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Deribew K. Assessment of knowledge on emergency contraceptives and factors associated with utilization among female students in Bonga College of Education, Southwest Region, Ethiopia: cross-sectional study. BMC MEDICAL EDUCATION 2024; 24:538. [PMID: 38750476 PMCID: PMC11097585 DOI: 10.1186/s12909-024-05535-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 05/08/2024] [Indexed: 05/18/2024]
Abstract
BACKGROUND Unintended pregnancy is a major public health problem in sexually active female students in Ethiopia. In higher education, female students are exposed to unprotected sex and are at risk of pregnancy, abortion, and its associated problems. OBJECTIVE The objective of this study was to assess knowledge of female students about emergency contraceptives and determine factors associated with utilization among college female students at Bonga College of Education, Southwest Ethiopia. METHODS The study was conducted from November 10, 2022 to May 30, 2023. All female students of Bonga College of education in all departments were included in this study purposively. Data were collected using Amharic version pretested questionnaire. Data obtained from the survey was entered into Microsoft Excel 2010 and analysed with SPSS version 20.0. Data summary was done with descriptive statistics. Logistic regression was used to measure associations between dependent and independent variables. Odds ratio was used to measure strengths of association between variables. Statistical significance was considered at 95% confidence level (CL). P-value less than 0.05 was considered significant during the analysis. RESULTS In this study a total of 103 College female students were involved. The mean age of the respondents was 20.6 (SD ± 2.06) years. The finding showed that 31 (31.1%) female students had started sexual intercourse and among them 58.1% faced pregnancy. Among the total sexually experienced respondents, 93.5% use contraceptive methods while others 6.5% do not use. Among the total 31 study participants, 27(87.1%) started using EC. The majority of pregnancy (83.3%) was intended type whereas 16.7% was unwanted pregnancy. Regarding the general knowledge about contraceptive methods, 19(18.4%) had poor knowledge. Among the total 103 female college students, 66(64.1%) heard about emergency contraceptives. Forced sex and unprotected free sex are predicting factors that induces female students to use emergency contraceptives. Fear of discontinuing school was the main inducing factor to commit abortion. Logistic regression analysis showed that college female students whose age category above 25 years were more likely to use emergency contraceptives. Students who came from urban area are more likely to use EC than rural areas. Married female students (AOR = 2.5, 95% CI: 0.76, 8.7) were two times likely to use EC as contraceptive method. CONCLUSIONS Female students who came from urban area use EC better than who came from rural areas. Majority of sexually active female students had good practice and knowledge of using EC but some had poor knowledge. Forced sex and free sexual practice are key determinant factors that induces to use EC. Abortion was mainly done in private clinic. Fear of discontinuing school was determinant factors identified to commit abortion. Therefore, responsible bodies should develop strategies to improve female students' reproductive health related to emergency contraceptives.
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Affiliation(s)
- Ketema Deribew
- Department of Biology, Bonga College of Education, Bonga, Ethiopia.
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Mazibuko NE, Saruchera M, Okonji EF. A Qualitative Exploration of Factors Influencing Non-Use of Sexual Reproductive Health Services among University Students in South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2418. [PMID: 36767788 PMCID: PMC9916358 DOI: 10.3390/ijerph20032418] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 01/23/2023] [Accepted: 01/24/2023] [Indexed: 06/17/2023]
Abstract
(1) Background: There is growing concern in South Africa about risky sexual behaviour, sexual transmitted infections (STIs), and unplanned pregnancy among young people. Many sexually active students engage in several risky behaviours, including sex with multiple sexual partners, low condom use, and low contraceptive use. This paper qualitatively explores factors influencing non-use of sexual reproductive health services by students at Mangosuthu University of Technology in South Africa (MUT). (2) Methods: Data was collected through 20 in-depth interviews with MUT students and subjected to inductive thematic analysis. Informed consent was obtained before all data collection. (3) Results: The main themes identified were risky sexual behaviours translating to multiple intimate partners, perceived quality of condom use, perceived benefits of contraceptives, negotiating safer sex with partners, developing a greater sense of autonomy, alcohol and drug abuse, perceived benefits of health education provided by the MUT, and lack of open communication. (4) Conclusions: The findings suggest that university students need multi-faceted interventions designed to address challenges with risky sexual behaviours including knowledge and benefits of condom and contraceptive use to prevent STIs and unwanted pregnancies, as well as providing psychosocial interventions to support these students' autonomy.
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Affiliation(s)
- Ntombenhle E. Mazibuko
- Faculty of Economic and Management Sciences, Stellenbosch University, Stellenbosch 7599, South Africa
| | - Munyaradzi Saruchera
- Faculty of Economic and Management Sciences, Stellenbosch University, Stellenbosch 7599, South Africa
| | - Emeka Francis Okonji
- School of Public Health, University of the Western Cape, Cape Town 7535, South Africa
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Leelakanok N, Parmontree P, Petchsomrit A, Methaneethorn J. A systematic review and meta-analysis of attitude and knowledge involving emergency oral contraceptive use in patients and healthcare providers. Int J Clin Pharm 2022; 44:873-893. [PMID: 35732860 DOI: 10.1007/s11096-022-01445-0] [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: 03/16/2022] [Accepted: 06/12/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Levonorgestrel and ulipristal acetate are common emergency oral contraceptives (EOCs). Lack of knowledge and negative attitude toward EOCs pose barriers to the EOCs access and utilization. AIM This study aimed to summarize the studies on the knowledge and attitudes of healthcare providers and patients on the use of EOCs. METHOD A systematic search was conducted from conception to April 2022 using the following databases: CINAHL Complete, MEDLINE, ScienceDirect, Scopus, and Thai Journal Online. Data were extracted independently and were meta-analyzed using DerSimonian and Laird method for the binary random-effects model. RESULTS 121 articles with a total number of 92,484 participants were included. The awareness of levonorgestrel as an EOC was 66.7% while the awareness of ulipristal acetate as an EOC was 36.9%. EOCs users received EOC information mainly from the internet, media, and friends. We found that 32.2% of EOCs users and providers agreed that EOCs acted post-fertilization, and 39.8% of the prescribers know the correct time to take the pill postcoital. Negative attitudes toward EOC use were found in 25.4% of the participants. For example, 39.4% of the participants agreed that EOCs users had increased sexual activity. CONCLUSION The awareness of EOCs was low and misunderstandings or negative attitudes towards the use or prescription of EOCs were still prevalent. Educating healthcare providers, using media as educational tools, and improving education and economics can be useful in improving EOC users' awareness, knowledge, and attitude towards EOCs.
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Affiliation(s)
- Nattawut Leelakanok
- Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Burapha University, Chonburi, 20131, Thailand
| | - Porntip Parmontree
- Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Burapha University, Chonburi, 20131, Thailand.
