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Sidibé S, Grovogui FM, Kourouma K, Kolié D, Camara BS, Delamou A, Kouanda S. Unmet need for contraception and its associated factors among adolescent and young women in Guinea: A multilevel analysis of the 2018 Demographic and Health Surveys. Front Glob Womens Health 2022; 3:932997. [DOI: 10.3389/fgwh.2022.932997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 10/10/2022] [Indexed: 11/18/2022] Open
Abstract
Despite the recent repositioning efforts to increase the use of modern contraceptives, the prevalence of unmet need for contraception remains high among adolescent and young women in Guinea. This study analyzed the individual and contextual factors associated with the unmet need for contraception among adolescent and young women in 2018 in Guinea. We conducted a secondary analysis of the 2018 Demographic and Health Survey data. Multilevel mixed-effects logistic regression models were used to assess the association between individual and contextual characteristics and unmet need for contraception among adolescents and young women. Adjusted odds ratios (AORs) with their 95% confidence intervals (CIs) were calculated, with statistical significance set at p < 0.05. The prevalence of total unmet need for contraception was 22.6% (95% CI, 18.1–27.8). Being an adolescent aged 15–19 years (AOR = 1.44; 95% CI, 1.01–2.05), unmarried (AOR = 5.19; 95% CI, 3.51–7.67), having one or two children (AOR = 3.04; 95% CI, 2.18–4.25), or more than two children (AOR = 4.79; 95% CI, 3.00–7.62) were individual factors associated with the unmet need for contraception. As for community factors, only living in Labé (AOR = 2.54; 95% CI, 1.24–5.18) or Mamou (AOR = 1.73; 95% CI, 1.21–2.48) was significantly associated with the unmet need for contraception. In conclusion, both individual and community characteristics were significantly associated with the unmet need for contraception. This highlights the need to focus and strengthen communication and counseling strategies targeting adolescents and young women and aiming to increase the uptake of family planning in Guinea.
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Okunlola DA. Women’s and male partners’ socio-demographic and economic characteristics associated with contraceptive decision making in Nigeria. BMC Womens Health 2022; 22:450. [DOI: 10.1186/s12905-022-02045-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 11/02/2022] [Indexed: 11/17/2022] Open
Abstract
Abstract
Background
Women’s ability to make contraceptive decision can determine their contraceptive use which can improve their reproductive health and career. Improvement in such ability can increase contraceptive prevalence in Nigeria. However, factors that promote contraceptive decision-making among women are scarcely studied. This study examined factors associated with women’s individual or joint contraceptive decision-making in Nigeria.
Methods
Secondary (cross-sectional) data were analysed. The data were extracted from the individual recode file of the 2018 Nigeria Demographic and Health Survey (DHS). Partnered women (i.e., currently married or living with a partner) aged 15–49 years and currently using contraceptives before the survey were considered. They constituted 4,823 in total. Their data were analysed using frequency and percentage distributions of variables, Chi-square tests of independence and multinominal logistic regression.
Results
Findings reveal that 23% (1,125) of women made their own contraceptive decision, nearly 67% (3,213) were joint decision makers, and 10% (491) stated that their male partners had decided for them. The probability of solely making contraceptive decision and being a joint decision maker (relative to being a male partner’s decision) was higher among women above 29 years and aged 30–34 years (than women aged 15–24 years) respectively as well as among the employed (than the unemployed) and among those from Yoruba ethnic group (than their counterparts from Hausa/Fulani/Kanuri/Beri Beri) respectively. The probability of being responsible for contraceptive decision (than being the male partner’s decision) was higher among women from the Igbo group and women whose male partners desired more children (than those with the same number of desired children) respectively. The probability of being the main decision maker (relative to being the male partner) was lower among women in the poorer (RRR = 0.39; 95%CI = 0.21–0.73; p = 0.01), middle (RRR = 0.47; 95%CI = 0.25–0.90; p = 0.02) and richest (RRR = 0.41; 95%CI = 0.20–0.82; p = 0.01) groups respectively, than the poorest women. The probability of being a joint decision maker was higher among women with secondary education (than the uneducated), practised Christianity (than the Muslims/ others), and among those residing in the North West region (than those in North East) respectively. However, the probability of being a joint decision-maker was lower among women whose partners desire more children and those who did not know their partners’ desires.
Conclusions
Women’s age, highest level of education, employment status, wealth index, ethnicity, religion, region of residence and male partners’ desire for children are associated with contraceptive decision making respectively. There is a need for reproductive empowerment interventions in Nigeria that devise effective ways of improving contraceptive decision-making power of partnered women aged 15–24 years, unemployed, in the poorer and richest groups, from the Hausa/Fulani/Kanuri/Beri Beri ethnic group, practising Islam/ other religions, have the same fertility desire as their partners and those who do not know their male partner’s desire for children respectively. Women whose partners desire more children should be empowered to participate effectively in contraceptive decision making.
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Negash WD, Asmamaw DB. Time to first birth and its predictors among reproductive age women in high fertility countries in Sub-Saharan Africa: Inverse Weibull gamma shared frailty model. BMC Pregnancy Childbirth 2022; 22:844. [PMID: 36384519 PMCID: PMC9670487 DOI: 10.1186/s12884-022-05206-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 11/10/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Early initiation of childbearing leads to an increase in total fertility rate and population growth. It has been linked with both maternal and child morbidity and mortality. However, there is limited information on the timing of the first birth and its predictors in the area so far. Therefore, determining the time to first birth and its predictors will help to design strategies to improve fertility rate, maternal and child survival. METHODS The survey used recent (2010 - 2018) Demographic and Health data; a stratified, two-stage cluster sampling technique was used to select the sample. Inverse Weibull gamma shared frailty model was used to model the data at 95% confidence interval. Adjusted hazard ratio (AHR) and median hazard ratio (MHR) were reported as effect size. Statistical significance was declared at p value < 0.05. RESULTS The overall median age at first birth was found to be 19 years (IQR: 16, 21 years). Rural residency (AHR = 1.02, 95%, CI 1.00,1.04), agricultural employee (AHR = 1.14, 95%, CI 1.13, 1.17), and nonagricultural employee (AHR = 1.06, 95%, CI 1.05, 1.08), marriage below 15 years (AHR = 5.47, 95%, CI 5.37, 5.57) and 15-17 years (AHR = 3.27, 95%, CI 3.22, 3.32), had sex below 15 years (AHR = = 1.57, 95%, CI 1.54, 1.61) and 15-17 years (AHR = 1.38, 95%, CI 1.38, 1.43), women who had unmet need for contraceptive (AHR = 1.39, 95%, CI 1.37, 1.42), and met need (AHR = 1.32, 95%, CI 1.30, 1.35), high spousal age gap (AHR = 1.17, 95%, CI 1.15, 1.19), not heard family planning message (AHR = 1.02, 95%, CI 1.01,1.04) were the higher hazard of early childbirth. CONCLUSION The median age at first birth was found to be 19 years. This is lower than the optimal age for giving first birth, which is between late 20 s and early 30 s years. Rural residences, occupation, hearing family planning massage in the media, early sexual intercourse, early age at first marriage, high spousal gap, and unmet need for family planning were predictors of first birth at an early age. Thus, governments and non-governmental organizations should strive to implement programs that aim to reduce early age at first birth by considering these factors.
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Affiliation(s)
- Wubshet Debebe Negash
- Department of Health Systems and Policy, College of Medicine and Health Sciences, Institute of Public Health, University of Gondar, P.O.Box: 196, Gondar, Ethiopia
| | - Desale Bihonegn Asmamaw
- Department of Reproductive Health, College of Medicine and Health Sciences, Institute of Public Health, University of Gondar, Gondar, Ethiopia
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Binyamini IM, Shoshana A. "I wanted to be a bride, not a wife": Accounts of child marriage in the Bedouin community in Israel. Transcult Psychiatry 2022; 60:357-367. [PMID: 36384329 DOI: 10.1177/13634615221135936] [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] [Indexed: 11/18/2022]
Abstract
This article presents a qualitative study of the experience of child marriage among Bedouin in Israel. We conducted semi-structured interviews with a convenience sample of 17 young Bedouin women, aged 17-21, who were married between the ages of 12-17. The interviewees' descriptions indicate that child marriage is a powerful cultural practice that has evolved into a "natural" and "obvious" tool for supervising girls and women. All the interviewees reported domestic violence, despair, and reported suicide attempts as a response to their existential suffering in their marriage and as an act of daily resistance to a powerful and oppressive cultural practice. These findings raise challenges in the case of global mental health interventions since these interventions not only require cultural sensitivity to avoid the constraint of Western psychiatric diagnoses and classifications, but also more critical thinking about the interactions between global and local, universalist and culturalist perspectives.
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Eboreime E, Ogwa O, Nnabude R, Aluka-Omitiran K, Banke-Thomas A, Orji N, Eluwa A, Ezeokoli A, Rotimi A, Eze LU, Offiong V, Odu U, Okonkwo R, Umeh C, Ilika F, Oreh A, Adams FN, Okpani IA, Ogundeji Y, Mbachu C, Obi FA, Badejo O. Engaging stakeholders to identify gaps and develop strategies to inform evidence use for health policymaking in Nigeria. Pan Afr Med J 2022; 43:140. [PMID: 36762150 PMCID: PMC9898774 DOI: 10.11604/pamj.2022.43.140.36754] [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: 08/10/2022] [Accepted: 10/25/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction recent efforts to bridge the evidence-policy gap in low-and middle-income countries have seen growing interest from key audiences such as government, civil society, international organizations, private sector players, academia, and media. One of such engagement was a two-day virtual participant-driven conference (the convening) in Nigeria. The aim of the convening was to develop strategies for improving evidence use in health policy. The convening witnessed a participant blend of health policymakers, researchers, political policymakers, philanthropists, global health practitioners, program officers, students, and the media. Methods in this study, we analyzed conversations at the convening with the aim to disseminate findings to key stakeholders in Nigeria. The recordings from the convening were transcribed and analyzed inductively to identify emerging themes, which were interpreted, and inferences are drawn. Results a total of 630 people attended the convening. Participants joined from 13 countries. Participants identified poor collaboration between researchers and policymakers, poor community involvement in research and policy processes, poor funding for research, and inequalities as key factors inhibiting the use of evidence for policymaking in Nigeria. Strategies proposed to address these challenges include the use of participatory and embedded research methods, leveraging existing systems and networks, advocating for improved funding and ownership for research, and the use of context-sensitive knowledge translation strategies. Conclusion overall, better interaction among the various stakeholders will improve the evidence generation, translation, and use in Nigeria. A road map for the dissemination of findings from this conference has been developed for implementation across the strata of the health system.
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Affiliation(s)
- Ejemai Eboreime
- Talk Health Real Media Limited, Abuja, Nigeria,,Corresponding author: Ejemai Eboreime, Department of Psychiatry, University of Alberta, Edmonton, Canada.
| | - Oluwafunmike Ogwa
- Systems Development Initiative, Abuja, Nigeria,,Doctorkk Health International, Lagos, Nigeria
| | - Rosemary Nnabude
- Systems Development Initiative, Abuja, Nigeria,,School of Public Health, University of Alberta, Edmonton, Canada
| | - Kasarachi Aluka-Omitiran
- Systems Development Initiative, Abuja, Nigeria,,Department of Community Health Services, National Primary Health Care Development Agency, Abuja, Nigeria
| | - Aduragbemi Banke-Thomas
- School of Human Sciences, University of Greenwich, London, United Kingdom,,London School of Economics and Political Science, London, United Kingdom
| | - Nneka Orji
- Systems Development Initiative, Abuja, Nigeria,,Department of Health Planning, Research and Statistics, Federal Ministry of Health, Abuja, Nigeria
| | - Achama Eluwa
- Systems Development Initiative, Abuja, Nigeria,,Health, Nutrition and Population Global Practice Unit, The World Bank, Washington DC, United States of America
| | - Adaobi Ezeokoli
- Systems Development Initiative, Abuja, Nigeria,,Harvard Kennedy School, Harvard University, Cambridge, Massachusetts, United States
| | - Aanu Rotimi
- Systems Development Initiative, Abuja, Nigeria,,Centre for Accountability and Inclusive Development, Abuja, Nigeria
| | - Laz Ude Eze
- Systems Development Initiative, Abuja, Nigeria,,Talk Health Real Media Limited, Abuja, Nigeria
| | - Vanessa Offiong
- Systems Development Initiative, Abuja, Nigeria,,As Equals, CNN International, Abuja, Nigeria
| | - Ugochi Odu
- Systems Development Initiative, Abuja, Nigeria,,Healthreach limited, Abuja, Nigeria
| | - Rita Okonkwo
- Systems Development Initiative, Abuja, Nigeria,,Institute of Human Virology Nigeria, International Research Center of Excellence, Abuja, Nigeria
| | - Chukwunonso Umeh
- Systems Development Initiative, Abuja, Nigeria,,African Youth Initiative on Population Health and Development (AfrYPoD), Abuja, Nigeria
| | - Frances Ilika
- Palladium, Health Policy Plus Project, Abuja, Nigeria
| | - Adaeze Oreh
- Department of Planning, Research and Statistics, National Blood Transfusion Service, Abuja, Nigeria
| | | | - Ikedichi Arnold Okpani
- School of Population and Public Health, The University of British Columbia, Vancouver, Canada
| | - Yewande Ogundeji
- O'Brien Institute for Public Health, University of Calgary, Calgary, Canada
| | - Chinyere Mbachu
- Health Policy Research Group, College of Medicine, University of Nigeria, Enugu, Nigeria
| | - Felix Abrahams Obi
- Systems Development Initiative, Abuja, Nigeria,,Results for Development (R4D), Nigeria Country Office, Abuja, Nigeria
| | - Okikiolu Badejo
- Systems Development Initiative, Abuja, Nigeria,,Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
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Exploring the Influencing Factors for Contraceptive Use among Women: A Meta-Analysis of Demographic and Health Survey Data from 18 Developing Countries. Int J Reprod Med 2022; 2022:6942438. [DOI: 10.1155/2022/6942438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/13/2022] [Accepted: 10/19/2022] [Indexed: 11/15/2022] Open
Abstract
Background. The primary objective of this research was to investigate how socioeconomic and demographic factors influence the usage of contraceptives by women in 18 developing countries. Methods. The study used the latest DHS data from 18 developing countries in order to acquire a broad perspective of contraceptive methods. We applied meta-analysis techniques for 18 developing countries to find out the summary results. Results. The overall summary effect showed that the variable respondent education (
; 95% CI: 1.17 to 1.65), husband education (
; 95% CI: 1.32 to 1.93), type of place of residence (
; 95% CI 0.78 to 0.98), current working status (
; 95% CI 1.30 to 1.66), age of the respondent (
; 95% CI 2.35 to 4.93), breastfeeding status (
; 95% CI 1.11 to 1.62), and desire for more children (
; 95% CI 0.43 to 0.65) were the significant factors for contraceptive utilization in developing countries. Conclusions. According to the findings of this descriptive study, the respondent’s age, level of education, and work status were shown to be the most significant factors that influence the usage of contraceptives in developing countries. It is necessary to take reasonable steps in order to increase the rate of utilizing methods of contraception among women of reproductive age who are uneducated, living in rural areas, and unemployed.
