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Aibangbee M, Micheal S, Liamputtong P, Pithavadian R, Hossain SZ, Mpofu E, Dune T. Socioecologies in shaping migrants and refugee youths' sexual and reproductive health and rights: a participatory action research study. Reprod Health 2024; 21:134. [PMID: 39294779 PMCID: PMC11409589 DOI: 10.1186/s12978-024-01879-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Accepted: 09/12/2024] [Indexed: 09/21/2024] Open
Abstract
OBJECTIVE This study explores socioecological factors facilitating the sexual and reproductive health and rights (SRHR) experiences of migrant and refugee youth (MRY) in Greater Western Sydney, Australia. MRY may be at higher risk for poorer SRH outcomes due to cultural, linguistic, and systemic barriers. METHODS Using participatory action research, 17 focus groups were conducted with 87 MRY aged 15-29 from diverse cultural backgrounds. Data were analysed thematically, using socioecological framework. RESULTS Key facilitators of MRY's SRHR were identified at the microsystem and exosystem levels, including (1) Peer dynamics and support, with friends serving as trusted confidants and sources of advice; (2) Safety and contraceptive choices, highlighting the importance of access to contraception and STI prevention; and (3) Digital platforms for SRHR information access, with online resources filling knowledge gaps. CONCLUSION Findings suggest the need for SRHR interventions to leverage peer support networks, expand access to contraceptive options, and develop culturally appropriate digital resources for MRY. Further research is needed to identify and enhance facilitators across all socioecological levels to comprehensively support MRY's SRHR needs.
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Affiliation(s)
- Michaels Aibangbee
- School of Health Sciences, Western Sydney University, Penrith, NSW, Australia.
- School of Medicine, Western Sydney University, Campbelltown, NSW, Australia.
| | - Sowbhagya Micheal
- School of Medicine, Western Sydney University, Campbelltown, NSW, Australia
- Translational Health Research Institute & Diabetes Obesity and Metabolism Translational Research Unit, Western Sydney University, Penrith, NSW, Australia
| | | | - Rashmi Pithavadian
- School of Health Sciences, Western Sydney University, Penrith, NSW, Australia
| | - Syeda Zakia Hossain
- School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Elias Mpofu
- University of North Texas, Denton, USA
- University of Sydney, Sydney, NSW, Australia
- University of Johannesburg, Johannesburg, South Africa
- Western Sydney University, Sydney, Australia
| | - Tinashe Dune
- Translational Health Research Institute & Diabetes Obesity and Metabolism Translational Research Unit, Western Sydney University, Penrith, NSW, Australia
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Aziz MM, El-Gazzar AF. Provider bias and family planning in Upper Egypt: a simulated client approach. J Egypt Public Health Assoc 2023; 98:19. [PMID: 37777657 PMCID: PMC10542042 DOI: 10.1186/s42506-023-00144-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 08/17/2023] [Indexed: 10/02/2023]
Abstract
BACKGROUND Provider bias is a main barrier that extensively violates the right of free family planning method choice. Egypt is one of the countries that shows skewness in its method mix. Provider bias and insufficiency of alternative methods are identified as potential factors underlying this phenomenon which contributes to high unmet needs and discontinuation rates. Provider bias may be influenced by cultural beliefs and societal trends and is usually overlooked as a possible cause of this skewed method mix. This study aims to explore the presence of provider bias in rural Upper Egypt and its potential causes, a community with conservative cultural beliefs and least contraceptive prevalence rates. METHODS This is a qualitative study using the "simulated client's approach." The study was conducted in 16 villages in Assiut and Sohag governorates in Egypt. The simulated clients visited 30 clinics, 15 in each governorate, including primary healthcare units and private clinics. Three scenarios were used to explore the physicians-imposed restrictions for contraceptive use with different clients' eligibility criteria. Data was analyzed using the grounded theory methodology. RESULTS Recommending a contraceptive method for the mystery clients was not based on informed choice. Most providers had method or client bias. Copper IUD was the most favorable contraceptive method recommended by providers, with negative attitude towards using hormonal contraception. Nulliparous and young clients were discouraged to use contraception before proving fertility or offered temporary methods as emergency contraception or condoms. Providers have shown misconceptions related to infertility-associated complications of contraceptive use, especially for the young and nulliparous women. CONCLUSION In this study, providers had a clear bias towards recommending IUD rather than all other contraceptive methods, which was hindered in some cases by the lack of insertion skills. Interventions to reduce provider bias should go beyond technical training. Moreover, training on reproductive rights should be a main component of routine training. Providers should regularly receive research results and be oriented toward recent medical eligibility criteria of contraceptive methods use. Moreover, the sociocultural beliefs of providers that may affect their practice should be explored and addressed.
