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Galvin LJ, Nel YM. Contraceptive use in women with mental illness in Soweto, South Africa. S Afr J Psychiatr 2024; 30:2153. [PMID: 38322177 PMCID: PMC10839196 DOI: 10.4102/sajpsychiatry.v30i0.2153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 11/28/2023] [Indexed: 02/08/2024] Open
Abstract
Background The psychosocial and medical implications of unplanned pregnancy in women with mental illness (MI) are vast. International guidelines make clear recommendations about family planning for women with MI, particularly those exposed to known human teratogens; however, there is limited research related to contraceptive usage among women with MI. Aim The aim of this study was to investigate the prevalence of consistent contraceptive use and family planning education (FPE) among a population of women of childbearing age with MI. Setting This quantitative cross-sectional study was conducted at Chris Hani Baragwanath psychiatric unit in Soweto, South Africa. Methods A convenience sample comprising 190 eligible women of childbearing age with MI was employed for the study. The women were invited to participate by means of a structured questionnaire which was administered by the researcher. Clinical information was obtained from the patients' medical records. Results Consistent contraceptive usage occurred in 44.7% of participants. Family planning education was low (26.8%). Relationship status was associated with using contraception consistently (p = 0.0229). Teratogen exposure was not associated with either contraceptive use or FPE. Family planning education was not associated with contraceptive use. Conclusion Women with MI may have increased risk for unplanned pregnancy if they are not in a relationship because of perceived lack of need for contraception. Contribution Family planning education must be prioritised in women with MI, especially among women prescribed teratogenic medication, highlighting the risks associated with unplanned pregnancy.
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Affiliation(s)
- Lisa J Galvin
- Department of Psychiatry, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Perinatal HIV Research Unit, Wits Health Consortium, University of the Witwatersrand, Johannesburg, South Africa
| | - Yvette M Nel
- Department of Psychiatry, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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2
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Hellwig F, Barros AJD. Learning from success cases: ecological analysis of potential pathways to universal access to family planning care in low- and middle-income countries. Gates Open Res 2023; 6:59. [PMID: 36726686 PMCID: PMC9873636 DOI: 10.12688/gatesopenres.13570.3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2023] [Indexed: 01/21/2023] Open
Abstract
Background Universal access to family planning services is a well-recognized human right and several countries and organizations are committed to this goal. Our objective was to identify countries who improved family planning coverage in the last 40 years and investigate which contexts enabled those advances. Methods Analyses were based on data from publicly available national health surveys carried out since 1986 in Egypt, Ethiopia, Rwanda, Afghanistan, Brazil, and Ecuador, selected based on previous evidence. We estimated demand for family planning satisfied with modern methods (mDFPS) for each country and explored inequalities in terms of wealth, women's education, and women's age. We also explored contextual differences in terms of women's empowerment, percentage of population living in extreme poverty, and share of each type of contraceptive. To better understand political and sociocultural contexts, country case studies were included, based on literature review. Results Patterns of mDFPS increase were distinct in the selected countries. Current level of mDFPS coverage ranged between 94% in Brazil and 38% in Afghanistan. All countries experienced an important reduction in both gender inequality and extreme poverty. According to the share of each type of contraceptive, most countries presented higher use of short-acting reversible methods. Exceptions were Ecuador, where the most used method is sterilization, and Egypt, which presented higher use of long-acting reversible methods. In the first years analyzed, all countries presented huge gaps in coverage according to wealth, women's education and women's age. All countries managed to increase coverage over recent years, especially among women from the more disadvantaged groups. Conclusions Family planning coverage increased along with reductions in poverty and gender inequality, with substantial increases in coverage among the most disadvantaged in recent years. Policies involving primary health care services, provision of various methods, and high quality training of health providers are crucial to increase coverage.
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Affiliation(s)
- Franciele Hellwig
- International Center for Equity in Health, 1160 Marechal Deodoro St., 3rd floor, Pelotas, RS, 96020220, Brazil,Postgraduation Program in Epidemiology, Federal University of Pelotas, 1160 Marechal Deodoro St., 3rd floor, Pelotas, RS, 96020220, Brazil,
| | - Aluisio JD Barros
- International Center for Equity in Health, 1160 Marechal Deodoro St., 3rd floor, Pelotas, RS, 96020220, Brazil,Postgraduation Program in Epidemiology, Federal University of Pelotas, 1160 Marechal Deodoro St., 3rd floor, Pelotas, RS, 96020220, Brazil
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3
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Black KI, Trane W, Dorney E, Mola G. A cross-sectional study of factors associated with immediate postpartum uptake of contraceptive implants in Papua New Guinea. Contraception 2023; 117:25-29. [PMID: 36252651 DOI: 10.1016/j.contraception.2022.09.133] [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: 03/20/2022] [Revised: 09/27/2022] [Accepted: 09/30/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES In 2016 the Port Moresby General Hospital in Papua New Guinea introduced a midwife led postpartum contraception service to educate patients and provide contraceptive implants. This study examines the factors that were associated with immediate postpartum uptake of the implants. STUDY DESIGN We conducted a cross-sectional study of patients on the hospital postnatal ward who gave birth between March 2017 and January 2018. Patients aged 16-45 who had a vaginal birth with a singleton, live baby not requiring admission to the special care nursery were eligible for inclusion and invited to complete a survey prior to discharge. RESULTS Of 2082 patients approached, all consented to participate in the survey. Of those completing the survey, 531 (25.5%) chose to have the contraceptive implant provided immediately postpartum. Excluding patients who chose tubal ligation (n = 330), in multivariable analysis, higher odds of implant uptake was associated with no prior contraception use compared to prior use (aOR 1.38; 95% CI 1.07 -1.77), unplanned pregnancy compared to planned (aOR 1.37, 95% CI 1.07-1.79), and having received antenatal education about the implant compared to no information (AOR 1.65, 95% CI 1.23-2.10). CONCLUSIONS Antenatal education about the contraceptive implant impacted on likelihood of immediate postpartum method uptake. Patients who had no prior use of contraception and those with unplanned pregnancies were also more likely to request the implants, suggesting that the midwife-led postpartum service is successfully reaching patients with a previous unmet need for contraception. IMPLICATIONS This study demonstrates successful delivery of a postpartum implant program in a setting where community access to contraception is limited. Antenatal information and education can support implant uptake and that the program provides the opportunity for birth spacing and limiting in patients with a previous unmet need.
