Prevalence of unintended pregnancy and associated factors among married women in west Belessa Woreda, Northwest Ethiopia, 2016

Trend and determinants of unplanned pregnancy among expectant mothers in Ethiopia based on the Ethiopia Demographic and Health Survey (2000-2016) data: a cross-sectional study

OBJECTIVE

To investigate the trend and determinants of unplanned pregnancy among expectant women using the four Ethiopia Demographic and Health Survey (EDHS) data (2000-2016).

DESIGN

Cross-sectional study.

SETTING

Secondary data analysis using EDHS data.

PARTICIPANTS

The number of weighted participants were 1451 in 2000, 1184 in 2005, 1205 in 2011 and 1135 in 2016.

PRIMARY AND SECONDARY OUTCOME MEASURES

Unplanned pregnancy encompasses both mistimed (occurring earlier than desired) and unwanted (occurring when no further children are desired) forms of conception. Trend and multilevel logistic regression analyses were conducted.

RESULTS

The rate of unplanned pregnancies in Ethiopia showed a significant decline, decreasing from 45.8% (95% CI 41.8 to 49.8) in 2000 to 29.7% (95% CI 25.3 to 34.4) in 2016, indicating an overall change of 16.1%. Several factors were positively linked to unplanned pregnancy, including being multipara (adjusted OR (AOR)=9.8; 95% CI 1.74 to 15.23) and grand multipara (AOR=12.2; 95% CI 1.62 to 19.3), expressing a lack of desire for additional children (AOR=2.82; 95% CI 1.30 to 6.12), unemployment (AOR=1.91; 95% CI 1.12 to 3.78) and being unmarried (AOR=7.23; 95% CI 4.71 to 15.5), whereas, women residing in the Afar (AOR=0.12; 95% CI 0.02 to 0.79) and Somalia (AOR=0.20; 95% CI 0.07 to 0.67) regions were associated with reduced likelihood of experiencing unplanned pregnancy.

CONCLUSION

The study discovered that unplanned pregnancies in Ethiopia decreased significantly from 2000 to 2016. However, around one-third of pregnant women are still affected, indicating a high rate. To address this, policymakers and stakeholders should propose and implement targeted interventions on identified risk factors.

Identifying associated factors in relation to health-related quality of life among postpartum women in Jimma town: A community-based cross-sectional study

Background

The quality of life (QoL) of women during the postpartum period is affected by their living circumstances, reproductive history, exposure to and use of antenatal care, etc. The quality of life (QoL) issues associated to postpartum health among Ethiopian women have not been adequately examined in studies. Therefore, this study identified associated factors in relation to the health-related quality of life (QOL) among postpartum women in Jimma Town, Ethiopia.

Methods

A structured face-to-face interview and a self-administered questionnaire were utilized in a community-based cross-sectional study to obtain data from 397 postpartum women from May 15 to June 14, 2022, using a multistage sampling strategy. The data analysis utilized several descriptive statistics. Multiple logistic models were run on factors that were significant at the 25 % level in univariate analysis. Adjusted odds ratios and 95 % confidence intervals were computed to identify associated factors.

Results

The majority (51.2 %) of postpartum women had a low health-related quality of life, with a mean score of 50.58. Women poor health-related quality of life (QoL) was associated with age (AOR = 10.09; CI: 3.45-29.51), non-formal education of partners (AOR = 3.67; CI: 1.25-10.72), multiparousness (AOR = 2.21; CI: 1.14-4.29), unplanned pregnancy (AOR = 7.36; CI: 1.98-27.37), giving birth to a dead baby (AOR = 3.15; CI: 1.54-6.42), and not admitted to the hospital while pregnant (AOR = 5.50; CI: 3.86-26.30).

Conclusion

The finding revealed that the majority of postpartum women reported poorer health-related QoL. Thus, stakeholders should give attention to significant factors to set up measures to prevent and improve women's postpartum health-related QoL, and should be aware of women about the risk associated with poor health-related QoL.

Unintended Pregnancy and Associated Factors among Pregnant Women Attending Antenatal Care Unit in Public Health Facilities of Dire Dawa City, Eastern Ethiopia, 2021

Background

Unintended pregnancy refers to a pregnancy that is either mistimed or unwanted. Unintended pregnancy has been a troubling public health and reproductive health issue, which imposes appreciable adverse consequences on the mother, child, and the public in general. Globally 121 million unplanned pregnancies occurred from 2015 to 2019. A significant proportion (61%) of these pregnancies ended in abortions each year. In Ethiopia, the challenges of unintended pregnancy and its related complications still exist because of the high rate of unmet need for contraceptives. In addition, no research has been conducted on unintended pregnancy among pregnant women in Dire Dawa city administration.

Objective

To determine the prevalence of unintended pregnancy and associated factors among pregnant women attending antenatal care public health facilities in Dire Dawa in 2021.

Methods

A facility-based cross-sectional study was conducted. After being chosen randomly, 382 pregnant women were interviewed at 9 urban public health facilities. A pretested questionnaire was used to collect data, entered into Epi Info 7, and exported into SPSS version 25 for analysis. The variables, which were significant at P ≤ 0.25 in bivariate analysis, were included in multivariable analysis. Statistical significance was declared at a P value <0.05 and a 95% CI.

Results

In this study, the prevalence of unintended pregnancy was 23.8% at 95% CI (19.8-28.3). The following factors were associated with unintended pregnancy: single women (AOR = 10.93, 95% CI 3.65-32.74), low family income (2000 ETB) (AOR = 4.01, 95% CI 1.73-9.28), parity 3 (AOR = 10.3, 95% CI 4.07-25.84), no history of family planning use (AOR = 5.91, 95% CI 2.46-14.21), and husband decision-making role on reproductive health (AOR = 2.956, 95% CI 1.048-8.340). Conclusion and Recommendations. The prevalence of unintended pregnancy was relatively high in this study. Efforts should be made to scale up women's decision-making power on family planning services and give support to empower women economically. There is the need to promote family planning services to minimize unintended pregnancy and to decrease parity and family size.

Post-War Assessment of the Prevalence and Determinants of Unplanned Pregnancy Among Pregnant Women Attending Public Hospitals in Conflict-Zones of South Wollo, Northeast Ethiopia, 2022, Multi-Center Study

Background

Worldwide, although unplanned pregnancy seems decreasing, 38% of pregnancies are unintended. In sub-Saharan Africa, unintended pregnancy accounts for more than a quarter of the 40 million pregnancies that occur annually.

Objective

The study aimed to assess the prevalence and determinants of unplanned pregnancy among pregnant women attending public hospitals in conflict-zones of South Wollo zone, Northeast Ethiopia, 2022.

Methods

A multi-center facility-based cross-sectional study was conducted from December 20, 2021 to February 30, 2022 among the hospitals of South Wollo zone that that were destructed by the armed conflict.

