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Eva FN, Khan MAS, Islam T, Monisha UK, Meem NES, Hossain MA, Goutam A, Zerin T, Alam N, Nath R, Sifat S, Sultana S, Sultana MS, Saha SK, Sarker NE, Rahman ML, Nabi MH, Hawlader MDH. Awareness of HPV vaccine and its socio-demographic determinants among the parents of eligible daughters in Bangladesh: A nationwide study. Heliyon 2024; 10:e30897. [PMID: 38778954 PMCID: PMC11109798 DOI: 10.1016/j.heliyon.2024.e30897] [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: 11/10/2023] [Revised: 05/07/2024] [Accepted: 05/07/2024] [Indexed: 05/25/2024] Open
Abstract
Background Vaccination against Human papillomavirus (HPV) is recommended to avoid HPV infections and its associated diseases, including cervical cancer. However, there is no awareness study among Bangladeshi population. Hence, this nationwide study was conducted to explore HPV vaccine awareness and its determinants among parents of eligible adolescent girls. Methods This study was conducted among the parents of daughters aged 9-15 years from 42 out of 64 randomly selected districts of Bangladesh between June 28 to August 2, 2023. A multistage sampling method was used to enroll 2151 study participants from all eight divisions of Bangladesh. A semi-structured questionnaire was used for face-to-face interviews in this study. The statistical software Stata (Version 17) was used for statistical analyses. Results The average age of the participants was 38.18 (±5.86) years. Only 22.32 % of the participants were aware of the HPV vaccine. Every additional year of age increased the likelihood of being aware of the HPV vaccine by 3 % (AOR: 1.03; 95%CI: 1.00-1.06). Participants residing in the urban area had 3.56 times higher odds of awareness than rural and semi-urban people. Businessmen and housewives had 60 % (AOR: 0.40; 95 % CI: 0.22-0.69) and 77 % (AOR: 0.23; 95 % CI: 0.16-0.33) lower odds in comparison to job holders. The lower-income group exhibited significantly higher odds of awareness (AOR: 0.25, 95%CI: 0.16-0.39) compared to the middle and the higher-income group. Participants who never went through routine health check-ups had 77 % lower odds of being aware than those who availed of regular routine check-ups (AOR: 0.23; 95%CI: 0.16-0.34). Conclusion Awareness of the HPV vaccine among the general population of Bangladesh is very low. Age, residence, occupation, monthly income, and routine medical check-ups were associated with HPV vaccine awareness. A nationwide awareness campaign would increase this awareness level among the Bangladeshi population, especially among the parents of daughters.
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Affiliation(s)
- Fahima Nasrin Eva
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
| | - Md Abdullah Saeed Khan
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
- National Institute of Preventive and Social Medicine (NIPSOM), Dhaka, 1212, Bangladesh
| | - Tariful Islam
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
| | - Umme Kulsum Monisha
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
- Mandy Dental College & Hospital, Dhaka, 1209, Bangladesh
| | - Nur-E-Safa Meem
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
| | - Mohammad Ali Hossain
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
- Ibn Sina Medical College Hospital, Kallyanpur, Dhaka, 1216, Bangladesh
| | - Arpita Goutam
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
| | - Tahmina Zerin
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
| | - Nishat Alam
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
| | - Rima Nath
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
| | - Shamma Sifat
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
| | - Sayla Sultana
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
| | - Mosammat Sadeka Sultana
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
| | - Sumit Kumar Saha
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
| | - Naifa Enam Sarker
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
| | - Mohammad Lutfor Rahman
- Institute of Statistical Research and Training (ISRT), University of Dhaka, Dhaka, 1000, Bangladesh
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Esposito M, Szocik K, Capasso E, Chisari M, Sessa F, Salerno M. Respect for bioethical principles and human rights in prisons: a systematic review on the state of the art. BMC Med Ethics 2024; 25:62. [PMID: 38773588 PMCID: PMC11110298 DOI: 10.1186/s12910-024-01049-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Accepted: 04/18/2024] [Indexed: 05/24/2024] Open
Abstract
BACKGROUND Respect for human rights and bioethical principles in prisons is a crucial aspect of society and is proportional to the well-being of the general population. To date, these ethical principles have been lacking in prisons and prisoners are victims of abuse with strong repercussions on their physical and mental health. METHODS A systematic review was performed, through a MESH of the following words (bioethics) AND (prison), (ethics) AND (prison), (bioethics) AND (jail), (ethics) AND (jail), (bioethics) AND (penitentiary), (ethics) AND (penitentiary), (prison) AND (human rights). Inclusion and exclusion criteria were defined and after PRISMA, 17 articles were included in the systematic review. RESULTS Of the 17 articles, most were prevalence studies (n.5) or surveys (n.4), followed by cross-sectional studies (n.3), qualitative studies (n.1), retrospective (n.1) and an explanatory sequential mixed-methods study design (n.1). In most cases, the studies associated bioethics with prisoners' access to treatment for various pathologies such as vaccinations, tuberculosis, hepatitis, HIV, it was also found that bioethics in prisons was related to the mental health of prisoners, disability, ageing, the condition of women, the risk of suicide or with the request for end-of-life by prisoners. The results showed shortcomings in the system of maintaining bioethical principles and respect for human rights. CONCLUSIONS Prisoners, in fact, find it difficult to access care, and have an increased risk of suicide and disability. Furthermore, they are often used as improper organ donors and have constrained autonomy that also compromises their willingness to have end-of-life treatments. In conclusion, prison staff (doctors, nurses, warders, managers) must undergo continuous refresher courses to ensure compliance with ethical principles and human rights in prisons.
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Affiliation(s)
- Massimiliano Esposito
- Faculty of Medicine and Surgery, Kore" University of Enna, 94100, Enna, Italy.
