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Aibangbee M, Micheal S, Liamputtong P, Pithavadian R, Hossain SZ, Mpofu E, Dune T. Socioecologies in shaping migrants and refugee youths' sexual and reproductive health and rights: a participatory action research study. Reprod Health 2024; 21:134. [PMID: 39294779 PMCID: PMC11409589 DOI: 10.1186/s12978-024-01879-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Accepted: 09/12/2024] [Indexed: 09/21/2024] Open
Abstract
OBJECTIVE This study explores socioecological factors facilitating the sexual and reproductive health and rights (SRHR) experiences of migrant and refugee youth (MRY) in Greater Western Sydney, Australia. MRY may be at higher risk for poorer SRH outcomes due to cultural, linguistic, and systemic barriers. METHODS Using participatory action research, 17 focus groups were conducted with 87 MRY aged 15-29 from diverse cultural backgrounds. Data were analysed thematically, using socioecological framework. RESULTS Key facilitators of MRY's SRHR were identified at the microsystem and exosystem levels, including (1) Peer dynamics and support, with friends serving as trusted confidants and sources of advice; (2) Safety and contraceptive choices, highlighting the importance of access to contraception and STI prevention; and (3) Digital platforms for SRHR information access, with online resources filling knowledge gaps. CONCLUSION Findings suggest the need for SRHR interventions to leverage peer support networks, expand access to contraceptive options, and develop culturally appropriate digital resources for MRY. Further research is needed to identify and enhance facilitators across all socioecological levels to comprehensively support MRY's SRHR needs.
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Affiliation(s)
- Michaels Aibangbee
- School of Health Sciences, Western Sydney University, Penrith, NSW, Australia.
- School of Medicine, Western Sydney University, Campbelltown, NSW, Australia.
| | - Sowbhagya Micheal
- School of Medicine, Western Sydney University, Campbelltown, NSW, Australia
- Translational Health Research Institute & Diabetes Obesity and Metabolism Translational Research Unit, Western Sydney University, Penrith, NSW, Australia
| | | | - Rashmi Pithavadian
- School of Health Sciences, Western Sydney University, Penrith, NSW, Australia
| | - Syeda Zakia Hossain
- School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Elias Mpofu
- University of North Texas, Denton, USA
- University of Sydney, Sydney, NSW, Australia
- University of Johannesburg, Johannesburg, South Africa
- Western Sydney University, Sydney, Australia
| | - Tinashe Dune
- Translational Health Research Institute & Diabetes Obesity and Metabolism Translational Research Unit, Western Sydney University, Penrith, NSW, Australia
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Israel E, Abraham A, Tesfaw M, Geta T, Kercho MW, Dubale S, Yakob T, Jambo E, Elfios E. Epidemiology of intrapartum stillbirth and associated factors among women who gave childbirth in Ethiopia: systematic review and meta-analysis. Front Glob Womens Health 2024; 5:1432729. [PMID: 39329084 PMCID: PMC11424998 DOI: 10.3389/fgwh.2024.1432729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Accepted: 08/21/2024] [Indexed: 09/28/2024] Open
Abstract
Background Stillbirth always resulted in a multi-dimensional impact from the individual level to the country level at large. It causes psychological depression, social stigmatization, and decreased quality of life for women. Despite several studies conducted in Ethiopia, no national pooled estimates were done. Therefore, this systematic review and meta-analysis sought to assess intrapartum stillbirth and associated factors among women who had childbirth in Ethiopia using the available published evidence. Methods The current review included studies conducted in Ethiopia. The databases used primarily were Medline/PubMed, Google Scholar, Scopus, Web of Science, Ethiopian University Repository Online, CINAHL, African Journals Online and Cochrane Library. All cross-sectional studies conducted in English and met eligibility criteria were included in the final review. A random-effects meta-analysis was performed. Data extraction and analysis were also performed using Microsoft Excel and STATA version 14 software respectively. Results In the current review, eleven studies were included, and their quality was assessed before being chosen for the final review. The pooled prevalence of intrapartum stillbirth among women who had childbirth in Ethiopia was 9.21% [95% CI (7.03%, 11.39%); I 2 = 90.2, P = 0.000]. Women with a previous history of stillbirth [OR = 5.14, 95% CI (3.53-6.75), I 2 = 60.0%, p = 0.04] and had no use of antenatal care {[OR = 0.43, 95% CI (0.18-0.68) I 2 = 85.3%, p = 0.001]} were significantly associated with intrapartum stillbirth among women who gave childbirth. Conclusions Nearly one-tenth of women who had childbirth in Ethiopia had an intrapartum SB. Revitalizing the existing health extension package particularly family health services with emphasis on focused antenatal care and counselling as well as with prompt referral system would reduce intrapartum SB. This review calls for the need to assess the quality of ANC provision and tailor targeted interventions to best improve the service quality.