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Affiliation(s)
- Mirette M Aziz
- Department of Public Health and Community Medicine, Assiut University, Assiut, Egypt
| | - Amira F El-Gazzar
- Department of Public Health and Community Medicine, Assiut University, Assiut, Egypt.
- Department of Public Health and Community Medicine, Badr University in Cairo, Badr City, Egypt.
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Jana A, Shekhar C. Female sterilisation in India: Examining the role of women's own decision making and information given to client. J Biosoc Sci 2023; 55:960-979. [PMID: 36330846 DOI: 10.1017/s0021932022000402] [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: 11/06/2022]
Abstract
India has a very high prevalence of female sterilisation compared to other countries in the world, with a prevailing situation of very low level of information about contraceptive options given to women. It is well established in demographic research that, there exists a strong association between knowledge of contraceptive methods and type of contraception chosen. Present study uses data from 3 consecutive rounds of National Family Health Survey (3, 4 & 5). The sample contains currently married women who started using the current method 5 years prior to each round of survey. Multilevel Logistic Regression and Fairlie Decomposition Model are used to analyse the effect of information given to respondents and decision-making power regarding contraceptive methods on choice of female sterilisation. Women, who are informed about available methods, have lower chance (45.8%, 37.5% & 40% for NFHS 3, 4 & 5 respectively) to opt for sterilisation after controlling all other factors. If woman is the sole decision maker for contraceptive choice, the chance of sterilisation reduces than cases where decision is taken only by husband or jointly. Information about other methods also contributes towards reducing the chance of female sterilisation over the time. Information about contraceptive methods is found to be a major factor in controlling choice of temporary or permanent method. Thus, major focus for the policy makers should be to make information regarding contraceptives more accessible for women.
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Affiliation(s)
- Arjun Jana
- PhD Scholar, International Institute for Population Sciences, Mumbai, India
| | - Chander Shekhar
- Professor, Department of Fertility and Social Demography, International Institute for Population Sciences, Mumbai, India
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Tareke AA, Takele BA, Ahmed MH, Tegegne MD, Eshetu HB. Urban-rural inequalities and spatial arrangement of informed choice of family planning in Ethiopia: Further analysis of 2016 Ethiopian demographic health survey. PLoS One 2023; 18:e0289099. [PMID: 37607202 PMCID: PMC10443855 DOI: 10.1371/journal.pone.0289099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 07/11/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND Ethiopia has made satisfactory progress in improving maternal and child health over the past two decades. The introduction of family planning through informed choice is one of the main strategies to improve maternal and child health. However, this positive progress may have masked the significant urban-rural disparities in informed choice for family planning. OBJECTIVE To identify factor contributing to observed urban-rural disparities and to determine the spatial distribution of informed family planning choices in Ethiopia. METHODS The study used information from 3,511 women currently using contraceptives (rural-2685 and urban-826) as per recent Ethiopian demographic health survey cross-sectional data. Spatial and descriptive, bivariable, and multivariable logit-based decomposition analysis methods were used. RESULTS The spatial configuration of uninformed choice was clustered. The primary cluster (LLR = 34.8, p-value<0.001) was located at the southern portion of Amhara region that covers east & west Gojjam, south Gondar and south Wollo administrative zones. The magnitude of informed choice was 12 percent higher in urban residents compared to rural residents. Urban-rural gap was attributed to variations in characteristics (74%). Place of family planning offer i.e., private health facility, being aged between 35 and 49 years, and having visited to health facility in the last 1 year are found decrease the urban-rural gap of informed family planning choice by 15%, 9% and 5% respectively. Conversely, being aged between 25 and 34 years, being a listener to radio has increased the gap by 9% and 12% respectively. CONCLUSION The variables being private health facility visitors, being aged between 35 and 49 years and having visited health facilities in the last one year are found to increase the gap of informed family planning choices between urban and rural residents Besides, the spatial distribution of uninformed family planning choices is non-random.