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Ranney ML, Stettenbauer EG, Delgado MK, Yao KA, Orchowski LM. Uses of mHealth in Injury Prevention and Control: a Critical Review. CURR EPIDEMIOL REP 2022; 9:273-281. [PMID: 36404873 PMCID: PMC9644389 DOI: 10.1007/s40471-022-00312-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2022] [Indexed: 11/10/2022]
Abstract
Purpose of Reviews The purpose of this review was to summarize the current state of the literature on the use of "mHealth" (the use of mobile devices for health promotion) for injury prevention and control. Recent Findings mHealth is being used to measure, predict, and prevent the full spectrum of injuries. However, most literature remains preliminary or in a pilot stage. Use of best-of-class design principles (e.g., user-centered design, theory-based development) is uncommon, and wide-scale dissemination of effective monitoring or intervention tools is rare. Summary mHealth for injury prevention holds promise, but further work is needed across the full spectrum of development and translation.
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Affiliation(s)
- Megan L. Ranney
- Department of Emergency Medicine, Alpert Medical School Brown University, Providence, USA
- Brown-Lifespan Center for Digital Health, Providence, USA
- Department of Behavioral and Social Science, School of Public Health, Brown University, Providence, USA
| | - E. G. Stettenbauer
- Department of Health Services, Policy and Practice, School of Public Health, Brown University, Providence, USA
| | - M. Kit Delgado
- Department of Emergency Medicine and Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, USA
| | | | - Lindsay M. Orchowski
- Brown-Lifespan Center for Digital Health, Providence, USA
- Department of Psychiatry and Human Behavior, Rhode Island Hospital, Providence, RI USA
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Moturi AK, Suiyanka L, Mumo E, Snow RW, Okiro EA, Macharia PM. Geographic accessibility to public and private health facilities in Kenya in 2021: An updated geocoded inventory and spatial analysis. Front Public Health 2022; 10:1002975. [PMID: 36407994 PMCID: PMC9670107 DOI: 10.3389/fpubh.2022.1002975] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 10/19/2022] [Indexed: 11/06/2022] Open
Abstract
Objectives To achieve universal health coverage, adequate geographic access to quality healthcare services is vital and should be characterized periodically to support planning. However, in Kenya, previous assessments of geographic accessibility have relied on public health facility lists only, assembled several years ago. Here, for the first time we assemble a geocoded list of public and private health facilities in 2021 and make use of this updated list to interrogate geographical accessibility to all health providers. Methods Existing health provider lists in Kenya were accessed, merged, cleaned, harmonized, and assigned a unique geospatial location. The resultant master list was combined with road network, land use, topography, travel barriers and healthcare-seeking behavior within a geospatial framework to estimate travel time to the nearest (i) private, (ii) public, and (iii) both (public and private-PP) health facilities through a travel scenario involving walking, bicycling and motorized transport. The proportion of the population within 1 h and outside 2-h was computed at 300 × 300 spatial resolution and aggregated at subnational units used for decision-making. Areas with a high disease prevalence for common infections that were outside 1-h catchment (dual burden) were also identified to guide prioritization. Results The combined database contained 13,579 health facilities, both in the public (55.5%) and private-for-profit sector (44.5%) in 2021. The private health facilities' distribution was skewed toward the urban counties. Nationally, average travel time to the nearest health facility was 130, 254, and 128 min while the population within 1-h was 89.4, 80.5, and 89.6% for the public, private and PP health facility, respectively. The population outside 2-h were 6% for public and PP and 11% for the private sector. Mean travel time across counties was heterogeneous, while the population within 1-h ranged between 38 and 100% in both the public sector and PP. Counties in northwest and southeast Kenya had a dual burden. Conclusion Continuous updating and geocoding of health facilities will facilitate an improved understanding of healthcare gaps for planning. Heterogeneities in geographical access continue to persist, with some areas having a dual burden and should be prioritized toward reducing health inequities and attaining universal health coverage.
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Affiliation(s)
- Angela K. Moturi
- Population Health Unit, Kenya Medical Research Institute-Wellcome Trust Research Programme, Nairobi, Kenya
| | - Laurissa Suiyanka
- Population Health Unit, Kenya Medical Research Institute-Wellcome Trust Research Programme, Nairobi, Kenya
| | - Eda Mumo
- Population Health Unit, Kenya Medical Research Institute-Wellcome Trust Research Programme, Nairobi, Kenya
| | - Robert W. Snow
- Population Health Unit, Kenya Medical Research Institute-Wellcome Trust Research Programme, Nairobi, Kenya
- Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom
| | - Emelda A. Okiro
- Population Health Unit, Kenya Medical Research Institute-Wellcome Trust Research Programme, Nairobi, Kenya
- Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom
| | - Peter M. Macharia
- Population Health Unit, Kenya Medical Research Institute-Wellcome Trust Research Programme, Nairobi, Kenya
- Centre for Health Informatics, Computing, and Statistics, Lancaster Medical School, Lancaster University, Lancaster, United Kingdom
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Amoah AN, Danquah AO, Stanislav TS, Drokow EK, Yacong B, Wang L, Lyu Q. Correlates of dietary diversity among children aged 6-23 months of head porters in Ghana. Front Public Health 2022; 10:1020265. [PMID: 36407999 PMCID: PMC9671282 DOI: 10.3389/fpubh.2022.1020265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022] Open
Abstract
Objective In many developing countries, most children cannot meet minimum dietary diversity (MDD), defined as the consumption of four or more of the seven food groups. In Ghana, only 35% of children met MDD nationwide in 2017, but rates are worse among the rural poor and resource-constrained individuals like Head Porters (HPs). The current study investigated the correlates of MDD in children of HPs aged 6-23 months old in Ghana. Methods and materials A cross-sectional survey was carried out in 2021 among 423 HPs selected purposively from eight market centers in two commercial cities. A multi-stage sampling method was used in obtaining the sample, while a structured interview guide was used to collect data from the caregivers. Stata version 15.1 and descriptive and inferential statistics like frequency, percentage, chi-square and logistic regression were used to analyze the data. All results were deemed significant if the p-value was < 0.05 and the odds ratios with a 95% confidence interval. Results The children had a mean age of 14.3 (±4.9) months, while half of the caregivers (48.2%) were between 15 and 25 years. Approximately 59% (251) had good knowledge of infant and young child feeding practices (IYCF). About 45% of the children consumed a diversified diet. The number of postnatal care (PNC) visits, delivery in a health facility, meeting minimum meal frequency (MMF), and the child's age was independently associated with MDD at the multivariate level. Conclusion Over a third of the caregivers had poor knowledge of IYCF practices. Furthermore, less than half of the children achieved MDD reflecting the need for more education by the stakeholders. Regular PNC visits and delivery in health facilities were independently associated with MDD; therefore, interventions to combat low MDD should prioritize the relevance of these predictors.
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Affiliation(s)
| | | | | | - Emmanuel Kwateng Drokow
- Department of Radiation Oncology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Bo Yacong
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Ling Wang
- Faculty of Medicine, Macau University of Science and Technology, Macao, Macao SAR, China
| | - Quanjun Lyu
- School of Public Health, Zhengzhou University, Zhengzhou, China,*Correspondence: Quanjun Lyu
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60
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Jacobs R, Farina N, Schneider M. Cross-cultural adaptation of the EAST and CASE screening tools for elder abuse in South Africa. J Elder Abuse Negl 2022; 34:369-392. [PMID: 36734135 DOI: 10.1080/08946566.2023.2176393] [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: 02/04/2023]
Abstract
Elder abuse is globally considered a hidden problem with great variations in its conceptualization across cultures, non-uniformity in understanding, and manifestations of abuse and neglect. Currently, there are no validated or culturally adapted screening measures for elder abuse in South Africa. The aim of this study was to test the cultural appropriateness of the Elder Abuse Screening Tool (EAST) and the Caregiver Abuse Screen (CASE) in two regions and four languages in South Africa. Using a cognitive interviewing methodology, 23 carers and 19 older adults were interviewed. Findings show that questions in the EAST and CASE are generally well understood, but that adaptations of both tools are necessary for use within South Africa. Fear, knowledge, and experience of crime also showed that strangers, like family, deliberately use deception to build trust and abuse. Further validation is needed to determine suitable scoring and use by health and social care practitioners.
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Affiliation(s)
- Roxanne Jacobs
- Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Nicolas Farina
- Community and Primary Care Research Group, University of Plymouth, Plymouth, UK
| | - Marguerite Schneider
- Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
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61
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Svallfors S. Contraceptive choice as risk reduction? The relevance of local violence for women's uptake of sterilization in Colombia. POPULATION STUDIES 2022; 76:407-426. [PMID: 34374637 DOI: 10.1080/00324728.2021.1953118] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Altered childbearing behaviour has been observed in many settings of violent conflict, but few studies have addressed fertility control. This is the first study to investigate empirically the relationship between local conflict and uptake of sterilization, the only contraceptive method that reflects a definitive stop to childbearing. The study is based on Colombia, a middle-income, low-fertility, and long-term conflict setting. It builds on a mixed methods approach, combining survey and conflict data with expert interviews. Fixed effects regressions show that local conflict is generally associated with an increased sterilization uptake. The interviews suggest that women may opt for sterilization when reversible methods become less accessible because of ongoing violence. Since sterilization is a relatively available contraceptive option in Colombia, it may represent a risk-aversion strategy for women who have completed their fertility goals. These findings can enlighten research and programmes on fertility and family planning in humanitarian contexts.
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62
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Santos TM, Cata-Preta BO, Wendt A, Arroyave L, Hogan DR, Mengistu T, Barros AJD, Victora CG. Religious affiliation as a driver of immunization coverage: Analyses of zero-dose vaccine prevalence in 66 low- and middle-income countries. Front Public Health 2022; 10:977512. [PMID: 36388274 PMCID: PMC9642099 DOI: 10.3389/fpubh.2022.977512] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 10/05/2022] [Indexed: 01/25/2023] Open
Abstract
Background The literature on the association between religion and immunization coverage is scant, mostly consisting of single-country studies. Analyses in low and middle-income countries (LMICs) to assess whether the proportions of zero-dose children vary according to religion remains necessary to better understand non-socioeconomic immunization barriers and to inform interventions that target zero-dose children. Methods We included 66 LMICs with standardized national surveys carried out since 2010, with information on religion and vaccination. The proportion of children who failed to receive any doses of a diphtheria-pertussis-tetanus (DPT) containing vaccine - a proxy for no access to routine vaccination or "zero-dose" status - was the outcome. Differences among religious groups were assessed using a test for heterogeneity. Additional analyses were performed controlling for the fixed effect of country, household wealth, maternal education, and urban-rural residence to assess associations between religion and immunization. Findings In 27 countries there was significant heterogeneity in no-DPT prevalence according to religion. Pooled analyses adjusted for wealth, maternal education, and area of residence showed that Muslim children had 76% higher no-DPT prevalence than Christian children. Children from the majority religion in each country tended to have lower no-DPT prevalence than the rest of the population except in Muslim-majority countries. Interpretation Analyses of gaps in coverage according to religion are relevant to renewing efforts to reach groups that are being left behind, with an important role in the reduction of zero-dose children.