| | - Arpa Petchsomrit
- Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Burapha University, Chonburi, 20131, Thailand.,Pharmaceutical Innovations of Natural Products Unit (PhInNat), Faculty of Pharmaceutical Sciences, Burapha University, Chonburi, Thailand
| | - Janthima Methaneethorn
- Pharmacokinetic Research Unit, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand.,Center of Excellence for Environmental Health and Toxicology, Naresuan University, Phitsanulok, Thailand
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Kwame KA, Bain LE, Manu E, Tarkang EE. Use and awareness of emergency contraceptives among women of reproductive age in sub-Saharan Africa: a scoping review. Contracept Reprod Med 2022; 7:1. [PMID: 35039074 PMCID: PMC8762930 DOI: 10.1186/s40834-022-00167-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 01/08/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Emergency contraception (EC) is a method used to avoid pregnancy after unprotected sexual intercourse. Emergency contraceptives can reduce the risk of unintended pregnancy by up to over 95% when taken within 72 h of sexual intercourse. EC is helpful to women who have experienced method failure, incorrect use of contraceptives, raped or have consented to unplanned, and unprotected sexual intercourse. We set out to systematically review the current literature on the awareness and usage patterns of ECs among women of reproductive age in Sub-Saharan Africa. METHOD Eight hundred and sixty-seven (867) articles were selected from EMBASE and Google Scholar databases after a search was conducted. Sixty (60) full-text articles were checked for eligibility and 27 articles met our inclusion criteria. Manual data extraction on excel sheets was used to extract the authors' names, year of publication, country, sample size, study type, objectives, awareness levels, and the EC types. FINDINGS Awareness rates ranged from 10.1 to 93.5% (both reported from Ethiopia). The level of use was relatively low (ranging from 0% in DR Congo and Ethiopia to 54.1% in Nigeria). The most used types of EC were Postinor 2 (levonorgestrel), EC pills such as Norlevo (levonorgestrel only) and Nodette (levonorgestrel and estradiol), and intrauterine contraceptive device (IUCD). CONCLUSIONS Although variations in use and awareness do exist between countries in SSA according to the year of study, the general level of EC awareness has been on the increase. On the other hand, the level of EC use was lower compared to the level of awareness. Postinor 2 (levonorgestrel-only pills) was reported as the most type used EC. Further, studies could be done to find out the effect of culture, religion and believes on the use of contraceptive methods. It is important to understanding barriers to EC use despite high awareness rates. Emergency Contraceptive awareness and use should be promoted among women of reproductive age in SSA to reduce unwanted pregnancies and their complications.
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Affiliation(s)
| | - Luchuo Engelbert Bain
- Lincoln International Institute for Rural Health, LIIRH, University of Lincoln, Lincoln, UK.
- Global South Health Services and Research, GSHS, Amsterdam, The Netherlands.
| | - Emmanuel Manu
- School of Public Health, University of Health and Allied Sciences, PMB 31, Ho, Ghana
| | - Elvis Enowbeyang Tarkang
- School of Public Health, University of Health and Allied Sciences, PMB 31, Ho, Ghana
- HIV/AIDS Prevention Research Network Cameroon, PO Box 36, Kumba, Cameroon
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Tarafa H, Alemayehu Y, Nigussie M. Factors associated with pregnancy-related anxiety among pregnant women attending antenatal care follow-up at Bedelle general hospital and Metu Karl comprehensive specialized hospital, Southwest Ethiopia. Front Psychiatry 2022; 13:938277. [PMID: 36213901 PMCID: PMC9537765 DOI: 10.3389/fpsyt.2022.938277] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 08/29/2022] [Indexed: 12/02/2022] Open
Abstract
Pregnancy-related anxiety (PRA) is an anxiety related to the pregnancy, involving labor and delivery, the well-being of the fetus/infant and the mother, the availability of quality of healthcare resources, and the capacity to parent. There is scarcity of study conducted on magnitude of Pregnancy-related anxiety and its associated factors among pregnant women in Ethiopia. The main objective of this research was to assess factors associated with Pregnancy-related anxiety among pregnant women attending ANC follow-up at Bedelle general and Metu Karl comprehensive specialized hospitals, Southwest Ethiopia. A hospital-based cross-sectional study design was used among pregnant women attending ANC follow-up. Data were collected from 406 sampled pregnant women who were selected through a systematic random sampling technique. Pregnancy-Related Anxiety Questionnaire-Revised (PRAQ-R2) was used to measure the outcome variable. The collected data were analyzed using Statistical Package for Social Sciences (SPSS) version 26. Logistic regression analyses were done to identify factors associated with Pregnancy-related anxiety and significance level set at p < 0.05. The overall prevalence of PRA in this study was 32.7%. Unwanted pregnancy AOR = 2.77, 95% CI [1.71, 4.54], high perceived stress AOR = 2.39, 95% CI [1.54, 3.62], young age AOR = 2.14, 95% CI [1.49, 2.83], depression AOR = 2.09, 95% CI [1.39, 2.89], low income AOR = 2.01, 95% CI [1.29, 3.14], and poor social support AOR = 1.79, 95% CI [1.14, 3.37] were significantly associated with Pregnancy-related anxiety. The findings of this study showed that the prevalence of Pregnancy-related anxiety was high in the study area and positively associated with young age, low income, poor social support, high perceived stress, depression, and unwanted pregnancy. This finding suggests that clinicians should integrate screening for Pregnancy-related anxiety into clinical standards, more efforts should be made in the future to reduce the anxiety among pregnant women who had an unwanted pregnancy, young women, and poor social support. Also, it is good to encourage the pregnant mother to enhance their social connectedness by creating a self-help group, and increasing early identification of mental health problems throughout their daily ANC follow-up.
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Affiliation(s)
- Hunde Tarafa
- Department of Psychiatry, College of Health Sciences, Metu University, Metu, Ethiopia
| | - Yadeta Alemayehu
- Department of Psychiatry, College of Health Sciences, Metu University, Metu, Ethiopia
| | - Meskerem Nigussie
- Department of Psychiatry, College of Health Sciences, Metu University, Metu, Ethiopia
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Awopegba OE, Chukwudeh OS, Owolabi EO, Ajayi AI. Trends in emergency contraception awareness among women and girls in 28 sub-Saharan countries. BMC Public Health 2021; 21:1987. [PMID: 34732160 PMCID: PMC8567620 DOI: 10.1186/s12889-021-12067-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 10/21/2021] [Indexed: 11/23/2022] Open
Abstract
Background Studies have shown that emergency contraception (EC) remains underutilised in preventing unintended pregnancy in sub-Saharan Africa (SSA). Small-scale surveys have attributed EC underutilisation to gaps in EC awareness among SSA women and girls. However, limited studies have explored trends in EC awareness in SSA. We address this gap by examining trends in EC awareness using data from 28 SSA countries. Our analysis was disaggregated by age distribution, place of residence, level of education, and wealth to show differences in EC awareness trend. Methods We analysed the Demographic and Health Surveys (DHS) data of 1,030,029 women aged 15 to 49 on emergency contraception awareness. EC awareness was defined as having ever heard of special pills to prevent pregnancy within 3 days after unprotected sexual intercourse. Frequencies and percentages were used to summarise trends in EC awareness between years 2000 and 2019. Results Overall, there was an upward shift in the level of EC awareness in all countries, except in Burkina Faso, Niger, Chad, and Ethiopia. While some countries recorded a significant upward trend in EC awareness, others recorded just a slight increase. Women in Kenya, Ghana, Gabon, and Cameroon had the highest upward shift in EC awareness. For example, only 28% of women were aware of EC in Ghana in 2003, but in 2014, 64% of women knew about EC, an increase of over 36 percentage points. Increase in EC awareness was starker among women aged 20–24 years, those who resided in urban areas, had higher education, and belong to the highest wealth quintile, than those aged 15–19, in rural areas, with no formal education and belonging to the lowest wealth quintile. Conclusion Our analysis shows that the level of EC awareness has increased substantially in most SSA countries. However, EC awareness still differs widely within and between SSA countries. Intervention to improve EC awareness should focus on women aged 15 to 19, those with no formal education, residing in rural areas, and within the lowest quintile, especially, in countries such as Chad, Niger, Burkina Faso, and Ethiopia where level of EC is low with lagging progress. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12067-y.
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Affiliation(s)
- Oluwafemi Emmanuel Awopegba
- Economics and Business Policy Department, Nigerian Institute of Social and Economic Research, Ibadan, Nigeria
| | - Okechukwu Stephen Chukwudeh
- Department of Criminology and Security Studies, Faculty of Social Sciences, Federal University, Oye-Ekiti, Nigeria
| | - Eyitayo Omolara Owolabi
- Centre for Global Surgery, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - Anthony Idowu Ajayi
- Population Dynamics and Sexual and Reproductive Health, African Population and Health Research Centre, APHRC Campus, Manga Close, Nairobi, Kenya.
