality in Ethiopia: An investigation from the 2019 Ethiopia Mini Demographic and Health Survey. PLoS One 2022; 17:e0267999. [PMID: 36584102 PMCID: PMC9803101 DOI: 10.1371/journal.pone.0267999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 12/14/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Neonatal mortality is the probability of dying during the first 28 days of life. Of approximately 5 million children who die in the first year of life in the world, about 3 million are within their first 28 days of birth. In Ethiopia, the neonatal mortality rate is high about 37 per 1000 live births, and the factors are not well documented. Then, this study aimed to determine the key factors that have a significant influence on neonatal mortality. METHODS A total of 5753 neonatal mortality-related data were obtained from Ethiopia Mini Demographic and Health Survey (2019) data. A frequency distribution to summarize the overall data and Binary Logistic Regression to identify the subset of significant risk factors for neonatal mortality were applied to analyze the data. RESULTS An estimated 36 per 1000 live children had died before the first 28 days, with the highest in the Benishangul Gumuz region (15.9%) and the lowest in Addis Ababa (2.4%). From the Binary logistic regression analysis, the odds ratio and 95% CI of age 25-34 (OR = 0.263, 95% CI: 0.106-0.653), Afar (OR = 0.384, 95% CI: 0.167-0.884), SNNPR (OR = 0.265, 95% CI: 0.098-0.720), Addis Ababa (OR = 5.741, 95% CI: 1.115-29.566), Urban (OR = 0.253, 95% CI: 0.090, 0.709), toilet facility (OR = 0.603, 95% CI: 0.404-0.900), single birth (OR = 0.261, 95% CI: 0.138-0.495), poorest (OR = 10.573, 95% CI: 2.166-51.615), poorer (OR = 19.573, 95% CI: 4.171-91.848), never breastfed (OR = 35.939, 95% CI: 25.193-51.268), public health delivery (OR = 0.302, 95% CI: 0.106-0.859), private health facility (OR = 0.269, 95% CI: 0.095-0.760). CONCLUSION All regional states of Ethiopia, specially Benishangul Gumuz, and the Somali region must take remedial actions on public health policy, design strategies to improve facilities, and improve the capacities of stakeholders living in their region toward those major factors affecting neonatal mortality in the country.
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Affiliation(s)
- Abay Sahile
- Department of Statistics, Madda Walabu University, Robe, Oromia, Ethiopia
- * E-mail:
| | - Dereje Bekele
- Department of Statistics, Madda Walabu University, Robe, Oromia, Ethiopia
| | - Habtamu Ayele
- Department of Statistics, Madda Walabu University, Robe, Oromia, Ethiopia
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Rahman MA, Sultana S, Kundu S, Islam MA, Roshid HO, Khan ZI, Tohan M, Jahan N, Khan B, Howlader MH. Trends and patterns of inequalities in using facility delivery among reproductive-age women in Bangladesh: a decomposition analysis of 2007-2017 Demographic and Health Survey data. BMJ Open 2022; 12:e065674. [PMID: 36581408 PMCID: PMC9806084 DOI: 10.1136/bmjopen-2022-065674] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES The prime objectives of the study were to measure the prevalence of facility delivery, assess socioeconomic inequalities and determine potential associated factors in the use of facility delivery in Bangladesh.DesignCross-sectional. SETTING The study involved investigation of nationally representative secondary data from the Bangladesh Demographic and Health Survey between 2007 and 2017-2018. PARTICIPANTS The participants of this study were 30 940 (weighted) Bangladeshi women between the ages of 15 and 49. METHODS Decomposition analysis and multivariable logistic regression were both used to analyse data to achieve the study objectives. RESULTS The prevalence of using facility delivery in Bangladesh has increased from 14.48% in 2007 to 49.26% in 2017-2018. The concentration index for facility delivery utilisation was 0.308 with respect to household wealth status (p<0.001), indicating that use of facility delivery was more concentrated among the rich group of people. Decomposition analysis also indicated that wealth quintiles (18.31%), mothers' education (8.78%), place of residence (7.75%), birth order (5.56%), partners' education (4.30%) and antenatal care (ANC) seeking (8.51%) were the major contributors to the prorich socioeconomic inequalities in the use of facility delivery. This study found that women from urban areas, were overweight, had any level of education, from wealthier families, had ANC, and whose partners had any level of education and involved in business were more likely to have facility births compared with their respective counterparts. CONCLUSIONS This study found a prorich inequality in the use of facility delivery in Bangladesh. The socioeconomic disparities in facility delivery must be addressed if facility delivery usage is to increase in Bangladesh.