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Affiliation(s)
- Thiago M. Santos
- Postgraduate Program in Epidemiology, International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil,*Correspondence: Thiago M. Santos
| | - Bianca O. Cata-Preta
- Postgraduate Program in Epidemiology, International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil
| | - Andrea Wendt
- Postgraduate Program in Epidemiology, International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil,Programa de Pós-Graduação em Tecnologia em Saúde, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Luisa Arroyave
- Postgraduate Program in Epidemiology, International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil
| | | | | | - Aluisio J. D. Barros
- Postgraduate Program in Epidemiology, International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil
| | - Cesar G. Victora
- Postgraduate Program in Epidemiology, International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil
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A second demographic transition in Indonesia? CHINA POPULATION AND DEVELOPMENT STUDIES 2022; 6:288-315. [PMID: 36313816 PMCID: PMC9589626 DOI: 10.1007/s42379-022-00115-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 09/04/2022] [Indexed: 11/05/2022]
Abstract
As a predominantly Muslim and ethnically diverse new democracy in Asia, Indonesia is a timely case to study how the contending forces of development and social change are reflected in changing norms and practices around family formation. This paper examines the extent to which the second demographic transition (SDT) theory can provide a primary framework to understand contemporary patterns of fertility, marriage and family change in Indonesia. Against the backdrop of socio-political change following Reformasi in 1998, we found emerging demographic features typically associated with societies in later stages of fertility transition. These include fertility below replacement in some regions; increasing age at first marriage, non-marriage, and divorce rates; and growing diversity in household/family forms. As the vast regions of Indonesia is economically, culturally, and demographically heterogeneous, these key features of SDT are not likely to emerge and unfold in a uniform manner. Further, these demographic shifts are taking place amidst multiple tensions and contradictions in the nature and direction of ideational change pertaining to marriage and the family. We argue that the prevailing ideational change driving the shifts in marriage, fertility, and the family within Indonesia is neither unilinear nor singular in nature. Emerging ideational change embodying individualism, secularism, and post-materialism—originally proposed in SDT theory to be the primary drivers of fertility decline in post-industrial Western Europe—can overlap with popular values promoting de-secularization and the strengthening of familial institutions. As a demographic framework, the SDT theory is an important and useful starting point. But it needs to be reevaluated by considering the complex socio-political and increasingly precarious economic terrains behind fertility transition, as well as marriage and family change in post-Reformasi Indonesia.
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Iwuagwu AO, Ngwu CN, Ekoh CP. Challenges of Female Older Adults Caring for Their very old Parents in Rural Southeast Nigeria: A Qualitative Descriptive Inquiry. JOURNAL OF POPULATION AGEING 2022. [DOI: 10.1007/s12062-022-09392-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Asif MF, Ali S, Ali M, Abid G, Lassi ZS. The Moderating Role of Maternal Education and Employment on Child Health in Pakistan. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9101559. [PMID: 36291495 PMCID: PMC9600698 DOI: 10.3390/children9101559] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 10/07/2022] [Accepted: 10/09/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Pakistan has challenges in fulfilling its universal responsibilities of providing better health facilities to everyone. The Sustainable Development Goals (SDGs) aim to reduce maternal and infant mortality rates. Despite declines in mother and child death, the total mortality ratio has marginally increased. However, neonatal death has not decreased significantly. Family planning is important for controlling population growth and improving child as well as maternal health. Pakistan's government has unceasingly tried to enhance the provision of contraceptive facilities, but still, an unmet need for family planning (UMNFP) exists in our country. Women are said to have UMNFP if they want to limit or space childbearing, but they are not using contraception methods for any reason. The study aimed to explore the effect of the UMNFP and to investigate the moderating role of a mother's education and employment status on a child's health. METHODS We analyzed the data of 2,244 women in this study. To investigate the study objectives, we utilized the secondary dataset of the Pakistan Demographic and Health Survey (PDHS) 2017-18 (publicly available on the website of the National Institute of Population Studies) and applied binary logistic regression using SPSS 24. RESULTS Results suggest a positive effect of a woman's age (25 to 39 years), maternal education (higher), father's education (higher), family's wealth status (richest), mass media exposure, and adequate birth spacing (at least for 33 months) on a child's health. On the other hand, there is an indirect association between maternal employment, unmet need for family planning, and a child's health. The moderating role of maternal education and employment on the relationship between household wealth status and a child's health is positive. CONCLUSIONS We conclude that the strong predictors of child health are UMNFP, maternal education, and employment. The link between the met need for family planning and the child's health is positive. The moderating effect of maternal education and household wealth status on a child's health is progressive. Similarly, the interaction effect of a mother's employment and household wealth status on a child's health is positive. Finally, we concluded that the link between the health of the child and household wealth status is much more diverse and positive when the mother is highly educated and currently employed.
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Affiliation(s)
- Muhammad Farhan Asif
- National College of Business Administration and Economics, Lahore 54000, Pakistan
- Department of Statistics, Kohsar University, Murree 43600, Pakistan
| | - Shafaqat Ali
- National College of Business Administration and Economics, Lahore 54000, Pakistan
| | - Majid Ali
- Department of Economics and Agri. Economics, PMAS-UAAR, Rawalpindi 43600, Pakistan
| | - Ghulam Abid
- Kinnaird College for Women, Lahore 54000, Pakistan
| | - Zohra S. Lassi
- Robinson Research Institute, University of Adelaide, Adelaide, SA 5005, Australia
- Correspondence:
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Hinson L, Bhatti AM, Sebany M, Bell SO, Steinhaus M, Twose C, Izugbara C. How, when and where? A systematic review on abortion decision making in legally restricted settings in sub-Saharan Africa, Latin America, and the Caribbean. BMC Womens Health 2022; 22:415. [PMID: 36217197 PMCID: PMC9552475 DOI: 10.1186/s12905-022-01962-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 08/19/2022] [Indexed: 11/07/2022] Open
Abstract
Background With increasing global availability of medication abortion drugs, a safer option exists for many women to terminate a pregnancy even in legally restrictive settings. However, more than 22,000 women die each year from unsafe abortion, most often in developing countries where abortion is highly legally restricted. We conducted a systematic review to compile existing evidence regarding factors that influence women’s abortion-related decision making in countries where abortion is highly legally restricted.
Methods We searched ten databases in two languages (English and Spanish) for relevant literature published between 2000 and 2019 that address women’s decision-making regarding when, where and how to terminate a pregnancy in sub-Saharan African, Latin American and the Caribbean countries where abortion is highly legally restricted.
Results We identified 46 articles that met the review’s inclusion criteria. We found four primary factors that influenced women’s abortion-related decision-making processes: (1) the role of knowledge, including of laws, methods and sources; (2) the role of safety, including medical, legal and social safety; (3) the role of social networks and the internet, and; (4) cost affordability and convenience. Conclusions The choices women make after deciding to terminate a pregnancy are shaped by myriad factors, particularly in contexts where abortion is highly legally restricted. Our review catalogued the predominant influences on these decisions of when, where and how to abort. More research is needed to better understand how these factors work in concert to best meet women’s abortion needs to the full limit of the law and within a harm reduction framework for abortions outside of legal indications. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-022-01962-0.
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Affiliation(s)
- Laura Hinson
- grid.419324.90000 0004 0508 0388International Center for Research on Women, Washington, DC USA
| | | | | | - Suzanne O. Bell
- grid.21107.350000 0001 2171 9311Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | | | - Claire Twose
- grid.21107.350000 0001 2171 9311Welch Medical Library, Johns Hopkins School of Medicine, Baltimore, MD USA
| | - Chimaraoke Izugbara
- grid.419324.90000 0004 0508 0388International Center for Research on Women, Washington, DC USA
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Prevalence and factors associated with unmet need for family planning among women of reproductive age (15-49) in the Democratic Republic of Congo: A multilevel mixed-effects analysis. PLoS One 2022; 17:e0275869. [PMID: 36206283 PMCID: PMC9543979 DOI: 10.1371/journal.pone.0275869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 09/23/2022] [Indexed: 11/26/2022] Open
Abstract
The Democratic Republic of Congo (DRC) has experienced high levels of unmet need for family planning (UNFP) for many years, alongside high fertility, maternal and infant mortality rates. Previous research addressed the UNFP in DRC, but analyses were limited to the individual-level and to specific regions. This study aims to determine the individual- and community-level factors associated with UNFP among married women of reproductive age in DRC. Using data from the 2014 DRC Demographic and Health Survey, a two-level mixed-effect logistic model examined i) the associations between UNFP and individual- and community level factors, and ii) the extent to which individual variability in UNFP is due to the variability observed at the community-level, given the individual characteristics. A total of 10,415 women in 539 clusters were included. Prevalence of unmet need for limiting was 8.13%, and 23.81% for spacing. Compared to adolescents (15-24), young (25-34) (aOR = 0.75, CI: 0.63-0.90) and middle-aged (35-49) (aOR = 0.65, CI: 0.51-0.82) women were less likely to have unmet need for family planning. The odds of having unmet need increased significantly with number of living children [1-2 children (aOR = 2.46, CI: 1.81-3.35), 7+ children (aOR = 6.46, CI: 4.28-9.73)] and among women in a female-headed household (aOR = 1.22, CI: 1.04-1.42). Women from provinces Equateur (aOR = 1.82, CI: 1.24-2.68), Nord-Kivu (aOR = 1.66, CI: 1.10-2.55) and Orientale (aOR = 1.60, CI: 1.10-2.32) were more likely to have unmet need, compared to women from Kinshasa. Women from communities with medium (aOR = 1.32, CI: 1.01-1.72) and high (aOR = 1.46, CI: 0.98-2.18) proportion of women in wealthy households, and medium (aOR = 1.32, CI: 1.01-1.72) and high (aOR = 1.46, CI: 0.98-2.18) proportion of women with low ideal family size (≤6) were more likely to have unmet need, compared to those from communities with low proportion of wealthy households and high ideal family size, respectively. Policies should consider strengthening family planning programs in provinces Equateur, Orientale, and Nord-Kivu, and in wealthier communities and communities with a higher ideal family size. Family planning programs should target adolescents and young women.
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Magnitude of unmet need for family planning and its predictors among reproductive age women in high fertility regions of Ethiopia: Evidence from Ethiopian Demographic and Health Survey. BMC Womens Health 2022; 22:408. [PMID: 36199076 PMCID: PMC9535900 DOI: 10.1186/s12905-022-01982-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 09/21/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Unmet need for family planning refers to fertile women who want to limit or space their delivery but are not using contraceptive methods. Despite multiple studies were conducted to address family planning in Ethiopia, there is limited information on unmet need in high fertility regions. Knowing the magnitude and predictors of unmet need in the study area helps as an impute for interventions. Therefore, this study aims to assess the magnitude and predictors of unmet need for family planning among reproductive age women in high fertility regions of Ethiopia. METHODS A secondary data analysis was performed using the Ethiopian Demographic and Health Survey 2016. A total sample weight of 4312 currently married reproductive age women were included in this study. A multilevel mixed-effect binary logistic regression model was fitted. Finally, the odds ratios along with the 95% confidence interval were generated to determine the individual and community level factors of unmet need for family planning. A p-value less than 0.05 was declared as statistical significance. RESULTS The overall unmet need for family planning among currently married reproductive-age women in high fertility regions of Ethiopia was 29.78% (95% CI: 28.26, 31.3). Women with no formal education (AOR: 1.65, 95% CI: 1.17, 2.15), women in the poor wealth quantile (AOR: 1.67, 95% CI: 1.34, 2.09), women with no media exposure (AOR: 1.32, 95% CI: 1.09, 1.58), multiparous women (AOR: 1.57, 95% CI: 1.15, 2.16), sex of household head (AOR: 1.39, 95% CI: 1.11, 1.77) and rural residency (AOR: 2.45, 95% CI: 1.12, 3.59) were predictors of unmet need for family planning. CONCLUSION The magnitude of unmet need for family planning among currently married reproductive-age women in high fertility regions of Ethiopia was high when compared to the national average and the United Nations sphere standard of unmet need for family planning. Education, wealth index, mass media, parity, sex of household head, and residence were independent predictors of unmet need for family planning among reproductive-age women in high fertility regions of Ethiopia. Any interventional strategies that reduce the unmet need for family planning should consider these factors to overcome the problems in the regions.
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Predictors of COVID-19 Vaccine Acceptance among Healthcare Workers in Nigeria. Vaccines (Basel) 2022; 10:vaccines10101645. [PMID: 36298509 PMCID: PMC9610788 DOI: 10.3390/vaccines10101645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 09/27/2022] [Accepted: 09/27/2022] [Indexed: 11/22/2022] Open
Abstract
Healthcare workers (HCWs) are regarded as role models regarding health-related issues, including vaccination. Therefore, it is essential to identify the predictors for COVID-19 vaccine acceptance among them. A cross-sectional study to assess the risk perception, attitudes and knowledge of HCWs toward COVID-19 vaccination was carried out. A total of 710 responses were received between September 2021 and March 2022, from HCWs in the Northern, Western and Eastern regions of Nigeria. Cross tabulations were performed to determine statistical relations between sociodemographic variables, knowledge, attitudes and risk perceptions concerning COVID-19 vaccine acceptance. Multinomial logistic regression analysis was performed to determine the predictive variables for COVID-19 vaccine acceptance. Statistical analyses were performed and P-values less than 0.05 were considered statistically significant at a CI of 95%. Results showed that 59.3% of the participants were amenable to COVID-19 vaccines. Multinomial regression analysis identified 14 variables at α < 0.05 as predictors for vaccine acceptance. Male HCWs were 2.8 times more likely to accept the vaccine than their female counterparts. HCWs that were knowledgeable of the different kinds of vaccines, were willing to recommend the vaccines to their patients, believed that the timing of COVID-19 vaccination was appropriate and had recent vaccination history within three years were 1.6, 24.9, 4.4 and 3.1 times more likely to take COVID-19 vaccine than those not sure. The study found a relatively high trust (51.3%) in the Nigerian Center for Disease Control (NCDC) for information regarding COVID-19 vaccines. Therefore, the NDCD should disseminate more robust insights regarding the safety profiles of various COVID-19 vaccines.
