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Assegid DT, Abera L, Girma M, Hailu M, Tefera B. Pregnancy and sexual related problems among women living on the street in dire Dawa City, Eastern Ethiopia, 2021: qualitative study. BMC Womens Health 2022; 22:429. [PMID: 36329445 PMCID: PMC9635093 DOI: 10.1186/s12905-022-02006-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Accepted: 10/04/2022] [Indexed: 11/06/2022] Open
Abstract
Background The problem of women and youths living on the street is a global phenomenon. It has created countless problems while they lived on the street; such as unwanted pregnancies, sexual exploitation and prostitution. It is a frequent observation to see women begging on the streets of major cities in Ethiopia having one or two babies by their sides. This study will give an in-depth understanding of the distressing and highly challenging problem among women on the street regarding pregnancy and related problems. Objective To explore pregnancy and sexual-related problems among women living on the street in Dire Dawa city, Eastern Ethiopia 2021. Methods A community-based phenomenological qualitative study was conducted at Dire Dawa city. Data was collected from homeless women and Key informants through focus group discussion and in-depth interviews using a semi-structured tool aided by a voice recorder. Data were analyzed thematically using computer-assisted qualitative data analysis software Atlas.ti7. The thematic analysis with inductive approach goes through 6 steps; Familiarization, Coding, Generating themes, Reviewing themes, Defining and naming themes and Writing up. Result Women living on the street are more likely to experience physical abuse, sexual harassment, Sexual transmitted infection, unprotected sex and unwanted pregnancy. As a result, the fate of this pregnancy is abortion leads to high risk of getting health complications as most abortions are made in illegal and unsafe ways. Conclusion Teen pregnancy, STI, rape and unsafe abortion are the major concerns as it accompanied by their homelessness situation and abusive lifestyles. The regional health bureau needs to understand the extent of problem and plan to organize an awareness creation program on STI, risk of pregnancy and SRH services.
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Affiliation(s)
- Daniel Tadesse Assegid
- grid.449080.10000 0004 0455 6591Midwifery department, Dire Dawa University, Dire Dawa, Ethiopia
| | - Legesse Abera
- grid.449080.10000 0004 0455 6591Midwifery department, Dire Dawa University, Dire Dawa, Ethiopia
| | - Meklit Girma
- grid.30820.390000 0001 1539 8988College of Health Sciences, Department of Midwifery, Mekelle University, Mekelle, Ethiopia
| | - Mickiale Hailu
- grid.449080.10000 0004 0455 6591Midwifery department, Dire Dawa University, Dire Dawa, Ethiopia
| | - Bereket Tefera
- grid.449080.10000 0004 0455 6591Midwifery department, Dire Dawa University, Dire Dawa, Ethiopia
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Alemu K, Birhanu S, Fekadu L, Endale F, Tamene A, Habte A. Safe abortion service utilization and associated factors among insecurely housed women who experienced abortion in southwest Ethiopia, 2021: A community-based cross-sectional study. PLoS One 2022; 17:e0272939. [PMID: 35980966 PMCID: PMC9387822 DOI: 10.1371/journal.pone.0272939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 07/19/2022] [Indexed: 11/30/2022] Open
Abstract
Background Insecurely housed women are more vulnerable to physical and mental health issues than the general population, making access to a safe abortion more difficult. Though Ethiopia has a penal code regarding safe abortion care, there has been a dearth of studies investigating the safe abortion care practice among those insecurely housed women. Thus, this study aimed at assessing the magnitude of safe abortion service uptake and its determinants among insecurely housed women who experienced abortion in southwest Ethiopia. Methods A community-based cross-sectional study was conducted in three towns in southwest Ethiopia from May 20-July 20, 2021. A total of 124 street-involved women were included in the study. They were selected by snowball sampling technique and data was collected through a face-to-face interview. The data were entered into Epi-data Version 3.1 and exported to SPSS 21 for analysis. A bivariable and multivariable logistic regression analyses were performed to determine the association of independent variables with the outcome variable. The level of significance was determined at a p-value <0.05. To determine whether the model is powerful enough in identifying any significant effects that do exist on the dependent variables, a power analysis was performed via a Post-hoc Statistical Power Calculator for Multiple Regressions. Results The magnitude of safe abortion service utilization among insecurely housed women was found to be 27.9% [95% CI: 20.1, 34.2]. Average daily income [AOR:3.83, 95% CI: 1.38, 10.60], knowledge of safe abortion services [AOR:3.94; 95% CI: 1.27,9.24], and affordability of the service [AOR: 3.27; 95% CI:1.87, 8.41] were identified as significant predictors of safe abortion service among insecurely housed women. Conclusion and recommendation The magnitude of safe abortion service utilization among insecurely housed women in the study area was low. The respective town health offices and health care providers at the facility level should strive to improve awareness about safe abortion service’s legal framework, and its availability. In addition, a concerted effort is needed from local administrators, NGOs, and healthcare managers to engage those insecurely housed women in income-generating activities that allow them to access safe abortion and other reproductive and maternal health services.