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Affiliation(s)
| | - Sumaya Sultana
- Development Studies, Khulna University, Khulna, Bangladesh
| | - Satyajit Kundu
- Global Health Institute, North South University, Dhaka, Bangladesh
- School of Public Health, Southeast University, Nanjing, People's Republic of China
- Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, Bangladesh
| | | | - Harun Or Roshid
- Statistics Discipline, Khulna University, Khulna, Bangladesh
| | | | - Mortuza Tohan
- Development Studies, Khulna University, Khulna, Bangladesh
| | - Nusrat Jahan
- Development Studies, Khulna University, Khulna, Bangladesh
| | - Bayezid Khan
- Development Studies, Khulna University, Khulna, Bangladesh
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Onu JU, Olatayo TI, Okorie AC, Ohaeri JU. Family, twin and adoption studies of severe mental disorders in sub-Saharan Africa: a scoping review. Soc Psychiatry Psychiatr Epidemiol 2022; 58:685-692. [PMID: 36542114 DOI: 10.1007/s00127-022-02407-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE The traditional genetic epidemiological studies are necessary to improve accurate risk communication to service users and their families. This scoping review aimed to describe the volume and scope of existing research evidence on family, twin and adoption studies of severe mental disorders (SMDs) in SSA. This is with a view to identifying gaps in the literature and the adequacy of data for a systematic review and meta-analysis. METHODS Literature search was done for all original peer-reviewed research articles on the topic in SSA using PubMed and MEDLINE. Publications included were peer-reviewed original articles, irrespective of their quality, carried out in the region from the 1970s till 9th March, 2022, which were available in English or translated to English. Case reports, abstracts, and studies among populations living outside the region were excluded. RESULTS A total of five studies that met the inclusion criteria across the 46 countries in the region were identified. Of the three thematic areas of focus, only family studies on SMDs had research work in SSA. These studies provided evidence of familial clustering of SMDs in SSA. There were no twin and adoption studies on SMDs in the region. However, the review noted the establishment of two twin registries in Guinea-Bissau and Nigeria. A huge gap exists in the area of twin and adoption studies on SMDs in SSA. CONCLUSION The volume of research evidence on traditional family genetic studies of SMDs is grossly inadequate to consider a systematic review in SSA. We have suggested studies to remedy the situation.
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Affiliation(s)
- Justus U Onu
- Department of Mental Health, Nnamdi Azikiwe University, Nnewi Campus, Awka, Anambra State, Nigeria.
| | - Temitope I Olatayo
- Department of Clinical Services, Federal Neuropsychiatric Hospital, Enugu, Enugu State, Nigeria
| | | | - Jude U Ohaeri
- Department of Psychological Medicine, University of Nigeria, Enugu Campus, Nsukka, Nigeria
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Kalinda C, Phiri M, Chimpinde K, Ishimwe MCS, Simona SJ. Trends and socio-demographic components of modern contraceptive use among sexually active women in Rwanda: a multivariate decomposition analysis. Reprod Health 2022; 19:226. [PMID: 36527042 PMCID: PMC9758849 DOI: 10.1186/s12978-022-01545-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 12/08/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The attainment of targets set for modern contraceptive use remains a challenge in sub-Saharan Africa. Rwanda, in its new Family Planning and Adolescent Sexual Reproductive Health/Family Planning (FP/ASRH) Strategic Plan 2018-2024 has set the attainment of a contraceptive prevalence rate (CPR) of 60% by 2024. To achieve this, identifying factors that enhance modern contraceptive use among sexually active women is critical. METHODS We used three Rwanda Demographic Health Surveys (RDHS) datasets collected in 2010, 2015, and 2019/2020 in a multivariable decomposition analysis technique to describe trends and identify factors influencing change in modern contraceptive use among sexually active women aged 15-49 years. Results presented as coefficients and percentages took into consideration the complex survey design weighted using StataSE 17. RESULTS Modern contraceptive use increased from 40% in 2010 to 52.4% in 2020 among sexually active women. About 23.7% of the overall percentage change in modern contraceptive use was attributable to women's characteristics which included women's education levels, number of living children, and being told about family planning at health facilities. Coefficients contributed 76.26% to the change in modern contraceptive use. This change was attributed to modern contraceptive use among young women between the age of 20-24 years, women's education level, the number of living children, changes in family size, and being visited by community health workers. CONCLUSION Rwanda remains on course to archive its 2024 family planning targets. However, there is a need to enhance programs that target sexually active adolescents and young adults, and women from rural areas to sustain the gains made. Furthermore, continuous support of community health workers will be key in exceeding the set targets of modern contraceptive use among sexually active women in Rwanda.