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Huhn S, Matzke I, Koch M, Gunga HC, Maggioni MA, Sié A, Boudo V, Ouedraogo WA, Compaoré G, Bunker A, Sauerborn R, Bärnighausen T, Barteit S. Using wearable devices to generate real-world, individual-level data in rural, low-resource contexts in Burkina Faso, Africa: A case study. Front Public Health 2022; 10:972177. [PMID: 36249225 PMCID: PMC9561896 DOI: 10.3389/fpubh.2022.972177] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 08/30/2022] [Indexed: 01/25/2023] Open
Abstract
Background Wearable devices may generate valuable data for global health research for low- and middle-income countries (LMICs). However, wearable studies in LMICs are scarce. This study aims to investigate the use of consumer-grade wearables to generate individual-level data in vulnerable populations in LMICs, focusing on the acceptability (quality of the devices being accepted or even liked) and feasibility (the state of being workable, realizable, and practical, including aspects of data completeness and plausibility). Methods We utilized a mixed-methods approach within the health and demographic surveillance system (HDSS) to conduct a case study in Nouna, Burkina Faso (BF). All HDSS residents older than 6 years were eligible. N = 150 participants were randomly selected from the HDSS database to wear a wristband tracker (Withings Pulse HR) and n = 69 also a thermometer patch (Tucky thermometer) for 3 weeks. Every 4 days, a trained field worker conducted an acceptability questionnaire with participants, which included questions for the field workers as well. Descriptive and qualitative thematic analyses were used to analyze the responses of study participants and field workers. Results In total, n = 148 participants were included (and n = 9 field workers). Participant's acceptability ranged from 94 to 100% throughout the questionnaire. In 95% of the cases (n = 140), participants reported no challenges with the wearable. Most participants were not affected by the wearable in their daily activities (n = 122, 83%) and even enjoyed wearing them (n = 30, 20%). Some were concerned about damage to the wearables (n = 7, 5%). Total data coverage (i.e., the proportion of the whole 3-week study duration covered by data) was 43% for accelerometer (activity), 3% for heart rate, and 4% for body shell temperature. Field workers reported technical issues like faulty synchronization (n = 6, 1%). On average, participants slept 7 h (SD 3.2 h) and walked 8,000 steps per day (SD 5573.6 steps). Acceptability and data completeness were comparable across sex, age, and study arms. Conclusion Wearable devices were well-accepted and were able to produce continuous measurements, highlighting the potential for wearables to generate large datasets in LMICs. Challenges constituted data missingness mainly of technical nature. To our knowledge, this is the first study to use consumer-focused wearables to generate objective datasets in rural BF.
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Affiliation(s)
- Sophie Huhn
- Faculty of Medicine and University Hospital, Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany,*Correspondence: Sophie Huhn
| | - Ina Matzke
- Faculty of Medicine and University Hospital, Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
| | - Mara Koch
- Faculty of Medicine and University Hospital, Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
| | - Hanns-Christian Gunga
- Charité – Universitätsmedizin Berlin, Institute of Physiology, Center for Space Medicine and Extreme Environments Berlin, Berlin, Germany
| | - Martina Anna Maggioni
- Charité – Universitätsmedizin Berlin, Institute of Physiology, Center for Space Medicine and Extreme Environments Berlin, Berlin, Germany,Department of Biomedical Sciences for Health, Università Degli Studi di Milano, Milano, Italy
| | - Ali Sié
- Centre de Recherche en Santé, Nouna, Burkina Faso
| | | | | | | | - Aditi Bunker
- Faculty of Medicine and University Hospital, Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
| | - Rainer Sauerborn
- Faculty of Medicine and University Hospital, Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
| | - Till Bärnighausen
- Faculty of Medicine and University Hospital, Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany,Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, United States,Africa Health Research Institute (AHRI), KwaZulu-Natal, South Africa
| | - Sandra Barteit
- Faculty of Medicine and University Hospital, Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
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Associations between sexual identity, living with disability, bully victimisation, and HIV status and intimate partner violence among residents in Nigeria. BMC Public Health 2022; 22:1756. [PMID: 36114566 PMCID: PMC9479364 DOI: 10.1186/s12889-022-14186-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 09/14/2022] [Indexed: 11/24/2022] Open
Abstract
Background The aim of the study was to determine the associations between sexual identity, disability and HIV status and bullying victimisation, and a history of physical, emotional and sexual violence in Nigeria. Methods This was a secondary analysis of a primary dataset generated through an online survey conducted between February 7 and 19, 2021. The 3197 participants for the primary study were recruited through snowballing. The dependent variables were physical, emotional and sexual violence. The independent variables were sexual identity (heterosexual and sexual minority), HIV status (negative, positive and unknown), bullying victimisation (yes/no) and living with disability (yes/no). A multivariate logistic regression model was developed for each form of IPV. Each model was adjusted for age, sex assigned at birth, marital status and education level. Results Respondents living with HIV had higher odds for physical (AOR: 2.01; 95% CI: 1.46–2.76; p < 0.001), sexual (AOR: 2.17; 95%CI: 1.55–3.05; p < 0.001), and emotional (AOR: 1.59; 95%CI: 1.24–2.06; p < 0.001) violence. Also, those with history of bullying victimisation had higher odds for physical (AOR: 3.79; 95%CI: 2.86 – 5.68; p < 0.001), sexual (AOR: 3.05; 95%CI: 2.27 – 4.10; p < 0.001) and emotional (AOR: 2.66; 95%CI: 2.10 – 3.37; p < 0.001) violence. In addition, females had higher odds of physical (AOR: 1.52; 95%CI: 1.13–2.043; p < 0.001) and sexual (AOR: 1.83; 95%CI: 1.34 – 2.50; p < 0.001) violence; and respondents cohabiting (AOR: 1.95; 95%CI: 1.12 – 3.28; p = 0.012) had higher odds for emotional violence. Respondents who were married have significantly lower odds of experiencing physical (AOR: 0.66; 95%CI: 0.45 – 9.60; p = 0.029), sexual (AOR: 0.40; 95%CI: 0.26 – 0.62; p < 0.001) and emotional (AOR: 0.68; 95%CI: 0.50 – 0.93; p = 0.015) violence when compared to singles. Younger respondents also had lower odds of experiencing sexual violence (AOR: 0.97; 95%CI: 0.95–0.99; p = 0.016). Conclusion HIV positive status and bullying victimisation seem to increase the risk for all forms of IPV while the experience of IPV did not differ by sexual identity and disability status. The associations between age, sex, marital status and IPV may suggest moderating roles of the factors taking cognisance of the cultural context of these relationships. Future relational analysis is necessary to further understand the pathways for the associations found between the variables in this study. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-14186-6.
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Rettig EM, Hijmans RJ. Increased women’s empowerment and regional inequality in Sub-Saharan Africa between 1995 and 2015. PLoS One 2022; 17:e0272909. [PMID: 36103466 PMCID: PMC9473440 DOI: 10.1371/journal.pone.0272909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 07/28/2022] [Indexed: 11/23/2022] Open
Abstract
Women’s empowerment is a fundamental human right but attempts to measure progress in this area have been limited. We used 142 nationally representative surveys to quantify empowerment in six domains (Intimate Partner Violence, Family Planning, Reproductive Healthcare, Employment, Education, and Decision-Making) for first-level subdivisions of all countries in Sub-Saharan Africa for three years (1995, 2005, and 2015). The possible value for each domain ranged between zero (worst) and one (best). The median value for employment decreased by 0.02, but it increased between 0.09 and 0.16 for the other domains. The average empowerment score increased from 0.44 to 0.53, but it remained low for Education (0.34). While progress was clear and consistent, it was uneven within and between countries, and Sahelian West Africa fell further behind. The expanded understanding of geographic variation and trends in women’s empowerment that we provide should be instrumental in efforts to improve women’s lives.
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Affiliation(s)
- Erica M. Rettig
- Department of Environmental Science and Policy, University of California, Davis, Davis, California, United States of America
- * E-mail:
| | - Robert J. Hijmans
- Department of Environmental Science and Policy, University of California, Davis, Davis, California, United States of America
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Osanyin GE, Bankethomas A, Oluwole EO, Odeseye AK, Afolabi BB. Effects of a mHealth voice messaging intervention on antenatal care utilisation at primary care level in Lagos, Nigeria: a cluster randomised trial. J Public Health Afr 2022; 13:2222. [PMID: 36277941 PMCID: PMC9585595 DOI: 10.4081/jphia.2022.2222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 05/28/2022] [Indexed: 11/23/2022] Open
Abstract
Background Nigeria has one of the lowest antenatal care (ANC) utilization rates compared to other low- and middle-income nations. In order to ensure a positive pregnant experience, the World Health Organization recommends at least eight ANC visits during pregnancy. This study intends to examine the impact of a mobile phone-based voice message intervention on ANC use in Lagos, Nigeria. Methods In this cluster-randomized experiment, primary healthcare centres were divided into five intervention and five control groups using multistage simple random sampling. The intervention consisted of a weekly voice message transmitted through mobile phone from the time of recruitment in the first trimester until two weeks postpartum. Attending at least eight ANC visits before birth was the primary outcome. STATA v17.0 was used to conduct descriptive and bivariate analyses as well as multivariate linear models to calculate crude risk ratios. Results 458 women participated. All intervention group women (269 women, or 58.7% of the sample) received the text message. These ladies were mostly married, Christian, had several children, and had completed high school. Women who received the intervention were more likely to attend eight ANC visits. Conclusion A voice message-based intervention can boost ANC utilization, according to the conclusion. This contributes to the existing body of information about the influence of mHealth treatments on maternal health outcomes and serves as a useful tool for ensuring that no woman is left behind.
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Ebimgbo SO, Nwachukwu TS, Ugwu CI, Obioji JN, Idowu BO, Okoye UO. "They will only remember us during elections": The culture of government support to Nigerian older adults and policy implications. J Aging Soc Policy 2022:1-19. [PMID: 36067363 DOI: 10.1080/08959420.2022.2120322] [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: 06/08/2021] [Accepted: 02/17/2022] [Indexed: 10/14/2022]
Abstract
Governments are obliged to ensure the healthy living, well-being, and life satisfaction of every citizen. This, however, has not been achieved in Nigeria, especially with regard to older adults. Despite the notable shift in the country's demographic stance, few studies have investigated the government's roles in addressing the support to Nigerian older adults given that inadequate support is a risk factor for general poor health conditions and high mortality rates. This study, therefore, sought to investigate views on available government support to older adults in Nnewi, South-East Nigeria. Focus Group Discussion and In-depth interviews were adopted to collect data from older adults. The generated data were subjected to a thematic method of analysis. Findings show that Nigerian older adults are usually remembered during political activities, such as electioneering and election. However, the support is not all-inclusive but reserved for those who could actively participate in these political activities. To achieve the African Union and the 2030 global agenda's commitment to "leave no one behind," the study recommends social policies that address all-inclusive support and care for Nigeria older adults. Social workers' intervention will also be crucial to facilitate the formulation and implementation of welfare policies and programmes for the support and well-being of older adults.
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Affiliation(s)
- Samuel O Ebimgbo
- Department of Social Work, University of Nigeria, Nsukka, Nigeria
| | - Tochukwu S Nwachukwu
- Department of Public Administration and Local Government, University of Nigeria, Nsukka, Nigeria
| | - Collins I Ugwu
- Department of Religion and Cultural Studies, University of Nigeria, Nsukka, Nigeria
| | - Josephine N Obioji
- Department of Public Administration and Local Government, University of Nigeria, Nsukka, Nigeria
| | - Bashiru O Idowu
- Department of Population and Development, Higher School of Economics, Russia
| | - Uzoma O Okoye
- Department of Social Work, University of Nigeria, Nsukka, Nigeria
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Do the living arrangements of older people matter for the family transfers they receive? Evidence from Senegal. AGEING & SOCIETY 2022. [DOI: 10.1017/s0144686x22001039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
In the absence of broad-based formal health insurance and social protection systems in much of sub-Saharan Africa, the family acts as the key provider of support to older people. This paper furthers our understanding of family support mechanisms in the context of low-income countries by focusing on support from outside the household, which has been less studied so far. By using the data of 3,114 people aged ≥50 from the second round of the Senegalese Poverty and Family Structure Survey, the paper examines how the living arrangements of older people are associated with receiving transfers from non-coresident kin. Our findings highlight a net advantage of women receiving net positive family transfers compared to men for some living arrangements. Results also indicate that living without a husband or an adult significantly increases the likelihood of older women receiving support from non-resident family members compared to those who live with both spouse and a younger adult child. However, these differences are not significant among older men. These results suggest that in constrained settings, decision-makers should consider older people's living arrangements and potential external family support when designing public policies towards them, so as to optimise the impact of policy and interventions on their welfare.