Results

The prevalence of unplanned pregnancy in our study was 44.72% (CI=39.40-48.08%).

Conclusion

In this study nearly half of the pregnancies were unplanned, which is shocking to the health care system in the 21st century.

Spatial patterns and predictors of unintended pregnancy among reproductive age women in Ethiopia

INTRODUCTION

Unintended pregnancy is amajor sexual and reproductive health problem that imposes substantial health, economical and psychosocial costs to individuals and society as well as significant emotional distress to women, families, and society. The main aim of this study was to investigate the spatial distribution and predictors of unintended pregnancy in Ethiopian regions and administrative zones.

METHODS

This study was conducted based on data from 2016 Ethiopian Demographic and Health Survey. The prevalence of unintended pregnancy across regions and or zones was assessed using spatial analysis, and the effect of different factors on unintended pregnancy in Ethiopia was investigated using a generalized linear mixed model with a multistage clustered sampling strategy. The crude and best linear unbiased predictor estimations of zones were integrated with the shape file data to demonstrate the performance of each zone on maps.

RESULTS

The prevalence of unintended pregnancy for reproductive women in Ethiopia was29.49%. The highest rates of unintended pregnancy were recorded in the North Gondar zone of the Amhara region and the Jima zone in the Oromiya region. The mixed effects model revealed that age [AOR = 0.78, 95% CI, 0.62-0.97], residence [AOR = 2.62, 95%CI, 1.94, 7.27], marital status [AOR = 0.05, 95%CI, 0.01-0.38], women education [AOR = 1.34, 95%CI, 0.75-2.39], smoking cigarettes [AOR = 3.67, 95CI, 1.17-11.56], and poorer wealth index [AOR = 1.89, 95% CI, 1.51-2.31] were significantly associated with unintended pregnancy.

CONCLUSION

In Ethiopia, unintended pregnancy is a public health issue, and prevention stratagem for unintended pregnancy among reproductive women need to be focused based on the identified predictors. The spatial distribution of unintended pregnancy varied greatly at zonal and regional levels in Ethiopia. Hence, we recommended that, creating awareness of sexual and reproductive health with special priority to the identified hotspot areas (Amhara, Oromiya and SNN regions) to reduce unintended pregnancy. Emphasis on fertility and contraceptive techniques should be given to couples by health professionals.

Interrelationships Between Pregnancy Intention, Antenatal Care, and Sociodemographic Factors: Analysis of a Nationwide Population-Based Cross-Sectional Study in Vietnam

OBJECTIVES

This study aimed to improve the understanding of the interrelationships between sociodemographic factors, pregnancy intention, and antenatal care by: (1) identifying sociodemographic predictors of unintended pregnancy; (2) examining associations between unintended pregnancy types and antenatal care (ANC) inadequacy; (3) examining how the association between unintended pregnancy and ANC inadequacy is modified by maternal characteristics; and (4) identifying sociodemographic predictors of ANC inadequacy by pregnancy intention status.

METHODS

We analyzed women 15-49 years of age who participated in the nationwide cross-sectional Vietnam Multiple Indicator Cluster Survey. Pregnancy intention and ANC adequacy were assessed for the most recent live birth within two years preceding survey completion. Weighted Poisson regression was used to estimate risk ratios.

RESULTS

Of the 1,474 study participants, 17.8% had unintended pregnancy and 29.0% had inadequate ANC. There was no significant confounding-adjusted association between unintended pregnancy and ANC inadequacy, except in those currently not working. Women with intended pregnancy or unintended pregnancy had significantly higher ANC inadequacy risk if they lived in rural areas, were less educated, and had no media exposure, lower wealth status, or more than two children. Younger age, ever given birth, having child loss, and positive attitude towards partner violence were significant predictors of ANC inadequacy only in women with intended pregnancy.

CONCLUSIONS FOR PRACTICE

ANC inadequacy was more strongly predicted by sociodemographic characteristics rather than pregnancy intention, and the sociodemographic variables' prediction of ANC inadequacy was stronger in women with intended pregnancy than unintended pregnancy.

Sexual violence and adverse reproductive health outcomes among youth females in North Shoa zone, Oromia, Ethiopia: A community-based cross-sectional study

Objective:

The aim of this study is to assess the magnitude of sexual violence, its adverse reproductive health outcomes, and associated factors among female youth in the Northern Shoa zone, Oromia region, Ethiopia.

Methods:

A community-based cross-sectional study design was employed among 590 female youth from 1 December to 30 January 2021. A multi-stage sampling technique and a pretested structured interviewer-administered questionnaire were used. The data were entered into EpiData version 3.1 and then transferred to SPSS 23 for analysis. Descriptive statistical analysis was done, and an association between an outcome variable and independent variables was examined in logistic regression models.

Results:

According to the study, the respective rates of sexual violence and harmful sexual reproductive consequences were 20.7% and 11.9%. Sexual violence was significantly associated with alcohol consumption (adjusted odds ratio = 2.549, 95% confidence interval = (1.548, 4.195)) and childhood exposure to inter-parental violence (adjusted odds ratio = 1.66, 95% confidence interval = (1.002, 2.888)). Rural childhood residence (adjusted odds ratio = 0.037, 95% confidence interval = (0.007, 0.192)), fathers with college degrees (adjusted odds ratio = 0.037, 95% confidence interval = (0.013, 0.106)), and readiness for first sex (adjusted odds ratio = 0.073, 95% confidence interval = (0.028, 0.189)) were all independent predictors of adverse reproductive health outcomes.

Conclusion:

In this study, young females frequently experience sexual violence and poor reproductive health outcomes. Alcohol consumption and having experienced parental conflict as a child were found to be risk factors for sexual violence, while residing contracts during childhood, the father’s level of education, and willingness to engage in the first sexual encounter were linked to adverse reproductive health outcomes.

Multilevel analysis of factors associated with pregnancy termination in Ethiopia

Background

Pregnancy termination is a major public health issue that affects maternal mortality around the world. So the study aimed to identify factors that are associated with pregnancy termination in Ethiopia.

Methods

Community-based crossectional data came from Ethiopia's Mini Demographic and Health Survey 2019. The current study's sample included women who had their pregnancy terminated (aged 15–49) and had complete information on all factors of interest (N = 8885). The binary logistic regression model investigated the factors that contribute to pregnancy termination in Ethiopia and multilevel logistic regression were used to identify regional variation in Ethiopia.

Results

The current study showed that the prevalence of pregnancy termination in Ethiopia was 8.6%. The likelihood of pregnancy termination in uneducated women was 1.5 times (AOR = 1.479, 95% CI = 1.205–1.816) lower than in women who attended elementary school, 1.5 (AOR = 1.476, 95% CI = 1.107–1.969) lower than Secondary attended women and 1.8 times (AOR = 1.755, 95% CI = 1.270–2.427) lower than Higher school attended women. The likelihood of pregnancy termination in rural women was 0.8 times (AOR = 0.753, 95% CI = 0.573–0.990) higher than in urban women.