- , Enna, Italia.
| | - Konrad Szocik
- Interdisciplinary Center for Bioethics, Yale University, New Haven, USA
- Department of Social Sciences, University of Information Technology and Management in Rzeszow, Sucharskiego 2 St., 35-225, Rzeszow, Poland
| | - Emanuele Capasso
- Department of Advanced Biomedical Science-Legal Medicine Section, University of Naples "Federico II", 80138, Naples, Italy
| | - Mario Chisari
- Department of Medical, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, 95121, Catania, Italy
| | - Francesco Sessa
- Department of Medical, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, 95121, Catania, Italy
| | - Monica Salerno
- Department of Medical, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, 95121, Catania, Italy
- , Catania, Italia
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Tran GV, Hayashida T, Dang ALD, Nagai M, Matsumoto S, Tran LK, Le HNM, Van TD, Tanuma J, Pham TN, Oka S. Prevalence of transmitted drug resistance and phylogenetic analysis of HIV-1 among antiretroviral therapy-naïve patients in Northern Vietnam from 2019 to 2022. Glob Health Med 2024; 6:117-123. [PMID: 38690128 PMCID: PMC11043122 DOI: 10.35772/ghm.2023.01112] [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: 11/09/2023] [Revised: 01/31/2024] [Accepted: 02/06/2024] [Indexed: 05/02/2024]
Abstract
Since the rapid expansion of antiretroviral therapy (ART) for HIV, transmitted drug resistance (TDR) has become a major concern in Vietnam. HIV services there are transitioning to be covered by social insurance. Access to pre-exposure prophylaxis (PrEP) is being expanded to tackle the growing HIV epidemic among men who have sex with men. Therefore, a cross-sectional study was conducted at 10 ART facilities in Northern Vietnam from 9th December 2019 to 9th June 2022 to investigate the prevalence and pattern of TDR among ART-naïve people living with HIV (PLWH). TDR mutations were defined according to the World Health Organization 2009 List of Mutations for Surveillance of Transmitted Drug Resistant HIV Strains. Mutation transmission dynamics and TDR clusters were investigated via phylogenetic analysis. We enrolled 391 ART-naïve PLWH. The overall TDR prevalence was 4.6%, with an annual prevalence of 6.0% in 2019/2020, 4.8% in 2021, and 1.3% in 2022. TDR mutations to non-nucleoside reverse transcriptase inhibitors (2.8%), including K103N were the most common. Less commonly, the protease inhibitor-associated mutation M46I and mutations to nucleoside reverse transcriptase inhibitors, including M184V/ I, were observed. CRF01_AE was the most common subtype (77.0%). CRF07_BC (14.3%), which had been rare in Vietnam, was also observed. No genetic association was observed between HIV-1 sequences with TDR mutations. In conclusion, the overall prevalence of TDR was stably low in this region. The phylogenetic tree suggests that TDR clusters have not formed. Continuous monitoring of HIV TDR and strains is crucial to maintaining ART and PrEP efficacy.
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Affiliation(s)
- Giang Van Tran
- Department of Infectious Diseases, Hanoi Medical University, Hanoi, Vietnam
- Department of Viral and Parasitic Diseases, National Hospital for Tropical Diseases, Hanoi, Vietnam
| | - Tsunefusa Hayashida
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - An Luong-Dieu Dang
- Department of Biology, Ecology and Earth Sciences, University of Calabria, Italy
| | - Moeko Nagai
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Shoko Matsumoto
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Linh Khanh Tran
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hoa Nguyen-Minh Le
- Department of Viral and Parasitic Diseases, National Hospital for Tropical Diseases, Hanoi, Vietnam
| | - Trang Dinh Van
- Department of Viral and Parasitic Diseases, National Hospital for Tropical Diseases, Hanoi, Vietnam
| | - Junko Tanuma
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Thach Ngoc Pham
- Department of Viral and Parasitic Diseases, National Hospital for Tropical Diseases, Hanoi, Vietnam
| | - Shinichi Oka
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
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Forse R, Yoshino CA, Nguyen TT, Phan THY, Vo LNQ, Codlin AJ, Nguyen L, Hoang C, Basu L, Pham M, Nguyen HB, Van Dinh L, Caws M, Wingfield T, Lönnroth K, Sidney-Annerstedt K. Towards universal health coverage in Vietnam: a mixed-method case study of enrolling people with tuberculosis into social health insurance. Health Res Policy Syst 2024; 22:40. [PMID: 38566224 PMCID: PMC10985876 DOI: 10.1186/s12961-024-01132-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 03/13/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Vietnam's primary mechanism of achieving sustainable funding for universal health coverage (UHC) and financial protection has been through its social health insurance (SHI) scheme. Steady progress towards access has been made and by 2020, over 90% of the population were enrolled in SHI. In 2022, as part of a larger transition towards the increased domestic financing of healthcare, tuberculosis (TB) services were integrated into SHI. This change required people with TB to use SHI for treatment at district-level facilities or to pay out of pocket for services. This study was conducted in preparation for this transition. It aimed to understand more about uninsured people with TB, assess the feasibility of enrolling them into SHI, and identify the barriers they faced in this process. METHODS A mixed-method case study was conducted using a convergent parallel design between November 2018 and January 2022 in ten districts of Hanoi and Ho Chi Minh City, Vietnam. Quantitative data were collected through a pilot intervention that aimed to facilitate SHI enrollment for uninsured individuals with TB. Descriptive statistics were calculated. Qualitative interviews were conducted with 34 participants, who were purposively sampled for maximum variation. Qualitative data were analyzed through an inductive approach and themes were identified through framework analysis. Quantitative and qualitative data sources were triangulated. RESULTS We attempted to enroll 115 uninsured people with TB into SHI; 76.5% were able to enroll. On average, it took 34.5 days to obtain a SHI card and it cost USD 66 per household. The themes indicated that a lack of knowledge, high costs for annual premiums, and the household-based registration requirement were barriers to SHI enrollment. Participants indicated that alternative enrolment mechanisms and greater procedural flexibility, particularly for undocumented people, is required to achieve full population coverage with SHI in urban centers. CONCLUSIONS Significant addressable barriers to SHI enrolment for people affected by TB were identified. A quarter of individuals remained unable to enroll after receiving enhanced support due to lack of required documentation. The experience gained during this health financing transition is relevant for other middle-income countries as they address the provision of financial protection for the treatment of infectious diseases.
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Affiliation(s)
- Rachel Forse
- Friends for International TB Relief, Hanoi, Vietnam.