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Lewis-Smith H, Hasan F, Ahuja L, White P, Diedrichs PC. A comic-based body image intervention for adolescents in semi-rural Indian schools: Study protocol for a randomized controlled trial. Body Image 2022; 42:183-196. [PMID: 35750013 DOI: 10.1016/j.bodyim.2022.05.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 05/24/2022] [Accepted: 05/27/2022] [Indexed: 10/18/2022]
Abstract
Adolescents in India experience body dissatisfaction, however, empirically supported interventions are lacking. This paper describes the protocol for the development, acceptability testing, and cluster randomized controlled trial (RCT) of a six-session comic-based intervention, which aims to improve body image and related outcomes among adolescents in semi-rural Indian schools. If found to be acceptable and effective, UNICEF will disseminate the intervention across schools in eight states of India. The acceptability study will be conducted with 24 students in Classes 6-8 (age 11-14) and nine teachers from Hindi-medium government schools using interviews and focus groups. The subsequent RCT will be conducted with 2400 students, with schools randomized to either the comic-based intervention or lessons-as-usual (control) groups. The primary outcome is body esteem, and secondary outcomes are disordered eating, appearance ideal internalization, body-image-related life disengagement, self-esteem, negative affect, and positive affect. Additional exploratory outcome measures are skin colour dissatisfaction, body hair dissatisfaction, appearance-based teasing, and endorsement of traditional gender roles. These outcomes will be examined at three timepoints: baseline (T1), 1 week-post-intervention (T2), and 12-weeks follow-up (T3). Analyses will compare outcomes in the intervention with the control group. This will be the first study to evaluate a body image intervention for adolescents in semi-rural Indian schools.
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Affiliation(s)
| | - Farheen Hasan
- Centre for Appearance Research, University of the West of England, UK
| | - Latika Ahuja
- Centre for Appearance Research, University of the West of England, UK
| | - Paul White
- Applied Statistics Group, University of the West of England, UK
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Pattnaik A, Mohan D, Zeger S, Kanyuka M, Kachale F, Marx MA. From raw data to a score: comparing quantitative methods that construct multi-level composite implementation strength scores of family planning programs in Malawi. Popul Health Metr 2022; 20:18. [PMID: 36050721 PMCID: PMC9438221 DOI: 10.1186/s12963-022-00295-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 03/27/2022] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Data that capture implementation strength can be combined in multiple ways across content and health system levels to create a summary measure that can help us to explore and compare program implementation across facility catchment areas. Summary indices can make it easier for national policymakers to understand and address variation in strength of program implementation across jurisdictions. In this paper, we describe the development of an index that we used to describe the district-level strength of implementation of Malawi's national family planning program. METHODS To develop the index, we used data collected during a 2017 national, health facility and community health worker Implementation Strength Assessment survey in Malawi to test different methods to combine indicators within and then across domains (4 methods-simple additive, weighted additive, principal components analysis, exploratory factor analysis) and combine scores across health facility and community health worker levels (2 methods-simple average and mixed effects model) to create a catchment area-level summary score for each health facility in Malawi. We explored how well each model captures variation and predicts couple-years protection and how feasible it is to conduct each type of analysis and the resulting interpretability. RESULTS We found little difference in how the four methods combined indicator data at the individual and combined levels of the health system. However, there were major differences when combining scores across health system levels to obtain a score at the health facility catchment area level. The scores resulting from the mixed effects model were able to better discriminate differences between catchment area scores compared to the simple average method. The scores using the mixed effects combination method also demonstrated more of a dose-response relationship with couple-years protection. CONCLUSIONS The summary measure that was calculated from the mixed effects combination method captured the variation of strength of implementation of Malawi's national family planning program at the health facility catchment area level. However, the best method for creating an index should be based on the pros and cons listed, not least, analyst capacity and ease of interpretability of findings. Ultimately, the resulting summary measure can aid decision-makers in understanding the combined effect of multiple aspects of programs being implemented in their health system and comparing the strengths of programs across geographies.
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Affiliation(s)
- Anooj Pattnaik
- grid.21107.350000 0001 2171 9311Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, E5541, Baltimore, MD 21205 USA
| | - Diwakar Mohan
- grid.21107.350000 0001 2171 9311Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, E5541, Baltimore, MD 21205 USA
| | - Scott Zeger
- grid.21107.350000 0001 2171 9311Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, E5541, Baltimore, MD 21205 USA
| | | | - Fannie Kachale
- grid.415722.70000 0004 0598 3405Reproductive Health Directorate, Ministry of Health, Lilongwe, Malawi
| | - Melissa A. Marx
- grid.21107.350000 0001 2171 9311Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, E5541, Baltimore, MD 21205 USA
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Yu ST, Houle B, Manderson L, Jennings EA, Tollman SM, Berkman LF, Harling G. The double-edged role of accessed status on health and well-being among middle- and older-age adults in rural South Africa: The HAALSI study. SSM Popul Health 2022; 19:101154. [PMID: 35855969 PMCID: PMC9287360 DOI: 10.1016/j.ssmph.2022.101154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 06/20/2022] [Accepted: 06/23/2022] [Indexed: 12/04/2022] Open
Abstract
Background Social capital theory conceptualizes accessed status (the socioeconomic status of social contacts) as interpersonal resources that generate positive health returns, while social cost theory suggests that accessed status can harm health due to the sociopsychological costs of generating and maintaining these relationships. Evidence for both hypotheses has been observed in higher-income countries, but not in more resource-constrained settings.We therefore investigated whether the dual functions of accessed status on health may be patterned by its interaction with network structure and functions among an older population in rural South Africa. Method We used baseline survey data from the HAALSI study ("Health and Aging in Africa: a Longitudinal Study of an INDEPTH Community in South Africa") among 4,379 adults aged 40 and older. We examined the direct effect of accessed status (measured as network members' literacy), as well as its interaction with network size and instrumental support, on life satisfaction and self-rated health. Results In models without interactions, accessed status was positively associated with life satisfaction but not self-rated health. Higher accessed status was positively associated with both outcomes for those with fewer personal contacts. Interaction effects were further patterned by gender, being most health-protective for women with a smaller network and most health-damaging for men with a larger network. Conclusions Supporting social capital theory, we find that having higher accessed status is associated with better health and well-being for older adults in a setting with limited formal support resources. However, the explanatory power of both theories appears to depending on other key factors, such as gender and network size, highlighting the importance of contextualizing theories in practice.
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Affiliation(s)
- Shao-Tzu Yu
- School of Demography, The Australian National University, Canberra, ACT, Australia
| | - Brian Houle
- School of Demography, The Australian National University, Canberra, ACT, Australia
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faulty of Health Science, University of the Witwatersrand, Johannesburg, South Africa
- CU Population Center, Institute of Behavioral Science, University of Colorado at Boulder, Boulder, CO, USA
| | - Lenore Manderson
- School of Public Health, Faulty of Health Science, University of the Witwatersrand, Johannesburg, South Africa
- School of Social Sciences, Monash University, Victoria, Australia
| | - Elyse A. Jennings
- Harvard Center for Population and Development Studies, Harvard University, USA
| | - Stephen M. Tollman
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faulty of Health Science, University of the Witwatersrand, Johannesburg, South Africa
- Center for Global Health Research, Umeå University, Umeå, Sweden
- INDEPTH Network, Accra, Ghana
| | - Lisa F. Berkman
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faulty of Health Science, University of the Witwatersrand, Johannesburg, South Africa
- Harvard Center for Population and Development Studies, Harvard University, USA
- INDEPTH Network, Accra, Ghana
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, USA
| | - Guy Harling
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faulty of Health Science, University of the Witwatersrand, Johannesburg, South Africa
- Harvard Center for Population and Development Studies, Harvard University, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, USA
- Institute for Global Health, University College London, UK
- Africa Health Research Institute, KwaZulu-Natal, South Africa
- School of Nursing & Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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Khan MN, Islam MM. Women's experience of unintended pregnancy and changes in contraceptive methods: evidence from a nationally representative survey. Reprod Health 2022; 19:187. [PMID: 36050768 PMCID: PMC9438238 DOI: 10.1186/s12978-022-01492-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 08/15/2022] [Indexed: 11/10/2022] Open
Abstract
Background Ineffective or no use of contraception following an unintended pregnancy contributes to a subsequent unintended pregnancy. This study aimed to determine whether women’s experiences of unintended pregnancies affect changing their contraceptive using patterns. Methods We analysed the 2017/2018 Bangladesh Demographic and Health Survey data. The contraceptive switching pattern was computed by comparing women’s contraceptives using data before and after pregnancy. Women were categorised into the following three groups, depending on their patterns of contraceptive use before and after pregnancy: no change, if there were no change in contraceptive using pattern; switched to higher effective contraceptives, if changed from pre-pregnancy less effective contraceptives to post-pregnancy more effective contraceptives; switched to less effective contraceptives, if changed from pre-pregnancy more effective contraceptives to post-pregnancy less effective contraceptives. Women’s intention in the most recent pregnancy was our primary explanatory variable, classified as wanted, mistimed and unwanted. Multinomial multilevel logistics regression was used to determine the association between women’s intention in the most recent pregnancy and women’s contraceptive methods switching patterns from before to after pregnancy. Results Around 20% of the most recent pregnancies that ended with a live birth were unintended at conception. No contraceptive use was reported by 37% of women before their pregnancies which decreased to 24% after pregnancies. Overall, around 54% of women who reported no contraceptive use before pregnancy used modern contraceptives after pregnancy. The rate was higher among women who experienced unwanted pregnancy (73.4%) than mistimed (58.8%) and wanted (53.4%) pregnancy. Experience of mistimed pregnancy was associated with a higher likelihood of no contraceptive change (aOR, 1.84, 95% CI 1.41–2.39) and switching to less effective contraceptives (aOR, 1.58, 95% CI 1.10–2.26) than switching to more effective contraceptives. However, unwanted pregnancy was not associated with any significant change in contraceptives use from before to after pregnancy. Conclusion Experience of unintended pregnancy did not change women’s contraception using patterns, which indicates the risk of repeat unintended pregnancies and associated adverse consequences, including maternal and child morbidity and mortality. Policies to ensure access to and use of modern contraceptives among women facing unwanted or mistimed pregnancies are recommended. Unintended pregnancy is considered a public health challenge in low- and middle-income countries (LMICs). Around 89% of the global occurrences of unintended pregnancies occur in LMICs. In absolute numbers, this is equivalent to nearly 88 million pregnancies. Adverse pregnancy consequences, including bleeding, haemorrhage and maternal mortality are common in this group. The adverse consequences are even higher among women facing unintended pregnancies more than once, i.e., repeat unintended pregnancies, which represent around half of the total occurrences of unintended pregnancies in LMICs. Ensuring proper access to effective contraceptives following birth is key to reducing repeat unintended pregnancies and associated adverse consequences. It is critical to know the patterns of women’s pre-pregnancy contraceptive methods use and whether experiences of unintended pregnancies affect their contraceptive methods uptake and their types. However, this data is completely lacking in the context of LMICs. Using nationally representative survey data from Bangladesh, we examined women’s contraceptive switching patterns from before to after pregnancy and their association with pregnancy types. We found increased likelihood of no change in contraceptive using pattern or switching to less effective contraceptives among women after they experienced mistimed pregnancy compared to those whose pregnancy was wanted. This pattern increases the risk of repeat unintended pregnancies in Bangladesh and associated adverse consequences, including maternal and child morbidity and mortality.
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Affiliation(s)
- Md Nuruzzaman Khan
- Department of Population Science, Jatiya Kabi Kazi Nazrul Islam University, Mymensingh, 2222, Bangladesh.
| | - M Mofizul Islam
- Department of Public Health, La Trobe University, Melbourne, 3086, Australia
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Imo CK, Ugwu NH, Ukoji UV, Isiugo-Abanihe UC. Intimate partner violence and its association with skilled birth attendance among women in Nigeria: evidence from the Nigeria Demographic and Health Surveys. BMC Pregnancy Childbirth 2022; 22:667. [PMID: 36042396 PMCID: PMC9425983 DOI: 10.1186/s12884-022-04989-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 08/19/2022] [Indexed: 11/23/2022] Open
Abstract
Background Intimate Partner Violence (IPV) has been identified as a violation of human rights and a major public health challenge. IPV against women has negative effects on women’s mental well-being and leads to unfavourable health outcomes through poor maternal healthcare services utilisation, especially skilled birth attendance (SBA). This study examined the trends in IPV and SBA, as well as the different forms of IPV as predictors of SBA in Nigeria. Methods Data for the study were derived from a nationally representative weighted sample of 34,294 women selected and interviewed for the questions on the domestic violence module in the three consecutive Nigeria Demographic and Health Surveys conducted in 2008, 2013 and 2018. Descriptive and analytical analyses were carried out, including frequency distribution and binary logistic regression model at the multivariate level. The results of the explanatory variables were expressed as odds ratio (OR) and 95% confidence intervals (CI). Results The prevalence of emotional and physical IPV among the sampled women decreased in 2013 from 2008 but later increased in 2018. Sexual IPV increased from 4.1% in 2008 to 7.6% in 2018, while births delivered with the assistance of skilled providers increased from 37.7% in 2008 to 50.8% in 2018. The likelihood of using SBA significantly decreased among women who experienced emotional IPV in 2008 (aOR: 0.74; CI: 0.63–0.87) and sexual IPV in 2018 (aOR: 0.62; CI: 0.45–0.86). Women who experienced physical IPV were more likely to use SBA in 2008, 2013 and 2018 (aOR: 1.72; CI: 1.55–1.92; aOR: 1.40; CI: 1.26–1.56 and aOR: 1.33; CI: 1.15–1.54, respectively). The covariates have varying degrees of influence on SBA across the survey years. Conclusions The showed that the prevalence of emotional and physical IPV increased in 2018 after a decrease in 2013, with an increase in sexual IPV and the use of SBA across the survey years. Also, emotional and sexual IPV, unlike physical IPV are associated with low chances of using SBA. There is a need for more pragmatic intervention programmes towards eliminating all forms of violence against all women, reducing maternal and child mortality and promoting the empowerment of women.