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Affiliation(s)
- Kirsten I Black
- Central Clinical School, Faculty of Medicine and Health, Susan Wakil Health Building D18, University of Sydney, New South Wales, 2006, Australia.
| | - Willie Trane
- Discipline of Obstetrics and Gynaecology, School of Medicine and Health Sciences, University of Papua New Guinea, PO Box 5623, Boroko, NCD 111, Papua New Guinea
| | - Edwina Dorney
- Central Clinical School, Faculty of Medicine and Health, Susan Wakil Health Building D18, University of Sydney, New South Wales, 2006, Australia
| | - Glen Mola
- Discipline of Obstetrics and Gynaecology, School of Medicine and Health Sciences, University of Papua New Guinea, PO Box 5623, Boroko, NCD 111, Papua New Guinea
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Negash WD, Eshetu HB, Asmamaw DB. Predictors of modern contraceptive use among reproductive age women in high fertility countries in sub-Saharan Africa: evidence from demographic and health surveys. BMC Womens Health 2022; 22:520. [PMID: 36514075 PMCID: PMC9746200 DOI: 10.1186/s12905-022-02121-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 12/09/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The world's population has increased faster than expected due to high fertility rates, with sub-Saharan Africa accounting for most of the increase. Modern contraceptive use is the best option to reduce the high fertility rate. There is limited information on the prevalence of modern contraception and its predictors in sub-Saharan Africa's high-fertility countries. Therefore, this study aimed to assess the prevalence and predictors of modern contraception among reproductive-age women in high fertility countries in sub-Saharan Africa. METHODS We used Demographic and Health Survey data sets from the top 10 high fertility countries in sub-Saharan Africa. Stata version 16.0 software was used to analyze the data, and all statistical analyses were completed after the data had been weighted. Multilevel binary logistic regression was performed to identify factors associated with modern contraceptive use. Adjusted odds ratio with a 95% confidence interval, and a p value < 0.05 was used to declare statistical significance. RESULTS The prevalence of modern contraceptive use in all the countries considered in this study was 10.72% (95% CI 10.57, 10.87). In terms of the predictor variables, young aged women, those who had attended a primary or secondary level of formal education, women who received antenatal care follow up, women who reported distance to the health facility as not a big problem, and women from rich families were more likely to use modern contraceptives. CONCLUSION Only one in 10 women of reproductive age used modern contraceptive methods in high fertility countries in sub-Saharan Africa. To improve the use of modern contraceptives, governments and non-governmental organizations studied in the countries should intensify programs that focus on those women who are economically poor, those with no formal education, no media exposure, and those with no antenatal care follow up.
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Affiliation(s)
- Wubshet Debebe Negash
- grid.59547.3a0000 0000 8539 4635Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P.O. Box: 196, Gondar, Ethiopia
| | - Habitu Birhan Eshetu
- grid.59547.3a0000 0000 8539 4635Department of Health Education and Behavioral Sciences, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Desale Bihonegn Asmamaw
- grid.59547.3a0000 0000 8539 4635Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Mardhiyah A, Panduragan SL, Mediani HS. Reducing Psychological Impacts on Children with Chronic Disease via Family Empowerment: A Scoping Review. Healthcare (Basel) 2022; 10:healthcare10102034. [PMID: 36292480 PMCID: PMC9602354 DOI: 10.3390/healthcare10102034] [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: 08/06/2022] [Revised: 09/27/2022] [Accepted: 10/12/2022] [Indexed: 11/04/2022] Open
Abstract
Chronic diseases cause physical and psychological impacts on sufferers. In dealing with illness, the family is not involved in the treatment of chronic diseases. Children also do not receive support from their families in dealing with their illness. Family empowerment is an important thing to implement in treating children with chronic diseases. The purpose of this study was to explore family empowerment interventions as potential methods to reduce the impact of chronic disease. This study used the scoping review method. A literature review was conducted via CINAHL, PubMed, and ProQuest databases. The keywords used in English were "family empowerment OR family center empowerment" AND "child OR children" AND "chronic disease". The criteria for articles in this study were full text, free access, randomized control trial or quasi-experiment research design, English language, population and samples of chronic disease, and the publication period of the last 10 years (2013-2022). We found nine articles that used a family empowerment intervention in an effort to reduce the impact of chronic disease on children. Most of the study designs were randomized control trial and quasi-experiment. Some of the benefits of family empowerment interventions were quality of life, family care, and self-ability. The interventions helped the families to be empowered and actively participate in caring for children with chronic diseases. There were nine articles that discussed family empowerment interventions that have an impact in dealing with the impact of chronic disease on children, namely improving quality of life, family care, and self-ability.
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Affiliation(s)
- Ai Mardhiyah
- Faculty of Health Science, Lincoln University College, Petaling Jaya 47301, Malaysia
- Department of Pediatric Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung 40132, Indonesia
- Correspondence: ; Tel.: +60-3-7806-3478
| | | | - Henny Suzana Mediani
- Department of Pediatric Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung 40132, Indonesia
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Islam MA, Sathi NJ, Abdullah HM, Tabassum T. A Meta-Analysis of Induced Abortion, Alcohol Consumption, and Smoking Triggering Breast Cancer Risk among Women from Developed and Least Developed Countries. Int J Clin Pract 2022; 2022:6700688. [PMID: 36474551 PMCID: PMC9683974 DOI: 10.1155/2022/6700688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 10/29/2022] [Accepted: 10/31/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The most prominent form of cancer in women is breast cancer, and modifiable lifestyle risk factors, including smoking, alcohol consumption, and induced abortion, can all contribute significantly to this disease. OBJECTIVES This study's primary purpose was to assess the prevalence of breast cancer among women in developed and developing countries and the association between three modifiable hazard factors (induced abortion, smoking behavior, and alcohol use) and breast cancer. METHODS This study performed a systematic literature database review up to September 21, 2021. We employed meta-analytic tools such as the random effects model, forest plot, and subgroup analysis to conduct the research. Additionally, we conducted a sensitivity analysis to assess the influence of outliers. RESULTS According to the random effects model, smoker women have a higher risk of developing breast cancer from different countries (OR = 1.46; 95% CI: 1.08-1.97). In the case of induced abortion, the pooled estimate (OR = 1.25; 95% CI: 1.01-1.53) indicated a significant link between abortion and breast cancer. Subgroup analysis revealed that smoking substantially influences breast cancer in developing and developed countries. Breast cancer was more common among women who smoked in developed countries than in developing nations. CONCLUSION The observed findings give sufficient support for the hypothesis that smoking and abortion have a significant influence on breast cancer in different nations. Health organizations should individually design comprehensive scientific plans to raise awareness about the risks of abortion and smoking in developed and developing countries.