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Affiliation(s)
- Eskinder Israel
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Sodo, Ethiopia
| | - Awoke Abraham
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Sodo, Ethiopia
| | - Mihiret Tesfaw
- Department of Public Health, Marie-stopes International (MSI) Ethiopia Reproductive Choices, Hawassa, Ethiopia
| | - Temesgen Geta
- School of Nursing, College of Health Science and Medicine, Wolaita Sodo University, Sodo, Ethiopia
| | - Melkamu Worku Kercho
- School of Midwifery, College of Health Science and Medicine, Wolaita Sodo University, Sodo, Ethiopia
| | - Samson Dubale
- Department of Public Health, Marie-stopes International (MSI) Ethiopia Reproductive Choices, Hawassa, Ethiopia
| | - Tagese Yakob
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Sodo, Ethiopia
| | - Endale Jambo
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Sodo, Ethiopia
| | - Eshetu Elfios
- Department of Public Health, Marie-stopes International (MSI) Ethiopia Reproductive Choices, Hawassa, Ethiopia
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Zulu JM, Crankshaw TL, Ouedraogo R, Juma K, Aantjes CJ. "The ones at the bottom of the food chain": structural drivers of unintended pregnancy and unsafe abortion amongst adolescent girls in Zambia. Arch Public Health 2024; 82:137. [PMID: 39187865 PMCID: PMC11346015 DOI: 10.1186/s13690-024-01377-3] [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: 05/25/2024] [Accepted: 08/17/2024] [Indexed: 08/28/2024] Open
Abstract
BACKGROUND Access to safe abortion care is highly unequal and fundamentally rooted in socioeconomic inequalities which are amplified by restrictive social norms and legal systems. We analyse these inequalities along the reproductive health continuum amongst adolescent girls in Zambia. METHODOLOGY This paper draws from 20 focus group discussions conducted in 2021 with community members (young/adult) in five urban, peri urban, and rural sites in Zambia. Data was analysed using thematic analysis. RESULTS Adolescent pregnancy in the community was reported to be very common across the communities with girls from poorer families being disproportionately affected. Parents were reported to be complicit in facilitating their daughter's sexual-economic exchanges which emerged as a key driver of pregnancies. Young age and unmarried status meant adolescent girls could face triple stigma: stigma around accessing contraception to prevent a pregnancy, stigma in experiencing an unintended pregnancy and stigma around terminating an unintended pregnancy. There were clear socioeconomic differences in adolescent girl's exposure to community and health provider censure and/or acceptance of their pregnancy, and in their ability to conceal an abortion. Having the means to pay for health care allows some adolescents to seek terminations earlier and to access private health facilities while poorer adolescent girls face greater exposure to community censure through their embeddedness within the community. Abortions in this group attracts greater visibility through complications arising from their constrained choice for safe abortion methods. Stigmatising attitudes of community members also undermined adolescents' reproductive agency and mental health. For adolescents who choose to keep an unintended pregnancy, reintegration into school was highly challenging despite a national policy in place, with marriage being viewed as the only future option for poorer teenage mothers. CONCLUSION The embeddedness of adolescent pregnancies within community structures of economic insecurity and gendered and age-related power relations highlight the importance of introducing community level approaches to tackle unintended pregnancies and unsafe abortion. Understanding teenage pregnancy as a community issue creates opportunities for community level support to young girls especially when they return to school.