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Affiliation(s)
- Chukwuechefulam Kingsley Imo
- Department of Sociology, Faculty of the Social Sciences, Adekunle Ajasin University, Akoko-Akungba, Ondo State, Nigeria.
| | - Nnebechukwu Henry Ugwu
- Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Institute for Development Studies, University of Nigeria, Enugu Campus, Nsukka, Nigeria
| | - Ukoji Vitalis Ukoji
- Department of Sociology, Faculty of Social and Management Sciences, Nigeria Police Academy, Kano, Nigeria
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Ameyaw EK, Seidu AA, Ahinkorah BO. Women’s healthcare decision-making and unmet need for contraception in Mali. Reprod Health 2022; 19:183. [PMID: 35987680 PMCID: PMC9392281 DOI: 10.1186/s12978-022-01484-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 07/21/2022] [Indexed: 11/15/2022] Open
Abstract
Background Contraception plays a significant role in fertility regulation. Evidence suggests that reproductive health rights influence contraception use. Women of Mali are noted to have limited control over their healthcare decisions. As a result, this study aimed at investigating the association between women’s healthcare decision-making capacity and unmet need for contraception in Mali. Methods This study comprised 6593 women who participated in the 2018 Mali Demographic and Health Survey. Two binary logistic regression models were built. Whilst the first model (crude) involved healthcare decision-making capacity and unmet need for contraception, the second one was a complete model which controlled for all the socio-demographic characteristics. Sample weight was applied and Stata version 13.0 was used for all analyses. Results Most of the women were not taking their healthcare decisions alone (92.8%). Nearly four out of ten of them indicated that they had unmet need for contraception (35.7%). Unmet need for contraception was high among women aged 45–49 (50.9%) and low among those aged 15–19 (19.2%). Unmet need for contraception was more probable among women who took their healthcare decisions alone compared to those who did not take their healthcare decisions alone [AOR = 1.35; CI = 1.08–1.70]. Compared with women aged 15–19, unmet need was higher among women aged 45–49 [AOR = 4.58, CI = 3.05–6.86]. Richer women had lower odds of unmet need for contraception compared with poorest women [AOR = 0.77, CI = 0.61–0.97]. Conclusion Women who took their healthcare decisions alone had higher odds of unmet need for contraception. To increase contraceptive use in Mali, it is imperative to take women’s healthcare decisions into consideration to strengthen existing policies geared towards fertility control and improvement in maternal health to achieve Sustainable Development Goals 3 and 5. Sustainable Development Goal 3 seeks to ensure healthy lives and promote well-being for all at all ages whilst Goal 5 aims at achieving gender equality and empower all women and girls. Evidence suggests that reproductive health rights influence contraception use. In Mali, women are noted to have limited control over their healthcare decisions. Due to that, this current study explored the relationship between women’s healthcare decision-making capacity and unmet need for contraception in Mali. The sample was 6593 women aged 15–49. About nine out of ten of the women were not taking their healthcare decisions alone and 35.7% indicated that they had unmet need for contraception. Unmet need for contraception dominated among those aged 45–49 (50.9%) but was low among those aged 15–19 (19.2%). Women who took their healthcare decisions alone had high odds of unmet need for contraception. Compared with women aged 15–19, unmet need was nearly five times likely among women aged 45–49. Richer women had lower odds of unmet need for contraception compared with poorest women. To increase contraceptive use in Mali, it is important to take into consideration the variations revealed in this study. This will help to strengthen existing policies geared towards fertility control and improvement in maternal health.
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82
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Forty J, Navaneetham K, Letamo G. Determinants of fertility in Malawi: Does women autonomy dimension matter? BMC Womens Health 2022; 22:342. [PMID: 35971111 PMCID: PMC9377123 DOI: 10.1186/s12905-022-01926-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 08/05/2022] [Indexed: 12/02/2022] Open
Abstract
Background Power inequality within the household and sexual relationships is linked to poor reproductive health. Malawi Government through National Sexual and Reproductive Health and Rights policy is committed to women empowerment as well fertility reduction. However, there is limited evidence in Malawi regarding whether women’s autonomy in the household is an independent determinant of fertility. With this background, the aim of this study is to investigate whether women’s autonomy in the household is a determinant of fertility in a poor socioeconomic and cultural setting. Methods This study used Malawi Demographic and Health Survey, 2015–2016. A multivariable Poisson regression model was used to investigate if women’s autonomy in the household in Malawi determines fertility. The outcome measure, children ever born, was used as a measure of fertility. Women’s autonomy was measured with two dimensions, such as women’s household related decision makings and women’s sexual autonomy. The individual recode and household recode were merged for the analysis. The final study sample was 15,952 women who were cohabiting or married at the time of the survey. Results The level of autonomy among women in the household related decisions and sexual autonomy was 49.1% and 64.0% respectively. Controlling for covariates, the study found no significant association between women’s autonomy dimensions in the household and number of children ever born. On the other hand, living in urban area (IRR = 0.91, CI 0.88–0.93); having less than tertiary education thus, no education (IRR = 1.83, CI 1.67–1.99) or primary education (IRR = 1.55, CI 1.42–1.69) or secondary education (IRR = 1.23, CI 1.13–1.33); poor households (IRR = 1.05, CI 1.01–1.09), starting cohabiting at the age of 19 years or less (AIRR = 1.15, CI 1.13–1.18) and not using modern contraceptive methods (AIRR = 1.17, CI 1.15–1.19) were significantly associated with fertility. Conclusions and recommendations Though women’s autonomy does not have independent effect on fertility, it may be interacting with other sociocultural norms prevailing in the society. The study recommends that the Government of Malawi should come up with economic hardship emancipation policy for poor households. The government should also come up with a girl-child secondary school completion policy. Furthermore, the government should accelerate the implementation, monitoring and evaluation of National Gender Policy to ensure the women empowerment/autonomy is having positive effect at all level including the household.
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Intimate partner violence and the spatial pattern of maternal healthcare services utilization among parous married women in northern Nigeria. JOURNAL OF POPULATION RESEARCH 2022. [DOI: 10.1007/s12546-022-09293-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
AbstractThe low uptake of maternal healthcare services (MHS) in Nigeria is implicated in the country’s poor maternal health outcomes. In northern Nigeria where these outcomes are poorest, not much is known about the contribution of violence within unions on married women’s uptake of MHS. Using data on antenatal care (ANC) utilisation and place of delivery, and their sociodemographic confounders from the Nigerian Demographic and Health Survey, this study investigates this relationship. Results of univariate, bivariate and multivariate analyses show that 46.4% and 22.1% of the women had at least four ANC sessions and had health facility delivery respectively. At the subregional level however, the North-Central zone had the highest utilisation rates while the North-West zone had the lowest. The prevalence of intimate partner violence (IPV) ranged from 8.2% (sexual violence) to 16.7% (physical violence) and 35.8% (emotional violence). Subregional analysis of IPV shows that the North-West zone had the lowest prevalence rates. Contrary to some literature evidence, women who experienced IPV in the study area had higher odds of utilising MHS (P < 0.001). When the sociodemographic characteristics of the women were adjusted for, the relationship became statistically insignificant however. The association between the women’s socioeconomic characteristics and their MHS uptake suggests that attention be paid to the wealth and educational status of the population because of their propensity for sustaining the higher uptake recorded. The role of religion in the outcomes further suggests that it be used as a tool to promote the uptake of MHS in the region.
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84
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Kasonde ME, Bwalya BB, Nyirenda ET, Mapoma CC, Sikaluzwe M, Chimpinde K, Songolo GI. Association between sexual violence and unintended pregnancy among married women in Zambia. BMC Public Health 2022; 22:1491. [PMID: 35927643 PMCID: PMC9354302 DOI: 10.1186/s12889-022-13881-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 07/26/2022] [Indexed: 11/15/2022] Open
Abstract
Background One of the outcomes of sexual violence is unintended pregnancy. In Zambia, 15% of married women age 15—49 years had experienced sexual violence from their husband or partner. The prevalence of unintended pregnancies among women age 15—49 years has risen from 33% in 1992 to 38% in 2018. The link between sexual violence and unintended pregnancy in Zambia was investigated in this study. Methods This study used the women's dataset from the 2018 Zambia Demographic and Health Survey, a cross-sectional survey. The study looked at a weighted sample size of 4,465 women age 15 – 49 years. Unintended pregnancy was measured by combining response categories of mistimed and unwanted pregnancy. Multivariate binary logistic regression was performed to establish the net effects of sexual violence and each explanatory variable on unintended pregnancy. Results The findings suggest that sexual violence does have a role in unintended pregnancies (AOR 1.74; CI 1.38—2.19). Ever use of contraception is also a significant predictor of unintended pregnancy (AOR 1.48; CI 1.16—1.88), even when other characteristics are taken into account. Results have shown that a woman who had ever used contraception and had experienced sexual violence was more likely to have an unintended pregnancy. Conclusion Spousal sexual violence is highly associated with unintended pregnancies in Zambia. Addressing intimate partner sexual violence is among the ways to prevent unintended pregnancies. It is also important to sensitize women on reporting acts of sexual violence to relevant authorities as this will not only prevent reoccurrence of sexual violence but also reduce unintended pregnancies and associated long-term effects.
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Affiliation(s)
- Mwewa E Kasonde
- Department of Population Studies, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia.
| | - Bwalya Bupe Bwalya
- Directorate of Research and Postgraduate Studies, Mulungushi University, Kabwe, Zambia
| | - Elizabeth T Nyirenda
- Department of Population Studies, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia
| | - Chabila Christopher Mapoma
- Department of Population Studies, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia
| | - Milika Sikaluzwe
- Department of Population Studies, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia
| | - Kafiswe Chimpinde
- Department of Population Studies, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia
| | - Gloria I Songolo
- Department of Population Studies, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia
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Bayesian Shared Frailty Models for Time to First Birth of Married Women in Ethiopia: Using EDHS 2016. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:5760662. [PMID: 35966242 PMCID: PMC9371872 DOI: 10.1155/2022/5760662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 06/26/2022] [Accepted: 07/12/2022] [Indexed: 12/03/2022]
Abstract
Introduction The primary effect of the fertility process is the birth of the first child. The ages at which women establish marital union and give their first birth depend on and result in varying demographic features. This research demonstrates how to examine the effect of numerous factors on married women's delay to first birth in Ethiopia using Bayesian parametric models with gamma shared frailty distribution. Methods This study analyzed data from the 2016 EDHS on factors related to the time of married women to first birth. A sample of 8810 married women from all parts of Ethiopia participated in the study. The Akaike information criterion (AIC) and Bayesian information criterion (BIC) were used to compare several parametric models with gamma shared frailty distributions to find the best model (BIC). Finally, when the prior data was taken into account, the chosen model was proven to be accurate (Bayesian approach). Results The median survival time for the first birth after marriage is 24 years (95% CI; 23.4, 25.3). The result shows that the place of residence, the access to media, the level of education of the mother, the education level of the husband, the use of the head of the contraceptives, and the sex of the household are statistically associated with the time to first birth of married women. The Weibull-gamma shared frailty model under the Bayesian approach was found to be the best model that fit the time to first birth data in this study. The result also showed that there is heterogeneity between regions of married women. Conclusion To slow the increase in the Ethiopian population, families must be taught how to use contraception, and rural populations must be educated on the necessity of increasing the length of the first birth gap rather than encouraging early marriage. In general, attempts to reduce fertility by raising the age of the first marriage must consider the social and cultural settings in which marriage takes place. On the other hand, the campaign against early marriage should focus on the sociocultural, physiological, and psychological effects, as well as the reduction of reproduction.
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Azanaw MM, Fentie DT, Bukayaw YA, Lakew AM, Sisay MM. Spatial distribution and determinant factors of unmet need for family planning among all reproductive-age women in Ethiopia: a multi-level logistic regression modelling approach. Contracept Reprod Med 2022; 7:13. [PMID: 35909115 PMCID: PMC9341114 DOI: 10.1186/s40834-022-00178-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 05/14/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Unmet need for family planning has been remaining high in developing countries than developed countries, notably in sub-Saharan Africa. Data on unmet needs can help countries set service priorities. This study aimed to explore the geographical disparities of unmet need among reproductive-age women in Ethiopia using a 2016 national population-based survey. METHODS This study was based on the nationally representative 2016 Ethiopian Demographic and Health Survey data. We used a total weighted sample of 15,683 reproductive-aged women. A multi-level logistic regression analysis was used to account for the Demographic Health Survey data's hierarchal nature. In the multivariable multi-level analysis, those variables with a p-value < 0.05 were significantly associated with unmet needs. Spatial autocorrelation techniques were used to explore the clustering tendencies of unmet needss using Getis-Ord Gi* statistics. RESULTS Overall, 15.2% (95% Confidence Interval (CI): 14.63, 15.76) of women of the reproductive age group in Ethiopia had an unmet need for family planning in 2016. In multivariable multilevel logistic regression analysis; individual-level variables such as being married (Adjusted odds ratio (AOR) = 25.7,95% CI: 11.50,60.42), lowest wealth status (AOR = 1.43,95% CI:1.14,1.79), having five or more children (AOR = 1.98, 95% CI:1.62,2.41), being a follower of Muslim religion (AOR = 1.35,95% CI:1.03,1.76) and protestant religion (AOR = 0.73,95% CI: 0.53,0.99) than orthodox Christian followers were statistically associated factors with unmet need. Among community-level variables; being in rural residency (AOR = 1.37, 95% CI: 1.01, 1.93), belong to the Oromia region (AOR = 1.53, 95%CI: 1.10, 2.11) and Somali region (AOR = 0.37, 95% CI: 0.22, 0.61) were significantly associated unmet need. The spatial analysis of unmet need among all women revealed that Oromia, Southern Nations, and Nationality of People and Gambela regions had high hotspots than other parts of the country. CONCLUSIONS In this study, the prevalence of unmet needs was high. Significant regional unmet need variation was indicated among reproductive-age women in Ethiopia, specifically in western parts of the country. Wealth status, number of children, marital status, residence, and religion were the most important associated factors with unmet needs. Addressing unmet needs targeted rural residents with low socioeconomic status, and western regions should be given top priority.