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Affiliation(s)
- Md. Akhtarul Islam
- Statistics Discipline, Science Engineering & Technology School, Khulna University, Khulna-9208, Bangladesh
| | - Nusrat Jahan Sathi
- Statistics Discipline, Science Engineering & Technology School, Khulna University, Khulna-9208, Bangladesh
| | - Hossain Mohammad Abdullah
- Statistics Discipline, Science Engineering & Technology School, Khulna University, Khulna-9208, Bangladesh
| | - Tarana Tabassum
- Statistics Discipline, Science Engineering & Technology School, Khulna University, Khulna-9208, Bangladesh
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Exploring Readiness for Birth Control in Improving Women Health Status: Factors Influencing the Adoption of Modern Contraceptives Methods for Family Planning Practices. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182211892. [PMID: 34831646 PMCID: PMC8618296 DOI: 10.3390/ijerph182211892] [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: 09/15/2021] [Revised: 11/05/2021] [Accepted: 11/05/2021] [Indexed: 12/03/2022]
Abstract
Background: Pakistan is the world’s sixth most populated country, with a population of approximately 208 million people. Despite this, just 25% of legitimate couples say they have used modern contraceptive methods. A large body of literature has indicated that sexual satisfaction is a complex and multifaceted concept, since it involves physical and cultural components. The purpose of this study is to investigate the impact of influencing factors in terms of contraceptive self-efficacy (CSE), contraceptive knowledge, and spousal communication on the adoption of modern contraceptive methods for family planning (FP) under the moderating role of perceived barriers. Methods: Data were collected using an adopted questionnaire issued to married women of reproductive age belonging to the Rawalpindi and Neelum Valley regions in Pakistan. The sample consisted of 250 married women of reproductive age. SPSS was used to analyze the respondents’ feedback. Results: The findings draw public attention towards CSE, contraceptive knowledge, and spousal communication, because these factors can increase the usage of modern methods for FP among couples, leading to a reduction in unwanted pregnancies and associated risks. Regarding the significant moderation effect of perceived barriers, if individuals (women) are highly motivated (CSE) to overcome perceived barriers by convincing their husbands to use contraceptives, the probability to adopt modern contraceptive methods for FP practices is increased. Conclusions: Policymakers should formulate strategies for the involvement of males by designing male-oriented FP program interventions and incorporating male FP workers to reduce communication barriers between couples. Future research should address several other important variables, such as the desire for additional child, myths/misconceptions, fear of side effects, and partner/friend discouragement, which also affect the adoption of modern contraceptive methods for FP practices.
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Lee D, Chua B. Soft Candy as an Electronic Material Suitable for Salivary Conductivity-Based Medical Diagnostics in Resource-Scarce Clinical Settings. ACS APPLIED MATERIALS & INTERFACES 2021; 13:43984-43992. [PMID: 34506102 DOI: 10.1021/acsami.1c11306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Soft candy was discovered to be an excellent electronic material and was used to fabricate electrodes for salivary conductivity-based diagnostics. Using a simple molding process, a soft candy (Tootsie Roll) was made into 20 × 20 × 5 mm electrodes with a stable frequency response (0.1-100 kHz). The soft candy electrode-liquid interface circuit model was also developed for the first time. Using 0.01, 0.05, and 0.1 M phosphate-buffered saline and artificial saliva of varying conductivities, the performance of the soft candy (Tootsie Roll) electrode was evaluated. The electrode has a low temperature coefficient of ∼0.02 V/C, and the evaporation-induced mass change during measurement (<3 min) was negligible. Using a trenched surface, a limit of detection (LOD) of ∼1630 μS/cm was obtained and was lower than the saliva conductivity of a healthy adult at ∼3500 μS/cm. Thus, it is suitable for monitoring the ovulation cycle for natural family planning as well as chronic kidney disease diagnosis. Given the ubiquity of soft candy, the simplicity of the molding process, and the negligible medical waste stream, it is a more appropriate approach to diagnostics design for resource-scarce clinical settings, such as those in developing countries. The broader impact of this work will be the paradigm shift of soft candy from food to a new class of edible, moldable, high-resistivity, and stable electronic materials.
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Affiliation(s)
- Donghyun Lee
- School of Electrical Engineering, Korea University, Seoul 02841, Republic of Korea
- School of Dentistry, Pusan National University, Yangsan 50612, Republic of Korea
| | - Beelee Chua
- School of Electrical Engineering, Korea University, Seoul 02841, Republic of Korea
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Mapping Evidence of Impacts of COVID-19 Outbreak on Sexual and Reproductive Health: A Scoping Review. Healthcare (Basel) 2021; 9:healthcare9040436. [PMID: 33917784 PMCID: PMC8068100 DOI: 10.3390/healthcare9040436] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/01/2021] [Accepted: 04/06/2021] [Indexed: 12/23/2022] Open
Abstract
Introduction: The emergence of the coronavirus disease 2019 (COVID-19) pandemic has rapidly transformed the pre-existing worldwide sexual and reproductive health environment. The provision and supply of contraceptives, and a wide variety of sexual health, new-born, and maternal health services have been seriously affected. Thus, this scoping review mapped the available evidence on the impacts of the COVID-19 outbreak on sexual and reproductive health. Methods: Arksey and O’Malley’s methodological framework guided this scoping review. A search was conducted from the following databases: Embase, PubMed, CINAHL, Scopus, WOS, and AJOL. The preferred reporting items for systematic reviews and meta-analyses (PRISMA) chart and PRISMA extension for scoping reviews (PRISMA-ScR) checklist were used to document the review process. The McMaster critical review checklist was used to determine the quality of the included studies. Thematic analyses were conducted using NVivo version 12. Results: Three studies showed evidence on the impact of COVID-19 and family planning services, six studies reported on maternal and child services and eleven studies reported on sexual health (sexual behavior). Limited access to family planning use, reduction in multiple sexual partnership, decreased transactional sex, and maternal and child services disruption were some impacts reported in the included studies. Conclusion: This study has demonstrated the impacts of COVID-19 on family planning access, multiple sexual partnership, transactional sex, and disruption of maternal and child health services. Interventions that will consider the immediate availability of and access to all sexual and reproductive health services should be prioritized.
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Aventin Á, Rabie S, Skeen S, Tomlinson M, Makhetha M, Siqabatiso Z, Lohan M, Clarke M, Lohfeld L, Thurston A, Stewart J. Adaptation of a gender-transformative sexual and reproductive health intervention for adolescent boys in South Africa and Lesotho using intervention mapping. Glob Health Action 2021; 14:1927329. [PMID: 34106036 PMCID: PMC8205055 DOI: 10.1080/16549716.2021.1927329] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 05/04/2021] [Indexed: 12/15/2022] Open
Abstract
Background: Rates of adolescent HIV and unintended pregnancy in southern Africa are amongst the highest in the world. Gender-transformative interventions that address underlying gender inequalities and engage both males and females have been emphasised by the World Health Organisation, amongst others, to target prevention. However, few such gender-transformative interventions have been rigorously developed or evaluated.Objective: To expedite potential impact and reduce development costs, we conducted a needs assessment to inform the co-design, in consultation with local stakeholders, of adapted versions of an existing gender-transformative Relationships and Sexuality Education intervention for use in South Africa and Lesotho.Methods: Adaptation of the intervention was guided by a modified version of Intervention Mapping (IM). This process involved consultation with separate adolescent, community and expert advisory groups and a collaboratively conducted needs assessment, which drew on focus groups with adolescents (8 groups, n = 55) and adults (4 groups, n = 22) in South Africa and Lesotho, and was informed by our systematic review of the literature on the determinants of condom use among adolescents in the region.Results: The findings clarified how the intervention should be adapted, which individual- and environmental-level determinants of condom use to target, and actions for facilitating successful adoption, evaluation and implementation in the new settings.Conclusions: The IM approach allows for a systematic appraisal of whether components and processes of an existing intervention are appropriate for a new target population before costly evaluation studies are conducted. The findings will be of interest to those wishing to rigourously develop and evaluate gender-transformative interventions engaging men to improve health for all.