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Affiliation(s)
- Chester Kalinda
- grid.507436.30000 0004 8340 5635Bill and Joyce Cummings Institute of Global Health, University of Global Health Equity, Kigali Heights, Plot 772 KG 7 Ave., P. O. Box 6955, Kigali, Rwanda
| | - Million Phiri
- grid.12984.360000 0000 8914 5257School of Humanities and Social Sciences, University of Zambia, Great East Road Campus, P. O. Box 32379, Lusaka, Zambia ,grid.11951.3d0000 0004 1937 1135School of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Kafiswe Chimpinde
- grid.12984.360000 0000 8914 5257School of Humanities and Social Sciences, University of Zambia, Great East Road Campus, P. O. Box 32379, Lusaka, Zambia
| | - Marie C. S. Ishimwe
- grid.507436.30000 0004 8340 5635Institute of Global Health Equity Research (IGHER), University of Global Health Equity, Kigali Heights, Plot 772 KG 7 Ave, P. O. Box 6955, Kigali, Rwanda
| | - Simona J. Simona
- grid.12984.360000 0000 8914 5257School of Humanities and Social Sciences, University of Zambia, Great East Road Campus, P. O. Box 32379, Lusaka, Zambia
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Kundu S, Kundu S, Rahman MA, Kabir H, Al Banna MH, Basu S, Reza HM, Hossain A. Prevalence and determinants of contraceptive method use among Bangladeshi women of reproductive age: a multilevel multinomial analysis. BMC Public Health 2022; 22:2357. [PMID: 36526989 PMCID: PMC9756620 DOI: 10.1186/s12889-022-14857-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Much scholarly debate has centered on Bangladesh's family planning program (FPP) in lowering the country's fertility rate. This study aimed to investigate the prevalence of using modern and traditional contraceptive methods and to determine the factors that explain the contraceptive methods use. METHODS The study used data from the 2017-18 Bangladesh Demographic and Health Survey (BDHS), which included 11,452 (weighted) women aged 15-49 years in the analysis. Multilevel multinomial logistic regression was used to identify the factors associated with the contraceptive method use. RESULTS The prevalence of using modern contraceptive methods was 72.16%, while 14.58% of women used traditional methods in Bangladesh. In comparison to women in the 15-24 years age group, older women (35-49 years) were more unwilling to use modern contraceptive methods (RRR: 0.28, 95% CI: 0.21-0.37). Women who had at least a living child were more likely to use both traditional and modern contraceptive methods (RRR: 4.37, 95% CI: 3.12-6.11). Similarly, given birth in the previous 5 years influenced women 2.41 times more to use modern method compared to those who had not given birth (RRR: 2.41, 95% CI: 1.65-3.52). Husbands'/partners' decision for using/not using contraception were positively associated with the use of both traditional (RRR: 4.49, 95% CI: 3.04-6.63) and modern methods (RRR: 3.01, 95% CI: 2.15-4.17) rather than using no method. This study suggests rural participants were 21% less likely to utilize modern methods than urban participants (RRR: 0.79, 95% CI: 0.67-0.94). CONCLUSION Bangladesh remains a focus for contraceptive use, as it is one of the most populous countries in South Asia. To lower the fertility rate, policymakers may design interventions to improve awareness especially targeting uneducated, and rural reproductive women in Bangladesh. The study also highlights the importance of male partners' decision-making regarding women's contraceptive use.