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Affiliation(s)
- Abiyu Abadi Tareke
- Amref health Africa in Ethiopia, SLL project, Covid-19 vaccine /EPI Technical Assistant at West Gondar Zone, Gondar, Ethiopia
| | - Bayley Adane Takele
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | | | - Masresha Derese Tegegne
- Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Habitu Birhan Eshetu
- Department of Health Education and Behavioral Sciences, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Pradhan MR, Mondal S. Examining the influence of Mother-in-law on family planning use in South Asia: insights from Bangladesh, India, Nepal, and Pakistan. BMC Womens Health 2023; 23:418. [PMID: 37553598 PMCID: PMC10410985 DOI: 10.1186/s12905-023-02587-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 08/04/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND Contraceptive use contributes to improved maternal and child health, education, empowerment of women, slow population growth, and economic development. The role of the family in influencing women's health and health-seeking behavior is undergoing significant changes, owing to higher education, media exposure, and numerous government initiatives, in addition to women's enhanced agency across South Asia. Against this backdrop, this study assesses the relationship between women's living arrangements and contraceptive methods used in selected south Asian countries (India, Pakistan, Nepal, and Bangladesh). METHODS Data of currently married women aged 15-49 from the recent round of Demographic and Health Survey (DHS) of four South Asian countries, i.e., Nepal (2016), Pakistan (2017-18), Bangladesh (2017-18), and India (2019-21) had been used. Bivariate and multinomial logistic regression was performed using Stata with a 5% significance level. RESULTS Living arrangement of women had a significant association with contraceptive use in South Asia. The Mother-in-law (MIL) influenced the contraceptive method used by the Daughter-in-law (DIL), albeit a country-specific method choice. Modern limiting methods were significantly higher among women living with MIL in India. The use of the modern spacing method was considerably high among women co-residing with husband and/or unmarried child(ren) and MIL in Nepal and India. In Bangladesh, women living with husband and other family member including MIL were more likely to use modern spacing methods.. Women co-residing with the MIL had a higher likelihood of using any traditional contraceptive method in India. CONCLUSIONS The study suggests family planning program to cover MIL for enhancing their understanding on the benefits of contraceptive use and modifying norms around fertility. Strengthening the interaction between the grassroots level health workers and the MIL, enhancing social network of DIL may help informed choice and enhance the use of modern spacing methods. Women's family planning demands met with modern contraception, and informed contraceptive choices, must also be achieved to reach the 2030 Agenda for Sustainable Development.
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Affiliation(s)
- Manas Ranjan Pradhan
- Department of Fertility and Social Demography, International Institute for Population Sciences (IIPS), Govandi Station Road, Deonar, Mumbai, Maharashtra 400088 India
| | - Sourav Mondal
- Department of Fertility and Social Demography, International Institute for Population Sciences (IIPS), Govandi Station Road, Deonar, Mumbai, Maharashtra 400088 India
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Quality of female sterilization counseling in India: A method information index analysis. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2023. [DOI: 10.1016/j.cegh.2023.101263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023] Open
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Kisuza RK, Kicaber S, Abila DB, Bongomin F, Garimoi CO. Prevalence of discontinuation of contraceptives due to failure among women aged 14 to 49 years in Uganda: a nation wide cross-sectional survey. Contracept Reprod Med 2023; 8:12. [PMID: 36755292 PMCID: PMC9909952 DOI: 10.1186/s40834-022-00210-y] [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: 03/30/2022] [Accepted: 12/14/2022] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Sustained motivation is essential for effective use of contraceptive methods by women in low- and middle-income countries as many women are likely to abandon contraceptives, especially when they continually experience episodes of failure. We aimed to determine the prevalence of discontinuation of contraceptives due to failure and its associated factors among Ugandan women aged 14-49 years. METHODS A cross sectional study was conducted using the UDHS 2016 data. Multi stage stratified sampling was used to select participants. All eligible women aged 15 to 49 years at the time of the survey were enrolled. Bivariable and Multivariable logistic regression analysis were used to determine the factors associated with contraceptive failure. All analysis were done using Stata version 13. Contraceptive failure (getting pregnant while on contraceptives) within five years preceding the survey was the dependent variable. RESULTS A total of 9061 women were included in the study. The overall prevalence of contraceptive failure was 5.6% [n = 506, 95% CI: 5.1-6.1] and was higher (6.2%) among women aged 20-29 years or had completed secondary education (6.1%). Having informed choice on contraceptives [aOR = 0.59, 95% CI: 0.49 - 0.72] and older age [aOR = 0.46, 95% CI: 0.24-0.89] were associated with lower odds of contraceptive failure. CONCLUSION The burden of contraceptive failure among women of reproductive age in Uganda is substantial and significantly varied by women's age, level of education, exposure to the internet, mass media, and informed choice. These findings highlight the need for improved counseling services and contraceptive quality to help women and couples use methods correctly and consistently.