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Affiliation(s)
- Kidist Alemu
- Mizan Aman College of Health Science, Southern Region Health Bureau, Mizan, Ethiopia
| | - Solomon Birhanu
- Department of Epidemiology, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Leta Fekadu
- Department of Epidemiology, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Fitsum Endale
- School of Public Health, College of Medicine and Health Sciences, Wachemo University, Hosanna, Ethiopia
| | - Aiggan Tamene
- School of Public Health, College of Medicine and Health Sciences, Wachemo University, Hosanna, Ethiopia
| | - Aklilu Habte
- School of Public Health, College of Medicine and Health Sciences, Wachemo University, Hosanna, Ethiopia
- * E-mail:
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Solomon S, Yitayew B, Kebede A. Contraceptive Utilization and Unmet Need for Contraception Among Women Undergoing Treatment for Tuberculosis in Addis Ababa, Ethiopia: a Cross-Sectional Study. Open Access J Contracept 2022; 13:29-38. [PMID: 35422662 PMCID: PMC9005122 DOI: 10.2147/oajc.s348811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 03/27/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction Pregnancy can pose a risk to women on tuberculosis (TB) treatment with a threat to the wellbeing of the mother and fetus. Physiological and stress-related effects result when pregnancy occurs during TB illness and while on treatment. Hence, this study aimed to assess contraceptive utilization, unmet need among women on TB treatment, and integration of family planning (FP) services with TB clinics in Addis Ababa, Ethiopia. Methods A facility-based cross-sectional study was conducted using an interviewer-administered questionnaire. A total of 316 women aged 18-49 who were on TB treatment were enrolled. Contraceptive utilization rate, unmet need, and integration of FP and TB services were determined. Logistic regression models were conducted to identify factors associated with contraceptive utilization. Results Among women on TB treatment 49 (41.9%) were using contraceptives. Out of contraceptive users, 10 (34.5%) used contraceptives to limit and 18 (62.1%) used to space. Only parity had a significant association with contraceptive utilization. Women who had 1-3 children were less likely to use contraception than those who had ≥4 children. Among women who were married or sexually active, 12 (18.9%) had an unmet need. Of the study participants, 144 (45.6%) had been informed about FP services at the TB clinics. Conclusion The contraceptive utilization rate in the current study (41.9%) is slightly higher than the national prevalence (36.2%) yet it is still low. Furthermore, the unmet need (18.9%) was lower than the national report for the general population (22%). Educating women about the risk of getting pregnant while visiting the health facility for TB medication will help to improve their chances of better recovery and avoid medication side effects on the fetus. TB guidelines can consider providing FP counseling when initiating treatment to provide women with the power of information to make deliberate decisions.