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Affiliation(s)
- Melkalem Mamuye Azanaw
- Department of Public Health, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
| | | | | | - Ayenew Molla Lakew
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Malede Mequanent Sisay
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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Unmet need for family planning and associated factors, among women of child-bearing age working in Hawassa industrial park, Southern Ethiopia 2021: An institution based cross-sectional study. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2022. [DOI: 10.1016/j.cegh.2022.101122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Larasanti A, Ayuningtyas D. Determinants of Family Planning Service Utilization on Unmet Need Incidents with Generalized Structural Equation Modeling (GSEM). AJOG GLOBAL REPORTS 2022; 2:100088. [PMID: 36275399 PMCID: PMC9579701 DOI: 10.1016/j.xagr.2022.100088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Agadjanian V, Nedoluzhko L. Group Normative Propensities, Societal Positioning, and Childbearing: Ethno‑linguistic Variation in Completed and Desired Fertility in Transitional Central Asia. POPULATION RESEARCH AND POLICY REVIEW 2022; 41:1571-1596. [PMID: 37649791 PMCID: PMC10468155 DOI: 10.1007/s11113-022-09701-x] [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: 08/04/2021] [Accepted: 01/27/2022] [Indexed: 10/18/2022]
Abstract
Considerable research in western, low-fertility contexts has examined minority-vs.-majority fertility differentials, typically focusing on minority groups' cultural idiosyncrasies and on socioeconomic disadvantages associated with minority status. However, the formation and functioning of ethnic complexities outside the western world often diverge from the standard western model and so may their impact on fertility preferences, behavior, and outcomes. We expand on the previous research by analyzing ethnic variation in completed and desired fertility in the multiethnic transitional setting of Kyrgyzstan, where ethnic groups and their ethnolinguistic subparts are characterized by both different stages of the demographic transition and different positioning in the socioeconomic and political hierarchies. Using combined data from two rounds of a nationally representative survey, we find that ethnic-specific levels of completed fertility generally align with culturally shaped group-level normative propensities. In contrast, in desires to have a(nother) child, the ranking of the ethnic segments is more reflective of their collective societal positioning, with more disadvantaged segments having lower fertility desires, regardless of actual number of children and various other characteristics. We also find that ethnic homophily of respondents' social milieu and their optimism about the future of their ethnic group are positively associated with fertility desires, even though these associations are more potently present among women, compared to men. We relate our findings to the extant scholarship and reflect on their implications for a better understanding of ethno-racial fertility dynamics and differentials in transitional contexts.
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Affiliation(s)
- Victor Agadjanian
- Department of Sociology and the International Institute, University of California - Los Angeles, Los Angeles, CA 90095-1551, USA
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Duclaux Habit Tankeu F, Mimche H. Gestion de l’intimité conjugale en situation de cohabitation intergénérationnelle au Cameroun : cas des couples vivant chez eux avec la mère de l’un des conjoints. ENFANCES, FAMILLES, GÉNÉRATIONS 2022. [DOI: 10.7202/1090931ar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
Cadre de recherche :Cet article jette un regard sur le chez-soi, entendu ici comme le domicile du couple qui accueille sous son toit un parent de l’un des conjoints, constituant une limite au processus d’individualisation du couple dans sa vie intime.Objectif :L’objectif est d’analyser comment les couples vivant chez eux avec la mère de l’un des conjoints gèrent leur intimité, dans la mesure où cette cohabitation est susceptible d’interférer dans la relation conjugale.Méthodologie :Nous avons privilégié une analyse qualitative des entrevues semi-directives menées auprès de 17 enquêtés âgés entre 28 et 49 ans, vivant en couple et cohabitant chez eux avec la mère de l’un des conjoints.Résultats :La cohabitation intergénérationnelle se pose comme une entrave à l’individualisation et conduit à la modification des comportements intimes des couples qui accueillent chez eux la mère de l’un des conjoints. De même, sa présence et son interférence dans les affaires conjugales amènent les couples à ajuster leurs comportements en vue de préserver leur intimité toujours limitée.Conclusion :La cohabitation intergénérationnelle constitue, d’une part, une entrave à l’individualisation et à l’intimité des couples. D’autre part, les ajustements tant sur le plan comportemental que dans la gestion de l’espace qu’adoptent les couples témoignent de l’importance qu’ils accordent à leur individualité conjugale.Contribution :Cet article, qui s’inscrit dans la problématique de la cohabitation intergénérationnelle, permet à partir des différentes dimensions du chez-soi, de documenter et d’élaborer les savoirs autour de cette notion, à travers le cas spécifique des couples camerounais.
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Affiliation(s)
- Félix Duclaux Habit Tankeu
- Unité de Recherche Philosophie et Sciences Sociales Appliquées (URPHISSA), Université de Dschang (Dschang, Cameroun),
| | - Honoré Mimche
- Institut de Formation et de Recherche Démographiques (IFORD), Université de Yaoundé II, (Yaoundé, Cameroun),
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Women’s contraceptive profiles in Burundi: Knowledge, attitudes, and interactions with media and health services. PLoS One 2022; 17:e0271944. [PMID: 35895735 PMCID: PMC9328534 DOI: 10.1371/journal.pone.0271944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 07/11/2022] [Indexed: 11/19/2022] Open
Abstract
Reproductive health program managers seek information about existing and potential clients’ motivations, behaviors, and barriers to services. Using sequence and cluster analysis of contraceptive calendar data from the 2016–17 Burundi Demographic and Health Survey, we identified discrete clusters characterizing patterns in women’s contraceptive and pregnancy behaviors over the previous 5 years. This study pairs these clusters with data on factors typically targeted in social behavior change interventions: knowledge, attitudes, and women’s interactions with media and health services, to create composite profiles of women in these clusters. Of six clusters, three are characterized by contraceptive use and three are characterized by its absence. Media exposure and attitudes regarding sex preference, wife beating, and self-efficacy largely do not explain cluster membership. Contraceptive knowledge is positively associated with two clusters (Family Builder 1 and Traditional Mother) and negatively associated with a third (Quiet Calendar). Clusters also differ in their members’ fertility desires, contraceptive intentions, and interactions with health services. Two “Family Builder” clusters are both characterized by the presence (but not timing) of multiple pregnancies in their calendar histories, but differ in that women with high contraceptive knowledge, intentions to use contraception, and well-articulated family size ideals are characteristic of one cluster (Family Builder 1), and low contraceptive knowledge, no use of contraception, and vague family size preferences are characteristic of the other (Family Builder 2). These results can guide reproductive health programs as they target social and behavioral change and other interventions to the unique subpopulations they seek to serve.
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92
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Mussie KM, Setchell J, Elger BS, Kaba M, Memirie ST, Wangmo T. Care of Older Persons in Eastern Africa: A Scoping Review of Ethical Issues. Front Public Health 2022; 10:923097. [PMID: 35874990 PMCID: PMC9298985 DOI: 10.3389/fpubh.2022.923097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 06/16/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction The aging population is rapidly increasing globally, with 80% of the older population living in low- and middle-income countries. In Eastern African countries, there exists an incongruence between readiness-economically, structurally, politically, and culturally-to create a conducive environment for healthy aging, which implies public health as well as ethical concerns. The aim of this scoping review was to explore existing evidence addressing the various ethical issues in connection with elder care in the region of Eastern Africa. Methods We searched six databases (Africa-Wide Information, AgeLine, CINHAL, MEDLINE, APA PsycInfo, and SocINDEX) to identify peer-reviewed journal articles that could meet some eligibility criteria such as being a peer-reviewed journal article written in English, having been published in any year until July 2020, and focusing on ethical issues in the care of older people aged 60 years and older from Eastern Africa. We also searched for additional evidence in the references of included papers and web-based platforms. We included 24 journal articles and analyzed them using the inductive content analysis approach. Results The included articles represent seven (38.9%) of the 18 countries in the Eastern African region. The articles covered six ethical concerns: lack of government attention to older persons (n = 14, 58.3%), inaccessibility of health care services (n = 13, 54.2%), loneliness and isolation (n = 11, 45.8%), gender inequalities in old age (n = 9, 37.5%), mistreatment and victimization (n = 8, 33.3%), and medical errors (n = 2, 8.3%). Conclusion This scoping review summarized ethical issues arising in relation to providing care for older persons in the Eastern African context. In light of the rapid increase in the number of older persons in this region, it is critical for governments and responsible bodies to implement and accelerate efforts promptly to generate more evidence to inform programs and policies that improve the health and wellbeing of older persons. Further research is needed to inform global health efforts that aim at improving the lives of older persons, particularly in low- and middle-income countries. Clinical Trial Registration https://osf.io/sb8gw, identifier: 10.17605/OSF.IO/SB8GW.
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Affiliation(s)
| | - Jenny Setchell
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Bernice Simone Elger
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland.,Center for Legal Medicine, University of Geneva, Geneva, Switzerland
| | - Mirgissa Kaba
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Solomon Tessema Memirie
- Addis Centre for Ethics and Priority Setting, Addis Ababa University, Addis Ababa, Ethiopia.,Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, United States
| | - Tenzin Wangmo
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
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93
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Coulibaly M, Kouamé J, Kadjo F, Koumi-Mélèdje MD, Hounsa A, Sackou-Kouakou J, Aké O. Determinants of contraceptive use in Abidjan (Côte d’Ivoire). J Public Health Afr 2022; 13:2204. [PMID: 36051516 PMCID: PMC9425952 DOI: 10.4081/jphia.2022.2204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 07/03/2022] [Indexed: 11/30/2022] Open
Abstract
In Côte d’Ivoire, contraceptive prevalence is low (21%). The search for determinants of contraceptive use could make it possible to redirect existing strategies. The objective is to identify the determinants of the use of contraception among women in Abidjan. A cross-sectional survey was conducted from May to June 2018 in the Dallas neighborhood of Adjamé municipal (Abidjan). Women of reproductive age (15 to 49 years old) were selected there. Sociodemographic, gyneco-obstetrical characteristics, educational level, attitudes and practices of women on contraception were collected. Univariate and multivariate analyzes were performed. A total of 301 women aged 29.34±8.98 years were selected. The proportion of women using modern contraception was 27.24%. In univariate analysis, the factors associated with use were: level of education (p=0.005), unwanted pregnancies (p=0.017), abortions (p<0.001), consultation of the gynecologist (p=0.003) or a family planning service (p=0.001). Hearing about contraception (p=0.043), knowing (p<0.001) and talking about it with their partner (p=0.027) was significantly associated with its use. In the multivariate analyses, the women who consulted a gynecologist and those who knew the contraceptive methods used them respectively 2 times more (OR= 2.16 [1.14-4.15], p=0.019) and 22 times more (OR= 22.38 [8.42-78.56], p<0.001). Women with primary school education used them significantly less (OR= 0.15 [0.05-0.41], p<0.001). Awareness, the gynecologist’s consultation, and the level of education were the main determinants of contraceptive use. Also, it is necessary to adapt awareness messages to the characteristics of women.
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94
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Sulemana I, Bugri Anarfo E, Doabil L. Migrant Remittances and Food Security in Sub-Africa: The Role of Income Classifications. INTERNATIONAL MIGRATION REVIEW 2022. [DOI: 10.1177/01979183221107925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The pervasiveness of food insecurity in sub-Saharan Africa and other developing regions has resulted in increased emigration not only to wealthier countries within the continent but also to developed countries elsewhere in the world. A growing body of research has examined the welfare implications of remittances from international migrants for families left behind. A strand of that literature focuses on the association between international remittances and household food security. We contribute to this body of work by examining the variability of this relationship across three groupings of African countries, based on the World Bank's income classifications. Using data from the Afrobarometer Surveys, our results from an instrumental variable ordered probit regressions reveal that international remittances are positively and significantly correlated with household food security for all three country groupings. After correcting for endogeneity, we find that remittance-receiving households were 83.59 percent, 72.66 percent, and 26.06 percent more likely to report having never gone without enough food to eat in low-income, lower-middle income, and upper-middle income countries in sub-Saharan Africa, respectively. These findings suggest that central governments and policymakers in Africa should reform public policy in a way that strengthens the effectiveness and efficiency of international remittances transfer to reduce food insecurity across the continent.