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Affiliation(s)
- Ruth Ketty Kisuza
- College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda.
| | - Saviour Kicaber
- grid.11194.3c0000 0004 0620 0548College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda
| | - Derrick Bary Abila
- grid.11194.3c0000 0004 0620 0548College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda
| | - Felix Bongomin
- grid.442626.00000 0001 0750 0866Department of Medical Microbiology and Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda
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Pradhan MR, Mondal S. Predictors of contraceptive use among young married women in India: Does pregnancy history matter? J Obstet Gynaecol Res 2023; 49:331-340. [PMID: 36281034 DOI: 10.1111/jog.15479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 10/11/2022] [Accepted: 10/14/2022] [Indexed: 01/19/2023]
Abstract
AIM Contraceptive use and its correlates among young women continue to draw research attention due to its implication for fertility reduction, improved maternal and child health, and sexual and reproductive rights. This study explores the association between pregnancy history and contraceptive use among currently married young women (aged 15-24 years at childbirth) in India. METHOD Data from the National Family Health Survey (2019-2021) was analyzed through STATA with a significance level of 5%. The births in the last 5 years preceding the survey to the women aged 15-24 years at childbirth (n = 127 954) were considered for analysis. Multinomial logistic regression was used to check the unadjusted and adjusted effects of the pregnancy history on contraceptive use. RESULTS Young women with a history of mistimed pregnancy had significantly lower odds of using modern limiting methods of contraception (odds ratio [OR] = 0.90, confidence interval [CI] = 0.82-0.98), and those with a prior unwanted pregnancy were more likely to use modern limiting methods of contraception (OR = 1.75, CI = 1.57-1.95). CONCLUSION Pregnancy history influences young married women's current contraceptive use in India. Family planning programs may use the contacts with antenatal, delivery, and post-delivery care system as an opportunity to identify women with an unwanted pregnancy, especially those educationally and economically weaker, for targeted information and service delivery. Better counseling of potential young contraceptive acceptors will ensure informed decision-making and increased use of modern spacing methods.
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Affiliation(s)
- Manas R Pradhan
- Department of Fertility and Social Demography, International Institute for Population Sciences (IIPS), Mumbai, Maharashtra, India
| | - Sourav Mondal
- International Institute for Population Sciences (IIPS), Mumbai, Maharashtra, India
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Anbesu EW, Alemayehu M, Asgedom DK, Jeleta FY. Women’s decision-making power regarding family planning use and associated factors in Ethiopia: A systematic review and meta-analysis. SAGE Open Med 2023; 11:20503121231162722. [PMID: 37008684 PMCID: PMC10052484 DOI: 10.1177/20503121231162722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 02/21/2023] [Indexed: 03/30/2023] Open
Abstract
Objective: Although emphasis is placed on women’s decision-making power regarding family planning use in Ethiopia, the utilization of contraceptives is low. There are studies conducted in different parts of the country on women’s decision-making power regarding family planning use; however, there are inconsistent findings. Thus, this study aimed to determine the pooled prevalence of women’s decision-making power regarding family planning use and associated factors in Ethiopia. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed to develop the systematic review and meta-analysis. All observational studies were retrieved from online databases, including PubMed, CINAHL, Google Scholar, African Journal Online and gray literature. The data search was performed from 1 December to 16 May 2022. The quality of the studies was critically assessed using the Joanna Briggs Institute checklist. Heterogeneity among studies was examined using the I2 statistic. RevMan version 5.3 and STATA version 14 software were used for analysis. Results: A total of 852 studies were retrieved, and 8 studies were included in the final meta-analysis. The pooled prevalence of women’s decision-making power regarding family planning use was 57 (95% confidence interval: 37, 77). Good knowledge of family planning methods (odds ratio: 2.46, 95% confidence interval: 1.65, 3.67), a positive attitude toward family planning methods (odds ratio: 2.04, 95% confidence interval: 1.3, 3.2), and having primary or higher education (odds ratio: 9.76, 95% confidence interval: 4.36, 21.99) were associated with increased odds of women’s decision-making power regarding family planning use. Conclusion: Nearly three in five married women made decisions regarding family planning use in Ethiopia. Women with good knowledge of family planning methods, a positive attitude toward family planning methods, and women having primary or higher education were associated with increased odds of women’s decision-making power regarding family planning use.