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Affiliation(s)
- Joseph Mumba Zulu
- Department of Health Promotion and Education, School of Public Health, University of Zambia, PO Box 50110, Lusaka, Zambia.
- Department of Health Policy and Management, School of Public Health, University of Zambia, PO Box 50110, Lusaka, Zambia.
| | - Tamaryn L Crankshaw
- Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-Natal, Durban, South Africa
| | - Ramatou Ouedraogo
- African Population and Health Research Center (APHRC), PO Box 10787-00100, Nairobi, Kenya
| | - Kenneth Juma
- African Population and Health Research Center (APHRC), PO Box 10787-00100, Nairobi, Kenya
| | - Carolien J Aantjes
- Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-Natal, Durban, South Africa
- Faculty of Science, Athena Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Tolossa T, Gold L, Dheresa M, Turi E, Yeshitila YG, Abimanyi-Ochom J. Adolescent maternal health services utilization and associated barriers in Sub-Saharan Africa: A comprehensive systematic review and meta-analysis before and during the sustainable development goals. Heliyon 2024; 10:e35629. [PMID: 39170315 PMCID: PMC11336889 DOI: 10.1016/j.heliyon.2024.e35629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Revised: 07/31/2024] [Accepted: 08/01/2024] [Indexed: 08/23/2024] Open
Abstract
Introduction Effective and adequate maternal health service utilization is critical for improving maternal and newborn health, reducing maternal and perinatal mortality, and important to achieve global sustainable development goals (SDGs). The purpose of this systematic review was to assess adolescent maternal health service utilization and its barriers before and during SDG era in Sub-Saharan Africa (SSA). Methods Systematic review of published articles, sourced from multiple electronic databases such as Medline, PubMed, Scopus, Embase, CINAHL, PsycINFO, Web of Science, African Journal Online (AJOL) and Google Scholar were conducted up to January 2024. Assessment of risk of bias in the individual studies were undertaken using the Johanna Briggs Institute (JBI) quality assessment tool. The maternal health service utilization of adolescent women was compared before and after adoption of SDGs. Barriers of maternal health service utilization was synthesized using Andersen's health-seeking model. Meta-analysis was carried out using the STATA version 17 software. Results Thirty-eight studies from 15 SSA countries were included in the review. Before adoption of SDGs, 38.2 % (95 % CI: 28.5 %, 47.9 %) adolescents utilized full antenatal care (ANC) and 44.9 % (95%CI: 26.2, 63.6 %) were attended by skilled birth attendants (SBA). During SDGs, 42.6 % (95 % CI: 32.4 %, 52.8 %) of adolescents utilized full ANC and 53.0 % (95 % CI: 40.6 %, 65.5 %) were attended by SBAs. Furthermore, this review found that adolescent women's utilization of maternal health services is influenced by various barriers, including predisposing, enabling, need, and contextual factors. Conclusions There was a modest rise in the utilization of ANC services and SBA from the pre-SDG era to the SDG era. However, the level of maternal health service utilization by adolescent women remains low, with significant disparities across SSA regions and multiple barriers to access services. These findings indicate the importance of developing context-specific interventions that target adolescent women to achieve SDG3 by the year 2030.