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Affiliation(s)
- Iddisah Sulemana
- Citibank, Wilmington, DE, USA
- Business School, Department of Accounting and Finance, Ghana institute of Management and Public Administration, Achimota, Accra, Ghana
| | - Ebenezer Bugri Anarfo
- Business School, Department of Accounting and Finance, Ghana institute of Management and Public Administration, Achimota, Accra, Ghana
| | - Louis Doabil
- Business School, Department of Accounting and Finance, Ghana institute of Management and Public Administration, Achimota, Accra, Ghana
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Tariku M, Tusa BS, Weldesenbet AB, Bahiru N, Enyew DB. More Than One-Third of Pregnant Women in Ethiopia Had Dropped Out From Their ANC Follow-Up: Evidence From the 2019 Ethiopia Mini Demographic and Health Survey. Front Glob Womens Health 2022; 3:893322. [PMID: 35936819 PMCID: PMC9350521 DOI: 10.3389/fgwh.2022.893322] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 06/21/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundIn Ethiopia, the magnitude of antenatal care (ANC) practice and institutional delivery is low as compared with developed countries. The majority of the pregnant women have not completed their ANC follow-up and only 43% of women have reached the four and above ANC. This study was conducted to determine the magnitude of ANC dropout and associated factors among pregnant women in Ethiopia.MethodsSecondary data analysis was conducted using the 2019 Ethiopia Mini Demographic and Health Survey 2019 (2019 EMDHS). The sample was selected using a stratified, two-stage cluster sampling design and the data were analyzed using the binary logistic regression model to identify factors associated with ANC dropout. Adjusted odds ratio (AOR) with 95% CI was reported to declare significance and strength of association. A total weighted sample of 2,143 women who had antenatal care follow-up during pregnancy was included. In the multivariate logistic regression analysis, variables having a p-value < 0.05 were considered to have a significant association with ANC dropout.ResultThe magnitude of ANC dropout was 39.12% (95% CI: 37.07 and 41.20%) among women who had ANC follow-up in Ethiopia. Aged 30–49 years [AOR = 0.71; 95% CI: (0.54, 0.94)], attended primary [AOR = 0.79; 95% CI: (0.62, 0.99)], secondary [AOR = 0.63; 95% CI: (0.44, 0.87)], and higher education [AOR = 0.39; 95% CI: (0.25, 0.62)], were in first trimesters [AOR = 0.49; 95% CI: (0.40, 0.60)] at the time of first ANC visit, and had access to laboratory service [AOR = 0.25; 95% CI: (0.13, 0.51)] were found to be a negative significant associated factors of ANC dropouts, whereas being rural resident [AOR = 1.53; 95% CI: (1.11, 2.10)] has a positive significant association with ANC dropouts.ConclusionMore than one-third of the pregnant women in Ethiopia had dropped out from their ANC follow-up in the study period. Being old-aged, educated, urban resident, having a first ANC visit in the first trimester, and having access to laboratory service were negatively associated with ANC dropouts. Therefore, we recommended encouraging women to have ANC visit at an early stage of pregnancy and conducting basic laboratory investigations during their visit. When undertaking that, due attention should be given to young, uneducated, and rural dweller women.
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Affiliation(s)
- Mandaras Tariku
- Department of Psychiatry, College of Health and Medical Sciences, Haramaya University, Haramaya, Ethiopia
| | - Biruk Shalmeno Tusa
- Department of Epidemiology and Biostatistics, School of Public Health, College of Health and Medical Sciences, Haramaya University, Haramaya, Ethiopia
| | - Adisu Birhanu Weldesenbet
- Department of Epidemiology and Biostatistics, School of Public Health, College of Health and Medical Sciences, Haramaya University, Haramaya, Ethiopia
| | - Nebiyu Bahiru
- Department of Public Health and Health Policy, School of Public Health, College of Health and Medical Sciences, Haramaya University, Haramaya, Ethiopia
| | - Daniel Berhanie Enyew
- Department of Epidemiology and Biostatistics, School of Public Health, College of Health and Medical Sciences, Haramaya University, Haramaya, Ethiopia
- *Correspondence: Daniel Berhanie Enyew
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Schindele AC, Areskoug Josefsson K, Lindroth M. Analysing intersecting social resources in young people's ability to suggest safer sex - results from a national population-based survey in Sweden. BMC Public Health 2022; 22:1285. [PMID: 35787796 PMCID: PMC9252084 DOI: 10.1186/s12889-022-13672-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 06/21/2022] [Indexed: 12/02/2022] Open
Abstract
Background Safer sex is one of the most crucial areas in sexual and reproductive health and rights (SRHR). Drawing on the theory of health promotion where social life generates resources for health our hypothesis is that having control over one’s life situation, affects the ability for safer sex and thereby sexual health. The aim is to explore the association between having control over one’s life and the ability to suggest safer sex among young people aged 16–29, and how this plays out in relation to membership of six constructed social groups based on: gender, transgender experience, sexual identity, economy, being foreign-born, and social welfare recipiency followed by an in-depth analysis of the intersection of gender and sexual identity. Methods The data set comprises cross-sectional survey responses from a stratified random sample of 7755 in the total Swedish population of young people. The SRHR-focused questionnaire was developed within the HIV-monitoring program at the Public Health Agency of Sweden. Data collection was conducted by Statistics Sweden between April 15 and June 8 in 2015. The survey had a response rate of 26%, which was in line with the study design. Statistical analysis was used to explore the self-reported outcome variable ability for safer sex and the exposure variable control over one’s life. The methods used comprise multivariate logistic regression and an intersecting multivariate regression exploring 12 intersecting social positions by gender and sexual identity. Results The results show that young people’s control over their lives is associated with their ability for safer sex. Due to this, control over one’s life can be seen as a resource for safer sex. The associations in the 12 intersecting social positions showed complex patterns. Conclusions The intersections of resources show the complexity and that gender cannot account for all differences in the resources for young people’s ability to suggest safer sex. Implications for policy and practitioners involve both addressing and strengthening the sexual rights of young people from sexual minorities and tailoring interventions in a way that takes the intersections between gender and sexual identity into consideration.
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Affiliation(s)
- Anna ChuChu Schindele
- Centre for Sexology and Sexuality Studies, Department of Social Work, Faculty for Health and Society, Malmö University, Malmö, Sweden. .,Unit for Sexual Health and HIV Prevention, Department of Communicable Disease Control and Health Protection, The Public Health Agency of Sweden, Solna, Sweden.
| | - Kristina Areskoug Josefsson
- Faculty of Health Studies, VID Specialized University, Sandnes, Norway.,Department of Behavioural Science, Oslo Metropolitan University, Oslo, Norway
| | - Malin Lindroth
- Centre for Sexology and Sexuality Studies, Department of Social Work, Faculty for Health and Society, Malmö University, Malmö, Sweden
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The factors associated with antenatal care utilization in Ethiopia. Ann Med Surg (Lond) 2022; 79:104092. [PMID: 35860111 PMCID: PMC9289506 DOI: 10.1016/j.amsu.2022.104092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 06/24/2022] [Accepted: 06/24/2022] [Indexed: 11/21/2022] Open
Abstract
Background Antenatal care (ANC) is the provision of health services to pregnant women by trained health professionals before the birth of their babies to reduce maternal mortality and morbidity. So, the study aimed to identify the factors associated with Antenatal care utilization in Ethiopia. Methods A Community-based Crossectional study design was used for 8885 women aged 15 to 49. The dependent variable was the utilization of Antenatal care services. Independent variables were Socio-demographic and Socioeconomic factors. The data was from the 2019 Ethiopian Mini demographic and health survey. Bivariate and multilevel binary logistic regression was used. Results Out of 8885 of all women considered for this study, 3910(44%) were utilized Antenatal Care (ANC) four or more times. 72.81% of the women were aged 15–34 years. On the other hand, high portions of women were from Amhara, Oromia and Southern Nations Nationalities Regional State with their respective percentages of 10.7%, 11.8% and 11.3%. Women from Somalia Region were 0.285 times less likely to utilize Four or more Antenatal Care (ANC) as Compared to a Women from Tigray Region [AOR = 0.285, 95% CI = 0.109–0.747]. Conclusion The utilization of the Antenatal Care service was underutilized in Ethiopia. Education status, Ages of mothers, Size of family, Religion and Place of Residence were major Factors of influenced ANC utilization. The concerned government body should also create a better environment for impoverished women to participate in entrepreneurial activities. Antenatal care (ANC) is the provision of health services to pregnant women by trained health professionals before the birth of their babies to reduce maternal mortality and morbidity. A Community-based Crossectional study design was used for 8885 women aged 15 to 49. Out of 8885 all women considered for this study, 3910(44%) were utilized Antenatal Care (ANC) four or more times. The utilization of the Antenatal Care service was underutilized in Ethiopia. The concerned government body should also create a better environment for impoverished women to participate in entrepreneurial activities.
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Müller MW, Hamory J, Johnson-Hanks J, Miguel E. The illusion of stable fertility preferences. POPULATION STUDIES 2022; 76:169-189. [PMID: 35576966 PMCID: PMC9256780 DOI: 10.1080/00324728.2022.2057577] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 02/04/2022] [Indexed: 10/18/2022]
Abstract
Fertility preferences have long played a key role in models of fertility differentials and change. We examine the stability of preferences over time using rich panel data on Kenyan women's fertility desires, expectations, actual fertility, and recall of desires in three waves over a nine-year period, when respondents were in their 20s. We find that although desired fertility is quite unstable, most women perceive their desires to be stable. Under hypothetical future scenarios, few expect their desired fertility to increase over time but, in fact, such increases in fertility desires are common. Moreover, when asked to recall past desires, most respondents report previously wanting exactly as many children as they desire today. These patterns of bias are consistent with the emerging view that fertility desires are contextual, emotionally laden, and structured by identity.
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Analysis of Unmarried Adolescents and Modern Contraceptives Initiation in Nigeria: Evidence from 2018 NDHS. SOCIAL SCIENCES 2022. [DOI: 10.3390/socsci11070282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Nigeria is one of Africa’s most populous countries. Nigeria’s population is expected to exceed 400 million by 2050, putting it among the top five most populous countries in the world. High birth rates, limited contraception use, and early marriage are the main causes of this rapid increase. In Nigeria, adolescents play a substantial role in these issues, with 117 births per 1000 girls aged 15–19 years. Data for this article comes from the 2018 Nigerian Demographic and Health Survey (NDHS). Our sample consisted of 1014 sexually active unmarried adolescents aged 15–19 years. Kaplan Meier’s curve, Log Rank Test, and Cox proportional hazards model were modeled to estimate the parameters at p > 0.05. Findings show that the average time to the first use of modern contraceptives after sexual initiation is two years. Initiating sex at age 15 or later, belonging to the richest household wealth quintile, and use of the internet is associated with the early initiation of modern contraceptive methods, while residing in the northwest region and being older are associated with a low incidence of modern contraceptive use. Results indicate a deferred initiation of modern contraceptives after first sexual encounter. It has become imperative for tailored interventions to improve the time of initiation of contraceptives, so as to reduce the associated burdens and consequences.
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Nahar MT, Anik SMFI, Islam MA, Islam SMS. Individual and community-level factors associated with skilled birth attendants during delivery in Bangladesh: A multilevel analysis of demographic and health surveys. PLoS One 2022; 17:e0267660. [PMID: 35767568 PMCID: PMC9242462 DOI: 10.1371/journal.pone.0267660] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 04/13/2022] [Indexed: 11/25/2022] Open
Abstract
Background Skilled birth attendants (SBAs) play a crucial role in reducing infant and maternal mortality. Although the ratio of skilled assistance at birth has increased in Bangladesh, factors associated with SBA use are unknown. The main goal of our study was to reveal the individual- and community-level factors associated with SBA use during childbirth in Bangladesh. We also showed the prevalence and trend of SBA use and related independent variables in Bangladesh over the past decade. Methods This study utilized the Bangladesh Health and Demographic Survey (BDHS) 2017–2018, a cross-sectional study. We used binary logistic regression to examine the extent of variation in SBA use attributable to the individual- and community-level variables. Results Overall, 53.35% of women received assistance from SBAs during childbirth. The average annual rate of increase (AARI) in the number of SBA-assisted births over the past 10 years was 8.88%. Respondents who gave birth at or above 19 years had 1.40 times (AOR = 1.40; 95% CI: 1.21–1.62) greater odds of having skilled delivery assistance than respondents aged 18 years old or less. Women and their husband’s education levels were significantly associated with using skilled assistance during delivery, with odds of 1.60 (AOR = 1.60; 95% CI: 1.45–2.01) and 1.41 (AOR = 1.41; 95% CI: 1.21–1.66), respectively compared to those with education up to primary level. Women from rich families and those receiving better antenatal care (ANC) visits were more likely to have professional delivery assistance. Community-level factors also showed significance towards having professional assistance while giving birth. Women from urban communities and those who utilized more than four ANC visits and had completed secondary or higher education showed a greater tendency to use an SBA during childbirth than their counterparts. Conclusion The use of SBAs during delivery was significantly associated with some individual- and community-level factors. To reduce maternal and child mortality, there is a need to focus on rural and uneducated people who are less likely to access these facilities. Special programs could increase awareness and help the poor community obtain the minimum facility in maternal care.
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Affiliation(s)
- Mst. Tanmin Nahar
- Statistics Discipline, Science Engineering & Technology School, Khulna University, Khulna, Bangladesh
| | - S. M. Farhad Ibn Anik
- Statistics Discipline, Science Engineering & Technology School, Khulna University, Khulna, Bangladesh
| | - Md. Akhtarul Islam
- Statistics Discipline, Science Engineering & Technology School, Khulna University, Khulna, Bangladesh
- * E-mail:
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