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Ajayi AI, Otukpa EO, Mwoka M, Kabiru CW, Ushie BA. Adolescent sexual and reproductive health research in sub-Saharan Africa: a scoping review of substantive focus, research volume, geographic distribution and Africa-led inquiry. BMJ Glob Health 2021; 6:bmjgh-2020-004129. [PMID: 33568395 PMCID: PMC7878134 DOI: 10.1136/bmjgh-2020-004129] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 01/18/2021] [Accepted: 01/20/2021] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Previous review studies have not systematically mapped the existing body of knowledge on adolescent sexual and reproductive health (ASRH) in sub-Saharan Africa (SSA). Our scoping review addresses this gap by examining how the body of research on ASRH in SSA has evolved over the past decade, and its present profile, in terms of trends in volume, geographic and substantive focus, and Africa-led inquiry. METHODS We used a three-step search strategy to identify English and French peer-reviewed publications and relevant grey literature on ASRH in SSA published between January 2010 and December 2019. Two reviewers screened the titles, abstracts and full texts of publications for eligibility and inclusion. RESULTS A total of 1302 articles were published over the period, rising from 91 in 2010 to 183 in 2015. However, the bulk of the studies (63.9%) focused on six (South Africa, Kenya, Nigeria, Tanzania, Uganda and Ethiopia) of the 46 SSA countries. Ten countries had no ASRH papers, while five others each had only one publication. While issues like HIV (17.2%), sexual behaviours (17.4%) and access to sexual and reproductive health services (13.0%) received substantial attention, only a few studies focused on early adolescence (10-14 years), programme interventions, scaling up of interventions and policy evaluation. Just over half of publications had authors with African institutional affiliations as first authors (51.1%) or last author (53.0%). Sixteen per cent of papers did not include any authors from institutions in Africa. CONCLUSIONS Our review demonstrated that research on ASRH is limited in focus and is unevenly distributed across SSA countries. The identified gaps can guide future research and funding to advance ASRH policies and programmes. It is also vital for stakeholders in the research enterprise, including researchers, donors, ethical review boards, and journal editors and reviewers, to implement measures that foster national investigators' inclusion.
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Affiliation(s)
- Anthony Idowu Ajayi
- Population Dynamics and Sexual and Reproductive Health and Rights Unit, African Population and Health Research Center, Nairobi, Kenya
| | - Emmanuel Oloche Otukpa
- Population Dynamics and Sexual and Reproductive Health and Rights Unit, African Population and Health Research Center, Nairobi, Kenya
| | - Meggie Mwoka
- Population Dynamics and Sexual and Reproductive Health and Rights Unit, African Population and Health Research Center, Nairobi, Kenya
| | - Caroline W Kabiru
- Population Dynamics and Sexual and Reproductive Health and Rights Unit, African Population and Health Research Center, Nairobi, Kenya
| | - Boniface Ayanbekongshie Ushie
- Population Dynamics and Sexual and Reproductive Health and Rights Unit, African Population and Health Research Center, Nairobi, Kenya
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Sarder A, Islam SMS, Maniruzzaman, Talukder A, Ahammed B. Prevalence of unintended pregnancy and its associated factors: Evidence from six south Asian countries. PLoS One 2021; 16:e0245923. [PMID: 33524018 PMCID: PMC7850499 DOI: 10.1371/journal.pone.0245923] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 01/11/2021] [Indexed: 11/19/2022] Open
Abstract
AIM Unintended pregnancy is a significant public health concern in South Asian countries because of its negative association with the socioeconomic and health outcomes for both children and mothers. The present study aimed to explore the prevalence of unintended pregnancy and explore its determinants among women of reproductive age in six South Asian countries. METHODS Nationwide latest demography and health survey data from six South Asian countries, including Bangladesh (2014), Pakistan (2017-2018), Nepal (2016), Afghanistan (2015), Maldives (2016-2017) and India (2015-2016) were pooled for the present study. Multivariate analysis was performed to explore the association between unintended pregnancy and its associated factors. RESULTS Amongst the total women (n = 41,689), overall, 19.1% pregnancies were reported as unintended (ranging from 11.9% in India to 28.4% in Bangladesh). The logistic regression model showed that younger women (15-19 years) had 1.42 times higher chance of unintended pregnancies. The odds of unintended pregnancies was 1.24 times higher for poorest women and 1.19 times higher for poorer women. Further, urban women (aOR = 0.70, 95% CI = 0.50-0.80), women having no children (aOR = 0.10, 95% CI = 0.09-0.12), smaller (≤4) family (aOR = 0.72, 95% CI = 0.67-0.78), those who intent to use contraceptive (aOR = 0.72, 95% CI = 0.60-0.86), currently living with partner (aOR = 0.90, 95% CI = 0.81-0.99), first cohabitation in teenage (≤19 years) (aOR = 0.85, 95% CI = 0.78-0.92) were less likely to report unintended pregnancies. CONCLUSIONS This study has showed that women's age, wealth index, place of residence, number of children, family size, the intention of contraceptive use, living with a partner, and first cohabitation age are essential determinants of unintended pregnancy. These factors should be considered when trying to reduce unintended pregnancy in six South Asian countries. However, there is a need to improve health education, counselling, skills-building, sex education, modern contraceptive use and its access in this region. Intervention programs regarding reproductive health and policies are warranted to reduce rates of unintended pregnancy in South Asian countries.
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Affiliation(s)
- Alamgir Sarder
- Statistics Discipline, Khulna University, Khulna, Bangladesh
| | - Sheikh Mohammed Shariful Islam
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
| | - Maniruzzaman
- Statistics Discipline, Khulna University, Khulna, Bangladesh
| | - Ashis Talukder
- Statistics Discipline, Khulna University, Khulna, Bangladesh
| | - Benojir Ahammed
- Statistics Discipline, Khulna University, Khulna, Bangladesh
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Ajayi AI, Odunga SA, Oduor C, Ouedraogo R, Ushie BA, Wado YD. "I was tricked": understanding reasons for unintended pregnancy among sexually active adolescent girls. Reprod Health 2021; 18:19. [PMID: 33482843 PMCID: PMC7821647 DOI: 10.1186/s12978-021-01078-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 01/11/2021] [Indexed: 12/03/2022] Open
Abstract
Background While the Kenya government is mobilizing high-level strategies to end adolescent pregnancy by 2030, a clear understanding of drivers of early unintended pregnancy in the country is a necessary precursor. In this study, we determine the prevalence, associated factors, and reasons for unintended pregnancy among sexually active adolescent girls (aged 15–19 in two Kenya counties with the highest rate of teenage pregnancy. Methods We used the “In Their Hands” (ITH) program's baseline evaluation data. The study adopted a mixed-methods design with 1110 sexually active adolescent girls in the quantitative component and 19 girls who were either pregnant or nursing a child in the qualitative. We used adjusted and unadjusted logistic regression to model factors associated with unintended pregnancy among respondents. We used a thematic analysis of qualitative data to examine girls’ reasons for having unintended pregnancy. Results Overall, 42% of respondents have had an unintended pregnancy; however, higher proportions were observed among girls who were 19 years (49.4%), double orphans (53.6%), never used contraceptive (49.9%), out-of-school (53.8%), and married (55.6%). After adjusting for relevant covariates, the odds of unintended pregnancy were higher among girls who resided in rural areas (AOR 1.64, 95% CI 1.22–2.20), had primary or no formal education (AOR 1.50 95% CI 1.11–2.02), and had never used contraceptive (AOR 1.69 95% CI 1.25–2.29) compared with their counterparts. Current school attendance was associated with a 66% reduction in the probability of having an unintended pregnancy. Participants of the qualitative study stated that the desire to maintain a relationship, poor contraceptive knowledge, misinformation about contraceptive side effects, and lack of trusted mentors were the main reasons for their unintended pregnancies. Conclusion A massive burden of unintended pregnancy exists among sexually active adolescent girls in the study setting. Adolescent boys and girls need better access to sexuality education and contraceptives in the study setting to reduce early unintended pregnancy.