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Affiliation(s)
- Etsay Woldu Anbesu
- Department of Public Health, College of Medical and Health Sciences, Samara University, Samara, Ethiopia
- Etsay Woldu Anbesu, Department of Public Health, College of Medical and Health Sciences, Samara University, Samara, 132, Ethiopia.
| | - Mussie Alemayehu
- School of Public Health, College of Health Science, Mekelle University, Mekelle, Tigray, Ethiopia
| | - Dejen Kahsay Asgedom
- Department of Public Health, College of Medical and Health Sciences, Samara University, Samara, Ethiopia
| | - Fikru Yigezu Jeleta
- Department of Nursing, College of Medical and Health Sciences, Samara University, Samara, Ethiopia
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Nazarbegian M, Averbach S, Johns NE, Ghule M, Silverman J, Lundgren R, Battala M, Begum S, Raj A. Associations between Contraceptive Decision-Making and Marital Contraceptive Communication and use in Rural Maharashtra, India. Stud Fam Plann 2022; 53:617-637. [PMID: 36193029 PMCID: PMC10695302 DOI: 10.1111/sifp.12214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Women's contraceptive decision-making control is crucial for reproductive autonomy, but research largely relies on the Demographic and Health Survey (DHS) measure which asks who is involved with decision-making. In India, this typically assesses joint decision-making or male engagement. Newer measures emphasize female agency. We examined three measures of contraceptive decision-making, the DHS and two agency-focused measures, to assess their associations with marital contraceptive communication and use in rural Maharashtra, India. We analyzed follow-up survey data from women participating in the CHARM2 study (n = 1088), collected in June-December 2020. The survey included the DHS (measure 1), Reproductive Decision-Making Agency (measure 2), and Contraceptive Final Decision-Maker measures (measure 3). Only Measure 1 was significantly associated with contraceptive communication (adjusted odds ratio [AOR]: 2.75, 95 percent confidence interval [CI]: 1.69-4.49) and use (AOR: 1.73, 95 percent CI: 1.14-2.63). However, each measure was associated with different types of contraceptive use: Measure 1 with condom (adjusted relative risk ratio [aRRR]: 1.99, 95 percent CI: 1.12-3.51) and intrauterine device (IUD) (aRRR: 4.76, 95 percent CI: 1.80-12.59), Measure 2 with IUD (aRRR: 1.64, 95 percent CI: 1.04-2.60), and Measure 3 with pill (aRRR: 2.00, 95 percent CI: 1.14-3.52). Among married women in Maharashtra, India, male engagement in decision-making may be a stronger predictor of contraceptive communication and use than women's agency, but agency may be predictive of types of contraceptives used.
