1
|
Oyediran K, Davis N. Relationship between health insurance enrolment and unintended pregnancy in Ghana. J Biosoc Sci 2024; 56:104-124. [PMID: 36852702 DOI: 10.1017/s0021932023000032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
CONTEXT The effect of health insurance coverage on sexual and reproductive health, especially unintended pregnancy, has scantly been researched. Using the 2014 Ghana Demographic and Health Survey, the study examined the links between women's health insurance enrolment on unintended pregnancy in Ghana. METHOD The sample consisted of 9,396 women aged 15-49 years, but the analysis was limited to the 4,544 women who were pregnant in the two years preceding the survey. The effects of health insurance enrolment on unintended pregnancy was examined with the propensity score matching. The health insurance enrolment was the treatment variable and unintended pregnancy as the outcome variable. RESULTS This study showed that 66.0% of all women surveyed had health insurance coverage and 31.8% of all women of childbearing age who were currently or had previously been pregnant reported having at least one unintended pregnancy. Thirty percent of insured women had an unintended pregnancy, compared to 37% of uninsured women. The results showed that education, household wealth index, religion, and type of marital union were significant predictor of health insurance coverage among Ghanaian women. The PSM split the women based on their health insurance status. After matching, the difference between the insured and uninsured women reduces significantly. Results demonstrated that, the probability of unintended pregnancy was 0.312 among insured women and 0.351 among those not insured in Ghana. This implies that having health insurance coverage will help in reducing the likelihood of women experiencing unintended pregnancy. CONCLUSIONS Results highlight the importance of the target of universal health coverage under the sustainable development goal 3 and demonstrate that expanding existing health insurance schemes within Ghana could contribute to reducing the number unintended pregnancies experienced each year.
Collapse
Affiliation(s)
| | - Nikki Davis
- Senior Research, Monitoring, and Evaluation Advisor John Snow Inc.Arlington, VA22202
| |
Collapse
|
2
|
Steinberg JR, Marthey D, Xie L, Boudreaux M. Contraceptive method type and satisfaction, confidence in use, and switching intentions. Contraception 2021; 104:176-182. [PMID: 33621581 PMCID: PMC8286312 DOI: 10.1016/j.contraception.2021.02.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 02/12/2021] [Accepted: 02/15/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE We examined whether contraceptive method type, satisfaction with use, and confidence in correct use were independently associated with switching intentions, a precursor of switching behaviors. STUDY DESIGN Data were from a probability-based sample survey carried out in Delaware and Maryland in 2016 and 2017 among women ages 18 to 44. Women's current contraceptive methods were classified into 5 categories: coitally-dependent methods (barrier methods, withdrawal, and natural family planning); oral contraceptive pills, patches, and rings; injections; implants; and intrauterine contraception (IUC). Satisfaction, confidence, and switching intentions were dichotomized into being very versus less satisfied, being completely versus less confident, and having very low versus not very low switching intentions. We conducted binomial logistic regression to examine whether method type, satisfaction, and confidence were independently associated with having very low switching intentions, adjusting for a range of covariates including sociodemographics, perceived health, religious attendance frequency, sexual, contraceptive, and reproductive experiences, and state of residence (Maryland or Delaware). RESULTS Among 1,077 women using reversible contraception, those using IUC relative to implants, pills, patches, or rings, and coitally-dependent methods were more likely to have very low switching intentions. Among all survey respondents, those who were very satisfied and those who were completely confident in correct use were also more likely to report very low switching intentions. CONCLUSIONS Using IUC, being very satisfied, and being very confident in correct use were independently associated with having very low switching intentions. IMPLICATIONS These results suggest that those using IUC have very low intentions to switch for reasons in addition to satisfaction-level with their method. Other aspects of using IUC such as ease of use, perceived barriers to switching, or having very low switching intentions before beginning IUC may be such reasons.
Collapse
Affiliation(s)
- Julia R Steinberg
- Department of Family Science, University of Maryland College Park, College Park, MD, United States; Maryland Population Research Center, University of Maryland College Park, College Park, MD, United States.