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Affiliation(s)
- Tadesse Tolossa
- Department of Public Health, Institutes of Health Sciences, Wollega University, Nekemte, Ethiopia
- Deakin University, Deakin Health Economics, School of Health and Social Development, Institute for Health Transformation, Faculty of Health, Geelong, 3220, Australia
| | - Lisa Gold
- Deakin University, Deakin Health Economics, School of Health and Social Development, Institute for Health Transformation, Faculty of Health, Geelong, 3220, Australia
| | - Merga Dheresa
- Haramaya University, College of Health and Medical Sciences, Department of Nursing and Midwifery, Harar, Ethiopia
| | - Ebisa Turi
- Department of Public Health, Institutes of Health Sciences, Wollega University, Nekemte, Ethiopia
- Deakin University, Deakin Health Economics, School of Health and Social Development, Institute for Health Transformation, Faculty of Health, Geelong, 3220, Australia
| | - Yordanos Gizachew Yeshitila
- Deakin University, Deakin Health Economics, School of Health and Social Development, Institute for Health Transformation, Faculty of Health, Geelong, 3220, Australia
- School of Nursing, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
- Intergenerational Health, Murdoch Children’s Research Institute, Parkville, Victoria, Australia
| | - Julie Abimanyi-Ochom
- Deakin University, Deakin Health Economics, School of Health and Social Development, Institute for Health Transformation, Faculty of Health, Geelong, 3220, Australia
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Lassi ZS, Rahim KA, Stavropoulos AM, Ryan LM, Tyagi J, Adewale B, Kurji J, Bhaumik S, Meherali S, Ali M. Use of contraceptives, empowerment and agency of adolescent girls and young women: a systematic review and meta-analysis. BMJ SEXUAL & REPRODUCTIVE HEALTH 2024; 50:195-211. [PMID: 38479786 PMCID: PMC11287556 DOI: 10.1136/bmjsrh-2023-202151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 02/19/2024] [Indexed: 04/21/2024]
Abstract
INTRODUCTION The evidence on adolescent empowerment, which involves access to personal and material resources for reproductive autonomy and economic equity, is limited. This systematic review assesses the use of contraceptives in empowering and strengthening the agency and vice versa among adolescents and young women. METHODS We ran the searches in six electronic databases: Cochrane Database of Systematic Reviews (CDSR) and the Cochrane Central Register of Controlled Trials (CENTRAL), The Campbell Library, MEDLINE (PubMed), EMBASE, Cumulated Index to Nursing and Allied Health Literature (CINAHL) and Web of Science. The methodological quality of studies was assessed using ROBINS-I and ROB-II tools as appropriate. Meta-analysis was performed using Review Manager 5.4. RESULTS Forty studies that assessed the impact of empowerment on contraceptive use were included. Of these, 14 were non-randomised studies for intervention (NRSIs), and the remaining 26 were randomised controlled trials (RCTs). The results from RCTs show a significant effect of the sexual and reproductive health empowerment in increasing ever use of contraception (RR 1.22; 95% CI 1.02, 1.45; n=9; I²=77%; GRADE: Very Low), and insignificant effect on unprotected sex (RR 0.97; 95% CI 0.74, 1.26; n=5; I²=86%; GRADE: Very Low) and adolescent pregnancy (RR 1.07; 95% CI 0.61, 1.87; n=3; I²=36%; GRADE: Very Low). None of the studies assessed impact of contraceptive use on empowerment. CONCLUSIONS Empowerment of adolescents and young women certainly improves contraceptive use in the immediate or short-term period. However, more robust studies with low risk of bias, longer-term outcomes, and impact of contraceptive use on empowerment and agency-strengthening are required. To increase contraceptive use uptake, tailored policies and delivery platforms are necessary for youth in low- and middle-income countries.