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Affiliation(s)
- Áine Aventin
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast, Northern Ireland, UK
| | - Stephan Rabie
- Institute for Life Course Health Research, Stellenbosch University, Cape Town, South Africa
- Department of Psychiatry and Mental Health, HIV Mental Health Research Unit, Cape Town, South Africa
| | - Sarah Skeen
- Institute for Life Course Health Research, Stellenbosch University, Cape Town, South Africa
| | - Mark Tomlinson
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast, Northern Ireland, UK
- Institute for Life Course Health Research, Stellenbosch University, Cape Town, South Africa
| | | | - Zenele Siqabatiso
- Institute for Life Course Health Research, Stellenbosch University, Cape Town, South Africa
| | - Maria Lohan
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast, Northern Ireland, UK
| | - Mike Clarke
- Centre for Public Health, Queen’s University Belfast, Belfast, Northern Ireland
| | - Lynne Lohfeld
- Centre for Public Health, Queen’s University Belfast, Belfast, Northern Ireland
| | - Allen Thurston
- School of Education, Social Sciences, Education and Social Work, Queen’s University Belfast, Belfast, Northern Ireland, UK
| | - Jackie Stewart
- Institute for Life Course Health Research, Stellenbosch University, Cape Town, South Africa
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11
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Akamike IC, Okedo-Alex IN, Eze II, Ezeanosike OB, Uneke CJ. Why does uptake of family planning services remain sub-optimal among Nigerian women? A systematic review of challenges and implications for policy. Contracept Reprod Med 2020; 5:30. [PMID: 33292842 PMCID: PMC7603738 DOI: 10.1186/s40834-020-00133-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 10/21/2020] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Over the years, family planning uptake in Nigeria has remained low and this is as a result of the various challenges and barriers faced by women. The aim of this study was to systematically review studies on family planning services undertaken in Nigeria in order to understand the challenges to uptake of the services and the policy implications. METHODS A PubMed search was performed in June 2020 and studies that investigated challenges of family planning uptake in Nigeria published in English between 2006 and 2020 were sought. A combination of the search terms family planning, contraceptives, challenges, barriers, Nigeria was used. Review articles, case reports, and case studies were excluded. Studies that did not report barriers or challenges to family planning or contraceptives were excluded. RESULT Twenty seven studies carried out in Nigeria which provided sufficient information were identified and used for this review. The Uptake of family planning recorded in the reviewed studies ranges from 10.3 to 66.8%. Challenges that are client related include education, desire for more children, uncertainty about its need, partner disapproval, previous side effects, religious beliefs, culture disapproval, age, marital status, and wealth index, residence, ignorance, embarrassment, domestic violence and sexual factor. Health service related factors identified include cost, difficulty accessing services, and procurement difficulties. Recommendations for family planning propram and policy include targeting of health service delivery for improvement, focus on gender issues and male involvement, involvement of religious leaders, targeting of younger women for better education and counseling, and continuous awareness creation and counseling among others. CONCLUSION The review has shown that uptake of family planning remains low in Nigeria and challenges abound. We recommend that strategies that are multi-sectoral should be applied to address the multi-pronged challenges facing uptake of family planning services.
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Affiliation(s)
- Ifeyinwa Chizoba Akamike
- Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria.
- African Institute for Health Policy and Health Systems, Ebonyi State University, Abakaliki, Nigeria.
| | - Ijeoma Nkem Okedo-Alex
- Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria
- African Institute for Health Policy and Health Systems, Ebonyi State University, Abakaliki, Nigeria
| | - Irene Ifeyinwa Eze
- Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria
- African Institute for Health Policy and Health Systems, Ebonyi State University, Abakaliki, Nigeria
| | | | - Chigozie Jesse Uneke
- African Institute for Health Policy and Health Systems, Ebonyi State University, Abakaliki, Nigeria
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12
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Bagade T, Chojenta C, Harris ML, Nepal S, Loxton D. Does gender equality and availability of contraception influence maternal and child mortality? A systematic review. BMJ SEXUAL & REPRODUCTIVE HEALTH 2020; 46:244-253. [PMID: 31754064 DOI: 10.1136/bmjsrh-2018-200184] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 10/30/2019] [Accepted: 10/31/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Current global maternal and child health policies rarely value gender equality or women's rights and are restricted to policies addressing clinical interventions and family planning. Gender equality influences the knowledge, autonomy and utilisation of contraception and healthcare, thereby affecting maternal and child health. This systematic review aims to analyse the concurrent effect of gender equality and contraception on maternal and under-5 child mortality. METHODS A systematic review was conducted to investigate the current evidence. Studies were eligible if three themes-namely, indicators of gender equality (such as female education, labour force participation, gender-based violence), contraception, and maternal or child mortality-were present together in a single article analysing the same sample at the same time. RESULTS Even though extensive literature on this topic exists, only three studies managed to fit the selection criteria. Findings of two studies indicated an association between intimate partner violence (IPV) and infant mortality, and also reported that women's contraceptive use increased the risk of IPV. The third study found that the mother's secondary education attainment significantly reduced child mortality, while the mother's working status increased the odds of child mortality. The researchers of all included studies specified that contraceptive use significantly reduced the risk of child mortality. CONCLUSION Improvement in gender equality and contraception concurrently affect the reduction in child mortality. These findings provide strong support to address the research gaps and to include a gender equality approach towards maternal and child health policies.
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Affiliation(s)
- Tanmay Bagade
- School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Catherine Chojenta
- School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Melissa L Harris
- School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Smriti Nepal
- School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Deborah Loxton
- School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, Callaghan, New South Wales, Australia
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13
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Abebe HT, Belachew AB, Gebretsadik LG, Berhe YZ, Gebru HB, Kahsay AB, Gebrekidan AG. Contraceptive use and its determinants among adolescent women in Tigray, Ethiopia: a multilevel modeling. Int J Adolesc Med Health 2020; 34:327-336. [PMID: 32881709 DOI: 10.1515/ijamh-2020-0107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 07/28/2020] [Indexed: 11/15/2022]
Abstract
Background Adolescent women are central for intergenerational health of human populations. Adolescent women are the most vulnerable to a range of reproductive health problems. One of the leading causes of death for adolescent women is complications from childbirth and pregnancy. Contraceptive prevents the occurrence of unwanted pregnancies and its complications, thus potentially lower the death rate for adolescent women. However, contraceptive use assumed to be affected by multilevel factors thus needs statistical modeling that account the effect of these factors. Understanding multilevel factors affecting contraceptive use among adolescent women is important for improving the access to and quality of health services. Objective The aim of this study was to assess the contraceptive use and its multilevel determinants among adolescent women in Tigray region. Methods A community based cross-sectional study was conducted. Women who were 15-19 years of age residing in the selected households at the time of data collection were included in the survey. Multi-stage cluster sampling was used to select study units. A multivariable two-level mixed effect binary logistic regression model was fitted to assess the effect of the explanatory variables on contraceptive use. Results A total of 1,755 adolescent women were participated. Of these 12.3% were contraceptive users. Pills (40%) and intrauterine device (30%) were commonly used contraceptive methods. Educational level, schooling, marital status, age, being informed about contraceptive, health facility visit, duration of stay at their residence, having partner and hearing of contraceptive use message through media were the most important determinants for use of contraceptive among adolescent women. Study participants who were not at school currently had more likely to use contraceptive methods compared to those who were at school (Adjusted odds ratio [AOR]=2.05; 95% confidence interval [CI]: 1.502, 4.183). Similarly, adolescent women who had no history of health facility visit had less likely to use contraceptive methods than those have history of health facility visit (AOR=0.057; 95% CI: 0.034, 0.096). Adolescent women who heard of contraceptive through median had two times (AOR=2.103; 95% CI: 1.207, 3.664) more likely to use contraceptive methods than those not heard contraceptive through media. Conclusion and recommendation The factors affecting use of contraceptive method among adolescent women were educational level, schooling, marital status, age, being informed about contraceptive, health facility visit, duration of stay at their residence, having partner and hearing of contraceptive use message through media. This study recommends that in order to increase use of contraceptive method among adolescent women, interventions should continue like the promotion of contraceptive methods through media.