| | - Daniel Marthey
- Maryland Population Research Center, University of Maryland College Park, College Park, MD, United States; Department of Health Policy and Management, University of Maryland College Park, College Park, MD, United States
| | - Liyang Xie
- Maryland Population Research Center, University of Maryland College Park, College Park, MD, United States; Department of Health Policy and Management, University of Maryland College Park, College Park, MD, United States
| | - Michel Boudreaux
- Maryland Population Research Center, University of Maryland College Park, College Park, MD, United States; Department of Health Policy and Management, University of Maryland College Park, College Park, MD, United States
| |
Collapse
|
3
|
Bovbjerg ML. Current Resources for Evidence-Based Practice, January 2019. J Obstet Gynecol Neonatal Nurs 2019; 48:99-111. [DOI: 10.1016/j.jogn.2018.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
|
4
|
Increasing Long-Acting Reversible Contraceptive Method Use Among Alaska Native Women. J Nurse Pract 2018. [DOI: 10.1016/j.nurpra.2017.12.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
5
|
Syeda SS, Sánchez G, Hong KH, Hawkinson JE, Georg GI, Blanco G. Design, Synthesis, and in Vitro and in Vivo Evaluation of Ouabain Analogues as Potent and Selective Na,K-ATPase α4 Isoform Inhibitors for Male Contraception. J Med Chem 2018; 61:1800-1820. [PMID: 29291372 PMCID: PMC5846083 DOI: 10.1021/acs.jmedchem.7b00925] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
![]()
Na,K-ATPase α4 is a testis-specific
plasma membrane Na+ and K+ transporter expressed
in sperm flagellum.
Deletion of Na,K-ATPase α4 in male mice results in complete
infertility, making it an attractive target for male contraception.
Na,K-ATPase α4 is characterized by a high affinity for the cardiac
glycoside ouabain. With the goal of discovering selective inhibitors
of the Na,K-ATPase α4 and of sperm function, ouabain derivatives
were modified at the glycone (C3) and the lactone (C17) domains. Ouabagenin
analogue 25, carrying a benzyltriazole moiety at C17,
is a picomolar inhibitor of Na,K-ATPase α4, with an outstanding
α4 isoform selectivity profile. Moreover, compound 25 decreased sperm motility in vitro and in vivo and affected sperm
membrane potential, intracellular Ca2+, pH, and hypermotility.
These results proved that the new ouabagenin triazole analogue is
an effective and selective inhibitor of Na,K-ATPase α4 and sperm
function.
Collapse
Affiliation(s)
- Shameem Sultana Syeda
- Department of Medicinal Chemistry and Institute for Therapeutics Discovery and Development, College of Pharmacy , University of Minnesota , Minneapolis , Minnesota 55414 , United States
| | - Gladis Sánchez
- Department of Molecular and Integrative Physiology , University of Kansas Medical Center , Kansas City , Kansas 66160 , United States
| | - Kwon Ho Hong
- Department of Medicinal Chemistry and Institute for Therapeutics Discovery and Development, College of Pharmacy , University of Minnesota , Minneapolis , Minnesota 55414 , United States
| | - Jon E Hawkinson
- Department of Medicinal Chemistry and Institute for Therapeutics Discovery and Development, College of Pharmacy , University of Minnesota , Minneapolis , Minnesota 55414 , United States
| | - Gunda I Georg
- Department of Medicinal Chemistry and Institute for Therapeutics Discovery and Development, College of Pharmacy , University of Minnesota , Minneapolis , Minnesota 55414 , United States
| | - Gustavo Blanco
- Department of Molecular and Integrative Physiology , University of Kansas Medical Center , Kansas City , Kansas 66160 , United States
| |
Collapse
|
6
|
Allen C, Evans G, Sutton EL. Pharmacologic Therapies in Women's Health: Contraception and Menopause Treatment. Med Clin North Am 2016; 100:763-89. [PMID: 27235614 DOI: 10.1016/j.mcna.2016.03.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Female hormones play a significant role in the etiology and treatment of many women's health conditions. This article focuses on the common uses of hormonal therapy. When prescribing estrogen-containing regimens throughout the span of a woman's life, the risks are similar (ie, cardiovascular risk and venous thromboembolism), but the degree of risk varies significantly depending on a woman's particular set of risk factors and the details of the hormone regimen. In addition to estrogens and progestogens, this article also touches on the use of selective steroid receptor modulators in emergency contraception and in treatment of menopause symptoms.
Collapse
Affiliation(s)
- Caitlin Allen
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, 5120 MFCB, 1685 Highland Avenue, Madison, WI 53705, USA.