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Affiliation(s)
- Semaria Solomon
- Department of Microbiology, Immunology and Parasitology, St. Paul’s Hospital Millennium Medical College (SPHMMC), Addis Ababa, Ethiopia
| | - Berhanu Yitayew
- College of Health Science, Debre Berhan University (DBU), Debre Berhan, Ethiopia
| | - Abebaw Kebede
- TB/HIV Research Directorate, Ethiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia
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Guta A, Amsalu B, Weldamanuel T, Sema A, Abera L, Demissie BS, Belay Y. Utilization of modern contraceptives and associated factors among street women in Dire Dawa, Eastern Ethiopia: a mixed study. Reprod Health 2021; 18:212. [PMID: 34702303 PMCID: PMC8549275 DOI: 10.1186/s12978-021-01263-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 10/11/2021] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Unwanted pregnancy and sexually transmitted diseases are the major problems in street women because of the non-utilization of modern contraceptives. To the best of our knowledge, no studies have assessed the utilization of modern contraceptives and associated factors among street women in the study area. Therefore, this study aimed to determine the utilization of modern contraceptives and its associated factors among street women. METHODS A community-based cross-sectional study using mixed methods was conducted from February 16th to April 10, 2021, among all censuses and 615 reproductive-aged street women. Face-to-face and in-depth interviews were employed to generate quantitative and qualitative data, respectively. Binary logistic regression was used to analyze the association between modern contraceptive utilization and independent variables with statistical significance set at p < 0.05. Qualitative data were analyzed using a thematic approach. RESULTS Approximately half 279 (50.3%) (95% CI: 46.3%, 54.4%) street women currently used modern contraceptives. Factors significantly associated were women aged 25-34 years [AOR = 5.5, 95% CI: 1.2-24], distance from a nearby health facility within 30 min [AOR = 9.2, 95% CI: 1.6-51], getting advice from health professionals [AOR = 14.3; 95% CI = 5.3-38.4], discussed with their sexual partners about the utilization of modern contraceptives [AOR = 6.2, 95% CI: 2.4-16.5], a history of pregnancy [AOR = 2.7, 95% CI: 1.2-6], the desire to have a child after two years [AOR = 2.2, 95% CI: 1.1-4.7], and women who faced rape in street life [AOR = 5.4; 95% CI = 1.9-15.3]. Fear of side effects, misperceptions, and the desire to have a child are the main identified themes for the key barriers to using modern contraceptives. CONCLUSION The proportion of street women currently using modern contraceptives was low. Age, distance from the health facility, discussion with health professionals, discussion with sexual partners, history of pregnancy, desire time to have a child in the future, and history of rape were factors significantly associated with the use of modern contraceptives. Most of the participants' reasons for the lack of use of modern contraceptives were fear of its side effects.
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Affiliation(s)
- Alemu Guta
- Department of Midwifery, College of Medicine and Health Science, Dire Dawa, Ethiopia.
| | - Bezhabh Amsalu
- Department of Midwifery, College of Medicine and Health Science, Dire Dawa, Ethiopia
| | - Tadesse Weldamanuel
- Department of Midwifery, College of Medicine and Health Science, Dire Dawa, Ethiopia
| | - Alekaw Sema
- Department of Midwifery, College of Medicine and Health Science, Dire Dawa, Ethiopia
| | - Legesse Abera
- Department of Midwifery, College of Medicine and Health Science, Dire Dawa, Ethiopia
| | - Bekele Simegn Demissie
- Department of Public Health, St. Lideta College of Health Sciences, Addis Ababa, Ethiopia
| | - Yalelet Belay
- Department of Midwifery, College of Medicine and Health Science, Dire Dawa, Ethiopia
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Contraceptive Method Utilization and Determinant Factors among Young Women (15-24) in Ethiopia: A Mixed-Effects Multilevel Logistic Regression Analysis of the Performance Monitoring for Action 2018 Household Survey. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6642852. [PMID: 33880373 PMCID: PMC8046539 DOI: 10.1155/2021/6642852] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 03/20/2021] [Accepted: 03/29/2021] [Indexed: 11/23/2022]
Abstract