Conclusion

The current study showed that there was regional Variation among women in Ethiopia to terminate the pregnancy. The characteristics of education level, place of residency, marital status and contraceptive knowledge are significant and differ between regions of the country. As a result, increasing contraception use and enhancing women's knowledge are the most effective ways to avert the problem.

•

Pregnancy termination is a major public health issue that affects maternal mortality around the world.

•The study aimed to identify factors that are associated with pregnancy termination in Ethiopia.

•Community-based crossectional data came from Ethiopia's Mini Demographic and Health Survey 2019.

•The current study showed that the prevalence of pregnancy termination in Ethiopia was 8.6%.

•The current study showed that there was regional Variation among women in Ethiopia to terminate the pregnancy.

•As a result, increasing contraception use and enhancing women's knowledge are the most effective ways to avert the problem.

Evaluation of the Amharic version of the London measure of unplanned pregnancy in Ethiopia

Background

Unplanned pregnancy is an important public health problem in both the developing and developed world, as it may cause adverse social and health outcomes for mothers, children, and families as a whole. London Measure of Unplanned Pregnancy (LMUP) has been formally and informally validated in multiple and diverse settings. However, there is a dearth of literature on the validation of LMUP in Ethiopia either in the Amharic version or other languages.

Objective

The general objective of this study was to translate the LMUP into Amharic and evaluate its psychometric properties in a sample of Amharic-speaking women receiving antenatal care (ANC) service at public health facilities in Arbaminch and Birbir towns.

Methods

A cross-sectional study design was used for the study. Forward and backward translation of original English LMUP to Amharic was done. A cognitive interview using a pretested structured questionnaire was used to collect the data from respondents. The collected data was analyzed using SPSS version 25. Reliability was assessed using Cronbach’s alpha, inter-item correlations, and corrected item-total correlations while construct validity was assessed using principal components analysis and hypothesis testing.

Results

Data was collected from 320 women attending antennal care services at selected public health care facilities. LMUP range of 1to 11 was captured. The prevalence of unplanned pregnancies was 19(5.9%), while 136(42.5 were ambivalent and 165(51.6%) were planned pregnancies. The reliability testing demonstrated acceptable internal consistency (Cronbach’s alpha = 0.799) and the validity testing confirmed the unidimensional structure of the scale. In addition, all hypotheses were confirmed.

Conclusions

Amharic version of LMUP is a valid and reliable tool to measure pregnancy intention so that it can be used by Amharic speaking population in Ethiopia. It can also be used in research studies among Amharic-speaking women to measure unplanned pregnancy.

Performance Evaluation of Machine Learning Algorithm for Classification of Unintended Pregnancy among Married Women in Bangladesh

Intended pregnancy is one of the significant indicators of women's well-being. Globally, 74 million women become pregnant every year without planning. Unintended pregnancies account for 28% of all pregnancies among married women in Bangladesh. This study aimed to investigate the performance of six different machine learning (ML) algorithms applied to predict unintended pregnancies among married women in Bangladesh. From BDHS 2017-18, only 1129 pregnant women aged 15-49 were eligible for this study. An independent χ 2 test had performed before we considered six popular ML algorithms, such as logistic regression (LR), random forest (RF), support vector machine (SVM), k-nearest neighbor (KNN), naïve Bayes (NB), and elastic net regression (ENR) to predict the unintended pregnancy. Accuracy, sensitivity, specificity, Cohen's Kappa statistic, and area under curve (AUC) value were used as model evaluation. The bivariate analysis result showed that women aged 30-49 years, poor, not educated, and living in male-headed households had a higher percentage of unintended pregnancy. We found various performance parameters for the classification of unintended pregnancy: LR accuracy = 79.29%, LR AUC = 72.12%; RF accuracy = 77.81%, RF AUC = 72.17%; SVM accuracy = 76.92%, SVM AUC = 70.90%; KNN accuracy = 77.22%, KNN AUC = 70.27%; NB accuracy = 78%, NB AUC = 73.06%; and ENR accuracy = 77.51%, ENR AUC = 74.67%. Based on the AUC value, we can conclude that of all the ML algorithms we investigated, the ENR algorithm provides the most accurate classification for predicting unwanted pregnancy among Bangladeshi women. Our findings contribute to a better understanding of how to categorize pregnancy intentions among Bangladeshi women. As a result, the government can initiate an effective campaign to raise contraception awareness.

The effect of mindfulness-based stress reduction therapy on maternal anxiety, depression, and sleep quality: A protocol for systematic review and meta-analysis

BACKGROUND

Depression and anxiety are common in the prenatal and postnatal periods, which significantly influence pregnant women and their unborn babies. Pharmacological interventions can negatively affect maternal and infant health outcomes, while psychotherapy can avoid adverse events of medication and improve maternal depression and anxiety. Whether mindfulness-based stress reduction (MBSR) can alleviate maternal anxiety and depression and improve sleep quality is still controversial. Therefore, we aim to conduct a meta-analysis by collecting randomized controlled trials (RCTs) reporting the effects of MBSR on maternal anxiety, depression, and sleep quality, thus providing evidence-based medical evidence for non-pharmacological interventions.

METHODS

RCTs reporting the effect of MBSR on maternal anxiety, depression, and sleep quality versus conventional obstetric care will be searched in online databases, including the Cochrane Central Register of Controlled Trials Repositories, PubMed, Embase, Web of Science, Chinese Science Citation Database, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, Chinese Scientific Journal Database, and Wan Fang Database. Literature selection, data extraction, risk of bias assessment, and meta-analyses will be independently completed by 2 researchers. Meta-analysis will be performed by using RevMan5.4.

RESULTS

The results of this meta-analysis will be submitted to a peer-reviewed journal for publication.

CONCLUSION

This study will provide reliable evidence-based evidences for the effects of MBSR on improving maternal anxiety, depression, and sleep quality.

Unintended Pregnancy and Associated Factors among Women Who Live in Ilu Gelan District, Western Ethiopia, 2021

Background

The World Health Organization Report noted that unintended pregnancy is the most common cause of maternal mortality in developing countries. Most unintended pregnancies occur where access to maternal care is limited, and because of this, many mothers lose their life. Therefore, this study was an attempt to assess the proportion of unintended pregnancy and associated factors among women who live in Ilu Gelan District, Western Ethiopia, 2021.

Method

A community-based cross-sectional study was conducted in the rural and urban kebeles of Ilu Gelan Woreda West Shoa Zone, Ethiopia, from March 1 to 30, 2021. The study population consists of 540 pregnant women who were living in Ilu Gelan Woreda for at least the last six months during the data collection period. Simple random sampling by lottery method was used to recruit the study subject. Data were checked, coded, entered to EpiData version 3, and then exported to SPSS version 25 for analysis. Both descriptive and analytical statistical procedures were utilized. Both bivariable and multivariable logistic regressions was implemented.