- Department of Global Public Health, WHO Collaboration Centre on Tuberculosis and Social Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - Clara Akie Yoshino
- Department of Global Public Health, WHO Collaboration Centre on Tuberculosis and Social Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | | | - Luan N Q Vo
- Friends for International TB Relief, Hanoi, Vietnam
- Department of Global Public Health, WHO Collaboration Centre on Tuberculosis and Social Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Andrew J Codlin
- Friends for International TB Relief, Hanoi, Vietnam
- Department of Global Public Health, WHO Collaboration Centre on Tuberculosis and Social Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | | | | | | | | | | | - Maxine Caws
- Centre for TB Research, Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
- Birat Nepal Medical Trust, Kathmandu, Nepal
| | - Tom Wingfield
- Department of Global Public Health, WHO Collaboration Centre on Tuberculosis and Social Medicine, Karolinska Institutet, Stockholm, Sweden
- Centre for TB Research, Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Knut Lönnroth
- Department of Global Public Health, WHO Collaboration Centre on Tuberculosis and Social Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Kristi Sidney-Annerstedt
- Department of Global Public Health, WHO Collaboration Centre on Tuberculosis and Social Medicine, Karolinska Institutet, Stockholm, Sweden
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5
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Raziani Y, Hasheminasab L, Gheshlagh RG, Dalvand P, Baghi V, Aslani M. The prevalence of intimate partner violence among Iranian pregnant women: a systematic review and meta-analysis. Scand J Public Health 2024; 52:108-118. [PMID: 36207824 DOI: 10.1177/14034948221119641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Intimate partner violence against pregnant women is an important public health concern and human rights issue. According to the various findings of previous studies, this study was conducted to assess the pooled prevalence of intimate partner violence against Iranian women. METHODS In this systematic review and meta-analysis, a literature search was conducted in databases such as PubMed, Scopus, Web of Science, MagIran, and Scientific Information Database without a time limit. Heterogeneity was assessed by Cochrane Q test statistics and the I2 test, and the results were incorporated into a random effects model to estimate the prevalence of intimate partner violence. Data analysis was performed using R software version 4.3.2. RESULTS The overall prevalence of intimate partner violence was reported to be 51.5% (95% confidence interval (CI) 45.0-58.1), and the prevalence rate of physical, sexual, and psychological intimate partner violence was 18.0% (95% CI 15.1-20.9), 22.1% (95% CI 17.7-26.60) and 43.2% (95% CI 36.6-49.8), respectively. The lowest level of physical, sexual, and emotional intimate partner violence rate was observed in district 1 of Iran (includes Tehran, the capital of Iran and the surrounding provinces). The rate of physical and sexual intimate partner violence prevalence decreased with the increased mean age of the husband (P=0.005) and the mean age of the wife (P=0.035), respectively. CONCLUSIONS Studies included in this review report that more than half of Iranian women experience violence during pregnancy. In order to prevent adverse maternal and neonatal consequences, it is necessary to identify these women and introduce them to support centres.
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Affiliation(s)
- Yosra Raziani
- Nursing Department, Komar University of Science and Technology, Sulimaniya, Iraq
| | - Leila Hasheminasab
- Clinical Care Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Reza Ghanei Gheshlagh
- Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Pegah Dalvand
- Department of Mathematics, Shahrood University of Technology, Shahrood, Iran
| | - Vajiheh Baghi
- Be'sat Hospital, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Marzieh Aslani
- Department of Nursing, Asadabad School of Medical Sciences, Asadabad, Iran
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6
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Moodley L, Ntlantsana V, Tomita A, Paruk S. The missed pandemic: Intimate partner violence in female mental-health-care-users during the COVID-19 pandemic. PSYCHOL HEALTH MED 2023; 28:3064-3075. [PMID: 37122135 DOI: 10.1080/13548506.2023.2206143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 04/17/2023] [Indexed: 05/02/2023]
Abstract
Adverse childhood experiences (ACEs) and interpersonal violence (IPV) in mentally ill women are often neglected and need to be reviewed in light of the suggested increase in IPV during the COVID-19 pandemic.We investigated the prevalence of ACEs and IPV in women living with severe mental illness (SMI) attending an outpatient psychiatry service at a public hospital in KwaZulu-Natal, South Africa, during the COVID-19 pandemic. We also described the association of ACEs with later IPV.A written survey comprising socio-demographic and clinical questionnaire, WHO Adverse Childhood Experiences International Questionnaire (ACE-IQ) for ACEs and the Women abuse screening tool (WAST) for IPV, was completed by the 154 women with SMI.141 (91.6%) participants scored positive for ACEs and 104 (67.5%) had experienced three or more ACEs. The most prevalent forms of ACEs were emotional neglect 72 (46.8%), one or no parents, parental separation, or divorce 104 (67.5%), contact sexual abuse 67 (43.5%) and witnessing a household member treated violently 67 (43.5%). Sixty-one (46.6%) participants reported IPV with scores 13 (indicative of abuse). On logistic regression, experience of three or more ACEs was significantly associated with IPV in adulthood (aOR 3.3, 95% CI: 1.2-9.6).The high prevalence of IPV and association of IPV with cumulative ACEs reflect firstly the hidden epidemic of domestic violence and secondly the vulnerability of those with ACEs to become victims of abuse later which is often missed in the care of women with SMI.
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Affiliation(s)
- Lynette Moodley
- Discipline of Psychiatry, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Vuyokazi Ntlantsana
- Discipline of Psychiatry, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Andrew Tomita
- Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
- KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP), College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Saeeda Paruk
- Discipline of Psychiatry, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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Leal M, Kerr L, Mota RMS, da Justa Pires Neto R, Seal D, Kendall C. Differences in non-communicable diseases between women in prison and the general population in Brazil. Sci Rep 2023; 13:18782. [PMID: 37907710 PMCID: PMC10618190 DOI: 10.1038/s41598-023-46045-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 10/26/2023] [Indexed: 11/02/2023] Open
Abstract
Women in prison have high risk for non-communicable diseases both in relation to men in prison and in relation to women in the general population. This study documented the health disparities related to diseases among women in prison and in the general female population in Brazil. Women in prisons (WP) < 30 years old had a prevalence of hypertension (PR = 4.5; 95% CI 3.4-6.1), cardiovascular disease (PR = 4.4; 95% CI 2.4-7.9) and asthma (PR = 3.0; 95% CI 2.3-3.8) higher than general female population in Brazil in the same age group. Women in prison > 50 years old also presented asthma prevalence (PR = 4.3; 95% CI 2.9-6.3) higher than the general female population in Brazil in the same age group. These women in prison, overwhelmingly young, could be mistaken for an elderly population in Brazil. Actively responding to early disease in these women can reduce overall health costs and improve health care for this population that may have limited access to health care outside of prison.