Despite highly effective modern contraceptive methods (both short and long acting) are made widely available and accessible globally, their utilization remains low among young women in low- and middle-income countries, including Ethiopia. Hence, this study is aimed at determining its status and identifying the determinant factors by using nationally representative data. A multilevel analysis of the nationwide Performance Monitoring for Action 2018 of Ethiopia round 6 data, collected from June to July, 2018, was conducted. A total of 982 both married and unmarried young women (15-24) were included in the analysis. Descriptive statistics was used to describe the status of contraceptive method utilization and unmet need across regions. A mixed-effects multilevel logistic regression model was used to identify the determinants of the contraceptive method utilization. Adjusted odds ratios with corresponding 95% confidence intervals were used to show the significance of the associations at p < 0.05. The status of contraceptive method utilization was 54.8% (95% CI: 51.7%, 57.9%), and 18.6% (95% CI: 16.3%, 21.2%) had unmet need. Afar (12.3%), Harari (12.5%), and Ethiopian Somali (20.0%) regions had the lowest contraceptive method utilization. Wealth quintiles and religion were the higher level variables affecting contraceptive method utilization among the young women. Age, marital status, parity, future birth intention, and knowledge of contraceptive methods were the individual level factors identified as determinants of contraceptive method use among the young women. In conclusion, the status of contraceptive method utilization among the young women in Ethiopia is promising as compared to the national target of 55% for 2020; however, still high unmet need exists. The factors also exist both at the contextual and at individual levels. Hence, multilevel interventions need to be in place giving special emphasis to the low performing regions. Besides, region-specific behavioral interventions and family planning services that will be able to reach the young women need to be designed.
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Modern Contraceptive Utilization and Determinant Factors among Street Reproductive-Aged Women in Amhara Regional State Zonal Towns, North West Ethiopia, 2019: Community-Based Study. Int J Reprod Med 2020; 2020:7345820. [PMID: 33354561 PMCID: PMC7737461 DOI: 10.1155/2020/7345820] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 10/04/2020] [Accepted: 11/12/2020] [Indexed: 11/18/2022] Open
Abstract
Objective Reproductive-aged women living on the street, with no doubt, are with lesser benefits of exercising their reproductive rights. Pregnancies from this marginalized population are likely to be unplanned, unwanted, and unsupported. The aim of this study, therefore, was to assess modern contraception utilization and associated factors among street reproductive-aged women in Amhara regional state zonal towns. Method A community-based cross-sectional study was conducted among street reproductive-aged women in Amhara regional state zonal towns. A single population proportion formula was used to calculate the sample size, a similar literature-based tool adaptation was done, and a semistructured, pretested sectioned questionnaire was used. Cluster sampling technique was used to reach the study participants. Data was entered into Epi Info version 7 and exported to SPSS version 23 for analysis. A multivariable logistic regression model was fitted to control the possible effect of confounders, and finally, the independent variables were identified on the basis of OR, with 95% CI and p values less than 0.05. Results 604 street reproductive-aged women were interviewed in the study which make the response rate 94.2%. The study revealed that current modern contraceptive utilization among the study participants was found to be 38.9%. Having history of pregnancy in street life (AOR = 1.70, 1.1-2.7), having three or more live children (AOR = 6.4, 2.0-20.4), undesiring to have additional children in the future (AOR = 2.7, 1.4-5.1), mentioning three to four (AOR = 2.2, 1.5-3.3) and five or more modern contraceptive types (AOR = 5.5, 1.4-21.0), and discussion with sexual partners for contraceptive use (AOR = 6.6, 4.3-10.1) were variables significantly associated with modern contraceptive utilization. Modern contraceptive utilization among the street reproductive-aged women was low. Authors suggest that awareness creation and male partner involvement in the maternal services may be important to increase contraceptive utilization.