Result

In this study, the proportion of unintended pregnancy was found to be 55%, at 95% CI: 50.7-59.3. Multivariable logistic regression results showed that married women (AOR = 0.117, CI: 0.04-0.38), monthly income less than 1000 Ethiopian Birr (AOR = 4.93, CI: 1.72-14.09), gravidity greater than or equal to five (AOR = 6.07, CI: 2.4-15.28), birth interval less than 2 years (AOR = 3.35 (1.44-7.8)), lack of awareness about contraceptive (AOR = 2.06 (1.03-4.15)), and husband decision-making on health care (AOR = 11.1 (2.07-59.51)) were significantly associated with unintended pregnancy. Conclusion and Recommendation. This study indicated that more than half of pregnant women reported that their current pregnancy was found to be unintended pregnancy. Married women, family monthly income less than 1000 Ethiopian Birr, gravidity greater than or equal to five, birth space less than two years, lack of contraceptive awareness, and health care decisions by husband only showed a significant association with unintended pregnancy. To decrease the current level of unintended pregnancy, all concerned stakeholders should emphatically consider those identified factors for intervention; specifically, Ilu Gelan District Health Bureau and health providers should empower women with health education about family planning and decision-making related to their health issues in the study area.

Four out of ten married women utilized modern contraceptive method in Ethiopia: A Multilevel analysis of the 2019 Ethiopia mini demographic and health survey

Background

Modern contraceptive method is a product or medical procedure that interferes with reproduction from acts of sexual intercourse. Globally in 2019, 44% of women of reproductive age were using a modern method of contraception but it was 29% in sub-Saharan Africa. Therefore, the main aim of this analysis was to assess the prevalence of modern contraceptive utilization and associated factors among married women in Ethiopia.

Method

The current study used the 2019 Ethiopia mini demographic and health survey dataset. Both descriptive and multilevel mixed-effect logistic regression analysis were done using STATA version 14. A p-value of less than 0.05 and an adjusted odds ratio with a 95% confidence interval were used to report statistically significant factors with modern contraceptive utilization.

Result

The overall modern contraceptive utilization among married women in Ethiopia was 38.7% (95% CI: 37.3% to 40.0%). Among the modern contraceptive methods, injectables were the most widely utilized modern contraceptive method (22.82%) followed by implants (9.65%) and pills (2.71%). Maternal age, educational level, wealth index, number of living children, number of births in the last three years, number of under 5 children in the household, religion, and geographic region were independent predictors of modern contraceptive utilization.

Conclusion

In the current study only four out of ten married non-pregnant women of reproductive age utilized modern contraceptive methods. Furthermore, the study has identified both individual and community-level factors that can affect the utilization of modern contraceptive methods by married women in the country. Therefore, concerned bodies need to improve access to reproductive health services, empower women through community-based approaches, and minimize region wise discrepancy to optimize the utilization.

Unintended pregnancy and associated factors during COVID-19 pandemic in Ethiopia: Community-based cross-sectional study

INTRODUCTION

The term 'unintended pregnancy' refers to a pregnancy that occurred when no children were desired or occurred earlier than desired. Unintended births account for one out of every three births in Ethiopia, and they are the leading cause of maternal morbidity and mortality. During the coronavirus disease (COVID-19) pandemic, this could be useful. COVID-19 has a significant impact on maternal health care utilization, including family planning services. As a result, this study aimed to assess unintended pregnancy and associated factors in Ethiopia during the COVID-19 pandemic.

METHOD

A community-based cross-sectional study was conducted in Gedeo zone, Ethiopia, from April 1 to May 30, 2021. A simple random sampling technique was utilized to get 383 pregnant women from their respective kebeles. A structured questionnaire was used to collect data during a face-to-face interview. The data were coded, cleaned, and entered into Epidemiological Data Version 3.1 before being exported to the Statistical Package for Social Science Version 23.0 for analysis. A bivariate and multivariable logistic regression model was used to identify statistically significant associations between dependent and independent variables. The odds ratio, with a 95% confidence interval and a P value of 0.05%, was considered statistically significant.

RESULT

A total of 383 pregnant women participated in the study, giving a response rate of 90.8%. During the COVID-19 pandemic, 140 (36.6%) participants stated that their current pregnancy was unintended. Unintended pregnancy was significantly associated with respondents' age (adjusted odds ratio (AOR) = 5.214 (1.449-18.762)), primary decision maker for family planning services (AOR = 9.510 (5.057-17.887)), and fear of COVID-19 to visit a health care facility (AOR = 7.061 (2.665-18.710)).

CONCLUSION

During the COVID-19 era, more than one-third of women had unintended pregnancies. Unintended pregnancy was significantly associated with respondents' age, autonomy to use contraceptive methods, and fear of COVID-19, which required them to attend a health care institution.

Unintended Pregnancy and Associated Factors Among Women Attending Antenatal Care in Public Hospitals During COVID-19 Pandemic, Southwest Ethiopia: A Cross-Sectional Study

Background

COVID-19 pandemic directly or indirectly increases the burden of unintended pregnancy by limiting women’s access to family planning and other reproductive health services. COVID-19 results in extra 15 million unintended pregnancies over a year. Almost all previous studies conducted about unintended pregnancy were before COVID-19 pandemic in Ethiopia. Therefore, the purpose of this study was to assess the prevalence and associated factors of unintended pregnancy during the COVID-19 pandemic among women attending antenatal care in public hospitals of southwest Ethiopia.

Methods

This study was cross-sectional and conducted among women attending antenatal care at public hospitals of southwest Ethiopia from June 14 to July 14, 2021. Data were collected using a face-to-face interview. Factors associated with unintended pregnancy were analyzed using binary and multiple logistic regressions with an adjusted odds ratio and 95% confidence interval. Finally, the p-value was used as a graded measure of evidence to quantify the degree of significance.

Results

A total of 405 women participated in this study. The overall prevalence of unintended pregnancy was 19.5% (95% CI: 1.44–6.92) among women attending antenatal care during COVID-19 pandemic. Of which, 50.6% were mistimed and 49.4% unwanted. Urban residence (AOR: 3.1 95% CI: 1.44–6.92) and not being primary decision-maker (AOR: 2.85 95CI: 1.18–6.88) had high significance with unintended pregnancy. Not having ANC in a previous pregnancy (AOR: 3.40; 95% CI: 1.02–11.94) and not being exposed to community education about maternal health care (AOR: 2.36; 95% CI: 1.06–5.27) had medium significance with unintended pregnancy.

Conclusion

One-fifth of women attending antenatal care had unintended pregnancies during the COVID-19 pandemic. Efforts to scale up women’s decision-making power on family planning services and access to community education are needed to prevent unintended pregnancy.