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Affiliation(s)
- Melody Nazarbegian
- University of California San Diego School of Medicine, La Jolla, CA, 92093, USA
| | - Sarah Averbach
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego School of Medicine, La Jolla, CA, 92037, USA
- Center on Gender Equity and Health, University of California San Diego School of Medicine, La Jolla, CA, 92093, USA
| | - Nicole E Johns
- Center on Gender Equity and Health, University of California San Diego School of Medicine, La Jolla, CA, 92093, USA
| | - Mohan Ghule
- Center on Gender Equity and Health, University of California San Diego School of Medicine, La Jolla, CA, 92093, USA
| | - Jay Silverman
- Center on Gender Equity and Health, University of California San Diego School of Medicine, La Jolla, CA, 92093, USA
| | - Rebecka Lundgren
- Center on Gender Equity and Health, University of California San Diego School of Medicine, La Jolla, CA, 92093, USA
| | - Madhusudana Battala
- Population Council, Zone 5A, Ground Floor, India Habitat Center, New Delhi, 110003, India
| | - Shahina Begum
- Department of Biostatistics, ICMR-National Institute for Research in Reproductive Health, Mumbai, 400012, India
| | - Anita Raj
- Center on Gender Equity and Health, University of California San Diego School of Medicine, La Jolla, CA, 92093, USA
- Department of Education Studies, University of California, San Diego, CA, 92161, USA
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Bullington BW, Tumlinson K, Karp C, Senderowicz L, Zimmerman L, Akilimali PZ, Zakirai MS, OlaOlorun FM, Kibira SP, Makumbi FE, Shiferaw S. Do users of long-acting reversible contraceptives receive the same counseling content as other modern method users? A cross-sectional, multi-country analysis of women's experiences with the Method Information Index in six sub-Saharan African countries. Contracept X 2022; 4:100088. [PMID: 36419776 PMCID: PMC9676194 DOI: 10.1016/j.conx.2022.100088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 11/02/2022] [Accepted: 11/03/2022] [Indexed: 11/13/2022] Open
Abstract
Objective There has been a growing focus on informed choice in contraceptive research. Because removal of long-acting reversible contraception (LARC), including implants and IUDs, requires a trained provider, ensuring informed choice in the adoption of these methods is imperative. We sought to understand whether information received during contraceptive counseling differed among women using LARC and those using other modern methods of contraception. Study Design We used cross-sectional data from Burkina Faso, Côte d'Ivoire, the Democratic Republic of Congo (DRC), Kenya, Nigeria, and Uganda collected in 2019-2020 by the Performance Monitoring for Action project. We included 7969 reproductive-aged women who reported use of modern contraception. Our outcome of interest, information received during contraceptive counseling, was measured using a binary indicator of whether respondents answered "yes" to all 4 questions that make up the Method Information Index Plus (MII+). We used modified Poisson models to estimate the prevalence ratio between method type (LARC vs. other modern methods) and the MII+, controlling for individual- and facility-level covariates. Results Reported receipt of the full MII+ during contraceptive counseling ranged from 21% in the DRC to 51% in Kenya. In all countries, a higher proportion of LARC users received the MII+ compared to other modern method users. A greater proportion of LARC users answered "yes" to all questions that make up the MII+ at the time of counseling compared to other modern method users in DRC, Kenya, Nigeria, and Uganda. There was no significant difference in the prevalence of reporting the full MII+ between users of LARC and other modern methods in Burkina Faso (Adjusted prevalence ratio (aPR): 1.16; 95% confidence interval (CI): 0.91, 1.48) and Côte d'Ivoire (aPR: 1.13; 95% CI: 0.87, 1.45). Conclusion Information received during contraceptive counseling was limited for all modern contraceptive users. LARC users had significantly higher prevalence of receiving the MII+ compared to other modern method users in the DRC, Kenya, and Uganda. Family planning programs should ensure that all women receive complete, unbiased contraceptive counseling. Implications Across 6 sub-Saharan African countries, a substantial proportion reproductive-aged women using contraception did not report receiving comprehensive counseling when they received their method. Women using long-acting reversible contraception received more information compared to women using other modern methods in the DRC, Kenya, Nigeria, and Uganda after controlling for individual- and facility-level factors.
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Affiliation(s)
- Brooke W. Bullington
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapell Hill, Chapel Hill United States of America,Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill United States of America,Corresponding author.