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Modern Contraceptive Utilization and Its Associated Factors among Indigenous and Nonindigenous Married Women of Reproductive Age Group in Jigjiga Town, Eastern Ethiopia, 2018. BIOMED RESEARCH INTERNATIONAL 2020; 2020:6878075. [PMID: 32596352 PMCID: PMC7273474 DOI: 10.1155/2020/6878075] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 04/28/2020] [Accepted: 05/11/2020] [Indexed: 11/17/2022]
Abstract
Background The use of birth control and its promotion has potential benefits of reducing poverty, maternal, and child mortality. However, there is limited evidence regarding modern contraceptive utilization among indigenous and nonindigenous married women of the reproductive age group in Ethiopia. Therefore, this study aimed to assess the magnitude of modern contraceptive utilization and its associated factors among indigenous and nonindigenous married women in Eastern Ethiopia. Methodology. A community based comparative cross-sectional study design was conducted among married women of the reproductive age group from February 01 to March 01/2018 in Jigjiga town, Eastern Ethiopia. A total of 1004 married women were selected using a simple random sampling method. The collected data were entered into EpiData software version 3.1 and exported to SPSS version 22.0 for analysis. Bivariable and multivariable logistic regression analyses were used to identify the associated factors. Statistical significance was declared using 95% confidence interval and p value of less than 0.05. Result A total of 987 study participants were included in the study with a response rate of 98.3%. The overall prevalence of modern contraceptive utilization among married reproductive age group women was found to be 19.9% (95% CI (17.4%-22.3%) with 26.5% and 11.4% for nonindigenous and indigenous women, respectively. Primary level of education (AOR 0.84; 95% CI (0.15-0.85) p 0.0001) and Somali in ethnicity (AOR 0.75; 95% CI (0.15-0.94) p 0.03) were associated factors among indigenous group, while age group 30-34 years (AOR 1.56; 95% CI (1.31-9.52) p 0.02) and being a housewife in occupation (AOR 0.49; 95% CI (0.42-0.96) p 0.04) were the associated factors among the nonindigenous group. Conclusion Overall utilization of modern contraceptives was approximately one-fifth, with markedly lower use among indigenous participants. One-third of nonindigenous and less than one-seventh of indigenous were utilizing modern contraceptive methods. There is a need to further explore and understand the factors across indigenous and nonindigenous women for the use of modern contraceptives; hence, a longitudinal study is desirable.
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Singh P, Singh KK, Singh A, Pandey A. The levels and trends of contraceptive use before first birth in India (2015-16): a cross-sectional analysis. BMC Public Health 2020; 20:771. [PMID: 32448153 PMCID: PMC7247209 DOI: 10.1186/s12889-020-08917-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 05/14/2020] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Indian women are more prone to first birth at a relatively younger age after marriage. Also, we do not have sufficient literature available that focuses on contraceptive use before first birth. The analysis of the present study was done using data from the fourth round of National Family Health Survey (2015-16), India. The objectives of the present study were to measure the levels and trends of contraceptive use before first birth among Indian ever married women, aged 15-34 years. METHODS The study includes 279,896 ever married women aged 15-34 years at the time of the NFHS-4 survey. To identify the socio-demographic determinants governing the pioneering study behavior, multivariable techniques have been used in the analysis. The statistical significance of the relationship between socio-demographic factors and contraceptive use prior to first birth was tested using a chi-squared test for association. Hosmer Lemeshow statistics and Nagelkerke R square have been used to check how well the logistic regression model fits the data. Map of India showing different zonal classification is made using the ArcGIS software version 10.3. RESULT The trends of contraceptive usage show a decline in use before first birth and the various socio-demographic factors affecting the use of contraceptive before first birth are religion, caste, education, wealth index, media exposure, age at marriage and the zonal classifications. CONCLUSION The noticeable result in this study is the comparative decline in contraceptive use by women in India before first birth in NFHS-4 with respect to previous NFHS done in India. The likelihood of using contraception before first birth is significantly affected by factors like place of residence, religion, caste, current age of women, age at marriage, education level of women, wealth index, media exposure and zonal classification.