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Affiliation(s)
- Anthony Idowu Ajayi
- Population Dynamics and Sexual and Reproductive Health, African Population and Health Research Center, Off Kirawa Road, Manga Close, Kenya.
| | - Sally Atieno Odunga
- Population Dynamics and Sexual and Reproductive Health, African Population and Health Research Center, Off Kirawa Road, Manga Close, Kenya
| | - Clement Oduor
- Population Dynamics and Sexual and Reproductive Health, African Population and Health Research Center, Off Kirawa Road, Manga Close, Kenya
| | - Ramatou Ouedraogo
- Population Dynamics and Sexual and Reproductive Health, African Population and Health Research Center, Off Kirawa Road, Manga Close, Kenya
| | - Boniface Ayanbekongshie Ushie
- Population Dynamics and Sexual and Reproductive Health, African Population and Health Research Center, Off Kirawa Road, Manga Close, Kenya
| | - Yohannes Dibaba Wado
- Population Dynamics and Sexual and Reproductive Health, African Population and Health Research Center, Off Kirawa Road, Manga Close, Kenya
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Pregnancy-related anxiety among Chinese pregnant women in mid-late pregnancy under the two-child policy and its significant correlates. J Affect Disord 2020; 276:272-278. [PMID: 32697709 DOI: 10.1016/j.jad.2020.07.099] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 05/17/2020] [Accepted: 07/05/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND Pregnancy-related anxiety (PRA) is a global public health concern. This study aims to understand the PRA among Chinese pregnant women at mid-late pregnancy and to explore the significant correlates. METHODS The Chinese PRA scale was used to measure PRA among 342 pregnant women from Zhejiang Province in China at their mid- and late- pregnancy respectively. RESULTS The participants aged from 21 to 42 years old, and their mean age was 30. 1 (SD=4. 0). The average scores of the Chinese PRA scale at mid- and late- pregnancy were 1. 60 (SD=0. 33) and 1. 58 (SD=0. 33) respectively. Unplanned pregnancy (mid-pregnancy: β=0. 18, p<0. 001; late-pregnancy: β=0. 11, p = 0. 024) and gender of the first child being male (mid-pregnancy:β=-0. 20, p = 0. 001; late-pregnancy: β=-0. 14, p = 0. 016) were significantly correlated with PRA among pregnant women at mid- and late- pregnancy. Living with parents-in-law was not associated with the PRA overall and domain scores. LIMITATIONS This study was done among pregnant women at their mid-late pregnancy, and no follow-up was conducted at postpartum. The sample size of this study was relatively small which might affect the generalizability of the findings. CONCLUSIONS The current study found that the correlates of PRA at mid- and late-pregnancy were generally similar. For future studies, special attention should be paid to pregnant women who are in the condition of unplanned pregnancy and those who already have a female child to relieve their anxiety levels.
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Cegolon L, Bortolotto M, Bellizzi S, Cegolon A, Mastrangelo G, Xodo C. Birth control knowledge among freshmen of four Italian universities. Sci Rep 2020; 10:16466. [PMID: 33020531 PMCID: PMC7536290 DOI: 10.1038/s41598-020-72200-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 08/27/2020] [Indexed: 11/16/2022] Open
Abstract
Since sexual health education (SHE) is not mandatory in Italian schools, we conducted a survey on freshmen of four Italian university campuses in 2012 to investigate the respective level of sexual health knowledge (SHK) in relation to birth control, with the aim to inform public health policy makers. A convenience strategy was employed to sample 4,552 freshmen registered with various undergraduate courses at four Italian universities: Padua university (Veneto Region); university of Milan (Lombardy Region); university of Bergamo (Lombardy Region); university of Palermo (Sicily Region). We investigated the level of SHK on birth control using 6 proxy indicators: (1) the average length of a woman’s period [outcome with 3 levels: wrong (base) vs. acceptable vs. correct]; (2) the most fertile interval within a woman’s period (binary outcome: correct vs. wrong answer); (3) the event between the end of a period and the beginning of the next cycle (binary outcome: correct vs. wrong answer); (4) the average survival of spermatozoa in the womb (binary outcome: correct vs. wrong answer); (5) the concept of contraception (binary outcome: correct vs. wrong answer); (6) the efficacy of various contraceptives to prevent unintended pregnancies (linear score: 0–17). We fitted 6 separate models of multiple regression: multinomial for outcome 1; logistic for outcomes 2, 3, 4, 6; linear for outcome 6. Statistical estimates were adjusted for a number of socio-demographic factors. Results were expressed as odds ratios (OR) for the 4 multiple logistic regression models, linear coefficients (RC) for the linear regression model and relative risk ratio (RRR) for the multinomial logistic regression model. The level of significance of each risk estimate was set at 0.05. The level of SHK of freshmen sampled was rather low, as 60% interviewees did not know the average length of a woman’s period, the average survival of spermatozoa in the womb and the concept of contraception, whilst the most fertile interval within a woman’s period was known only to 55% of interviewees. The mean score of SHK on the efficacy of various contraceptive methods was only 5 (scale 0–17). Some categories of students were consistently and significantly less knowledgeable on birth control at multivariable analysis: males; students from the university of Palermo; those with vocational secondary school education and those not in a romantic relationship at the time the survey was conducted. The results of this survey clearly call for the introduction of SHE programs in Italian schools, as already done in several European countries. School SHE should start as early as possible, ideally even before secondary school. SHE should be holistic and delivered with a multiple agency coordinated approach involving the Ministry of Health, the Ministry of Education, University and Scientific Research (MIUR), families, schools, public health departments, primary health care providers, pharmacists, media, other.
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Affiliation(s)
- L Cegolon
- Public Health Department, Local Health Unit N.2 "Marca Trevigiana", Treviso, Italy.
| | - M Bortolotto
- FISPPA Department, Padua University, Padua, Italy
| | - S Bellizzi
- Medical Epidemiologist, Independent Consultant, Geneva, Switzerland
| | - A Cegolon
- Department of Political Sciences, Communication and International Relations, University of Macerata, Macerata, Italy
| | - G Mastrangelo
- Department of Cardiac, Thoracic & Vascular Sciences and Public Health, Padua University, Padua, Italy
| | - C Xodo
- FISPPA Department, Padua University, Padua, Italy
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Ajayi AI, Ezegbe HC. Association between sexual violence and unintended pregnancy among adolescent girls and young women in South Africa. BMC Public Health 2020; 20:1370. [PMID: 32894130 PMCID: PMC7487533 DOI: 10.1186/s12889-020-09488-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 08/31/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Unintended pregnancy has dire consequences on the health and socioeconomic wellbeing of adolescent girls and young women (AGYW) (aged 15-24 years). While most studies tend to focus on lack of access to contraceptive information and services, and poverty as the main contributing factor to early-unintended pregnancies, the influence of sexual violence has received limited attention. Understanding the link between sexual violence and unintended pregnancy is critical towards developing a multifaceted intervention to reduce unintended pregnancies among AGYW in South Africa, a country with high teenage pregnancy rate. Thus, we estimated the magnitude of unintended pregnancy among AGYW and also examined the effect of sexual violence on unintended pregnancy. METHODS Our study adopted a cross-sectional design, and data were obtained from AGYW in a South African university between June and November 2018. A final sample of 451 girls aged 17-24 years, selected using stratified sampling, were included in the analysis. We used adjusted and unadjusted logistic regression analysis to examine the effect of sexual violence on unintended pregnancy. RESULTS The analysis shows that 41.9% of all respondents had experienced an unintended pregnancy, and 26.3% of those unintended pregnancies ended in abortions. Unintended pregnancy was higher among survivors of sexual violence (54.4%) compared to those who never experienced sexual abuse (34.3%). In the multivariable analysis, sexual violence was consistently and robustly associated with increased odds of having an unintended pregnancy (AOR:1.70; 95% CI: 1.08-2.68). CONCLUSION Our study found a huge magnitude of unintended pregnancy among AGYW. Sexual violence is an important predictor of unintended pregnancy in this age cohort. Thus, addressing unintended pregnancies among AGYW in South Africa requires interventions that not only increase access to contraceptive information and services but also reduce sexual violence and cater for survivors.