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Adampah T, Angwa LM, Demuyakor A, Achinkok D, Boah M. Contraceptive use among women with a history of induced abortion: findings from a national sample of sexually active, non-pregnant women in Ghana. EUR J CONTRACEP REPR 2020; 25:394-401. [PMID: 32684009 DOI: 10.1080/13625187.2020.1795117] [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: 10/23/2022]
Abstract
OBJECTIVE The aim of the study was to examine the relationship between a history of induced abortion and current use of contraception among reproductive-aged women in Ghana. METHODS The analysed data were a weighted sample of 6544 sexually active, non-pregnant women aged 15-49 years, obtained from the 2014 Ghana Demographic and Health Survey. Survey logistic regression analysis was used to estimate the odds of currently using any contraception and of using a modern method of contraception, given a history of induced abortion in the period 2009-2014. RESULTS A history of induced abortion between 2009 and 2014 was reported by 17.4% of women (95% CI 16.0%, 18.9%); 28.7% (95% CI 26.9%, 30.6%) were currently using a method of contraception and 23.0% (95% CI 21.4%, 24.7%) were currently using a modern method of contraception. The majority (80.1%) of current contraceptive users were using a modern method. The adjusted analysis revealed no statistically significant association between a history of induced abortion and current contraceptive behaviour. Other factors were associated with modern contraceptive use. CONCLUSION Overall, the use of contraception among sexually active women in Ghana was found to be low. Our findings showed that women's experience of induced abortion was unlikely to influence their current use of modern contraception.
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Affiliation(s)
- Timothy Adampah
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, China.,Center for Education, Culture and Health Opportunities (ECHO) Research Group International, Aflao, Ghana
| | - Linet Musungu Angwa
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, China.,Department of Clinical Medicine, Kabarak University, Nakuru, Kenya
| | - Abigail Demuyakor
- Key Laboratory of Myocardial Ischemia, Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Chinese Ministry of Education, Harbin, China
| | - Dominic Achinkok
- School of Medicine and Health Sciences, University for Development Studies, Tamale, Ghana
| | - Michael Boah
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, China.,Ghana Health Service, Bolgatanga, Ghana
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Yakob B, Gage A, Nigatu TG, Hurlburt S, Hagos S, Dinsa G, Bowser D, Berman P, Kruk ME, Tekle E. Low effective coverage of family planning and antenatal care services in Ethiopia. Int J Qual Health Care 2020; 31:725-732. [PMID: 30608585 DOI: 10.1093/intqhc/mzy251] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 10/29/2018] [Accepted: 12/14/2018] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To assess the quality and effective coverage (EC) of family planning (FP) and antenatal care (ANC) services in Ethiopia. DESIGN Secondary analyses of the 2014 Ethiopia Service Provision Assessment Plus Survey and 2016 Ethiopia Demographic and Health Survey data. SETTING AND PARTICIPANTS Women using FP and ANC. MAIN OUTCOME MEASURES Quality indices are created as a proportion of recommended clinical actions done in observations of ANC and FP visits. We adjust the crude coverage of ANC and of FP by the quality to estimate EC for both services. RESULTS The crude coverage of FP was 61% and 62% for ANC in Ethiopia in 2016. On average, quality was 35.8% during FP visits and 86% of women received <50% of the recommended clinical actions. When adjusting the crude coverage to account for the quality of service, Ethiopia's FP services EC was 22%. On average, ANC quality was 34% and 81% received <50% of the recommended ANC clinical actions. When adjusting the crude coverage by the service quality, the mean EC of ANC services was 22% in Ethiopia. CONCLUSIONS The quality of both FP and ANC services is low in Ethiopia, with women obtaining only a fraction of the standard clinical actions during their visits. In addition, there is considerable variation in EC across Ethiopia's regions, with variation driven largely by variations in crude coverage. To improve EC, actions are needed to improve the quality of ANC and FP care.
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Affiliation(s)
- Bereket Yakob
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Fenot Project, Addis Ababa, Ethiopia
| | - Anna Gage
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 665 Huntington Ave., Building 1, Boston, MA 02115, USA
| | - Tsinuel Girma Nigatu
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Fenot Project, Addis Ababa, Ethiopia
| | - Sarah Hurlburt
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Fenot Project, Addis Ababa, Ethiopia
| | - Seifu Hagos
- School of Public Health, Fenot Project, Addis Ababa University, Addis Ababa, Ethiopia
| | - Girmaye Dinsa
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Fenot Project, Addis Ababa, Ethiopia
| | - Diana Bowser
- Heller School for Social Policy and Management, Brandeis University 415 South St, Waltham, MA, USA
| | - Peter Berman
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 665 Huntington Ave., Building 1, Boston, MA 02115, USA.,School of Population and Public Health, University of British Columbia, 2206 E Mall, Vancouver, Canada
| | - Margaret E Kruk
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 665 Huntington Ave., Building 1, Boston, MA 02115, USA
| | - Ephrem Tekle
- Maternal and Child Health Directorate, Ministry of Health, Federal Democratic Republic of Ethiopia, Addis Ababa, Ethiopia
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Bahamondes L, Peloggia A. Modern contraceptives in sub-Saharan African countries. Lancet Glob Health 2019; 7:e819-e820. [DOI: 10.1016/s2214-109x(19)30199-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 04/24/2019] [Indexed: 11/26/2022]
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Adedze M, Osei-Yeboah R. Underuse of modern contraception in sub-Saharan Africa: are there implications for sustainable development and climate change? A review of the literature. EUR J CONTRACEP REPR 2019; 24:314-318. [DOI: 10.1080/13625187.2019.1618448] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Miranda Adedze
- Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Richard Osei-Yeboah
- Division of Computational Biology, Faculty of Health Sciences, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
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Adedini SA, Omisakin OA, Somefun OD. Trends, patterns and determinants of long-acting reversible methods of contraception among women in sub-Saharan Africa. PLoS One 2019; 14:e0217574. [PMID: 31163050 PMCID: PMC6548375 DOI: 10.1371/journal.pone.0217574] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 05/14/2019] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Method-specific contraceptive prevalence varies widely globally, as huge variations exist in the use of different types of contraception, with short-term methods being the most common methods in sub-Saharan Africa (SSA). Evidence is scanty on the trends, patterns and determinants of long-acting reversible contraceptive (LARC) methods in SSA. This study aimed to address this knowledge gap. METHODS Using a pseudo longitudinal research design and descriptive and inferential statistics, we analysed Demographic and Health Survey data of eight countries selected on the basis of contraceptive prevalence rates across SSA. Multinomial logistic regression modelling was used to tease out the predictors of the uptake of LARC methods in the selected countries. RESULTS Findings exhibit a steady but slow upward trend in LARC methods across selected countries, as a marginal increase was recorded in LARC uptake over a 10-year period in many of the selected countries. Results established significant predictors of LARC methods uptake, including fertility-related characteristics, age, level of education, work status, wealth index and exposure to mass media. This study underscored the need to address various barriers to the uptake of LARC methods in SSA. It is recommended that governments at different levels undertake to cover the costs of LARC methods in order to increase access and uptake.