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Affiliation(s)
- Satyajit Kundu
- grid.443020.10000 0001 2295 3329Global Health Institute, North South University, Dhaka, 1229 Bangladesh ,grid.263826.b0000 0004 1761 0489School of Public Health, Southeast University, Nanjing, 210096 China ,grid.443081.a0000 0004 0489 3643Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, 8602 Bangladesh
| | - Subarna Kundu
- grid.412118.f0000 0001 0441 1219Statistics Discipline, Khulna University, Khulna, 9208 Bangladesh
| | - Md. Ashfikur Rahman
- grid.412118.f0000 0001 0441 1219Development Studies Discipline, Khulna University, Khulna, 9208 Bangladesh
| | - Humayun Kabir
- grid.443020.10000 0001 2295 3329Department of Public Health, North South University, Dhaka, 1229 Bangladesh
| | - Md. Hasan Al Banna
- grid.443081.a0000 0004 0489 3643Department of Food Microbiology, Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, 8602 Bangladesh
| | - Saurav Basu
- grid.415361.40000 0004 1761 0198Indian Institute of Public Health, New Delhi, 122002 India
| | - Hasan Mahmud Reza
- grid.443020.10000 0001 2295 3329Department of Pharmaceutical Sciences, North South University, Dhaka, 1229 Bangladesh
| | - Ahmed Hossain
- grid.412789.10000 0004 4686 5317College of Health Sciences, University of Sharjah, 27272 Sharjah, United Arab Emirates
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Hussen NM. Application of two level count regression modeling on the determinants of fertility among married women in Ethiopia. BMC Womens Health 2022; 22:509. [PMID: 36494659 PMCID: PMC9733175 DOI: 10.1186/s12905-022-02060-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 11/10/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Fertility is the element of population dynamics that has a vital contribution toward changing population size and structure over time. The global population showed a major increment from time to time due to fertility. This increment was higher in south Asia and sub-Saharan Africa including Ethiopia. So this study targeted the factors affecting fertility among married women in Ethiopia through the framework of multilevel count regression analysis using the 2016 Ethiopian Demographic and Health Survey data. METHODS Secondary data set on the birth records were obtained from the 2016 Ethiopia Demographic and Health Survey. The survey was a population-based cross-sectional study with a two-stage stratified cluster sampling design, where stratification was achieved by separating every region into urban and rural areas except the Addis Ababa region because it is entirely urban. A two-level negative binomial regression model was fitted to spot out the determinants of fertility among married women in Ethiopia. RESULTS Among the random sample of 6141 women in the country, 27,150 births were recorded based on the 2016 Ethiopian Demographic and Health Survey report. The histograms showed that the data has a positively skewed distribution not extremely picked at the beginning. Findings from the study revealed that the contraception method used, residence, educational level of women, women's age at first birth, and proceeding birth interval were the major predictors of fertility among married women in Ethiopia. Moreover, the estimates from the random effect result revealed that there is more fertility variation between the enumeration areas than within the enumeration areas. CONCLUSION Unobserved enumeration area fertility differences that cannot be addressed by a single-level approach were determined using a two-level negative binomial regression modeling approach. So, the application of standard models by ignoring this variation ought to embrace spurious results, then for such hierarchical data, multilevel modeling is recommended.