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Affiliation(s)
- Zohra S Lassi
- School of public health, Faculty of health and medical sciences, The University of Adelaide, Adelaide, South Australia, Australia
- Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia
| | - Komal Abdul Rahim
- Dean's Office, Medical College, Aga Khan University, Karachi, Pakistan
- Center of Excellence in Trauma and Emergencies, Aga Khan University, Karachi, Pakistan
| | | | - Lareesa Marie Ryan
- Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia
| | - Jyoti Tyagi
- George Institute of Global Health, New Delhi, India
| | - Bisi Adewale
- University of Alberta, Edmonton, Alberta, Canada
| | - Jaameeta Kurji
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Soumyadeep Bhaumik
- Meta-Research and Evidence Synthesis Unit, Health Systems Science, George Institute of Global Health, New Delhi, India
- George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales (UNSW Sydney), Sydney, New South Wales, Australia
| | | | - Moazzam Ali
- Department of Sexual and Reproductive Health, World Health Organization, Geneva, Switzerland
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Sidamo NB, Abebe Kerbo A, Gidebo KD, Wado YD. Adolescent utilization of sexual and reproductive health services in Gamo Zone, Southern Ethiopia. Insights from multilevel and latent class analysis. FRONTIERS IN REPRODUCTIVE HEALTH 2024; 6:1356969. [PMID: 39021710 PMCID: PMC11251959 DOI: 10.3389/frph.2024.1356969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Accepted: 06/17/2024] [Indexed: 07/20/2024] Open
Abstract
Introduction Adolescents face unique challenges related to their sexual and reproductive health (SRH), with access to timely services being critical for positive outcomes. However, SRH service utilization among adolescents remains low. This study aimed to identify factors influencing SRH service use among adolescents in Gamo Zone, Ethiopia. Methods A community-based cross-sectional study involved 1172 adolescents selected through stratified sampling. Structured face-to-face interviews were employed for data collection. Multilevel mixed logistic regression was fitted to identify factors and latent class analysis was conducted to understand population heterogeneity. Results The findings of this study reveal that 198 (16.89%) adolescents (95% CI: 14.8%-19.2%) utilized SRH services within the past 12 months. Factors significantly associated with SRH service utilization included good knowledge about SRH rights (AOR = 4.65; 95% CI: 2.68, 8.07), belonging to one-parent families (AOR = 4.13; 95% CI: 2.39, 7.12), engaging in parental discussions regarding SRH issues (AOR = 3.17; 95% CI: 1.89, 5.29), high family support (AOR = 1.96; 95% CI: 1.09, 3.51), and enrolling in school (AOR = 0.19; 95% CI: 0.11, 0.33). Additionally, access to social media was associated with increased SRH service utilization among adolescents (AOR = 1.98; 95% CI: 1.25, 3.15). Latent class analysis identified four groups: rural school-enrolled adolescents living with parents, urban school-enrolled adolescents with both parents, urban disadvantaged female adolescents, and early adolescents with limited social media access. Conclusions In conclusion, our study sheds light on the utilization of SRH services among adolescents, revealing that 16.89% of the participants accessed these services within the past year. Significant factors associated with SRH service utilization included good knowledge about SRH rights, belonging to one-parent families, engaging in parental discussions regarding SRH issues, high family support, and enrollment in school. Interestingly, access to social media was also linked to increased utilization of SRH services among adolescents. Furthermore, our latent class analysis identified four distinct classes of adolescents based on socio-demographic indicators, highlighting the heterogeneity within this population. These findings underscore the importance of tailored interventions and targeted approaches to address the diverse needs of adolescents in accessing and utilizing SRH services.