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Affiliation(s)
- Sunday A. Adedini
- Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand, Johannesburg, South Africa
- Programme in Demography and Population Studies, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Oluwaseyi Dolapo Somefun
- Programme in Demography and Population Studies, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Some Determinants of Contraceptive Use Among Women at the Reproductive Age with Thalassemia Major Children in Sistan and Baluchestan Province, Iran. WOMEN’S HEALTH BULLETIN 2019. [DOI: 10.5812/whb.90092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Harzif AK, Mariana A, Malik DM, Silvia M, Lovita BT. Factors associated with the utilization of long-acting reversible contraceptives among family planning clients at the Pameungpeuk Rural Hospital, Indonesia. F1000Res 2018; 7:1891. [PMID: 31754422 PMCID: PMC6852292 DOI: 10.12688/f1000research.15755.2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/27/2019] [Indexed: 11/29/2022] Open
Abstract
Background: Uncontrolled population development can prompt an assortment of populace issues and can be one of the reasons for increasing maternal death rates. The utilization of contraceptives in Indonesia was progressively dominated by injectable contraceptives and pill contraceptives in 2015 (52.21% and 24.36%, respectively). However, the rate of termination of the use of short-acting contraceptives by family planning clients was higher than other methods, therefore the use of short-acting contraceptives is less efficient than long acting reversible contraceptives (LARCs) for longer term spacing because it is easy to skip a treatment for economic or other reasons, which can result in unintended pregnancy. Therefore, the National Family Planning Program in Indonesia is encouraging the use of LARCs to control population growth. Pameungpeuk is a region which has the second largest population, with the highest total fertility rate in South-West Java. The proportion of active users of LARCs in Pameungpeuk is very low (10.66%). This study aimed to analyze factors associated with the utilization of LARCs among family planning clients at the Pameungpeuk Rural Hospital. Methods: This study design was cross-sectional with systematic random sampling. The sample group in this study was 84 family planning clients. We performed statistical analyses using chi-square test. Results: We found significant associations between the age of women (p=0.024), the cost of contraception (p=0.022), knowledge (p=0.042), beliefs (p=0.002), skill of health workers (p=0.008) and support from health workers (p=0.014). However, education (p=0.212), family income (p=0.087), attitude (p=0.593), exposure to information on LARCs (p=0.378), support from partners (p=0.094), support from friends (p=0.414) and the support of community leaders (p=0.367) had no significant association with the utilization of LARCs. Conclusions: These findings highlight a critical need for improved education among family planning clients at the Pameungpeuk rural hospital regarding the use of LARCs for both medical and elective reasons.
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Affiliation(s)
- Achmad Kemal Harzif
- Division of Immuno-Endocrinology and Fertility, Department of Obstetrics and Gynecology, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, DKI Jakarta Province, Indonesia
| | - Ana Mariana
- Indonesian Reproductive Medicine Research and Training Center (INA- REPROMED), Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, DKI Jakarta Province, Indonesia
| | - Devi Marischa Malik
- Department of Obstetrics and Gynecology, Persahabatan Public Hospital, Jakarta, DKI Jakarta Province, Indonesia
| | - Melisa Silvia
- Indonesian Reproductive Medicine Research and Training Center (INA- REPROMED), Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, DKI Jakarta Province, Indonesia
| | - Bara Tracy Lovita
- Indonesian Reproductive Medicine Research and Training Center (INA- REPROMED), Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, DKI Jakarta Province, Indonesia
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Harzif AK, Mariana A, Malik DM, Silvia M, Lovita BT. Factors associated with the utilization of long-acting reversible contraceptives among family planning clients at the Pameungpeuk Rural Hospital, Indonesia. F1000Res 2018; 7:1891. [PMID: 31754422 PMCID: PMC6852292 DOI: 10.12688/f1000research.15755.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/30/2018] [Indexed: 10/20/2023] Open
Abstract
Background: Uncontrolled population development can prompt an assortment of populace issues and can be one of the reasons for increasing maternal death rates. The utilization of contraceptives in Indonesia was progressively dominated by injectable contraceptives and pill contraceptives in 2015 (52.21% and 24.36%, respectively). However, the rate of termination of the use of short-acting contraceptives by family planning clients was higher than other methods, therefore the use of short-acting contraceptive is not effective enough for use. In anticipating the decreased use of short-acting contraceptives while also seeking to control population growth, the National Family Planning Program in Indonesia is encouraging the use of long-acting reversible contraceptives (LARCs). Pameungpeuk is a region which has the second largest population, with the highest total fertility rate in South-West Java. The proportion of active users of LARCs in Pameungpeuk is also very low (10.66%). This study therefore aimed to analyze factors associated with the utilization of LARCs among family planning clients at the Pameungpeuk Rural Hospital. Methods: This study used a cross-sectional design with systematic random sampling. The sample group in this study was 84 family planning clients. We performed statistical analyses using a chi-square test. Results: We found significant associations between the age of women (p=0.024), the cost of contraception (p=0.022), knowledge (p=0.042), beliefs (p=0.002), skill of health workers (p=0.008) and support from health workers (p=0.014). However, education (p=0.212), family income (p=0.087), attitude (p=0.593), exposure to information on LARCs (p=0.378), support from partners (p=0.094), support from friends (p=0.414) and the support of community leaders (p=0.367) had no significant association with the utilization of LARCs. Conclusions: These findings highlight a critical need for improved education among family planning clients at the Pameungpeuk rural hospital regarding the use of LARCs for both medical and elective reasons.