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Affiliation(s)
- Nuru Mohammed Hussen
- grid.459905.40000 0004 4684 7098Statistics Department, Samara University, Samara, Ethiopia
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Perceived Adequacy of Material Support Systems Available to the Childless Older Adults in Southeastern Nigeria: Implications for Social Workers. AGEING INTERNATIONAL 2022. [DOI: 10.1007/s12126-022-09514-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Zelalem AT, Adamek ME, Gebremariam Kotecho M. Barriers to Active Aging in Rural Ethiopia: A Call for a Paradigm Shift to a Rights-Based Approach. J Aging Soc Policy 2022; 35:440-462. [DOI: 10.1080/08959420.2022.2139988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Abraham Teshome Zelalem
- MSW, Department of Social Work, Ambo University, Ambo, Ethiopia
- PhD student, Indiana University, Indianapolis, IN, USA
| | - Margaret E. Adamek
- PhD, School of Social Work, Indiana University, Indianapolis, IN 46202, USA
| | - Messay Gebremariam Kotecho
- PhD, School of Social Work, Addis Ababa University, Addis Ababa, Ethiopia
- Senior Research Associate, Department of Social Work and Community Development, University of Johannesburg, Johannesburg, South Africa
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Contraceptive use among female head porters: implications for health policy and programming in Ghana. Heliyon 2022; 8:e11985. [PMID: 36506400 PMCID: PMC9732301 DOI: 10.1016/j.heliyon.2022.e11985] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 06/10/2022] [Accepted: 11/22/2022] [Indexed: 12/03/2022] Open
Abstract
Objective Despite the growing literature on the barriers to contraceptives use among women, the perspective of female head porters has not been exhaustively researched. Using Bronfenbrenner's socio-ecological theory, we explore the factors that influence the contraceptive decision-making of migrant female head porters in the Kumasi Metropolis and the implications for health policy and planning. Methodology A case study of female head porters in the Kumasi Metropolis was conducted. We employed a qualitative approach in the collection and analysis of the data. A combination of cluster, purposive, and convenience sampling procedures was used to select 48 migrant female head porters to participate in semi-structured in-depth interviews. The data collected were analyzed using the thematic analytical framework. Results We found the main barriers to the uptake of contraception among the head porters to include high cost of contraceptives, perceived side effects associated with contraceptive use, and the disapproval of a male sexual partners. Conclusion The findings indicate that head porters' contraceptive decision-making is largely influenced by their social and economic circumstances. To address these, we recommend a carefully tailored approach, starting with a free National Health Insurance Scheme (NHIS) enrollment policy for all head porters in the country. There is also the need for the Ghana Health Service, and NGOs in health to work together to create effective awareness among female head porters on the benefits and misconceptions of contraception by incorporating culturally appropriate education that would facilitate the adoption of positive attitudes towards contraception. Additionally, NGOs in health in collaboration with the health facilities should initiate a process that encourages joint reproductive health decision-making among partners which recognises the added value of men's participation. We argue that men's active participation in contraception decision-making could potentially address their scepticism towards uptake.
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Amo K. Les étudiantes musulmanes sénégalaises. Une ethnographie de la diversité religieuse et identitaire au sein des campus universitaires. CAHIERS D ETUDES AFRICAINES 2022. [DOI: 10.4000/etudesafricaines.40287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Lokubal P, Corcuera I, Balil JM, Frischer SR, Kayemba CN, Kurinczuk JJ, Opondo C, Nair M. Abortion decision-making process trajectories and determinants in low- and middle-income countries: A mixed-methods systematic review and meta-analysis. EClinicalMedicine 2022; 54:101694. [PMID: 36277313 PMCID: PMC9579809 DOI: 10.1016/j.eclinm.2022.101694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND About 45.1% of all induced abortions are unsafe and 97% of these occur in low- and middle-income countries (LMICs). Women's abortion decisions may be complex and are influenced by various factors. We aimed to delineate women's abortion decision-making trajectories and their determinants in LMICs. METHODS We searched Medline, EMBASE, PsychInfo, Global Health, Web of Science, Scopus, IBSS, CINAHL, WHO Global Index Medicus, the Cochrane Library, WHO website, ProQuest, and Google Scholar for primary studies and reports published between January 1, 2000, and February 16, 2021 (updated on June 06, 2022), on induced abortion decision-making trajectories and/or their determinants in LMICs. We excluded studies on spontaneous abortion. Two independent reviewers extracted and assessed quality of each paper. We used "best fit" framework synthesis to synthesise abortion decision-making trajectories and thematic synthesis to synthesise their determinants. We analysed quantitative findings using random effects model. The study protocol is registered with PROSPERO number CRD42021224719. FINDINGS Of the 6960 articles identified, we included 79 in the systematic review and 14 in the meta-analysis. We identified nine abortion decision-making trajectories: pregnancy awareness, self-reflection, initial abortion decision, disclosure and seeking support, negotiations, final decision, access and information, abortion procedure, and post-abortion experience and care. Determinants of trajectories included three major themes of autonomy in decision-making, access and choice. A meta-analysis of data from 7737 women showed that the proportion of the overall women's involvement in abortion decision-making was 0.86 (95% CI:0.73-0.95, I2 = 99.5%) and overall partner involvement was 0.48 (95% CI:0.29-0.68, I2 = 99.6%). INTERPRETATION Policies and strategies should address women's perceptions of safe abortion socially, legally, and economically, and where appropriate, involvement of male partners in abortion decision-making processes to facilitate safe abortion. Clinical heterogeneity, in which various studies defined "the final decision-maker" differentially, was a limitation of our study. FUNDING Nuffield Department of Population Health DPhil Scholarship for PL, University of Oxford, and the Medical Research Council Career Development Award for MN (Grant Ref: MR/P022030/1).