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Affiliation(s)
- Anthony Idowu Ajayi
- Population Dynamics and Sexual and Reproductive Health, Africa Population and Health Research Center, Off Kirawa Road, Manga Close, Nairobi, Kenya
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Ajayi AI, Somefun OD. Patterns and determinants of short and long birth intervals among women in selected sub-Saharan African countries. Medicine (Baltimore) 2020; 99:e20118. [PMID: 32384488 PMCID: PMC7440207 DOI: 10.1097/md.0000000000020118] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Optimal birth spacing (defined as a birth spacing of 24-59 months) is incontrovertibly linked to better health outcomes for both mothers and babies. Using the most recent available Demographic and Health Survey data, we examined the patterns and determinants of short and long birth intervals among women in selected sub-Saharan African (SSA) countries.Reproductive health and sociodemographic data of 98,934 women from 8 SSA countries were analyzed. Unadjusted and adjusted multinomial logistic regression models were used to examine the net relationship between all the independent variables and short and long birth intervals.Overall, the majority of women in all the countries optimally spaced births. However, a significant proportion of women had short birth intervals in Chad (30.2%) and the Democratic Republic of Congo (Congo DRC) (27.1%). Long birth spacing was more common in Eastern and Southern African countries, with Zimbabwe having the highest rate of long term birth interval (27.0%). Women who were aged 35 years and above in Uganda (RRR = 0.72, CI = 0.60-0.87), Tanzania (RRR = 0.62, CI = 0.49-0.77), Zimbabwe (RRR = 0.52, CI = 0.31-0.85), Nigeria (RRR = 0.82, CI = 0.72-0.94) and Togo (RRR = 0.67, CI = 0.46-0.96) had significantly lower odds of having short birth intervals compared to women aged 15-24 years. Older women (above 34 years) had increased odds for long birth intervals in all countries studied (Chad (RRR = 1.44, CI = 1.18-1.76), Congo DRC (RRR = 1.73, CI = 1.33-2.15), Malawi (RRR = 1.54, CI = 1.23-1.94) Zimbabwe (RRR = 1.95, CI = 1.26-3.02), Nigeria (RRR = 1.85 CI = 1.56-2.20), Togo (RRR = 2.12, CI = 1.46-3.07), Uganda (RRR = 1.48, CI = 1.15-1.91), Tanzania RRR = 2.12, CI = 1.53-2.93).The analysis suggested that the determinants of long and birth intervals differ and varies from country to country. The pattern of birth spacing found in this study appears to mirror the contraceptive use and fertility rate in the selected SSA countries. Birth intervals intervention addressing short birth intervals should target younger women in SSA, especially in Chad and Congo DRC, while intervention for long birth spacing should prioritize older, educated and wealthy women.
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Affiliation(s)
- Anthony Idowu Ajayi
- Sociology Department, University of Fort Hare, East London Campus, 50, Church Street, East London
| | - Oluwaseyi Dolapo Somefun
- Demography and Population Studies (DPS), University of the Witwatersrand, Johannesburg, South Africa
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Magnitude and Associated Factors of Unintended Pregnancy among Pregnant Women at Saesie Tsaeda Emba Woreda Eastern Zone of Tigray, North Ethiopia, 2018. J Pregnancy 2019; 2019:1694808. [PMID: 32089883 PMCID: PMC7029673 DOI: 10.1155/2019/1694808] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 08/12/2019] [Accepted: 09/17/2019] [Indexed: 11/24/2022] Open
Abstract
Background Each year there were about 80 million women who experienced unintended pregnancy in the globe. In Ethiopia, around one third of women have experiences of unintended pregnancy. However, the magnitude of unintended pregnancy was not determined in the study area. Hence the aim of the study was to assess the magnitude and associated factors of unintended pregnancy among pregnant women. Methods Institutional based cross-sectional study design was employed among 345 participants. Participants were selected by systematic random sampling. Data was collected though face to face interview by structured questioner. It was entered, clean and analyzed using SPSS version 20. Descriptive analysis was done to see the frequency, percentage, mean and standard deviation. Adjusted odds ratio was computed at 95% confidence level to determine the effect of independent variable on the outcome variable. Variable at p value < 0.05 was declared as statistically significant variable. Model goodness of fit was checked using Hosmer lemeshow test. Result The overall magnitude of unintended pregnancy was 24.9%. Employed women were 60% less likely having unintended pregnancy (AOR 0.4, 95% CI: 0.015, 0.785).Single women were 1.4 times more likely reported unintended pregnancy (AOR 1.4, 95% CI: 1.005, 3.675). Unintended pregnancy among ever visited by health extension workers was 1.7 times higher than not visited (AOR 1.7, 95% CI: 1.09, 5. 128). Unintended pregnancy among who had information about family planning were about 70% less likely reported unintended pregnancy than their counterparties (AOR 0.3, 95% CI: 0 .067, 0.845). Marital status, occupational status, visited by health extension workers, having information about family planning, discussing with their partners about contraceptive were found the major factors of unintended pregnancy. Thus the district health office, Tigray regional health office and other stakeholder should work to improve family planning accessibility, awareness, and utilization to overcome the problem.
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Ajayi AI, Ismail KO, Akpan W. Factors associated with consistent condom use: a cross-sectional survey of two Nigerian universities. BMC Public Health 2019; 19:1207. [PMID: 31477068 PMCID: PMC6719351 DOI: 10.1186/s12889-019-7543-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 08/25/2019] [Indexed: 11/10/2022] Open
Abstract
Background Consistent condom use is central to the prevention of transmission of human immunodeficiency virus (HIV) and other sexually transmitted diseases (STDs), especially among young adults. This study drew from a cross-sectional survey of two Nigerian universities to determine the level of consistent condom use, explored the determinants of condom use consistency and reasons for inconsistent condom use. Methods We adopted a descriptive cross-sectional design, which involves the recruitment of 800 male and female students using stratified random sampling. Adjusted and unadjusted logistic regression models were used to examine the factors associated with consistent condom use among a final sample of 498 students who engaged in sex in the last year preceding the study. Results Only 38.6% of sexually active participants (n = 498) used condoms consistently in the previous year. High condom self-efficacy score (AOR: 2.40; 95% CI: 1.58–3.64), discussion of HIV/STIs with sexual partner (AOR: 1.91; 95%CI: 1.29–2.83), knowing partner’s HIV status (AOR: 1.48; 95% CI: 1.02–2.16), being students of university located in a high HIV prevalence area (AOR: 2.86; 95% CI: 1.92–4.28) and engaging in sex with only steady partner (AOR: 1.74; 95% CI: 1.17–2.60) were associated with a higher odds of consistent condom use. Trust, unavailability of condoms, dislike of condoms and a perception that condoms reduced sexual pleasure were the main reasons for inconsistent use of condoms. Conclusion The study found a low level of consistent condom use among study participants. Counselling young adults in Nigeria on condom self-efficacy, providing condoms on campuses and encouraging the discussion of sexually transmitted infections with sexual partners are central to improving the level of consistent condom use among Nigerian university students. Electronic supplementary material The online version of this article (10.1186/s12889-019-7543-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Anthony Idowu Ajayi
- Population Dynamics and Reproductive Health Unit, African Population and Health Research Center, APHRC Campus, Off Kirawa Road, Nairobi, Kenya.