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Affiliation(s)
- Achmad Kemal Harzif
- Division of Immuno-Endocrinology and Fertility, Department of Obstetrics and Gynecology, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, DKI Jakarta Province, Indonesia
| | - Ana Mariana
- Indonesian Reproductive Medicine Research and Training Center (INA- REPROMED), Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, DKI Jakarta Province, Indonesia
| | - Devi Marischa Malik
- Department of Obstetrics and Gynecology, Persahabatan Public Hospital, Jakarta, DKI Jakarta Province, Indonesia
| | - Melisa Silvia
- Indonesian Reproductive Medicine Research and Training Center (INA- REPROMED), Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, DKI Jakarta Province, Indonesia
| | - Bara Tracy Lovita
- Indonesian Reproductive Medicine Research and Training Center (INA- REPROMED), Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, DKI Jakarta Province, Indonesia
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Harrison MS, Goldenberg RL. Immediate postpartum use of long-acting reversible contraceptives in low- and middle-income countries. Matern Health Neonatol Perinatol 2017; 3:24. [PMID: 29299334 PMCID: PMC5740832 DOI: 10.1186/s40748-017-0063-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 10/05/2017] [Indexed: 02/03/2023] Open
Abstract
Globally, data show that many women of reproductive age desire to use modern family planning methods. Many of these women do not have access to modern contraceptives, which is termed their 'unmet need' for contraception. In low- and middle-income countries where total fertility rates can be high and many women have undesired fertility, or wish to increase their inter-pregnancy intervals, access to modern contraceptives is often inadequate. The puerperium is a unique time for interventions to offer modern contraceptive methods. Having just given birth, women may desire contraceptives to prevent short-interval pregnancy, or further pregnancy, altogether. In high-, middle-, and low-income countries there has been an increased interest in the placement of long-acting reversible contraceptives at or immediately after delivery, regardless of delivery mode. These methods can provide women with highly effective contraception for years, can be manufactured at low cost, are generally well tolerated with a good safety profile, and do not require the user to remember to take them. Oral contraceptives and injectable medications require the patient to present to the clinic during a specific timeframe for follow-up care or a refill, and the clinic may not be proximate, affordable, or have the desired contraceptive in stock. This document will review the currently published literature on the use of immediate postpartum long-acting reversible contraceptives (placed within two days of delivery) in low- and middle-income countries to report on the prevalence of use and satisfaction rates, and note the lack of data on cost and economic implications. We will also explore data on how future maternal, neonatal, and infant outcomes may be influenced by increased peripartum long-term contraceptive use.
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Affiliation(s)
- Margo S. Harrison
- Columbia University Medical Center, New York, NY USA
- 622 W 168th St, PH 16-29, New York, NY 10032 USA
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Yamamoto Y, Matsumoto K. Choice of contraceptive methods by women's status: Evidence from large-scale microdata in Nepal. SEXUAL & REPRODUCTIVE HEALTHCARE 2017; 14:48-54. [PMID: 29195634 DOI: 10.1016/j.srhc.2017.09.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 08/28/2017] [Accepted: 09/27/2017] [Indexed: 11/16/2022]
Abstract
OBJECTIVE We aimed to investigate how improvement in women's status affects the choice of contraceptive methods in Nepal. STUDY DESIGN We regressed the choice of contraceptive methods on women's status and other controlling variables by employing large-scale microdata representing over 12,000 married women aged 15-49 years in Nepal. Years of schooling and literacy were defined as women's status variables. We estimated how educational attainment affects the choice of contraceptive methods. We also analyzed how fear of their partners affected women's choices. RESULTS Female sterilization was the most common choice among the contraceptive methods (25.5% of contraceptive users) in Nepal, followed by injections (19.9%). However, our estimation results showed that these options change with an improvement in women's status. An additional year of education increased the probability that women would choose condoms by 1.2 percentage points (95% confidence interval [CI]: 0.7, 1.6) and decreased the probability of choosing female sterilization by 1.4 percentage points (95% CI: -1.9, -0.8). For the well-educated women, injections and condoms became the first and second choices (29.5% and 21.5%), respectively, while female sterilization was the third option (17.9%) for contraceptive methods. Women's fear of their partners also affected the choice of contraceptive methods. The women who feared their partners were 7.0 percentage points more likely to choose female sterilization than condoms. CONCLUSION Improvement in women's status (more education and less fear of their partners) changed their contraceptive behaviors by increasing the probability of choosing condoms and decreasing the probability of choosing female sterilization in Nepal.
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Affiliation(s)
- Yuki Yamamoto
- Graduate School of Fisheries and Environmental Sciences, Nagasaki University, 1-14 Bunkyo-machi, Nagasaki 852-8521, Japan.
| | - Ken'ichi Matsumoto
- Graduate School of Fisheries and Environmental Sciences, Nagasaki University, 1-14 Bunkyo-machi, Nagasaki 852-8521, Japan.
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Sedekia Y, Jones C, Nathan R, Schellenberg J, Marchant T. Using contraceptives to delay first birth: a qualitative study of individual, community and health provider perceptions in southern Tanzania. BMC Public Health 2017; 17:768. [PMID: 28974208 PMCID: PMC5627429 DOI: 10.1186/s12889-017-4759-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 09/13/2017] [Indexed: 11/17/2022] Open
Abstract
Background Young adolescents and unmarried women in low and middle income countries face challenges in accessing family planning services. One factor likely to limit contraceptive use is the attitude and opinion of local stakeholders such as community leaders and health workers. Much of the existing evidence on this topic focuses on women who have already started childbearing. Using primary qualitative data, we explored individual, community and health provider’s perceptions about using modern contraceptives to delay the first birth in a high fertility setting. Methods A descriptive qualitative study was conducted in Tandahimba district in southern Tanzania between December 2014 and March 2015. We conducted 8 focus group discussions with men and women and 25 in-depth interviews (18 with women, 4 with family planning service providers and 3 with district-level staff). Participants were purposively sampled. Data transcripts were managed and coded using Nvivo 11 software and we employed a thematic framework analysis. Results Three main themes emerged about using modern contraceptives to delay first birth: (1) the social and biological status of the woman (2) the type of contraceptive and (3) non-alignment among national policies for adolescents. Use of modern contraceptives to delay first birth was widely acceptable for women who were students, young, unmarried and women in unstable marriage. But long-acting reversible methods such as implants and intrauterine devices were perceived as inappropriate methods for delaying first birth, partly because of fears around delayed return to fecundity, discontinuation once woman’s marital status changes and permanently limiting future fertility. The support for use of modern contraceptives to delay a first pregnancy was not unanimous. A small number of participants from both rural and urban areas did not approve the use of contraceptive methods before the birth of a first baby at all, not even for students. There was lack of clarity and consistency on the definition of ‘young’ and that had direct implications for access, autonomy in decision-making, confidentiality and consent for young people. Conclusions Women who wish to delay their first birth face challenges related to restrictions by age and method imposed by stakeholders in accessing and provision of modern contraceptives. There is a need for a clearly communicated policy on minimum age and appropriate method choice for delayers of first birth.