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Affiliation(s)
- Paul Lokubal
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
- Corresponding author at: National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Headington OX3 7LF Oxford, UK.
| | - Ines Corcuera
- Chelsea and Westminster Hospital, NHS Foundation Trust, London, UK
| | | | - Sandrena Ruth Frischer
- Ethox Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Christine Nalwadda Kayemba
- Department of Community Health and Behavioural Sciences, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Jennifer J. Kurinczuk
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Charles Opondo
- Department of Medical Statistics, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Manisha Nair
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
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Merera AM, Lelisho ME, Pandey D. Prevalence and Determinants of Contraceptive Utilization among Women in the Reproductive Age Group in Ethiopia. J Racial Ethn Health Disparities 2022; 9:2340-2350. [PMID: 34780019 DOI: 10.1007/s40615-021-01171-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 10/08/2021] [Accepted: 10/14/2021] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Despite the huge advantages of family planning programs, contraception use in Ethiopia remains low. Determining the magnitude and associated factors of contraceptive utilization helps to take action for further improvement. Therefore, this study aimed to assess the prevalence and identify determinants of using contraceptives among women of reproductive age in Ethiopia. METHODS The 2019 Ethiopian Mini Demographic and Health Survey 2019 (EMDHS 2019) dataset was utilized in this population-based investigation. In the current study, 8885 reproductive-age women were included. Binary logistic regression analysis was employed to examine significant factors associated with the utilization of contraceptive methods. The analysis was done using SPSS software version 20. RESULTS The prevalence of contraceptive utilization amongst women's reproductive age in Ethiopia was 37.6%. Of all contraceptive users, a large number of women, 57.0%, used injectable kinds of contraceptives followed by implants (24.3%). Participants aged 20-29 (AOR = 2.32, 95%CI: 1.79-3.01) and aged 30-39 years (AOR = 3.12, 95%CI: 2.58-3.78); from Addis Ababa (AOR = 3.27, 95%CI:2.42-4.43), Dire Dawa (AOR = 2.96, 95%CI:2.28-3.84), and urban residence (AOR = 2.49, 95%CI:2.13-2.91); who had secondary education level 1.391(AOR = 1.14-1.70), diploma and above (AOR = 1.39, 95%CI:1.12-1.72); being in rich wealth index (AOR = 1.260, 95%CI:1.06-1.50); having five or more children (AOR = 1.37, 95%CI:1.17-1.61); and who had knowledge about contraceptives (AOR = 1.88, 95%CI:1.42-2.48) and being married (AOR = 5.82, 95%CI: 4.60-7.36) had higher odds of utilizing contraceptives, while women aged 40-49 years (AOR = 0.93, 95%CI: 0.89-0.96) and from residential region of Oromia (AOR = 0.516, 95%CI: 0.40-0.67), Somalia (AOR = 0.48, 95%CI: 0.38-0.62) and Benishangul (AOR = 0.53, 95%CI: 0.40-0.70) had lower odds of using contraception. CONCLUSIONS The study concluded that the use of contraceptives remained very low (found below the national target) in Ethiopia. Factors like age, educational level, number of children, and region of the women, religion, wealth index, and marital status are determinant factors associated with contraceptive use among reproductive-age women in Ethiopia. For a more successful intervention approach that encourages the use of contraceptive methods, these variables should be considered.