Whole-exome sequencing reveals novel candidate single nucleotide variations for preventing adverse effects of levonorgestrel implantation

Aim: To identify novel genes associated with adverse effects of levonorgestrel (LNG) implants based on comparative whole-exome sequencing. Materials & methods: A cohort comprising 104 participants, including 52 controls and 52 women with LNG-related adverse effects, was recruited. Seven cases and eight controls were selected for whole-exome sequencing. We verified 13 single nucleotide variations (SNVs) related with integrin-mediated signaling pathway and cell proliferation using the MassARRAY platform. Results: Finally, we screened 49 cases and 52 controls for analyses. Two SNVs (rs7255721 and rs1042522) were located in ADAMTS10 and TP53, respectively, and significantly different between two groups. These two SNVs lead to changes in protein structure and physicochemical parameters. Conclusion: Here, we defined two pathogenic mutations related to adverse LNG effects.

Unintended pregnancy and the factors among currently pregnant married youths in Western Oromia, Ethiopia: A mixed method

BACKGROUND

Unintended pregnancy is a global concern affecting both developed and developing countries. Some young women who had unintended pregnancies obtain an abortion while others carry their pregnancies to term, incurring the risk of morbidity and mortality higher than those for adult women. Despite the availability of highly effective methods of contraception, different studies in Ethiopia revealed that there is a high level of unintended pregnancy.

OBJECTIVE

To assess the magnitude of unintended pregnancy and associated factors among currently pregnant married youths in Kiremu district.

METHODS

A community-based cross-sectional study was conducted among currently pregnant married 15-24 years women. Multi-stage stratified sampling technique was used to select 434 study units. Ten kebeles were randomly selected and samples were selected from each of ten kebeles by simple random sampling using kebeles household identification numbers as the sampling frame. Quantitative data was entered with SPSS version 20 and crude and adjusted odds ratio together with their 95%CI were computed and interpreted accordingly. A p-value<0.05 was considered to declare a result as statistically significant in this study. In-depth interviews and transcripts of the recorded discussions were coded and analyzed thematically. The results were finally presented in texts, tables, and graphs.

RESULT

Unintended pregnancies among currently pregnant married young women in the study area were 31.1%. Educational status (AOR = 3.195,95%CI = 1.757,5.811),being Gov't employee (AOR = 0.039, 95% CI = 0.002,0.988), ever heard contraceptives(AOR = 0.260, 95%CI = 0.077, 0.876), ever used contraceptives (AOR = 0.348,95%CI = 0.168,0.717),discussion about contraceptives with husband(AOR = 0.027,95%CI = 0.015, 0.050),fear of side effect of contraceptives (AOR = 5.819,95% CI = 1.438,23.422), autonomy on health (AOR = 0.122,95%CI = 0.035,0.431), age at first marriage (AOR = 3.195, 95%CI = 1.757,5.811), age first pregnancy(AOR = 23.660,95%CI = 12.573,44.522), being visited by health care providers (AOR = 0.202,95%CI = 0.073,0.566) and average birth interval (AOR = 3.472,95%CI = 1.392,8.61) were the factors associated with unintended pregnancy.

CONCLUSION AND RECOMMENDATION

Significant proportion of women had an unintended pregnancy in the study area. Therefore, emphasis should be given to married youths especially on women empowerment, encouraging partner discussions, and providing appropriate counseling on contraceptive side effects by giving due attention to those marred at younger ages (<18 years).

Prevalence and determinants of unintended pregnancy in Ethiopia: narrative synthesis and meta-analysis

BACKGROUND

Unintended pregnancy has enormous health, social and psychological impacts. Thus, comprehensive local evidence is required to guide interventions to prevent the occurrence and consequences of unintended pregnancy. This systematic review was conducted to examine the prevalence and determinants of unintended pregnancy in Ethiopia.

METHODS

The review was done following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Synthesis Without Meta-analysis (SWiM) guideline. Electronic databases including Medline/PubMed, Cochrane Library, CINAHL, Google scholar, and African journal online were searched to retrieve studies published from January 1/1990 to October 30/2020. Grey literatures were accessed from the online libraries of academic institutions in Ethiopia using the Google search engine. The qualities of the studies were assessed using Joanna Briggs Institute critical appraisal checklists. The retrieved studies were analyzed using STATA software version 13. The prevalence of unintended pregnancy was pooled using the random-effects model. The evidences on the determinants of unintended pregnancy were summarized in a narrative format. The statistical heterogeneity between studies was quantified by using the I-square values. Sub-group analysis and meta-regressions were done to identify the sources of heterogeneity among studies.

RESULTS

A total of 250 studies were retrieved of which 25 studies with 23,030 women were included for meta-analysis. Only 24 studies scrutinized the determinants of unintended pregnancy. The overall prevalence of unintended pregnancy was 30 % (95% CI; 27-33 %) with high heterogeneity among studies (I2 = 95.06 %). The pooled prevalence of unwanted and mistimed pregnancy was 12 &17% respectively. The study region was the source of heterogeneity whereas study setting, study year, sample size, and study quality score were not the sources of heterogeneity (p > 0.1). Unintended pregnancy was positively associated with a low level of education, poverty, multiparity, rural residence, extreme ages, being unmarried, lack of decision-making power, inaccessibility of health facilities, poor knowledge, and non-use of contraceptives.

CONCLUSIONS

The pooled prevalence of unintended pregnancy in Ethiopia was high. Empowering women and ensuring the accessibility of quality family planning services can reduce the prevailing high prevalence of unintended pregnancy. Interventions that target rural, poor, unmarried, multiparous, less-educated, and adolescent women are also important to avert untended pregnancy in Ethiopia.

The association between unmet need for contraception and unintended pregnancy among reproductive-age women in Ethiopia

Objectives:

An unintended pregnancy and unmet need for contraception remains a serious public health issues both in developed and developing countries. This study aimed to investigate the relation between unmet needs for contraception and unintended pregnancy, and identify other factors contributing for unintended pregnancy in Ethiopia.

Methods:

Data were obtained from the 2016 Ethiopian Demographic and Health Survey. A total of 7590 mothers were included. The planning status of the last pregnancy was the main outcome variable, and the unmet need for contraception was the primary explanatory variable. Bivariate and multiple logistic regressions were carried out. SPSS version 20.0 was used for data analysis. Statistical significance was declared at p < 0.05.

Results:

More than one-fourth of mothers (26.6%) gave either mistimed or unwanted birth. The rate of unmet need for contraception was 26.5%. Women with unmet need for contraception had (adjusted odds ratio (AOR) = 10.29, 95% confidence interval (CI) = 8.70–12.10) higher odds of experiencing unintended pregnancy than those who met their contraception need. Age, history of pregnancy termination, parity, women’s autonomy, and fertility preference were factors associated with unintended pregnancy.