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Affiliation(s)
- Pragya Singh
- Department of Statistics, Banaras Hindu University, Varanasi, Uttar Pradesh 221005 India
| | | | - Anjali Singh
- Department of Statistics, Banaras Hindu University, Varanasi, Uttar Pradesh 221005 India
| | - Anjali Pandey
- Department of Statistics,Amity Institute of Applied Sciences, Noida, Uttar Pradesh 201303 India
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Osei Asibey B, Conroy E, Marjadi B. Health problems and healthcare service utilisation amongst homeless adults in Africa- a scoping review. BMC Public Health 2020; 20:594. [PMID: 32357856 PMCID: PMC7193394 DOI: 10.1186/s12889-020-08648-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 04/02/2020] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Homelessness is a growing concern as it affects a large number of people worldwide. Individuals and families experiencing homelessness are vulnerable in terms of health and underutilise health services. Despite being a global problem, not much is known about the range and breath of literature exploring health problems and health care service utilisation among homeless adults in Africa. OBJECTIVES To identify the nature and scope of existing evidence on physical and mental health, and health service utilisation among homeless adults in Africa. The review aimed to examine how research is conducted, identify gaps, guide future research, and make recommendations for development and implementation of policies and practices. METHODS A search of articles and reports involving six databases: Scopus, MEDLINE, CINAHL, PubMed, African Journal Online, and Google Scholar was conducted from June 2018 to February 2019. Studies published between 1980 and 2019 that examined the health problems and health service utilisation among homeless adults in Africa were considered. Manual search in reference lists and grey literature was also done to add reports. Data was extracted manually using a charting developed. A descriptive analysis and narrative synthesis were performed. RESULTS Of 761 records found, 14 satisfied the pre-determined inclusion and exclusion criteria. Three themes emerged from the studies: Physical health problems, mental health problems; and healthcare services utilisation. Of the 14 included studies, nine studied and reported physical health problems such as sexually transmitted infections, injuries and disabilities, respiratory and cardiac diseases. Five studies explored mental health problems such as psychotic disorders, mood disorders, self-harm and suicidal behaviour. Only five studies investigated utilisation of different types of health care services among homeless people. CONCLUSIONS Evidence shows that homeless adults suffered from a range of physical and mental health problems, and underutilisation of health care services. However, there is lack of information on the complex interrelationship between homelessness and health, as well as differences in prevalence of health problems among the various sub-groups of homeless. There is also lack of information regarding utilisation other important healthcare services such as mental health services, alcohol and drugs services, and accident and emergency service, and future researches should address that. Also, attention should be given to intervention models for complex and effective physical and psychiatric care as well as social support to address the homeless people's health vulnerabilities.
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Affiliation(s)
- Benedict Osei Asibey
- Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, New South Wales 2751 Australia
| | - Elizabeth Conroy
- Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, New South Wales 2751 Australia
| | - Brahmaputra Marjadi
- School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, New South Wales 2751 Australia
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Mersha AG, Erku DA, Belachew SA, Ayele AA, Gebresillassie BM, Abegaz TM. Contraceptive use among HIV-positive and negative women: implication to end unintended pregnancy. Contracept Reprod Med 2019; 4:3. [PMID: 30783537 PMCID: PMC6376717 DOI: 10.1186/s40834-019-0084-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 01/28/2019] [Indexed: 11/20/2022] Open
Abstract
Background With the advancement of antiretroviral therapy and improved life expectancy, women living with HIV/AIDS are enjoying a better sexual life. Yet, the consistent utilization of contraceptive in such patients is highly recommended. There is paucity of data regarding contraceptive use among HIV-positive and negative women in Ethiopia. The present study aimed at examining the use of contraceptives among HIV-positive and HIV-negative women in Ethiopia. Methods A comparative cross-sectional study was conducted among HIV-positive and HIV-negative women attending family planning Clinic of Gondar university referral hospital between January 2016 and August 2017. Descriptive statistics were used to present categorical data and Pearson’s chi-square test was done to examine differences in the utilization of contraceptives between HIV-positive and HIV-negative women. Kaplan Meier test was also carried out to determine the incidence of unintended pregnancy. A p-value of 0.05 was deemed significant with corresponding 95% confidence intervals. Results A total of 894 participants consisting of 314 HIV-positive and 580 HIV-negative women were included in the study. The rate of previous unintended pregnancy was 280 (31.3%) in HIV-negative women and 115 (12.9%) in HIV-infected women. Women who routinely utilized contraceptives were more likely to avoid unintended pregnancy [log rank: 2.89, p < 0.05]. Unlike HIV-negative women (2.9%), HIV-positive (28.4%) women reported a higher rate of intrauterine device use. Male condom was used more commonly in HIV-infected women (26.7%) as compared to HIV negative (3.9%) women (p-value < 0.05). Conclusions Intrauterine contraceptive device was reported to be the most commonly used contraceptive method in HIV patients. Further, unintended pregnancy was relatively common in women with low contraceptive practice. The use of dual contraceptives should be advocated for HIV-positive women so as to protect unintended pregnancy and curtail the transmission of HIV.