| | - Katherine Tumlinson
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill United States of America,Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapell Hill, Chapel Hill United States
| | - Celia Karp
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore United States
| | - Leigh Senderowicz
- Departments of Gender and Women's Studies and Obstetrics and Gynecology, University of Wisconsin-Madison, Madison United States
| | - Linnea Zimmerman
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore United States
| | - Pierre Z. Akilimali
- Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | | | | | - Simon P.S. Kibira
- Department of Community Health and Behavioural Sciences, School of Public Health, Makerere University, Kimpala, Uganda
| | - Frederick Edward Makumbi
- Department of Epidemiology and Biostatistics, School of Public Health, Makerere University, Kimpala, Uganda
| | - Solomon Shiferaw
- Department of Reproductive and Health Services Management, Addis Ababa University, Ethiopia
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Raj P, Gupta N. A Review of the National Family Health Survey Data in Addressing India’s Maternal Health Situation. Public Health Rev 2022; 43:1604825. [DOI: 10.3389/phrs.2022.1604825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 10/17/2022] [Indexed: 11/05/2022] Open
Abstract
Objective: This study aims to understand the trend of research conducted on issues of maternal health in India considering data provided in five rounds of National Family Health Survey (NFHS).Methods: Systematic review of literature has been conducted using multi-stage search and review process adapted from Page et al.’s (2021) PRISMA. Initially 14,570 studies were identified and only 134 articles meeting selection criterion were considered in this study.Results: Approximately 32% studies have focused on regional and state variation of maternal health status; while 27% dealt with utilization of maternal healthcare services; and 19% the socio-economic determinants of maternal health. While few studies have discussed the place of delivery, antenatal care and post-natal care visits, only five studies focus on issues related to women’s autonomy, including their health-seeking behaviour, knowledge, attitude and practices related to maternal health.Conclusion: Non-communicable diseases and its role in maternal health still remains an unexplored domain of research on maternal health in India. Moreover, there exists geographical skewness in the number of studies conducted, focusing especially on few provinces while none on few others.
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Tsega NT, Haile TT, Asratie MH, Belay DG, Endalew M, Aragaw FM, Tsega SS, Gashaw M. Pooled prevalence and determinants of informed choice of contraceptive methods among reproductive age women in Sub-Saharan Africa: A multilevel analysis. Front Public Health 2022; 10:962675. [PMID: 36187687 PMCID: PMC9516336 DOI: 10.3389/fpubh.2022.962675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 08/23/2022] [Indexed: 01/24/2023] Open
Abstract
Background Despite the commitments of the government to minimize unintended pregnancy, abortion, and unmet need for contraceptives, as per our search of the literature, there is no study on the pooled prevalence and determinants of informed choice of contraceptive methods in sub-Saharan Africa. Therefore, this study aimed to assess the pooled prevalence and determinants of informed choice of contraceptive methods among reproductive-aged women in sub-Saharan Africa. Methods This study was based on the 32 Sub-Saharan African countries Demographic and Health Survey data. A total weighted sample of 65,487 women aged 15-49 was included in the study. The data were cleaned, weighted, and analyzed using STATA Version 14 software. Multilevel logistic regression modeling was used to identify determinants of an informed choice of contraceptive methods. Adjusted odds ratio (AOR) with 95% Confidence Interval (CI) and p-value < 0.05 were used to declare the significant determinants. Result The pooled prevalence of informed choice of contraceptive methods among reproductive age (15-49) women in sub-Saharan Africa was 49.47% (95%CI: 44.33, 54.62%) with I 2 =99.5%, and variations in range of 19.42 to 78.42%. Women aged 25-34 years old (AOR = 1.26 95%CI: 1.21, 1.32) and 35-49 years (AOR = 1.33 95%CI: 1.27, 1.40), attending primary education (AOR = 1.26, 95% CI: 1.20, 1.32), secondary education (AOR = 1.50, 95% CI: 1.43, 1.58) and higher education (AOR = 2.01, 95% CI: 1.84, 2.19), having media exposure (AOR = 1.12, 95%CI: 1.07, 1.16), utilizing IUD (AOR = 1.98, 95%CI: 1.79, 2.19), injectable (AOR = 1.29, 95%CI: 1.23, 1.36) and implants (AOR = 1.70, 95%CI: 1.61, 1.79), survey year 2016-2020 (AOR = 1.38, 95%CI: 1.31, 1.44), women from lower middle (AOR = 1.25, 95%CI: 1.19, 1.31) and upper middle income level countries (AOR = 1.37, 95%CI: 1.23, 1.53) were associated with increased odds of informed choice of contraceptive methods. While, women who accessed contraceptives from private clinics (AOR = 0.64, 95%CI: 0.61, 0.67), pharmacies (AOR = 0.37, 95%CI: 0.35, 0.40), and others (AOR = 0.47, 95%CI: 0.43, 0.52), women in East Africa (AOR = 0.70, 95% CI: 0.67, 0.73), Central Africa (AOR = 0.52, 95% CI: 0.47, 0.57), and South Africa (AOR = 0.36, 95% CI: 0.32, 0.40) were associated with decreased odds of informed choice of contraceptive methods. Conclusion The pooled prevalence of informed choice of contraceptive methods in Sub-Saharan Africa is low with high disparities among the countries. Enhancing maternal education and media exposure, providing greater concern for the source of contraceptive methods, and strengthening the economic status of the country are recommended to enhance informed choice of contraceptive methods.