| | - Kafayat Olanike Ismail
- Department of Sociology, Faculty of the Social Sciences, University of Ilorin, Ilorin, Nigeria
| | - Wilson Akpan
- Research and Innovation, Walter Sisulu University, Nelson Mandela Drive, Mthatha, South Africa
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Ameyaw EK, Budu E, Sambah F, Baatiema L, Appiah F, Seidu AA, Ahinkorah BO. Prevalence and determinants of unintended pregnancy in sub-Saharan Africa: A multi-country analysis of demographic and health surveys. PLoS One 2019; 14:e0220970. [PMID: 31398240 PMCID: PMC6688809 DOI: 10.1371/journal.pone.0220970] [Citation(s) in RCA: 96] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 07/26/2019] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Approximately 14 million unintended pregnancies are recorded annually in sub-Saharan Africa (SSA). We sought to investigate the prevalence and determinants of unintended pregnancies among women in sub-Saharan Africa. MATERIALS AND METHODS The study pooled data from current Demographic and Health Surveys (DHS) conducted from January 1, 2010 to December 31, 2016 from 29 countries in SSA. Logistic regression analysis was used to examine the factors that influence unintended pregnancies in SSA. Results were presented using odds ratios (OR). RESULTS We found overall unintended pregnancy prevalence rate of 29%, ranging from 10.8% in Nigeria to 54.5% in Namibia. As compared to women aged 15-19 years, women of all other age categories had higher odds of unintended pregnancies. Married women were 6 times more probable to report unintended pregnancy as compared to women who had never married (OR = 6.29, CI = 5.65-7.01). The phenomenon had higher odds among rural residents as compared to urban residents (OR = 1.08, CI = 1.01-1.16). Women with primary (OR = 0.74, CI = 0.69-0.80) and secondary (OR = 0.71, CI = 0.65-0.77) levels of education had less chances of unintended pregnancies, compared to those with no education. Again, women in all other wealth categories had less probability of unintended pregnancy, as compared to women with poorest wealth status. CONCLUSION Our study contributes substantially towards the discourse of maternal wellbeing by unveiling the prevalence and determinants of unintended pregnancy across the SSA region. There is the need for SSA countries with high prevalence of unintended pregnancies to consider past and present successful interventions of other countries within the region such as health education, counselling, skills-building, comprehensive sex education and access to contraception. Much of these efforts rest with the governments of SSA countries.
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Affiliation(s)
- Edward Kwabena Ameyaw
- The Australian Centre for Public and Population Health Research, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Eugene Budu
- Department of Population and Health, College of Humanities and Legal Studies, University of Cape Coast, Cape Coast, Ghana
| | - Francis Sambah
- Department of Health, Physical Education, and Recreation, University of Cape Coast, Cape Coast, Ghana
| | - Linus Baatiema
- Department of Population and Health, College of Humanities and Legal Studies, University of Cape Coast, Cape Coast, Ghana
| | - Francis Appiah
- Department of Population and Health, College of Humanities and Legal Studies, University of Cape Coast, Cape Coast, Ghana
| | - Abdul-Aziz Seidu
- Department of Population and Health, College of Humanities and Legal Studies, University of Cape Coast, Cape Coast, Ghana
- * E-mail:
| | - Bright Opoku Ahinkorah
- The Australian Centre for Public and Population Health Research, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
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Ajayi AI, Okeke SR. Protective sexual behaviours among young adults in Nigeria: influence of family support and living with both parents. BMC Public Health 2019; 19:983. [PMID: 31337383 PMCID: PMC6651974 DOI: 10.1186/s12889-019-7310-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 07/12/2019] [Indexed: 11/10/2022] Open
Abstract
Background Many studies have focused on risky sexual behaviour among adolescents and young adults; however, literature on protective sexual practices among this age cohort is still evolving. Since young adults are disproportionately burdened by sexually transmissible infections, including HIV, understanding factors that influence protective sexual behaviour among the age group is crucial in developing age-appropriate interventions. Drawing from a cross-sectional survey conducted among adolescents and young adults in two Nigerian universities, we examined gender differences in protective sexual behaviours and the influence of family support and living with both parents on these behaviours. Methods A total of 800 male and female university students in two Nigerian universities were recruited using stratified random sampling between February and April 2018. Analysis was, however, based on 599 participants aged between 15 and 24 . Adjusted and unadjusted multinomial logistic regression models were used to examine the influence of family support, and living with both parents on protective sexual behaviours at a 95% confidence interval. Results Findings show that the largest proportion of our participants engaged in protective sexual behaviours. We found no gender differences in protective sexual behaviours, including sexual abstinence, consistent condom use, and sexual fidelity. Family support and living with both parents were positively associated with protective sexual behaviours among adolescents and young adults. Conclusion This study found that a majority of adolescents and young adults in Nigerian Universities engage in protective sexual behaviours. Adequate family support and living with both parents are positively associated with protective sexual behaviours. The study however revealed that about one-fifth of our participants engaged in high-risk sexual behaviour. This suggests a need for behavioural change interventions, provision of sexual health services and empowerment of students who receive inadequate family support.
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Affiliation(s)
- Anthony Idowu Ajayi
- Population Dynamics and Reproductive Health Unit, African Population and Health Research Center, APHRC Campus, Nairobi, Kenya
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Emergency Contraceptives: Knowledge and Practice towards Its Use among Ethiopian Female College Graduating Students. Int J Reprod Med 2019; 2019:9397876. [PMID: 30713848 PMCID: PMC6333013 DOI: 10.1155/2019/9397876] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 11/19/2018] [Accepted: 11/29/2018] [Indexed: 11/18/2022] Open
Abstract
Introduction Ethiopia has a high incidence of unwanted pregnancies and incomplete and unsafe abortions, particularly among adolescents. This can be avoided by using different contraceptive methods including emergency contraceptives (EC). This study aimed to assess the knowledge and practice of EC among female college graduating students in Harar, Eastern Ethiopia. Methods Institution based cross-sectional study was conducted on 214 female students selected from two randomly selected colleges. Data was collected using a self-administered questionnaire and analyzed using SPSS for Windows version 20.1. Level of significance was taken at P <0.05. Results The mean (±SD) age of the participants was 21.06 (±2.14) years. Of the 200 (93.5%) study participants who had ever heard of ECs, 140 (70.0%) had good knowledge. Among the 214 graduating female students, 66 (33.0%) had ever used EC. Being above the age of 20 years old, father's and mother's literacy were found to be determinants of knowledge of EC. Moreover, knowledge was the only determinant factor of practice of EC. Conclusion Most of the respondents had relatively good knowledge of EC. The study revealed that female students of older age and higher educational status of parents had higher knowledge and practice of EC.
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Rokicki S, Merten S. The context of emergency contraception use among young unmarried women in Accra, Ghana: a qualitative study. Reprod Health 2018; 15:212. [PMID: 30567545 PMCID: PMC6299944 DOI: 10.1186/s12978-018-0656-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 12/05/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Over the past decade, awareness and use of emergency contraceptive pills (ECPs) among young women has rapidly increased in Ghana; however, the rate of unintended pregnancy among this group remains high. We conducted a qualitative study to better understand the context and patterns of ECP use among young unmarried women in Ghana. METHODS We conducted in-depth interviews with unmarried sexually active women aged 18-24 in Accra, Ghana to explore their perceptions, experiences, and opinions regarding sexual relationships and contraceptive methods, and to examine the factors that influence choice of ECPs. A total of 32 young women participated in the study. RESULTS Most participants had used ECPs at least once. Participants described being unable to plan for sexual encounters, and as a result preferred ECPs as a convenient post-coital method. Despite being widely and repeatedly used, women feared the disruptive effects of ECPs on the menstrual cycle and were concerned about long-term side-effects. ECPs were sometimes used as a back-up in cases of perceived failure of traditional methods like withdrawal. Misinformation about which drugs were ECPs, correct dosage, and safe usage were prevalent, and sometimes spread by pharmacists. Myths about pregnancy prevention techniques such as urinating or washing after sex were commonly believed, even among women who regularly used ECPs, and coincided with a misunderstanding about how hormonal contraception works. CONCLUSIONS ECPs appear to be a popular contraceptive choice among young urban women in Ghana, yet misinformation about their correct usage and safety is widespread. While more research on ECP use among young people is needed, these initial results point to the need to incorporate information about ECPs into adolescent comprehensive sexuality education and youth-friendly services and programmes.