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Affiliation(s)
- Amanual Getnet Mersha
- 1Department of Gynecology and Obstetrics, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Daniel Asfaw Erku
- 2Department of Medicinal Chemistry, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Sewunet Admasu Belachew
- 3Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Asnakew Achaw Ayele
- 3Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Begashaw Melaku Gebresillassie
- 3Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tadesse Melaku Abegaz
- 3Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Gebremariam A, Gebremariam H. Contraceptive use among lactating women in Ganta-Afeshum District, Eastern Tigray, Northern Ethiopia, 2015: a cross sectional study. BMC Pregnancy Childbirth 2017; 17:421. [PMID: 29246123 PMCID: PMC5732522 DOI: 10.1186/s12884-017-1613-0] [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: 04/04/2017] [Accepted: 12/05/2017] [Indexed: 11/29/2022] Open
Abstract
Background Women who are not exclusively breastfeeding are at risk of pregnancy after four to six weeks of childbirth. Postpartum contraceptive use is crucial to prevent unintended pregnancy, and to have spaced births. The study was conducted to determine the magnitude of modern contraceptive utilization and factors associated with it among lactating women in Ganta-Afeshum district. Methods A community based cross sectional study was conducted among lactating women with children in the age group of six to twelve months. A total of 605 women were included in the study. The study participants were selected using cluster sampling method. Data were collected using structured interviewer administered Tigrigna version questionnaire. Data were analyzed using SPSS version 21. Multivariable logistic regression was used to control the effect of confounders. Results The magnitude of institutional delivery was 96.5%. The mode of delivery of the participants was spontaneous, instrumental and caesarean section, 95.5%, 2.0%, and 2.5%, respectively. The magnitude of modern contraceptive (MC) utilization was 68.1% (95% CI: 64.4–71.8). The contraceptive method mix was dominated by Depo-Provera (58.8%) followed by implants (31.8%). Almost all the study participants had at least one antenatal care (ANC) visit (99.7%) during the pregnancy of their index child. Participants who had radio and those who delivered their recent child by assisted delivery had higher odds of modern contraceptive use. Conclusions The magnitude of contraceptive utilization among lactating mothers in the study area was higher than the national survey reports. However, significant numbers of women are not using contraceptives in their postpartum period, making them at risk of pregnancy. Mode of delivery of the women and having radio at home were significantly associated with the women’s contraceptive utilization. Family planning information dissemination using radio in rural settings should be encouraged to increase the uptake of contraceptives in the lactating women.
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Affiliation(s)
- Alem Gebremariam
- Department of Public Health, College of Medicine and Health Science, Adigrat University, Adigrat, Ethiopia.