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Affiliation(s)
- Marto Leal
- Department of Community Health, Federal University of Ceará, Rua Professor Costa Mendes, 1608-Bloco Didático, 5º Andar, Bairro Rodolfo Teófilo, Fortaleza, Ceará, CEP: 60.430-140, Brazil.
| | - Ligia Kerr
- Department of Community Health, Federal University of Ceará, Rua Professor Costa Mendes, 1608-Bloco Didático, 5º Andar, Bairro Rodolfo Teófilo, Fortaleza, Ceará, CEP: 60.430-140, Brazil
| | - Rosa Maria Salani Mota
- Department of Statistics and Applied Mathematics, Federal University of Ceará, 100 Cinco Street-Bloco 910, Fortaleza, CE, 60.355-636, Brazil
| | - Roberto da Justa Pires Neto
- Department of Community Health, Federal University of Ceará, Rua Professor Costa Mendes, 1608-Bloco Didático, 5º Andar, Bairro Rodolfo Teófilo, Fortaleza, Ceará, CEP: 60.430-140, Brazil
| | - David Seal
- Department of Global Community Health and Behavioral Sciences, Tulane University, 1440 Canal Street, New Orleans, LA, 70112, USA
| | - Carl Kendall
- Department of Community Health, Federal University of Ceará, Rua Professor Costa Mendes, 1608-Bloco Didático, 5º Andar, Bairro Rodolfo Teófilo, Fortaleza, Ceará, CEP: 60.430-140, Brazil
- Department of Global Community Health and Behavioral Sciences, Tulane University, 1440 Canal Street, New Orleans, LA, 70112, USA
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Toghiani Z, Kazemi A, Taebi M. Psychosocial determinants of sexual health in newly married couples: a protocol for a mixed-methods study. Reprod Health 2023; 20:159. [PMID: 37872551 PMCID: PMC10594687 DOI: 10.1186/s12978-023-01705-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 10/19/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND Regarding psychosocial factors affecting sexual health and in most cultures, healthy and pleasurable sexual relations are valued in the family context, the present study aims to identify the psychosocial determinants of sexual health in newly married couples. METHODS The present mixed-methods study will be conducted in three phases. The first phase will be carried out qualitatively based on which psychosocial determinants of the sexual health of newly married couples will be extracted. In the second phase, questionnaire items of psychosocial determinants of sexual health in newly married couples will be compiled, and face validity (quantitative and qualitative), content validity (quantitative and qualitative), and reliability of the questionnaire will be evaluated. In the third phase, which will be the quantitative phase of the study, the construct validity of the questionnaire will be assessed by analyzing the main items. Moreover, at this stage, the relationship between the extracted psychosocial determinants and the sexual health of newly married couples will be investigated. DISCUSSION By explaining the psychosocial determinants of sexual health in newly married couples, it is possible to identify key variables for designing interventions that improve the sexual health of this group, based on their cultural sensitivities.
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Affiliation(s)
- Zahra Toghiani
- Student Research Committee, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ashraf Kazemi
- Reproductive Health Department, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Hezarjerib AV., Isfahan, Iran.
| | - Mahbobeh Taebi
- Midwifery and Reproductive Health Department, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
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Mehari H, Haile F, Habtezghi S, Mulugeta Y, Abraham G, Berhe M, Abdu N. Determinants of Child Marriage and Its Related Adverse Health Outcomes Among Married Women in Sub-Region of Serejeka, Central Region in Eritrea: A Cross-Sectional Study. Int J Womens Health 2023; 15:215-224. [PMID: 36816453 PMCID: PMC9930585 DOI: 10.2147/ijwh.s389939] [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: 09/15/2022] [Accepted: 01/18/2023] [Indexed: 02/12/2023] Open
Abstract
Background Child marriage is a fundamental violation of human rights that can have numerous adverse effects on girls' social, mental and physical health and wellbeing. Marriage in Eritrea relatively occurs earlier for women. This study aimed to assess the magnitude of child marriage, determinants and its related adverse health outcomes in five selected villages of the sub-region of Serejeka in Central region of Eritrea. Methods An analytical cross-sectional study was conducted among 200 married women aged 18 to 30 years who are residents of five selected villages of the sub-region of Serejeka between July 12 and August 20, 2018. The sampling design was stratified random sampling and data were collected using an interview-based questionnaire. Descriptive and analytical statistics including chi-square test and logistic regression were employed using SPSS (v.22). Results The prevalence of child marriage was found to be 42% [95% CI (35.1, 48.9)]. The maximum and minimum age at marriage were 14 and 29, respectively. No formal education/primary level (AOR = 22.08, 95% CI: 4.16, 117.24), junior educational level (AOR = 6.95, 95% CI: 3.48, 13.87) and decision on the marriage (AOR = 4.30, 95% CI: 1.03, 17.92) were the significant determinants of child marriage. Prolonged labour (OR = 2.81, 95% CI: 1. 32, 5.98), abortion (OR = 3.95, 95% CI: 1.63, 9.53), hemorrhage during birth (OR = 4.83, 95% CI: 1.68, 13.87), spousal violence (OR = 2.07, 95% CI: 1.15, 3.75), pressure/stress (OR = 4.83, 95% CI: 1.68, 13.87), termination of education (OR = 8.24, 95% CI: 4.35, 15.63) and stigma or isolation from their society (OR = 7.38, 95% CI: 3.03, 17.98) were significant adverse health outcomes associated with child marriage. Conclusion This study revealed that child marriage was still a common practice. It is associated with detrimental physical health, psychological well-being and socio-economic status. This mandates policy makers and program managers to focus their programs on delaying entry of children into wedlock and motherhood by providing information, education and enhancing communication with their community.