| | - Ginger Evans
- Department of Medicine, VA Puget Sound Health Care System, University of Washington, 1660 South Columbian Way, S-123-PCC, Seattle, WA 98108, USA
| | - Eliza L Sutton
- Department of Medicine, Women's Health Care Center, University of Washington, 4245 Roosevelt Way Northeast, Box 354765, Seattle, WA 98105, USA
| |
Collapse
|
7
|
Foster DG, Barar R, Gould H, Gomez I, Nguyen D, Biggs MA. Projections and opinions from 100 experts in long-acting reversible contraception. Contraception 2015; 92:543-52. [PMID: 26515195 DOI: 10.1016/j.contraception.2015.10.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 10/13/2015] [Accepted: 10/15/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVE This survey of published researchers of long-acting reversible contraceptives (LARCs) examines their opinions about important barriers to LARC use in the United States (US), projections for LARC use in the absence of barriers and attitudes toward incentives for clinicians to provide and women to use LARC methods. STUDY DESIGN We identified 182 authors of 59 peer-reviewed papers on LARC use published since 2013. A total of 104 completed an internet survey. We used descriptive and multivariate analyses to assess LARC use barriers and respondent characteristics associated with LARC projections and opinions. RESULTS The most commonly identified barrier was the cost of the device (63%), followed by women's knowledge of safety, method acceptability and expectations about use. A shortage of trained providers was a commonly cited barrier, primarily of primary care providers (49%). Median and modal projections of LARC use in the absence of these barriers were 25-29% of contracepting women. There was limited support for provider incentives and almost no support for incentives for women to use LARC methods, primarily out of concern about coercion. CONCLUSIONS Clinical and social science LARC experts project at least a doubling of the current US rate of LARC use if barriers to method provision and adoption are removed. While LARC experts recognize the promise of LARC methods to better meet women's contraceptive needs, they anticipate that the majority of US women will not choose LARC methods. Reducing unintended pregnancy rates will depend on knowledge, availability and use of a wider range of methods of contraception to meet women's individual needs. IMPLICATIONS Efforts to increase LARC use need to meet the dual goals of increasing access to LARC methods and protecting women's reproductive autonomy. To accomplish this, we need reasonable expectations for use, provider training, low-cost devices and noncoercive counseling, rather than incentives for provision or use.
Collapse
Affiliation(s)
- Diana Greene Foster
- University of California, San Francisco, Advancing New Standards in Reproductive Health, 1330 Broadway, Suite 1100, Oakland, CA 94612, USA.
| | - Rana Barar
- University of California, San Francisco, Advancing New Standards in Reproductive Health, 1330 Broadway, Suite 1100, Oakland, CA 94612, USA
| | - Heather Gould
- University of California, San Francisco, Advancing New Standards in Reproductive Health, 1330 Broadway, Suite 1100, Oakland, CA 94612, USA
| | - Ivette Gomez
- University of California, San Francisco, Advancing New Standards in Reproductive Health, 1330 Broadway, Suite 1100, Oakland, CA 94612, USA
| | - Deborah Nguyen
- University of California, San Francisco, Advancing New Standards in Reproductive Health, 1330 Broadway, Suite 1100, Oakland, CA 94612, USA
| | - M Antonia Biggs
- University of California, San Francisco, Advancing New Standards in Reproductive Health, 1330 Broadway, Suite 1100, Oakland, CA 94612, USA
| |
Collapse
|
8
|
Kroelinger CD, Waddell LF, Goodman DA, Pliska E, Rudolph C, Ahmed E, Addison D. Working with State Health Departments on Emerging Issues in Maternal and Child Health: Immediate Postpartum Long-Acting Reversible Contraceptives. J Womens Health (Larchmt) 2015; 24:693-701. [PMID: 26390378 PMCID: PMC4872698 DOI: 10.1089/jwh.2015.5401] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Immediate postpartum long-acting reversible contraceptives (LARC) are highly effective in preventing unintended pregnancy. State health departments are in the process of implementing a systems change approach to better apply policies supporting the use of immediate postpartum LARC. METHODS Beginning in 2014, a group of national organizations, federal agencies, and six states have convened a LARC Learning Community to share strategies and best practices in immediate postpartum LARC policy development and implementation. Community activities consist of in-person meetings and a webinar series as forums to discuss systems change. RESULTS The Learning Community identified eight domains for discussion and development of resources: training, pay streams, stocking and supply, consent, outreach, stakeholder partnerships, service location, and data and surveillance. The community is currently developing resource materials and guidance for use by other state health departments. CONCLUSIONS To effectively implement policies on immediate postpartum LARC, states must engage a number of stakeholders in the process, raise awareness of the challenges to implementation, and communicate strategies across agencies during policy development.