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Affiliation(s)
- Amanuel Mengistu Merera
- Department of statistics, College of Natural and Computational Science, Mizan-Tepi University, Tepi, Ethiopia.
| | - Mesfin Esayas Lelisho
- Department of statistics, College of Natural and Computational Science, Mizan-Tepi University, Tepi, Ethiopia
| | - Digvijay Pandey
- Department of Technical Education, IET, Dr. A.P.J Abdul Kalam Technical University, Lucknow, India
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Ojifinni OO, Ibisomi L. Perception of men's need for preconception care-A qualitative exploration among health care providers and community members. Front Public Health 2022; 10:958618. [PMID: 36523582 PMCID: PMC9745313 DOI: 10.3389/fpubh.2022.958618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 11/15/2022] [Indexed: 11/30/2022] Open
Abstract
Background Several studies have shown that suboptimal health in men can result in poor reproductive health outcomes. The factors associated include lifestyle exposures and poor health-seeking behavior. The poor reproductive health outcomes can be mitigated through preconception care (PCC). PCC services for men are however rare. This qualitative study explored views about men's need for PCC in Nigeria. Methods This exploratory qualitative study was done in Ibadan North Local Government Area, Oyo State, Nigeria. Focus group discussions were held with 12 religious leaders, 22 men and 23 women of reproductive age at the community level. There were key informant interviews with two community leaders and 26 health workers including specialist physicians and nurses at the primary, secondary, and tertiary health care levels. Transcribed data were analyzed thematically using inductive coding on MAXQDA. Results The reasons participants proffered for men's health requiring attention included men's genetic contribution to pregnancy, treatment of low sperm count, and preventing transmission of infection to their partners. Participants stated however that men are often reluctant about accessing health services until complications arise. Opinions differed on men's need for PCC: while some believed that men need PCC, others expressed contrary views stating that men do not require PCC as the service is more appropriate for women. Conclusion Successful deployment and uptake of PCC services require the availability of the services and improved awareness about the need to optimize men's health along with that of their partners.
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Affiliation(s)
- Oludoyinmola O. Ojifinni
- School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Latifat Ibisomi
- Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- Monitoring and Evaluation Department, Nigerian Institute of Medical Research, Lagos, Nigeria
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Budu E, Ahinkorah BO, Seidu AA, Armah-Ansah EK, Salihu T, Aboagye RG, Yaya S. Intention to use contraceptives among married and cohabiting women in sub-Saharan Africa: a multilevel analysis of cross-sectional data. BMJ Open 2022; 12:e060073. [PMID: 36424119 PMCID: PMC9693891 DOI: 10.1136/bmjopen-2021-060073] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To examine the factors associated with intention to use contraceptives among married and cohabiting women in sub-Saharan Africa (SSA). DESIGN Data for the study were extracted from the most recent Demographic and Health Surveys of 29 countries in SSA conducted from 2010 to 2020. We included a total of 180 682 women who were married or cohabiting. Multilevel regression analysis was carried out and the results were presented as adjusted odds ratio (AOR), with 95% confidence interval (CI). SETTING 29 countries in SSA. PARTICIPANTS Women aged 15-49 years in sexual unions. OUTCOME MEASURE Intention to use contraceptives. RESULTS The pooled prevalence of intention to use contraceptives among married and cohabiting women in the 29 countries was 41.46%. The prevalence ranged from 18.28% in Comoros to 71.39% in Rwanda. Intention to use contraceptives was lower among women aged 45-49 (AOR=0.06, 95% CI= 0.05 to 0.07), those with no education (AOR=0.60, 95% CI= 0.58 to 0.61), and primary education (AOR=0.90, 95% CI 0.88 to 0.93), married women (AOR=0.81, 95% CI= 0.79 to 0.84), those of the poorest wealth quintile (AOR=0.78, 95% CI= 0.75 to 0.82), and women who were not exposed to mass media (AOR=0.87, 95% CI= 0.86 to 0.90). Women with four or more births (AOR=2.09, 95% CI= 1.99 to 2.19) had greater likelihood of contraceptive use intention compared to those with no birth. Women in rural settings were found to have greater likelihood of intention to use contraceptives compared to those in urban settings (AOR=1.10, 95% CI= 1.07 to 1.14). CONCLUSION There is a low prevalence of contraceptive use intention among married and cohabiting women in SSA with differences between countries. It is imperative for policymakers to consider these factors when developing and executing contraceptive programmes or policies to enhance contraceptive intents and use among married and cohabiting women. To resolve discrepancies and increase contraceptive intention among women, policymakers and other key stakeholders should expand public health education programmes.