| | - Hadush Gebremariam
- Department of Public Health, College of Medicine and Health Science, Adigrat University, Adigrat, Ethiopia
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12
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Debebe S, Andualem Limenih M, Biadgo B. Modern contraceptive methods utilization and associated factors among reproductive aged women in rural Dembia District, northwest Ethiopia: Community based cross-sectional study. Int J Reprod Biomed 2017. [DOI: 10.29252/ijrm.15.6.367] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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13
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Debebe S, Andualem Limenih M, Biadgo B. Modern contraceptive methods utilization and associated factors among reproductive aged women in rural Dembia District, northwest Ethiopia: Community based cross-sectional study. Int J Reprod Biomed 2017; 15:367-374. [PMID: 29202123 PMCID: PMC5605858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Improving women's health through modern contraceptive methods utilization is the key strategy to prevent unwanted pregnancy and its complication. However, there was limited evidence on utilization of modern contraceptive methods in the study area. OBJECTIVE This study identified factors affecting utilization of modern contraceptive methods among women at reproductive age group in rural areas of Dembia district, 2015. MATERIALS AND METHODS Community based cross sectional study was conducted in 2015 in Dembia District. Multi-stage sampling technique was used to select a total of 616 study participants. Bivariate and multivariable logistic regression model was fitted to identify factors associated with modern contraceptive utilization. Odds ratio with 95% confidence interval (CI) was computed to determine the level of significance. RESULTS Modern contraceptive methods utilization was found to be 31.7% 95%CI (28.0-35.3). Age [Adjusted odds ratio (AOR): 1.94, (95%CI: 1.170-3.216)], women who has educated husband [AOR: 0.28, (95%CI: 0.117-0.666)], Marital status [AOR: 2.81, (95%CI: 1.344-5.855)] and Spousal announcement about family planning issues [AOR: 2.58, (95%CI: (1.276-5.202)] were factors associated with modern contraceptive methods utilization. CONCLUSION Modern contraceptive methods utilization was found to be low. Providing educational opportunities, creating awareness about contraception and effective counseling would increase modern contraceptive methods utilization.
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Affiliation(s)
- Shibihon Debebe
- University of Gondar Hospital, Laboratory, Gondar, Ethiopia.
| | - Miteku Andualem Limenih
- University of Gondar, College of Medicine and Health Sciences, Department of Midwifery, Gondar, Ethiopia.
| | - Belete Biadgo
- University of Gondar, College of Medicine and Health sciences, School of Biomedical and Laboratory sciences, Department of Clinical Chemistry, Gondar, Ethiopia.
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14
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Berhan Y, Berhan A. Reasons for persistently high maternal and perinatal mortalities in Ethiopia: Part II-Socio-economic and cultural factors. Ethiop J Health Sci 2014; 24 Suppl:119-36. [PMID: 25489187 PMCID: PMC4249210 DOI: 10.4314/ejhs.v24i0.11s] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The major causes of maternal and perinatal deaths are mostly pregnancy related. However, there are several predisposing factors for the increased risk of pregnancy related complications and deaths in developing countries. The objective of this review was to grossly estimate the effect of selected socioeconomic and cultural factors on maternal mortality, stillbirths and neonatal mortality in Ethiopia. METHODS A comprehensive literature review was conducted focusing on the effect of total fertility rate (TFR), modern contraceptive use, harmful traditional practice, adult literacy rate and level of income on maternal and perinatal mortalities. For the majority of the data, regression analysis and Pearson correlation coefficient were used as a proxy indicator for the association of variables with maternal, fetal and neonatal mortality. RESULTS Although there were variations in the methods for estimation, the TFR of women in Ethiopia declined from 5.9 to 4.8 in the last fifteen years, which was in the middle as compared with that of other African countries. The preference of injectable contraceptive method has increased by 7-fold, but the unmet contraceptive need was among the highest in Africa. About 50% reduction in female genital cutting (FGC) was reported although some women's attitude was positive towards the practice of FGC. The regression analysis demonstrated increased risk of stillbirths, neonatal and maternal mortality with increased TFR. The increased adult literacy rate was associated with increased antenatal care and skilled person attended delivery. Low adult literacy was also found to have a negative association with stillbirths and neonatal and maternal mortality. A similar trend was also observed with income. CONCLUSION Maternal mortality ratio, stillbirth rate and neonatal mortality rate had inverse relations with income and adult education. In Ethiopia, the high total fertility rate, low utilization of contraceptive methods, low adult literacy rate, low income and prevalent harmful traditional practices have probably contributed to the high maternal mortality ratio, stillbirth and neonatal mortality rates.
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Affiliation(s)
- Yifru Berhan
- Hawassa University, College of Medicine and Health Sciences, Department of Gynecology-Obstetrics
| | - Asres Berhan
- Hawassa University, College of Medicine and Health Sciences, Department of Pharmacology
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