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Affiliation(s)
- Hanibal Mehari
- School of Public Health, Asmara College of Health Sciences, Asmara, Eritrea
| | - Feven Haile
- School of Public Health, Asmara College of Health Sciences, Asmara, Eritrea
| | - Sador Habtezghi
- School of Public Health, Asmara College of Health Sciences, Asmara, Eritrea
| | - Yuel Mulugeta
- School of Public Health, Asmara College of Health Sciences, Asmara, Eritrea
| | - Gebru Abraham
- School of Public Health, Asmara College of Health Sciences, Asmara, Eritrea
| | - Michael Berhe
- National Health Observatory, Ministry of Health, Asmara, Eritrea
| | - Nuru Abdu
- School of Pharmacy, Asmara College of Health Sciences, Asmara, Eritrea
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10
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Lin C, Li L, Le AT, Tran HML, Pham TD, Nguyen AT. An intervention pilot to facilitate harm reduction service decentralization in Vietnam. J Subst Abuse Treat 2023; 144:108927. [PMID: 36372055 PMCID: PMC9759177 DOI: 10.1016/j.jsat.2022.108927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 08/30/2022] [Accepted: 10/27/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Harm reduction services, including methadone maintenance therapy (MMT), have been decentralized to Vietnam's community health care settings. This study aims to pilot test an intervention to facilitate decentralized harm reduction service delivery in Vietnam. METHODS The research team conducted an intervention pilot between August 2020 and May 2021 with six community MMT distribution sites in Thai Nguyen Province of Vietnam. We recruited five commune health workers (CHW) from each center (N = 30). In-person intervention training included content to correct misconceptions about harm reduction and reduce stigmatizing attitudes toward patients who use drugs and teach CHWs to self-examine and improve their service provision process. The study team developed a web-based platform to streamline CHW's patient monitoring and referral efforts. The team assessed intervention outcomes at baseline, 3-, and 6-months. CHWs in the intervention group provided acceptability ratings and feedback on the intervention at 6-months. RESULTS CHWs in both intervention and control groups had similar background characteristics and outcome measures at baseline. CHWs in the intervention group, compared to those in the control group, showed a significantly higher level of improvement in adherence to service delivery protocol at 3-months. CHW in the intervention group had a significantly lower level of management-related stress compared to the control group at 6-months, although the intervention effect measured by the difference in change from baseline was not statistically significant. CHWs who participated in the final focus group reported high acceptability of the intervention. CONCLUSION This intervention pilot demonstrated acceptability and promising outcomes on community-based harm reduction service delivery. Similar intervention strategies can be applied to enhance the decentralization of other chronic disease treatment services.
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Affiliation(s)
- Chunqing Lin
- Semel Institute for Neuroscience and Human Behavior, Center for Community Health, University of California, Los Angeles, CA, USA.
| | - Li Li
- Semel Institute for Neuroscience and Human Behavior, Center for Community Health, University of California, Los Angeles, CA, USA
| | - Anh Tuan Le
- National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam
| | | | | | - Anh Tuan Nguyen
- National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam
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11
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Mulaga AN, Kamndaya MS, Masangwi SJ. Spatial disparities in impoverishing effects of out-of-pocket health payments in Malawi. Glob Health Action 2022; 15:2047465. [PMID: 35322766 PMCID: PMC8956308 DOI: 10.1080/16549716.2022.2047465] [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] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Out-of-pocket health payments as a means of financing health services are a cause of concern among households in low and middle-income countries. They prevent households from accessing health care services, can disrupt households' living standards by reducing consumption of other basic needs and push households into poverty. Previous studies have reported geographical variations in impoverishing effects of out-of-pocket health payments. Yet, we know relatively little about spatial effects on impoverishing effects of health payments. OBJECTIVE This paper assesses the factors associated with impoverishing effects of health payments and quantifies the role of districts spatial effects on impoverishment in Malawi. METHODS The paper uses a cross sectional integrated household survey data collected from April 2016 to April 2017 among 12447 households in Malawi. Impoverishing effect of out-of-pocket health payments was calculated as the difference between poverty head count ratio before and after subtracting health payments from total household consumption expenditures. We assessed the factors associated with impoverishment and quantified the role of spatial effects using a spatial multilevel model. RESULTS About 1.6% and 1.2% of the Malawian population were pushed below the national and international poverty line of US$1.90 respectively due health payments. We found significant spatial variations in impoverishment across districts with higher spatial residual effects clustering in central region districts. Higher socio-economic status (AOR=0.34, 95% CI=0.22-0.52) decreased the risk of impoverishment whereas hospitalizations (AOR=3.63, 95% CI 2.54-5.15), chronic illness (AOR=1.56, 95% CI=1.10-1.22), residency in rural area (AOR=2.03, 95% CI=1.07-4.26) increased the risk of impoverishment. CONCLUSIONS Our study suggests the need to plan financial protection programs according to district specific needs and target the poor, residents of rural areas and those with chronic illnesses. Policy makers need to pay attention to the importance of spatial and neighborhood effects when designing financial protection programs and policies.