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Affiliation(s)
- Slawa Rokicki
- Geary Institute, University College Dublin, Dublin, Ireland
| | - Sonja Merten
- Society, Gender and Health Unit, Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Socinstrasse 57, 4002, Basel, Switzerland. .,University of Basel, Petersplatz 1, 4001, Basel, Switzerland.
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Ajayi AI, Ismail KO, Adeniyi OV, Akpan W. Awareness and use of pre-exposure and postexposure prophylaxes among Nigerian university students: Findings from a cross-sectional survey. Medicine (Baltimore) 2018; 97:e12226. [PMID: 30200145 PMCID: PMC6133481 DOI: 10.1097/md.0000000000012226] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Despite the recent advances in biomedical preventive strategies, young adults-especially adolescent girls- continue to be disproportionately at risk of acquiring HIV. To avert this trend, it is critical that access to HIV preventive strategies, such as pre-exposure prophylaxis (PrEP) and postexposure prophylaxis be expanded, especially in sub-Saharan Africa, where young adults are known to engage in risky sexual practices. This study examined awareness levels and use of pre-exposure prophylaxis (PrEP) and postexposure prophylaxis (PEP) among Nigerian university students.A cross-sectional survey was conducted among 800 students selected using stratified random sampling at 2 Nigerian universities. Descriptive and inferential statistics were used for data analysis on 784 complete responses.The levels of awareness of PrEP and PEP were 18.9% and 25.4%, respectively. Ever tested for human immunodeficiency virus [HIV] (AOR: 1.58; 95% CI: 1.04-2.42) and knowledge of partner's HIV status (AOR: 1.87; 95% CI: 1.25-2.79) were the significant determinants of awareness to PrEP. In contrast, only ever tested for HIV (AOR: 1.50; 95% CI: 1.02-2.19), knowledge of partner's HIV status (AOR: 1.55; 95% CI: 1.07-2.24), ever used condoms (AOR: 1.65; 95% CI: 1.04-2.62), and nude exchanges (AOR: 1.62; 95% CI: 1.13-2.31) were independent determinants of awareness of PEP. Only a few students had seen (5.6%) or used (1.5%) any prophylaxes.The study findings indicate a low level of awareness and use of PrEP and PEP. To ensure no one is left behind in the goal of elimination of new HIV infections, intervention to expand access to these preventive strategies is needed in the study settings.
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Affiliation(s)
- Anthony Idowu Ajayi
- Department of Sociology, Faculty of Social Sciences and Humanities, University of Fort Hare, East London, South Africa
| | | | - Oladele Vincent Adeniyi
- Department of Microbiology, Faculty of Sciences and Agriculture, University of Fort Hare, Alice, South Africa
| | - Wilson Akpan
- Department of Sociology, Faculty of Social Sciences and Humanities, University of Fort Hare, East London, South Africa
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Ajayi AI, Adeniyi OV, Akpan W. Maternal health care visits as predictors of contraceptive use among childbearing women in a medically underserved state in Nigeria. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2018; 37:19. [PMID: 30041704 PMCID: PMC6057093 DOI: 10.1186/s41043-018-0150-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Accepted: 07/17/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Health care visits during pregnancy, childbirth and after childbirth may be crucial in expanding the uptake of contraceptive care in resource-poor settings. However, little is known about how health care visits influence the uptake of modern contraception in Nigeria. The focus of this paper was to examine how health care visits influence the use of contraceptives among parous women in a medically underserved setting. METHODS The study adopted a descriptive survey design. Data was collected from 411 women who gave birth between 2010 and 2015 selected through a two-stage cluster random sampling technique. Health care visits for antenatal care services, childbirth, postnatal care and modern contraceptive were dichotomised (yes, no). Descriptive analyses were performed, and percentages, frequencies and means were reported. Multiple logistic regressions were computed, and odds ratios and 95% confidence intervals were calculated. RESULTS Knowledge of all contraceptive methods was lowest among women who reside in rural areas. Health care visits for antenatal care (UOR 4.5; 95% CI 2.0-10.5), childbirth (UOR2.1; 95% CI 1.4-3.2) and postnatal care services (UOR 2.3; 95% CI 1.5-3.5) independently predict ever use of any contraceptive methods. Likewise, health care visits for antenatal care (UOR 5.6; 95% CI 2.1-14.8), childbirth (UOR 2.3; 95% CI 1.5-3.6) and postnatal care services (UOR 2.8; 95% CI 1.8-4.5) were independent predictors of current use of modern contraceptive methods. In the adjusted model, health care visits for antenatal care services (AOR 3.2; 95% CI 1.1-8.8) were significantly associated with the use of modern contraceptive methods. CONCLUSION Health care visits significantly predict the use of modern contraceptive methods. Expanding access to health care services would potentially increase contraceptive use among childbearing women in the medically underserved settings.
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Affiliation(s)
- Anthony Idowu Ajayi
- Department of Sociology, Faculty of Social Sciences & Humanities, University of Fort Hare, 50 Church street, East London, 5200 South Africa
| | - Oladele Vincent Adeniyi
- Department of Family Medicine, Walter Sisulu University, Cecilia Makiwane Hospital, East London Hospital Complex, East London, South Africa
| | - Wilson Akpan
- Department of Sociology, Faculty of Social Sciences & Humanities, University of Fort Hare, 50 Church street, East London, 5200 South Africa
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Ajayi AI, Akpan W. Determinants of condom use among parous women in North Central and South Western Nigeria: a cross-sectional survey. BMC Res Notes 2018; 11:467. [PMID: 30005715 PMCID: PMC6044001 DOI: 10.1186/s13104-018-3573-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Accepted: 07/06/2018] [Indexed: 11/20/2022] Open
Abstract
Objectives There appears to be an increasing trend of condom use for pregnancy prevention among nulliparous and multiparous women in developing countries. Drawing from a cross-sectional survey involving 1227 women selected using a 3-stage cluster random sampling technique, the study examines the rates of condom use and its determinants among parous women in three states in North Central and South Western Nigeria. Results The rate of condom use among parous women was 13.8% and 23.2% among women using any form of contraceptives. After adjusting for confounding factors (religion and marital status, socioeconomic status and access to a health facility in the resident community), women aged 26–35 (AOR 2.7; CI 1.6–4.5), urban residence (AOR: 3.6; CI 2.2–5.8), no income (AOR: 2.7; CI 1.4–4.9), living in Ekiti State (AOR: 1.8; CI 1.2–2.8) and having a tertiary level of education (AOR: 4.5; CI 1.3–15.6) were the independent predictors of condom use. There is an increasing trend of condom use among parous women. Electronic supplementary material The online version of this article (10.1186/s13104-018-3573-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Anthony I Ajayi
- Department of Sociology, University of Fort Hare, 50 Church Street, East London, 5200, South Africa.