Conclusion:

An unintended pregnancy and the unmet need for contraception remain a major public health issue in Ethiopia. A strong positive association between the unmet need for contraception and unintended pregnancy suggests that interventions targeting the unmet need for contraception could reduce unintended pregnancy. Furthermore, empowering women, promoting a clear fertility goal, and improving men’s involvement would reduce unintended pregnancy.

Factors associated with unintended pregnancy in Ethiopia; further analysis of the 2016 Ethiopian demographic health survey data

Background

Unintended pregnancy an important public health problem in Ethiopia. It is associated with adverse physical, mental, social and economic outcomes. Identifying factors associated with unintended pregnancy may help to reduce unintended pregnancy and hence adverse outcomes. There are few studies about the prevalence and associated factors of unintended pregnancy in Ethiopia. But these studies were based on small sample size and fragmented. Therefore, this analysis was done to identify factors associated with unintended pregnancy in Ethiopia based on nationally representative data.

Methods

The study used the 2016 Ethiopian demographic and health survey data. The data was downloaded from The DHS program with permission. A total of 1135 women were included in the final model. Data was weighted to consider disproportionate sampling and non-response. Multivariable logistic regression was used to identify factors associated with unintended pregnancy among women.

Result

About 30% (95% CI: 25.33–34.39) pregnancies were unintended. Married women (Adjusted odds ratio (AOR); 0.34; 95% CI: (0.01–0.14), woman living in developing regions AOR; 0.14; 95% CI: (0.07–0.27) and women who reported distance was not a big problem to get medical care AOR; 0.59; 95% CI: (0.36–0.99) had lower odds of unintended pregnancy. On the other hand, multiparous AOR; 3.77; 95% CI: (1.71–8.33), grand multiparous AOR; 6.72; 95% CI: (2.74–16.49) women and women who ever used contraceptives AOR; 1.86 95% CI: (1.06–3.26) had higher odds of unintended pregnancy.

Conclusion

Although high, the magnitude of unintended pregnancy in Ethiopia was lower compared to the global level. Marital status, region, perceived distance to seek medical care, parity and history of contraceptive use were found significant predictors of unintended pregnancy in Ethiopia.

The influence of mindfulness-based stress reduction (MBSR) on stress, anxiety and depression due to unwanted pregnancy: a randomized clinical trial

Background

Individuals with unwanted pregnancies often experience high levels of anxiety, stress and depression that associated with maternal-neonatal outcomes. Mindfulness training is a safe and acceptable strategy to support mental health before parturition.

Purpose

The main objective of present study was to evaluate the influence of eight-week application of mindfulness-based stress reduction on stress, anxiety and depression caused by unplanned pregnancy.

Method

In this study, 60 women with unwanted pregnancy before 32 weeks of gestational age were selected and randomly divided into two groups. Intervention group received MBSR sessions, practice at home and the recorded sound. Mental health was evaluated before intervention and at the end of the eight sessions by standard stress, anxiety and depression DASS-21 questionnaire. Data were analyzed using Chi-square, Mann-Whitney U and Wilcoxon tests.

Findings

In order to compare pre-test and post-test scores in each group, the Wilcoxon Test was used. The results revealed that the participants in the intervention group reported a significant decrease in mean scores of stress, anxiety and depression compared to baseline (P = 0.0). Whereas no significant decrease in mean stress, anxiety and depression score were found in control group. P-value was estimated to be 0.346, 0.212 and 0.343 respectively.

Conclusions

The mindfulness program has effectively reduced stress, anxiety and depression. Further research is needed to investigate the mechanisms and effects of mindfulness on maternal-neonatal outcomes.

Magnitude of Unintended Pregnancy and Associated Factors Among Pregnant Women in Debre Markos Town, East Gojjam Zone, Northwest Ethiopia: A Cross-Sectional Study

Background

Unintended pregnancy is an important public health concern in both developing and developed countries due to its serious consequences for women, infants, families and communities, including the risk of unsafe abortion, delayed prenatal care, poor maternal mental health, poor child health outcomes and unemployment.

Objective

The aim of the study was to assess the prevalence and associated factors of unintended pregnancy among pregnant women in the town of Debre Markos in 2019.

Methods

The magnitude and associated factors of unintended pregnancy were assessed using a community-based cross-sectional study design. A multi-stage sampling technique was used to select five Kebeles (basic administrative units), and households were selected from the selected Kebeles using simple random sampling. A total of 580 samples were collected through standardized pretested questionnaires. Bivariate and multivariate logistic regression were used to analyze the relationship between the UP and independent variables.

Results

Of the pregnant women, 202 (34.8%) (95% CI: 30.9-38.7) participants had an unintended current pregnancy; of those 144 (24.8%) were mistimed pregnancies. Women aged 24 years were three times more likely to have an unintended pregnancy than those aged 35 years. Divorced and widowed women were four times more likely than women who were currently married to experience an unintended pregnancy. Gravidity 1-2 and 3-4 were 94% and 86% less likely than gravidity > 5 to experience an unintended pregnancy, and women who made family planning decisions on their own were less likely to have an unintended pregnancy.

Conclusion

According to this study, the prevalence of unintended pregnancy was 34.8% and unintended pregnancy was significantly correlated with women's age, marital status, gravidity and who made decisions on family planning. There is an obvious need to devise communication strategies on fertility and contraceptive issues between couples through peer education, and to encourage correct use of long-acting modern methods of family planning.

Modern Contraceptive Use and Influencing Factors in Amhara Regional State: Further Analysis of Ethiopian Demographic Health Survey Data 2016

Background. Ethiopia is one of the Sub-Saharan African countries with a high unmet need for contraceptives. Contraception is a good indicator of the extent to which couples have access to reproductive health services. A study on contraceptives can provide overall direction by helping to identify the obstacles in society and weaknesses in services that need to be overcome. However, little is known in Amhara region context. Therefore, this analysis was aimed to assess modern contraceptive use and influencing factors in the Amhara regional state of Ethiopia. Methods. We used secondary data analysis of the regional representative sample of women aged 15–49 years from the 2016 Ethiopian Demography and Health Survey (EDHS). A total of 2207 married reproductive-age women (15–49 years) selected using a two-stage stratified cluster sampling technique were included in this analysis. Both descriptive and logistic regression analyses were performed using STATA V.14. A 95% confidence interval was used to declare statistical significance. Results. Modern contraceptive use among married reproductive-age women was 51.3% (95% CI: 47.0–55.6). Being from households with rich wealth index (AOR = 1.6; 95% CI: 1.1–2.5), a secondary or higher level of education (AOR = 3.0; 95% CI: 1.4–6.2), and desire to space (AOR = 2.6; 95% CI: 1.9–3.7) or want no more child (AOR = 2.4; 95% CI: 1.6–3.5) were found positively associated with modern contraceptive use. On the other hand, modern contraceptive use was negatively associated with women aged 35–49 years (AOR = 0.7; 95% CI: 0.5–0.9). Conclusion. Modern contraceptive use was relatively high in the Amhara region. The odds of modern contraceptive use were higher among women with secondary or more educational levels. Women from households with rich wealth index and those who want to delay or avoid pregnancy had also more odds of using modern contraceptives. Therefore, strengthening women’s and community education could improve modern contraceptive use. Moreover, more emphasis should be given for income generation activities.