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Affiliation(s)
- Eugene Budu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Bright Opoku Ahinkorah
- School of Public Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Abdul-Aziz Seidu
- Centre for Gender and Advocacy, Takoradi Technical University, Takoradi, Ghana
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Ebenezer Kwesi Armah-Ansah
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
- Population Dynamics Sexual and Reproductive Health Unit, African Population and Health Research Center, Nairobi, Kenya
- Department of Population and Development, National Research University - Higher School of Economics, Moscow, Russia
| | - Tarif Salihu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Richard Gyan Aboagye
- Department of Family and Community Health, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Ottawa, Ontario, Canada
- The George Institute for Global Healtj, Imperial College London, London, UK
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Logie CH, Okumu M, Loutet MG, Coelho M, Berry I, Gittings L, Odong Lukone S, Kisubi N, Atama M, Kyambadde P. Todurujo na Kadurok (empowering youth): study protocol of an HIV self-testing and edutainment comic cluster randomised trial among refugee youth in a humanitarian setting in Uganda. BMJ Open 2022; 12:e065452. [PMID: 36418143 PMCID: PMC9685005 DOI: 10.1136/bmjopen-2022-065452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Refugees experience HIV vulnerabilities due to the confluence of displacement, violence and poverty. HIV self-testing, understudied with refugees, is a promising method to increase testing uptake, yet challenges remain with linkages to confirmatory testing following a positive HIV self-test. This study aims to evaluate the effectiveness of HIV self-testing kits and 'edutainment' comics in increasing HIV testing and HIV status knowledge among refugee youth aged 16-24 years in Bidi Bidi Refugee Settlement, Uganda. METHODS AND ANALYSIS This study will be conducted in Bidi Bidi. We conducted a qualitative formative phase with focus groups (n=40) to generate knowledge of barriers and facilitators of HIV prevention, testing and care among refugee youth (aged 16-24) in Bidi Bidi. These findings were used to create comic scenarios aligning with edutainment approaches to health promotion and inform a four-arm cluster randomised controlled trial in Bidi Bidi using a 2×2 factorial design: (1) HIV self-testing alongside edutainment comics, (2) HIV self-testing alone, (3) edutainment comic alone and (4) standard of care. The target sample size will be 120 youth (30 per arm), who will be enrolled in the trial and followed for 3 months. Data will be collected at baseline and 3 months after enrolment. The primary outcomes (HIV testing frequency, HIV status knowledge) and secondary outcomes (linkage to confirmatory HIV testing, HIV care linkage, HIV self-test kit use, HIV-related stigma, HIV knowledge, safer sex efficacy, condom use, adolescent sexual and reproductive health (SRH) stigma, sexual relationship power, access to SRH services) will be evaluated using descriptive statistics and regression analyses. ETHICS AND DISSEMINATION This study was approved by the University of Toronto Research Ethics Board, Mildmay Uganda Research Ethics Committee and the Uganda National Council for Science and Technology. Results will be shared in peer-reviewed publications and community knowledge sharing. TRIAL REGISTRATION NUMBER NCT05213689.
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Affiliation(s)
- Carmen H Logie
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
- Women's College Research Institute, University of Toronto, Toronto, Ontario, Canada
- United Nations University Institute for Water, Environment and Health (UNU-INWEH), Hamilton, Ontario, Canada
- Centre for Gender & Sexual Health Equity, Vancouver, British Columbia, Canada
| | - Moses Okumu
- School of Social Work, University of Illinois-Champaign, Urbana, Illinois, USA
- School of Social Sciences, Uganda Christian University, Mukono, Uganda
| | - Miranda G Loutet
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Madelaine Coelho
- Department of Sociology, University of Toronto, Toronto, Ontario, Canada
| | - Isha Berry
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Lesley Gittings
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
- University of Cape Town, Rondebosch, South Africa
- School of Health Studies, Faculty of Health Sciences, Western University, London, ON, Canada
| | | | - Nelson Kisubi
- Uganda Refugee and Disaster Management Council, Yumbe, Uganda
| | - Malon Atama
- Yumbe Regional Referral Hospital, Yumbe, Uganda
| | - Peter Kyambadde
- Most at Risk Population Initiative, Mulago Hospital, Kampala, Uganda
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