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Affiliation(s)
- Atupele N Mulaga
- Department of Mathematics and Statistics, Faculty of Applied Sciences, University of Malawi, Blantyre, Malawi.,School of Science and Technology, Malawi University of Business and Applied Sciences, Blantyre, Malawi
| | - Mphatso S Kamndaya
- School of Science and Technology, Malawi University of Business and Applied Sciences, Blantyre, Malawi
| | - Salule J Masangwi
- School of Science and Technology, Malawi University of Business and Applied Sciences, Blantyre, Malawi.,Centre for Water, Sanitation, Health and Appropriate Technology Development (WASHTED), Malawi University of Business and Applied Sciences, Blantyre, Malawi
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12
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Adelabu A, Akinyemi O, Adebayo A, Oladokun B. Assessment of the level and distribution of health system responsiveness in Oyo State, Nigeria. BMC Health Serv Res 2022; 22:905. [PMID: 35831823 PMCID: PMC9281151 DOI: 10.1186/s12913-022-08276-9] [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: 04/07/2022] [Accepted: 06/30/2022] [Indexed: 11/23/2022] Open
Abstract
Background Health systems need to be evaluated to ascertain if they are meeting their objectives. There is an increased interest in health system responsiveness (HSR) as a means to appraise health systems. This becomes vital as we put people at the centre of integrated health systems and put a premium on their rights and perspectives. Thus, this study assessed the levels, distribution and factors associated with HSR in Oyo State. Methods The study was a cross-sectional study with 717 adults, who had used an out-patient health facility in the preceding 12 months, interviewed using a semi-structured, interviewer-administered questionnaire. HSR was measured on a multi-domain and multi-item (7 domains and 20 items) 5-point Likert scale that was developed by the WHO to measure HSR globally. Summary scores were computed for level, distribution and the most important domains of HSR. Determinants of poor HSR were determined using binomial logistic regression. The level of statistical significance was set at 5%. Results The overall level of HSR was 47%. The highest-rated domains were confidentiality (72%), dignity (64%) and choice (60%), while the least rated were prompt attention (43%) and communication (52%). The overall distribution of HSR was 0.228 (range of 0 to 1) with the domains of prompt attention (0.595) and choice (0.506) being the most unequally distributed. The most important domains were communication, prompt attention and dignity. The least important domains were choice and confidentiality. The factors associated with poor HSR (overall) were no formal education, (OR = 2.81; 95% CI: 1.35–5.86), primary education as the highest level of education (OR = 2.19; 95% CI: 1.28–3.75), poor socioeconomic class (OR = 1.86; 95% CI: 1.23–2.80), using a government-owned facility (OR = 1.56; 95% CI: 1.11–2.19) and not using the usual health facility (OR = 1.69; 95% CI: 1.13–2.53). Conclusions The overall level of HSR in Oyo State was low with the domains of prompt attention, communication and autonomy being the least rated domains. Therefore, concerted efforts should be targeted at improving HSR as this will improve wellbeing, health system utilization, and the overall health system. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08276-9.
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Affiliation(s)
| | - Oluwaseun Akinyemi
- Department of Health Policy and Management, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Ayodeji Adebayo
- Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Blessing Oladokun
- Department of Mathematics and Statistics, East Tennessee State University, Tennessee, USA
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13
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Tan SE, Kuschminder K. Migrant experiences of sexual and gender based violence: a critical interpretative synthesis. Global Health 2022; 18:68. [PMID: 35765002 PMCID: PMC9241205 DOI: 10.1186/s12992-022-00860-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 06/14/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Gender based violence (GBV) is a critical issue and migrants are at higher risk of experiencing and being victimized by GBV. This critical interpretative synthesis (CIS) examines migrants experiences of GBV with a focus on different migrant groups and experiences at different stages of the migrant journey. METHOD The guiding question of this review is: "how do migrants experience gender-based violence?" A total of 84 studies were included in the CIS, of which 67 peer-reviewed academic articles were selected from 2356 studies found on WebofScience, MedLINE, and ProQuest, and 17 relevant studies from the grey literature were selected from the time period 2011 to 2020. All final studies were reviewed and synthesized using a critical inductive approach to formulate the key results. RESULTS The results demonstrate a high prevalence of GBV amongst migrants, and in particular among vulnerable migrant groups such as forced migrants and irregular migrants, with an emerging focus on male victims. Findings of the CIS revealed three key themes: 1) Most GBV occurrences are rooted in unequal power dynamics; 2) Victims often live with long-lasting consequences that are worsened by their fear of disclosure and stigmatization; 3) There are differential understandings of victimhood across organizations, communities, and victims themselves. In order to support access, sampling, and methodological challenges in this field of research, this article also reports its findings on common risk-factors identified, consequences and coping mechanisms reported, protection policies targeting GBV, and finally, available databases and data collection methods. CONCLUSION Further directions for research should be encouraged to move beyond prevalence reporting into identifying risk-factors and possible prevention in both sexes. In addition, more research on GBV experiences throughout migrants' journeys, and coping mechanisms should be encouraged.
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Affiliation(s)
- Sze Eng Tan
- UNU-MERIT / Maastricht University, Boschstraat 24, 6211, AX, Maastricht, The Netherlands
| | - Katie Kuschminder
- Department of Political Science, University of Amsterdam, Nieuwe Achtergracht 166, 1018, Amsterdam, WV, Netherlands.
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14
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Berhe ET, Gesesew HA, Ward PR, Gebremeskel TG. Neglected and non-consented care during childbirth in public health facilities in Central Tigray, Ethiopia. BMC Pregnancy Childbirth 2022; 22:386. [PMID: 35505295 PMCID: PMC9066857 DOI: 10.1186/s12884-022-04662-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 03/03/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The present study aimed to assess the magnitude and factors associated with neglected and non-consented care during childbirth in public health facilities in Central Tigray, Ethiopia. METHODS A health facility-based cross-sectional survey supplemented by a qualitative study was conducted from April to May 2020 among women giving birth. We included 415 participants and recruited via a systematic random sampling technique. To collect the data, a pre-tested, face-to-face exit interview using an interviewer-administered structured questionnaire was used. Neglected and non-consented care and its outcomes (yes and no) were the dependent variables, and Socio-demographic data such as (age, educational level, region, and income), and other variables associated with compassionate and respective maternity care were the independent variables. We applied bivariate and multivariate logistic regression to determine predictors for non-consented and non-confidential care components of disrespect or abuse. The in-depth interviews were analyzed using content analysis. RESULTS Among the participants, 82.4% and 78.6% had neglected care and non-consented care among women giving birth respectively. No formal education level (AOR: 0.37, 95%, CI (0.18-0.78)) and primary education level (AOR: 0.18, 95%, CI (0.05-0.57))., mode of delivery (AOR 3.79, 95% CI 1.42-10.09), sex of skilled healthcare providers (AOR: 0.56, 95%, CI (0.34-0.93)), number of deliveries in a health Centre (AOR: 1.89, 95% CI (1.03-3.47)) predicted non-consented care, and history ANC (AOR: 8.10, 95% CI (1.33-49.51)), and federal government employee (AOR: 0.24, 95% CI (0.07-0.78)) predicted neglected care during childbirth. In-depth interview result shows the mode of delivery and sex of healthcare providers were factor associated with non-consented care and women's stay at health facilities were factor associated with neglected care. CONCLUSION The level of neglected and non-consented care during delivery was high reflecting substantial mistreatment. Educational level, mode of delivery, sex of skilled healthcare providers, and the number of deliveries in a health Centre were associated with non-consented care, and history ANC and Federal Government employees were associated with neglected care during childbirth. These findings imply the urgent needs or intervention including strengthening of awareness of both patients and healthcare providers on patients' rights and responsibilities and training service providers in patient-centered care and interpersonal communication and relationships to minimize mistreatment.