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Affiliation(s)
- Yovitha Sedekia
- Ifakara Health Institute, P.O BOX 78373, Dar-es-Salaam, Tanzania. .,Department of Disease Control, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | | | - Rose Nathan
- Ifakara Health Institute, P.O BOX 78373, Dar-es-Salaam, Tanzania
| | - Joanna Schellenberg
- Department of Disease Control, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Tanya Marchant
- Department of Disease Control, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
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Panchaud A, Stojanov M, Ammerdorffer A, Vouga M, Baud D. Emerging Role of Zika Virus in Adverse Fetal and Neonatal Outcomes. Clin Microbiol Rev 2016; 29:659-94. [PMID: 27281741 PMCID: PMC4978612 DOI: 10.1128/cmr.00014-16] [Citation(s) in RCA: 116] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The rapid spread of the Zika virus (ZIKV) in the Americas and its potential association with thousands of suspected cases of microcephaly in Brazil and higher rates of Guillain-Barré syndrome meet the conditions for a Public Health Emergency of International Concern, as stated by the World Health Organization in February 2016. Two months later, the Centers for Disease Control and Prevention (CDC) announced that the current available evidence supports the existence of a causal relationship between prenatal Zika virus infection and microcephaly and other serious brain anomalies. Microcephaly can be caused by several factors, and its clinical course and prognosis are difficult to predict. Other pathogens with proven teratogenicity have been identified long before the current ZIKV epidemic. Despite the growing number of cases with maternal signs of infection and/or presence of ZIKV in tissues of affected newborns or fetuses, it is currently difficult to assess the magnitude of increase of microcephaly prevalence in Brazil, as well as the role of other factors in the development of congenital neurological conditions. Meanwhile, health agencies and medical organizations have issued cautious guidelines advising health care practitioners and expectant couples traveling to, returning from, or living in affected areas. Analogous to dengue virus (DENV) epidemics, ZIKV has the potential to become endemic in all countries infested by Aedes mosquitoes, while new mutations could impact viral replication in humans, leading to increased virulence and consequently heightened chances of viral transmission to additional naive mosquito vectors. Studies are urgently needed to answer the questions surrounding ZIKV and its role in congenital neurological conditions.
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Affiliation(s)
- Alice Panchaud
- School of Pharmaceutical Sciences, University of Geneva and University of Lausanne, Geneva, Switzerland Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA Swiss Teratogen Information Service and Division of Clinical Pharmacology, University of Lausanne and University Hospital, Lausanne, Switzerland
| | - Miloš Stojanov
- Institute of Microbiology, Faculty of Biology and Medicine, University of Lausanne and University Hospital, Lausanne, Switzerland Materno-fetal and Obstetrics Research Unit, Department Femme-Mère-Enfant, University of Lausanne and University Hospital, Lausanne, Switzerland
| | - Anne Ammerdorffer
- Institute of Microbiology, Faculty of Biology and Medicine, University of Lausanne and University Hospital, Lausanne, Switzerland Materno-fetal and Obstetrics Research Unit, Department Femme-Mère-Enfant, University of Lausanne and University Hospital, Lausanne, Switzerland
| | - Manon Vouga
- Institute of Microbiology, Faculty of Biology and Medicine, University of Lausanne and University Hospital, Lausanne, Switzerland Materno-fetal and Obstetrics Research Unit, Department Femme-Mère-Enfant, University of Lausanne and University Hospital, Lausanne, Switzerland
| | - David Baud
- Institute of Microbiology, Faculty of Biology and Medicine, University of Lausanne and University Hospital, Lausanne, Switzerland Materno-fetal and Obstetrics Research Unit, Department Femme-Mère-Enfant, University of Lausanne and University Hospital, Lausanne, Switzerland
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Ugaz JI, Chatterji M, Gribble JN, Banke K. Is Household Wealth Associated With Use of Long-Acting Reversible and Permanent Methods of Contraception? A Multi-Country Analysis. GLOBAL HEALTH: SCIENCE AND PRACTICE 2016; 4:43-54. [PMID: 27016543 PMCID: PMC4807748 DOI: 10.9745/ghsp-d-15-00234] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 12/23/2015] [Indexed: 11/15/2022]
Abstract
In general, across the developing world, wealthier women are more likely than poorer women to use long-acting and permanent methods of contraception instead of short-acting methods. Exceptions are Bangladesh, India, and possibly Haiti. As programs continue to expand access to family planning information, services, and products, it is critical that these efforts be undertaken with an equity lens, ensuring that regardless of socioeconomic status, all women and couples can use the method that meets their needs. This study explores the relationship between household wealth and the use of long-acting and permanent methods (LAPMs) versus short-acting methods of contraception among modern method users, using multivariate analyses based on Demographic Health Survey data from 30 developing countries conducted between 2006 and 2013. Overall, and controlling for relevant individual and household characteristics including age, number of living children, education, and urban/rural residence, we found that wealthier women were more likely than poorer women to use LAPMs instead of short-acting methods: 20 of the 30 countries showed a positive and statistically significant association between wealth and LAPM use. For 10 of those countries, however, LAPM use was significantly higher only for the top (1 or 2) wealthiest quintiles. Eight countries showed no broad pattern of association, while in 2 countries—Bangladesh and India—poorer women were more likely to use LAPMs than wealthier women. The positive association between wealth and LAPM use was found most consistently in the Latin American and the Caribbean countries in our sample. These findings can help program implementers respond better to women’s needs for modern contraception, especially in reaching women from lower- and middle-income households.
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Affiliation(s)
- Jorge I Ugaz
- Abt Associates Inc, Strengthening Health Outcomes through the Private Sector (SHOPS) Project, Bethesda, MD, USA Now with Mathematica Policy Research, Washington, DC, USA
| | - Minki Chatterji
- Abt Associates Inc, Strengthening Health Outcomes through the Private Sector (SHOPS) Project, Bethesda, MD, USA Now with Mathematica Policy Research, Washington, DC, USA
| | | | - Kathryn Banke
- Abt Associates Inc, SHOPS Project, Bethesda, MD, USA
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Robinson N, Stoffel C, Haider S. Global women's health is more than maternal health: a review of gynecology care needs in low-resource settings. Obstet Gynecol Surv 2015; 70:211-22. [PMID: 25769435 DOI: 10.1097/ogx.0000000000000166] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Women's health care efforts in low-resource settings are often focused primarily on prenatal and obstetric care. However, women all over the world experience significant morbidity and mortality related to cervical cancer, sexually transmitted infections, and urogynecologic conditions as well as gynecologic care provision including insufficient and ineffective family planning services. Health care providers with an interest in clinical care in low-resource settings should be aware of the scope of the burden of gynecologic issues and strategies in place to combat the problems. This review article discusses the important concerns both in the developing world as well as highlights similar disparities that exist in the United States by women's age, race and ethnicity, and socioeconomic status. Ultimately, this review article aims to inform and update health care providers on critical gynecologic issues in low-resource settings.
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Affiliation(s)
- Nuriya Robinson
- Assistant Professor, Department of Obstetrics and Gynecology at the University of Illinois at Chicago, Chicago, IL
| | - Cynthia Stoffel
- Research Manager, Department of Obstetrics and Gynecology at the University of Illinois at Chicago, Chicago, IL
| | - Sadia Haider
- Assistant Professor, Department of Obstetrics and Gynecology at the University of Illinois at Chicago, Chicago, IL
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