Collapse
Affiliation(s)
- Charlan D. Kroelinger
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lisa F. Waddell
- Association of State and Territorial Health Officials, Arlington, Virginia
| | - David A. Goodman
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Ellen Pliska
- Association of State and Territorial Health Officials, Arlington, Virginia
| | - Claire Rudolph
- Association of State and Territorial Health Officials, Arlington, Virginia
| | - Einas Ahmed
- Association of State and Territorial Health Officials, Arlington, Virginia
| | - Donna Addison
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| |
Collapse
|
9
|
Holden SC, Gardiner P, Birdee G, Davis RB, Yeh GY. Complementary and Alternative Medicine Use Among Women During Pregnancy and Childbearing Years. Birth 2015; 42:261-9. [PMID: 26111221 PMCID: PMC4537684 DOI: 10.1111/birt.12177] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/19/2015] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Little is known regarding complementary and alternative medicine (CAM) use during pregnancy and the preconception period. Since half of all pregnancies in the United States are unintended, understanding the patterns of CAM use among women of childbearing age has implications for fetal and maternal health. METHODS Descriptive statistics were generated from the 2012 National Health Interview Study (NHIS) to estimate weighted prevalence and patterns of CAM use by women of childbearing age. Comparisons were made between pregnant and nonpregnant respondents. RESULTS In this sample of 10,002 women, 7 percent (n = 727) were recently pregnant. Over one-third of all the women used CAM during the previous year (34/38%, pregnant/nonpregnant, respectively) and only half disclosed CAM use to conventional providers (50/49%). In the adjusted model, taking multivitamins (OR 2.52 [CI 2.22-2.86]) and moderate to heavy alcohol use (OR 1.92 [CI 1.53-2.41]) were more likely associated with CAM use. The two most commonly used modalities were herbs (14/17%) and yoga (13/16%). The top reasons for CAM use were to improve general wellness or to prevent disease (33/35%) and to treat back pain (16/18%). When examining all pregnancy-related symptoms treated with CAM, no difference was found in the rates of CAM use between pregnant and nonpregnant users. CONCLUSIONS CAM use by women of childbearing age in the United States is common, with over a third of the population using one or more therapies. However, only half disclosed their use to conventional providers despite limited evidence on safety and effectiveness. This study highlights the important need for further research in this area.
Collapse
Affiliation(s)
- Selma C Holden
- Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Brookline, MA, USA
| | | | - Gurjeet Birdee
- Vanderbilt University Medical Center, Nashville, TN, USA
| | - Roger B Davis
- Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Brookline, MA, USA
| | - Gloria Y Yeh
- Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Brookline, MA, USA
| |
Collapse
|
10
|
Abstract
As medical advances improve survival, reduce disease-related morbidity, and improve quality of life, reproductive issues will take higher priority in the sickle cell disease (SCD) community. A wide variety of topics are addressed in this chapter, including fertility, gonadal failure, erectile dysfunction, and menstrual issues in SCD. Etiologies of impaired male fertility are multifactorial and include hypogonadism, erectile dysfunction, sperm abnormalities, and complications of medical therapies. Much less is known about the prevalence and etiology of infertility in women with SCD. Other reproductive issues in women included in this review are pain and the menstrual cycle, contraception, and preconception counseling. Finally, long-term therapies for SCD and their impact on fertility are presented. Transfusional iron overload and gonadal failure are addressed, followed by options for fertility preservation after stem cell transplantation. Focus is placed on hydroxyurea therapy given its benefits and increasing use in SCD. The impact of this agent on spermatogenesis, azoospermia, and the developing fetus is discussed.
Collapse
|
11
|
Smith-Whitley K. Reproductive issues in sickle cell disease. HEMATOLOGY. AMERICAN SOCIETY OF HEMATOLOGY. EDUCATION PROGRAM 2014; 2014:418-24. [PMID: 25696888 DOI: 10.1182/asheducation-2014.1.418] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
As medical advances improve survival, reduce disease-related morbidity, and improve quality of life, reproductive issues will take higher priority in the sickle cell disease (SCD) community. A wide variety of topics are addressed in this chapter, including fertility, gonadal failure, erectile dysfunction, and menstrual issues in SCD. Etiologies of impaired male fertility are multifactorial and include hypogonadism, erectile dysfunction, sperm abnormalities, and complications of medical therapies. Much less is known about the prevalence and etiology of infertility in women with SCD. Other reproductive issues in women included in this review are pain and the menstrual cycle, contraception, and preconception counseling. Finally, long-term therapies for SCD and their impact on fertility are presented. Transfusional iron overload and gonadal failure are addressed, followed by options for fertility preservation after stem cell transplantation. Focus is placed on hydroxyurea therapy given its benefits and increasing use in SCD. The impact of this agent on spermatogenesis, azoospermia, and the developing fetus is discussed.
Collapse
Affiliation(s)
- Kim Smith-Whitley
- Division of Hematology, The Children's Hospital of Philadelphia, Philadelphia, PA
| |
Collapse
|