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Affiliation(s)
- Elsa Tesfa Berhe
- Department of Reproductive Health, College of Health Sciences, Aksum University, Aksum, Ethiopia.
| | - Hailay Abrha Gesesew
- Department of Epidemiology, College of Health Sciences, Mekele University, Mekele, Ethiopia.,Centre for Research On Health Policy, Torrens University, Adelaide, South Australia, Australia
| | - Paul R Ward
- Centre for Research On Health Policy, Torrens University, Adelaide, South Australia, Australia
| | - Teferi Gebru Gebremeskel
- Department of Reproductive Health, College of Health Sciences, Aksum University, Aksum, Ethiopia. .,Discipline of Public Health, Flinders University, Adelaide, Australia.
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15
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Riley A, Daruwalla N, Kanougiya S, Gupta A, Wickenden M, Osrin D. Intimate partner violence against women with disability and associated mental health concerns: a cross-sectional survey in Mumbai, India. BMJ Open 2022; 12:e056475. [PMID: 35477887 PMCID: PMC9047698 DOI: 10.1136/bmjopen-2021-056475] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 02/15/2022] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES The risk of intimate partner violence (IPV) against women with disability is believed to be high. We aimed to compare the prevalence of past-year IPV against women with and without functional difficulties in urban informal settlements, to review its social determinants and to explore its association with mental health. DESIGN Cross-sectional survey. SETTING Fifty clusters within four informal settlements. PARTICIPANTS 5122 women aged 18-49 years. PRIMARY AND SECONDARY OUTCOME MEASURES We used the Washington Group Short Set of Questions to assess functional difficulties. IPV in the past year was described by binary composites of questions about physical, sexual and emotional violence. We screened for symptoms of depression using the Patient Health Questionnaire-9 and of anxiety using the Generalised Anxiety Disorder-7. Multivariable logistic regression models examined associations between functional difficulties, IPV and mental health. RESULTS 10% of participants who screened positive for functional disability had greater odds of experiencing physical or sexual IPV (adjusted OR (AOR) 1.68, 95% CI 1.23 to 2.29) and emotional IPV (1.52, 95% CI 1.16 to 2.00) than women who screened negative. Women who screened positive for functional disability had greater odds than women who screened negative of symptoms suggesting moderate or severe anxiety (AOR 2.50, 95% CI 1.78 to 3.49), depression (2.91, 95% CI 2.13 to 3.99) and suicidal thinking (AOR 1.94, 95% CI 1.50 to 2.50). CONCLUSIONS The burden of IPV fell disproportionately on women with functional difficulties, who were also more likely to screen positive for common mental disorder. Public health initiatives need to respond at local and national levels to address the overlapping and mutually reinforcing determinants of violence, while existing policy needs to be better utilised to ensure protection for the most vulnerable.
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Affiliation(s)
- Andrew Riley
- Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Nayreen Daruwalla
- Program on Prevention of Violence Against Women and Children, SNEHA, Mumbai, Maharashtra, India
| | - Suman Kanougiya
- Tata Institute of Social Sciences (TISS), Mumbai, Maharashtra, India
| | - Apoorwa Gupta
- Program on Prevention of Violence Against Women and Children, SNEHA, Mumbai, Maharashtra, India
| | - Mary Wickenden
- Institute of Development Studies, University of Sussex, Brighton, UK
| | - David Osrin
- Institute for Global Health, University College London, London, UK
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16
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Aboagye RG, Dadzie LK, Arthur-Holmes F, Okyere J, Agbaglo E, Ahinkorah BO, Seidu AA. Intimate partner violence against married and cohabiting women in sub-Saharan Africa: does sexual autonomy matter? Reprod Health 2022; 19:79. [PMID: 35346246 PMCID: PMC8962047 DOI: 10.1186/s12978-022-01382-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 03/11/2022] [Indexed: 11/15/2022] Open
Abstract
Background Literature shows that women’s sexual autonomy, which refers to women’s capacity to refuse sex and ask a partner to use condom, has significant implications on the sexual and reproductive health outcomes and sexual-and-gender based violence. Nevertheless, there is scarcity of empirical evidence to support the association between women’s sexual autonomy and intimate partner violence (IPV) in sub-Saharan Africa. Methods Data for the study were extracted from the recent Demographic and Health Surveys in 24 countries in sub-Saharan Africa between 2010 and 2019. Bivariable and multivariable binary logistic regression analyses were performed to examine the association between sexual autonomy and IPV in all the studied countries. Statistical significance was set at p < 0.05. Results The pooled prevalence of IPV and sexual autonomy in the 24 countries were 38.5% and 73.0% respectively. Overall, the odds of exposure to IPV were higher among women with sexual autonomy, compared to those without sexual autonomy even after controlling for covariates (age, level of education, marital status, current working status, place of residence, wealth quintile and media exposure). At the country-level, women from Angola, Cameroon, Chad, Gabon, Cote d’lvoire, Gambia, Mali, Nigeria, Kenya, Comoros, Zambia, and South Africa who had sexual autonomy were more likely to experience IPV whilst those in Burundi were less likely to experience IPV. The study showed that sexual autonomy increases women’s exposure to IPV and this occurred in many countries except Burundi where women with sexual autonomy were less likely to experience IPV. Conclusion The findings highlight the need for serious programs and policies to fight against IPV in the sub-region. Additionally, laws need to be passed and implemented, with law enforcement agencies provided with the necessary resources to reduce intimate partner violence among women with sexual autonomy. Supplementary Information The online version contains supplementary material available at 10.1186/s12978-022-01382-1. Globally, intimate partner violence is regarded as a public health concern due to its devastating effects on the physical, emotional, and reproductive health of women. This study sought to determine how women’s capacity to refuse sex, negotiate for safe sex practices such as insisting on partner to use condom, and feeling justified in asking a partner to use condom is associated with the potential of experiencing violence from an intimate partner. Using data from the demographic and health survey conducted between 2010 and 2019, we found that women who had more capacity to refuse sex, negotiate for safe sex practices such as insisting on partner to use condom, and feeling justified in asking a partner to use condom were more likely to experience violence from their intimate partners after controlling for other factors such as the age of the woman, level of education, marital status, place of residence, economic status, and media exposure. The results highlight the need for sub-Saharan African countries to step up programs that ease up intimate partner violence reporting and access to legal support for those who experience it. Additionally, laws need to be passed and implemented, with law enforcement agencies provided with the necessary resources to reduce intimate partner violence among women with sexual autonomy.