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Affiliation(s)
- Nuhamin Tesfa Tsega
- Department of Women's and Family Health, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia,*Correspondence: Nuhamin Tesfa Tsega
| | - Tsion Tadesse Haile
- Department of General Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Melaku Hunie Asratie
- Department of Women's and Family Health, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Daniel Gashaneh Belay
- Department of Human Anatomy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia,Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mastewal Endalew
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Fantu Mamo Aragaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Sintayehu Simie Tsega
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Moges Gashaw
- Department of Physiotherapy, School of medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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Pradhan MR, Mondal S. Contraceptive method use among women in India: Does the family type matter? BIODEMOGRAPHY AND SOCIAL BIOLOGY 2022; 67:122-132. [PMID: 35499260 DOI: 10.1080/19485565.2022.2071673] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The use of contraceptive methods and their correlates continues to be a subject of scientific interest in developing countries, including India, for its contribution to reducing fertility and improving maternal and child health. This study explores the family type and contraceptive use by analyzing the National Family Health Survey-4 data (2015-16). Multinomial logistic regression was used to check the adjusted effects of the predictor variables on contraceptive use. STATA (version 13) was used for the analysis with a significance level of 5 per cent. Adjusting the effects of socio-demographic and economic characteristics, women from nuclear family had 6 per cent lower odds of using modern limiting method (OR = 0.94, 95 per cent CI = 0.92-0.96) and 5 per cent lower odds of using any traditional method of contraception (OR = 0.95, 95 per cent CI = 0.91-0.99) than their counterparts from non-nuclear family with mother-in-law (MIL). Family type, especially the presence of MIL, was associated with daughter-in-law's (DIL) contraceptive behavior. The results based on a nationally representative recent survey contribute to the existing scanty evidence on the association between the MIL and DIL's contraceptive behavior in the Indian context. Results suggest more awareness about the benefits of modern spacing methods among the mothers-in-law, leading to their enhanced use.
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Affiliation(s)
- Manas Ranjan Pradhan
- Department of Fertility and Social Demography, International Institute for Population Sciences (IIPS), Mumbai, India
| | - Sourav Mondal
- Department of Fertility and Social Demography, Research Scholar, International Institute for Population Sciences (IIPS), Mumbai, India
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Sharma A, Keshava SN, Eapen A, Elias E, Eapen CE. An Update on the Management of Budd-Chiari Syndrome. Dig Dis Sci 2021; 66:1780-1790. [PMID: 32691382 DOI: 10.1007/s10620-020-06485-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 07/04/2020] [Indexed: 12/17/2022]
Abstract
Budd-Chiari syndrome (BCS) is an uncommon condition, caused by obstruction to hepatic venous outflow. It is largely underdiagnosed, and a high index of suspicion is required for any patient with unexplained portal hypertension. The understanding of its etiology and pathology is improving with advances in diagnostic techniques. Recent studies reported an identifiable etiology in > 80% of cases. Myeloproliferative neoplasm (MPN) is the most common etiology, and genetic studies help in diagnosing latent MPN. Better cross-sectional imaging helps delineate the site of obstruction accurately. The majority of BCS patients are now treated by endovascular intervention and anticoagulation which have improved survival in this disease. Angioplasty of hepatic veins/inferior vena cava remains under-utilized at present. While surgical porto-systemic shunts are no longer done for BCS, liver transplantation is reserved for select indications. Some of the unresolved issues in the current management of BCS are also discussed in this review.
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Affiliation(s)
- A Sharma
- Hepatology Department, Christian Medical College, Vellore, Tamil Nadu, India
| | - S N Keshava
- Department of Interventional Radiology, Christian Medical College, Vellore, India
| | - A Eapen
- Department of Radiodiagnosis, Christian Medical College, Vellore, India
| | - E Elias
- Hepatology Department, Christian Medical College, Vellore, Tamil Nadu, India.,Liver Unit, University Hospitals Birmingham, Birmingham, UK
| | - C E Eapen
- Hepatology Department, Christian Medical College, Vellore, Tamil Nadu, India.
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