| | - Wilson Akpan
- Department of Sociology, University of Fort Hare, 50 Church Street, East London, 5200, South Africa
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Ajayi AI, Adeniyi OV, Akpan W. Use of traditional and modern contraceptives among childbearing women: findings from a mixed methods study in two southwestern Nigerian states. BMC Public Health 2018; 18:604. [PMID: 29739372 PMCID: PMC5941455 DOI: 10.1186/s12889-018-5522-6] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Accepted: 04/27/2018] [Indexed: 11/27/2022] Open
Abstract
Background Contraceptive use has numerous health benefits such as preventing unplanned pregnancies, ensuring optimum spacing between births, reducing maternal and child mortality, and improving the lives of women and children in general. This study examines the level of contraceptive use, its determinants, reasons for non-use of contraception among women in the reproductive age group (18–49 years) in two southwestern Nigerian states. Methods The study adopted an interviewer-administered questionnaire to collect data from 809 participants selected using a 3-stage cluster random sampling technique. We also conducted 46 in-depth interviews. In order to investigate the association between the socio-demographic variables and use of contraceptive methods, we estimated the binary logistic regression models. Results The findings indicated that knowledge of any methods of contraception was almost universal among the participants. The rates of ever use and current use of contraception was 80 and 66.6%, respectively. However, only 43.9% of the participants had ever used any modern contraceptive methods, considered to be more reliable. The fear of side effects of modern contraceptive methods drove women to rely on less effective traditional methods (withdrawal and rhythm methods). Some women employed crude and unproven contraceptive methods to prevent pregnancies. Conclusion Our findings show that the rate of contraceptive use was high in the study setting. However, many women chose less effective traditional contraceptive methods over more effective modern contraceptive methods due to fear of side effects of the latter. Patient education on the various options of modern contraceptives, their side effects and management would be crucial towards expanding the family planning services in the study setting.
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Affiliation(s)
- Anthony Idowu Ajayi
- Department of Sociology, Faculty of Social Sciences & Humanities, University of Fort Hare, 50 Church street, East London, 5200, Eastern Cape, South Africa.
| | - Oladele Vincent Adeniyi
- Department of Family Medicine, Cecilia Makiwane Hospital, East London Hospital Complex, Walter Sisulu University, East London, Eastern Cape, South Africa
| | - Wilson Akpan
- Department of Sociology, Faculty of Social Sciences & Humanities, University of Fort Hare, 50 Church street, East London, 5200, Eastern Cape, South Africa
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Anguzu R, Sempeera H, Sekandi JN. High parity predicts use of long-acting reversible contraceptives in the extended postpartum period among women in rural Uganda. Contracept Reprod Med 2018; 3:6. [PMID: 29760943 PMCID: PMC5941484 DOI: 10.1186/s40834-018-0059-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 03/28/2018] [Indexed: 12/26/2022] Open
Abstract
Background The use of implants and Intra-uterine devices (IUD) during the post-partum period is very low in Uganda especially in rural settings. Long-acting reversible contraceptives (LARC) are known to be the most cost-effective for prevention of unintended pregnancy and unsafe abortions. This study aimed at determining the factors associated with long-acting reversible contraceptive use among women in the extended postpartum period in rural Uganda. Methods We conducted a household-based, cross-sectional study among 400 women in two rural communities in Mityana district, central Uganda. Eligible women were aged 15 to 45 years who had childbirth within 12 months of study enrollment in September 2014. The outcome variable was self-reported use of a LARC method, either IUD or implants in the extended postpartum period. The main independent variables were previous childbirths (parity), fertility desire, willingness to use modern contraception, duration of postpartum period and previous pregnancies (gravidity). A logistic regression model was run in STATA v12.0 to compute adjusted odds ratios (AOR) for factors that predicted LARC use statistically significant at p < 0.05. Results Four hundred respondents had a mean age of 27 years (SD = 12) and only 8.5% reported using a LARC method. Use of IUD and implant was 1.8% and 10.4% respectively. Most women using LARC (44.1%) had five or more childbirths (p = 0.01), 70.8% of non-LARC users were willing to use modern contraceptives (p = 0.07) and 2.5% ever had an induced abortion. Having five or more childbirths was independently associated with LARC use in the extended postpartum period (AOR = 4.07, 95%CI 1.08–15.4). Willingness to use modern contraception, desire for more children and postpartum duration had no significant association with LARC use in the extended postpartum period. Conclusion This study revealed low use of LARC within twelve months of child birth despite women’s willingness to use them. High parity (≥5 childbirths) predicted LARC use. The next logical step is to identify barriers to using LARC in the extended postpartum period and design appropriate interventions to increase access and use especially in multi-parous women.
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Affiliation(s)
- Ronald Anguzu
- 1Makerere University School of Public Health, Kampala, Uganda
| | | | - Juliet N Sekandi
- 1Makerere University School of Public Health, Kampala, Uganda.,2University of Georgia, Global Health Institute, Athens, GA USA
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Adeniyi OV, Ajayi AI, Moyaki MG, Goon DT, Avramovic G, Lambert J. High rate of unplanned pregnancy in the context of integrated family planning and HIV care services in South Africa. BMC Health Serv Res 2018; 18:140. [PMID: 29482587 PMCID: PMC5828463 DOI: 10.1186/s12913-018-2942-z] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 02/19/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Integration of family planning services into HIV care was implemented in South Africa as a core strategy aimed at reducing unintended pregnancies among childbearing women living with HIV. However, it is unclear whether this strategy has made any significant impact at the population level. This paper describes the prevalence and correlates of self-reported unplanned pregnancy among HIV-infected parturient women attending three large maternity centres in the Eastern Cape, South Africa. We also compare unplanned pregnancy rates between HIV-infected parturient women already in care (who have benefitted from services' integration) and newly diagnosed parturient women (who have not benefitted from services' integration). METHODS Drawing from the baseline data of the East London Prospective Cohort Study (ELPCS), data of 594 parturient women living with HIV in the Eastern Cape were included. Chi-square statistics and binary logistics regression were employed to determine the correlates of unplanned pregnancy among the cohort. RESULTS The prevalence of unplanned pregnancy was 71% (n = 422) with a higher rate among parturient women newly diagnosed during the index pregnancy (87%). Unplanned pregnancy was significantly associated with younger age, single status, HIV diagnosis at booking, high parity and previous abortion. Women who reported unplanned pregnancy were more likely to book late and have lower CD4 counts. After adjusting for confounding variables, having one child and five to seven children (AOR = 2.2; CI = 1.3-3.1), age less than 21 years (AOR = 3.3; CI = 1.1-9.8), late booking after 27 weeks (AOR = 2.7; CI = 1.5-5.0), not married (AOR = 4.3; CI = 2.7-6.8) and HIV diagnosis at booking (AOR = 3.0; CI = 1.6-5.8) were the significant correlates of unplanned pregnancy in the cohort. CONCLUSION Unplanned pregnancy remains high overall among parturient women living with HIV in the region, however, with significant reduction among those who were exposed to integrated services. The study confirms that integration of HIV care and family planning services is an important strategy to reduce unplanned pregnancy among women living with HIV. The study's findings have significant implications for the elimination of mother-to-child transmission of HIV in South Africa. Innovative interventions are needed to further consolidate and maximise the benefit of the integration of family planning services with HIV care.
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Affiliation(s)
- Oladele Vincent Adeniyi
- Department of Family Medicine and Rural Health, Walter Sisulu University, Cecilia Makiwane Hospital/East London Hospital Complex, East London, South Africa
| | - Anthony Idowu Ajayi
- Department of Sociology, University of Fort Hare, 50, Church Street, East London, South Africa
| | | | - Daniel Ter Goon
- Faculty of Health Sciences, University of Fort Hare, East London, South Africa
| | - Gordana Avramovic
- University College Dublin/Mater Misericordiae University Hospital, Catherine McAuley Education & Research Centre, Dublin, Ireland
| | - John Lambert
- University College Dublin/Mater Misericordiae University Hospital, Catherine McAuley Education & Research Centre, Dublin, Ireland
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