Association of husbands' education status with unintended pregnancy in their wives in southern Ethiopia: A cross-sectional study

Background

Unintended pregnancy rates are substantially higher in developing regions, have significant health consequences, and disproportionately affect subgroups with socio-economic disadvantage. We aimed to examine whether there is an association between husbands’ education status and their wives unintended pregnancy in southern Ethiopia.

Methods

The data source for this study was from a cross-sectional study on iron-folate supplementation and compliance in Wolaita, South Ethiopia. Data were collected from October to November 2015 in 627 married pregnant women regarding their husbands’ education status, socio-demographic characteristics, and if they wanted to become pregnant at the time of survey using an interviewer administered questionnaire. Logistic regression was used to estimate Odds Ratios (ORs) with associated z-tests and 95% Confidence Intervals (95% CI) for variables associated with unintended pregnancy.

Results

The proportion of unintended pregnancy in this sample was 20.6%. Husbands’ education status, age, residence, and using family planning methods were associated with unintended pregnancy (all P-values < 0.05). Multivariable models consistently showed that being married to a husband with at least some college or university education was associated with a decreased OR for unintended pregnancy after controlling for age and use of family planning at conception period (OR 0.36 [95%CI: 0.17, 0.82]) and age and rural residence (OR 0.40 [95%CI: 0.18, 0.90]).

Conclusion

Unintended pregnancy among Ethiopian woman was consistently associated with being married to least educated husbands in southern Ethiopia. Increasing age and living in a rural vs urban area were also independently associated with unintended pregnancy. Strategies for addressing family planning needs of women with poorly educated husbands should be the subject of future research.

Factors Associated with the Unplanned Pregnancy at Suhul General Hospital, Northern Ethiopia, 2018

Background

Unplanned pregnancy is a fundamental concept that is used to recognize the fertility of populations and the unmet need for contraception and family planning. Unplanned pregnancy happened mainly due to the results of not using contraception or inconsistent or incorrect use of effective methods. Reducing the number of unplanned pregnancy endorses reproductive health mainly by reducing the number of times a woman is exposed to the risk of pregnancy and childbearing.

Objective

This study is aimed at assessing the magnitude of unplanned pregnancy and associated factors among pregnant mothers attending antenatal care at Suhul General Hospital, Northern Ethiopia.

Methods

A facility-based cross-sectional study design was conducted among pregnant mothers visiting antenatal care follow-up from February to April 2018 at Suhul General Hospital, Shire, and Northern Ethiopia. The study participants were selected using a systematic sampling method, and the data was collected using a pretested structured questionnaire through face-to-face interviews. Bivariate and multivariate logistic regression analyses were done to determine the association of each independent variable with the dependent variable.

Result

The magnitude of unplanned pregnancy among 379 pregnant mothers was 20.6%. Unmarried women [AOR: 4.73, 95% CI: (1.56, 14.33)], age above forty [AOR: 4.17, 95% CI: (1.18, 14.6)], had no history of unplanned pregnancy [AOR: 3.26 95% CI: (1.65, 6.44)], and unemployed [AOR: 6.79; 95% CI: (2.05, 22.46)] were the variables significantly associated with the magnitude of unplanned pregnancy. Conclusion and Recommendation. The findings of this study showed that the magnitude of unplanned pregnancy was high and age, marital status, occupation, and history of unplanned pregnancy were statistically associated with an unplanned pregnancy. There is seeming necessity to plan strategies of communication within couples or individuals on reproductive especially on fertility and promote family planning methods.

Unintended pregnancy and associated factors among unmarried female students: A case of Bahir Dar University

Background

Unintended pregnancy is a mistimed, unplanned or unwanted pregnancy at the time of conception. Unintended pregnancy has a number of adverse physical, mental, and social impacts. It brings illegal and unsafe abortions which are causes of maternal morbidity and mortality in the developing countries like Ethiopia. Even if such problem has significant impact on the community, there is scarcity of evidence on this issue in Ethiopian higher institutions. Therefore, this study was aimed to assess unintended pregnancy and associated factors among unmarried female students in Bahir Dar University, North West Ethiopia.

Methods

A descriptive, cross-sectional study was conducted among unmarried female students at Bahir Dar University from March 1^st - 30^th, 2018. Data were collected by self-administered questionnaire. Data were entered, cleaned, coded and analyzed using SPSS version 23.0. The statistical association between dependent and independent variables was assessed using logistic regressions. P-value <0.05 in the multivariable analysis was set to statistically significant.

Result

Three hundred eighty-nine students had participated in the study making the response rate 92.00%. The prevalence of unintended pregnancy was 10.00%. Getting money from family (AOR: 0.16, 95% CI: [0.06, 0.42], p < 0.001) and being Health Science student (AOR: 0.40, 95% CI [0.16, 0.98], p < 0.001) were the preventive factors of unintended pregnancy. Being age of less than or equals to 18 years in the first sexual intercourse time (AOR: 6.31, 95% CI: [2.56, 15.53], p < 0.001) was positively associated with unintended pregnancy.

Conclusion

In the current study the prevalence of unintended pregnancy was high among unmarried female University students. Unintended pregnancy was determined by the source of money, field of study and age at first sexual intercourse. Hence, students should use family as a source of money, abstain from early sexual intercourse and share experiences from Health Science students about the prevention of unintended pregnancies. In line with the alleviation of modifiable factors, health professionals should provide comprehensive reproductive health and contraceptive services to University students.

Magnitude and associated factors of unintended pregnancy in Ethiopia: a multilevel analysis using 2016 EDHS data

Background

Unintended pregnancy has become a significant public health and reproductive health problem that has had a substantial and appreciable adverse impact on mother, child, and the general public. Despite the paramount negative effects of unintended pregnancy, many pregnancies are unintended in Ethiopia. Therefore, this study aimed to determine the prevalence and associated factors of unintended pregnancy in Ethiopia.

Methods

This study was based on the nationally representative 2016 Ethiopian Demographic and Health Survey data. We used a total weighted sample of 7590 reproductive-aged women who gave birth in the 5 years preceding the survey. A multi-level logistic regression analysis was used to account for the hierarchal nature of the DHS data. In the multivariable multilevel analysis, those variables with p-value < 0.05 were considered to be significantly associated with unintended pregnancy.