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Affiliation(s)
- Richard Gyan Aboagye
- Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana.
| | - Louis Kobina Dadzie
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Francis Arthur-Holmes
- Department of Sociology and Social Policy, Lingnan University, 8 Castle Peak Road, Tuen Mun, Hong Kong
| | - Joshua Okyere
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Ebenezer Agbaglo
- Department of English, University of Cape Coast, Cape Coast, Ghana
| | - Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Abdul-Aziz Seidu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana.,Centre for Gender and Advocacy, Takoradi Technical University, Takoradi, Ghana.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
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17
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Arefaynie M, Bitew G, Amsalu ET, Kefale B, Muche A, Fentaw Z, Dewau R, Melaku MS, Yalew M, Adane B, Adane M, Chanie MG, Ayele WM, Damtie Y. Determinants of wife-beating acceptance among reproductive age women in Ethiopia: a multilevel analysis of 2016 Ethiopian demographic and health survey. BMC WOMENS HEALTH 2021; 21:342. [PMID: 34579734 PMCID: PMC8474793 DOI: 10.1186/s12905-021-01484-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 08/29/2021] [Indexed: 12/04/2022]
Abstract
Background There is limited national representative evidence on determinants of women’s acceptance of wife-beating especially; community level factors are not investigated in Ethiopia. Thus, this study aimed to assess individual and community-level factors associated with acceptance of wife beating among reproductive age women in Ethiopia. Methods Secondary data analysis was done on 2016 Ethiopian Demographic and Health Survey data. A total of 15,683 weighted reproductive age group women were included in the analysis. Multi-level mixed-effect logistic regression analysis was done by Stata version 14.0 to identify individual and community-level factors. An adjusted odds ratio with a 95% confidence interval was used to show the strength and direction of the association. Statistical significance was declared at p value less than 0.05 at the final model. Result Individual-level factors significantly associated with acceptance of wife-beating among women were; being Muslim follower [AOR = 1.3, 95% CI = (1.1, 1.5)], Being married [AOR = 1.3, 95% CI = (1.1, 1.6)], attending primary, secondary and higher education [AOR = 0.8, 95% CI = (0.7, 0.9)], [AOR = 0.4, 95% CI = (0.3, 0.5)], [AOR = 0.3, 95% CI (0.2, 0.4)] respectively. From community level factors, living in Somali [AOR = 0.2 95% CI = (0.1, 0.3)], Addis Ababa [AOR = 0.3, 95%CI = (0.2, 0.5)] and Dire Dawa [AOR = 0.5, 95% CI = (0.3, 0.7)] were 80%, 70% and 50% less likely accept wife-beating when compare to women who live in Tigray region, respectively. Live in high proportion of poor community [AOR = 1.2, 95% CI = (1.1, 1.3)], live in low proportion of television exposure communities [AOR = 1.4, 95% CI = (1.2, 2.2)] were significantly associated with acceptance of wife-beating among women in Ethiopia. Conclusion Educational status, religion, marital status, region, community-level wealth, and community level of television exposure had a statistical association with women’s acceptance of wife-beating. Improving educational coverage, community-level of media exposure, community-level wealth status and providing community-friendly interventions are important to reduce the acceptance of wife-beating among women in Ethiopia.
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Affiliation(s)
- Mastewal Arefaynie
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, PO Box: 1145, Dessie, Ethiopia.
| | - Gedamnesh Bitew
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Erkihun Tadesse Amsalu
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Bereket Kefale
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, PO Box: 1145, Dessie, Ethiopia
| | - Amare Muche
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Zinabu Fentaw
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Reta Dewau
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Mequannent Sharew Melaku
- Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Melaku Yalew
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, PO Box: 1145, Dessie, Ethiopia
| | - Bezawit Adane
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Metadel Adane
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Muluken Genetu Chanie
- Department of Health Systems and Policy, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Wolde Melese Ayele
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Yitayish Damtie
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, PO Box: 1145, Dessie, Ethiopia
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Ismail R, Voss JG, Yona S, Nurachmah E, Boutain D, Lowe C, John-Stewart G, Woods NF. Classifying stigma experience of women living with HIV in Indonesia through the social ecological model. Health Care Women Int 2021; 43:345-366. [PMID: 34379051 DOI: 10.1080/07399332.2021.1929989] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Little is known how stigma theories apply to women living with HIV (WLWH). To apply stigma theories to WLWH, and locate within the dimensions of the Social-Ecological Model (SEM). Using a literature review and a theoretical subtraction to apply stigma forms to the SEM dimensions. WLWH begin to self-stigmatize, receive stigma based on fear from the family and community. Healthcare providers and society stigmatize WLWH by ascribing character flaws to them. The SEM allowed us to locate the dimensions of stigma and identify areas for future interventions for WLWH in Indonesia and other countries.
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Affiliation(s)
- Rita Ismail
- Ministry of Health Republic of Indonesia, Jakarta, Indonesia
| | - Joachim G Voss
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio, USA
| | - Sri Yona
- Department of Medical Surgical Nursing, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
| | - Elly Nurachmah
- Department of Medical Surgical Nursing, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
| | - Doris Boutain
- Psychosocial and Community Health, School of Nursing, University of Washington, Seattle, Washington, USA
| | - Celia Lowe
- Department of Anthropology, University of Washington, Seattle, Washington, USA
| | - Grace John-Stewart
- Department of Global Health, University of Washington, Seattle, Washington, USA
| | - Nancy Fugate Woods
- Biobehavioral Nursing and Health Systems, School of Nursing, University of Washington, Seattle, Washington, USA
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