Result

The prevalence of unintended pregnancy was 26.6% [95%CI: 25.6, 27.6]. In the multivariable multilevel logistic regression analysis; individual level variables such as being in the age group 20 to 34 [adjusted odds ratio (AOR) = 0.57; 95%CI: 0.41, 0.79] and 35 to 49 [AOR = 0.68; 95%CI: 0.47, 0.97], being follower of Muslim religion [AOR = 0.73; 95%CI: 0.60, 0.88], being married [AOR = 0.46; 95%CI: 0.37–0.58], household size of four to six [AOR = 1.38; 95%CI: 1.10, 1.69] and seven and above [AOR = 1.54; 95%CI: 1.20, 1.99], and being multiparous [AOR = 1.36; 95%CI: 1.10, 1.69] and grand multiparous [AOR = 1.92; 95%CI: 1.47, 2.52] were significantly associated with unintended pregnancy. Among community level variables; being living in large central [AOR = 2.56; 95%CI: 2.06, 3.17] and metropolitan regions [AOR = 1.91; 95%CI: 1.44, 2.53] were significantly associated with unintended pregnancy.

Conclusion

In this study the prevalence of unintended pregnancy was high. Maternal age, religion, marital status, household size, parity, and region were the most important factors associated with unintended pregnancy. Special attention should, therefore, be given to younger, single, multiparous and grand multiparous women, and not follower of Muslim religion as well as mothers from large central and metropolitan regions in terms of increasing accessibility and affordability of maternal health services, which could minimize unintended pregnancy.

Comparison of pregnancy incidence among African women in a randomized trial of intramuscular depot medroxyprogesterone acetate (DMPA-IM), a copper intrauterine device (IUDs) or a levonorgestrel (LNG) implant for contraception

OBJECTIVE

The objective was to address bias in contraception efficacy studies through a randomized study trial of intramuscular depot medroxyprogesterone acetate (DMPA-IM), a copper intrauterine device (IUDs) and a levonorgestrel (LNG) implant.

STUDY DESIGN

We analyzed data from the Evidence for Contraceptive Options and HIV Outcomes Trial, which assessed HIV incidence among 7829 women from 12 sites in eSwatini, Kenya, South Africa and Zambia seeking effective contraception and who consented to be randomized to DMPA-IM, copper IUD or LNG implant. We used Cox proportional hazards regression adjusted for condom use to compare pregnancy incidence during both perfect and typical (i.e., allowing temporary interruptions) use.

RESULTS

A total of 7710 women contributed to this analysis. Seventy pregnancies occurred during perfect and 85 during typical use. There was no statistically significant difference in perfect use pregnancy incidence among the methods: 0.61 per 100 woman-years for DMPA-IM [95% confidence interval (CI) 0.36-0.96], 1.06 for copper IUD (95% CI 0.72-1.50) and 0.63 for LNG implants (95% CI 0.39-0.96). Typical use pregnancy rates were also largely similar: 0.87 per 100 woman-years for DMPA-IM (95% CI 0.58-1.25), 1.11 for copper IUD (95% CI 0.77-1.54) and 0.63 for LNG implants (95% CI 0.39-0.96).

CONCLUSIONS

In this randomized trial of highly effective contraceptive methods among African women, both perfect and typical use resulted in low pregnancy rates. Our findings provide strong justification for improving access to a broader range of longer-acting contraceptive options including LNG implants and copper IUD for African women.

IMPLICATIONS STATEMENT

Data from this study support recommendations to providers, policy makers and patients that all of these methods provide safe and highly effective contraception for African women.

Prevalence and determinants of unintended pregnancy in Ethiopia: A systematic review and meta-analysis of observational studies

BACKGROUND

Unintended pregnancy has significant consequences for the health and welfare of women and children. Despite this, a number of studies with inconsistent findings were conducted to reduce unintended pregnancy in Ethiopia; unavailability of a nationwide study that determines the prevalence of unintended pregnancy and its determinants is an important research gap. Thus, this study was conducted to determine the overall prevalence of unintended pregnancy and its determinants in Ethiopia.

METHODS

We searched from Google Scholar, PubMed, Science Direct, Web of Science, CINAHL, and Cochrane Library databases for studies. Each of the original studies was assessed using a tool for the risk of bias of observational studies. The heterogeneity of studies was also assessed using I2 test statistics. Data were pooled and a random effect meta-analysis model was fitted to provide the overall prevalence of unintended pregnancy and its determinants in Ethiopia. In addition, the subgroup analyses were performed to investigate how the prevalence of unintended pregnancy varies across different groups of studies.

RESULTS

Twenty-eight studies that satisfy the eligibility criteria were included. We found that the overall prevalence of unintended pregnancy in Ethiopia was 28% (95% CI: 26-31). The subgroup analyses showed that the highest prevalence of unintended pregnancy was observed from the Oromiya region (33.8%) followed by Southern Nations Nationalities and Peoples' region (30.6%) and the lowest was in Harar. In addition, the pooled prevalence of unintended pregnancy was 26.4% (20.8-32.4) and 30.0% (26.6-33.6) for community-based cross-sectional and institution-based cross-sectional studies respectively. The pooled analysis showed that not communicating with one's husband about family planning was more likely to lead to unintended pregnancy (OR: 3.56, 95%CI: 1.68-7.53). The pooled odds ratio also showed that unintended pregnancy is more likely among women who never use family planning methods (OR: 2.08, 95%CI: 1.18-3.69). Furthermore, the narrative review of this study showed that maternal education, age, and household wealth index are strongly associated with an unintended pregnancy.

CONCLUSIONS

In this study, the prevalence of unintended pregnancy was high. Lack of spousal communication, never using family planning, maternal education, and household wealth level were significantly associated with an unintended pregnancy. This study implies the need to develop plans and policies to improve the awareness of contraceptive utilization and strengthen spousal communication related to pregnancy.

Institutional delivery service use and associated factors among women who delivered during the last 2 years in Dallocha town, SNNPR, Ethiopia

Aim

To determine the institutional delivery service use and identify factors associated among women who delivered during the last two years in Dallocha town.

Design

A community-based cross-sectional study.

Methods

The study was conducted from 10 March-10 April 2016. A total of 411 study participants were selected by using systematic sampling method. The source population was all reproductive age group mothers. Bivariate and multiple logistic regression was conducted.

Results

Institutional delivery was 304 (74%). Factors associated with increased likelihood of institutional delivery were owning a radio or television, making more than four antenatal care visits, knowing at least one maternity service advantage. Not knowing about at least one benefit institutional delivery decreased the likelihood of institutional delivery.

Conclusion

Three-quarters of the mothers delivered at the health institution. Accordingly, promotion of antenatal care follow-up, in-service training of health professionals and health education is recommended.

Magnitude and Associated Factors of Unintended Pregnancy among Pregnant Women at Saesie Tsaeda Emba Woreda Eastern Zone of Tigray, North Ethiopia, 2018

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.

Prevalence and determinants of unintended pregnancy in sub-Saharan Africa: A multi-country analysis of demographic and health surveys

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.