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Affiliation(s)
- Negussie Boti Sidamo
- School of Public Health, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Amene Abebe Kerbo
- School of Public Health, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Kassa Daka Gidebo
- School of Public Health, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
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Jamshidimanesh M, Mohammadkhani N. Translation and adaptation of the person-centered maternity care scale to a Persian-speaking population: a confirmatory factor analysis. BMC Public Health 2024; 24:1619. [PMID: 38886704 PMCID: PMC11184814 DOI: 10.1186/s12889-024-19117-1] [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: 02/04/2024] [Accepted: 06/12/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Recognized as the most exhaustive multidimensional evaluation of women's person-centered experiences during childbirth, the Person-Centered Maternity Care (PCMC) Scale offers domain-specific insights into facets of care. This instrument has yet to be translated into Persian. Hence, this study purposed to translate and ascertain the reliability and validity of a Persian version of the PCMC scale for postpartum women in Iran. METHODS A cross-sectional study was facilitated at multiple comprehensive health centers within Tehran, Iran, from February 2022 until July 2022. Postpartum women within seven days after childbirth who were referred to selected comprehensive health centers for newborn thyroid screening were conveniently sampled. The validation process for the questionnaire utilized confirmatory factor analysis (CFA), while it gauged convergent validity via factor loads, average variance extracted (AVE), along with composite reliability (CR). Discriminant credibility was evaluated utilizing HTMT alongside the Fornell-Larcker Criteria. Data analysis procedures were conducted through IBM SPSS Statistics for Windows Version 16 and SMART PLS Statistics for Windows Version 4.0.9.9. RESULTS All the items were within the acceptable range of factor loading, except for questions 3 of the facility and 6 of dignity, which were removed from the model. The AVE values for all the variables were above 0.50, and the CR values were above 0.78, indicating convergent validity. On the horizontal loading table, all of the indicators met the conditions. Additionally, the findings validate that the HTMT indicator associated with all constructs remained below 0.9, which confirms divergent relevance about the survey tool under consideration. The composite reliability values also indicated good overall reliability for all the constructs, ranging from 0.78 to 0.91. CONCLUSIONS The results of the present study indicate that the Persian version of the PCMC is a reliable and valid tool for measuring person-centered maternity care in Persian-speaking populations.
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Affiliation(s)
- Mansoureh Jamshidimanesh
- Department of Midwifery, School of Nursing and Midwifery, Iran University Medical and Sciences, Tehran, Iran
| | - Nafiseh Mohammadkhani
- Department of Midwifery, School of Nursing and Midwifery, Iran University Medical and Sciences, Tehran, Iran.
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Odii A, Akamike IC, Mbachu CO, Onwujekwe O. Factors influencing adoption of sexual and reproductive health intervention for adolescents in Ebonyi, Nigeria. BMC Health Serv Res 2024; 24:643. [PMID: 38764028 PMCID: PMC11102607 DOI: 10.1186/s12913-024-11103-y] [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: 10/06/2023] [Accepted: 05/10/2024] [Indexed: 05/21/2024] Open
Abstract
BACKGROUND School and Community-embedded reproductive health interventions have been implemented in developing countries, with evidence that they led to improved sexual and reproductive health among adolescents. However, this type of intervention is rarely evaluated for its potential adoption and use. This study evaluated the constraints and enablers of the adoption of a school and community-embedded intervention that used community engagement, capacity building, partnerships and collaborations to deliver sexual and reproductive health services to adolescents. METHODS The intervention was implemented between 2019 and 2021 in six local government areas in Ebonyi State. The results on adoption presented here were collected four months into the mid-phase of the project, targeting adolescents, parents, adult family members, healthcare providers, local authorities, and community members. Sixteen in-depth interviews were conducted with policymakers, 14 with health service providers and 18 Focus Group Discussions (FGDs) with parents, community leaders and adolescents who were part of the implementation process. The coding reliability approach, a type of thematic data analysis was used, that involves early theme development and the identification of evidence for the themes. RESULTS The adoption of school and community-embedded reproductive health intervention was strong among stakeholders at the early stages of the implementation process. Multi-stakeholder involvement and its multi-component approach made the intervention appealing, thereby enabling its adoption. However, at the later stage, the adoption was constrained by beliefs and norms about sexual and reproductive health (SRH) and the non-incentivisation of stakeholders who acted as advocates at the community level. The sustainability of the intervention may be threatened by the non-incentivisation of stakeholders and the irregular supply of materials and tools to facilitate SRH advocacy at the community level. CONCLUSIONS The inclusive community-embedded reproductive health intervention was adopted by stakeholders because of the enablers which include timely stakeholder engagement. However, for it to be sustainable, implementers must address the non-incentivising of community-level advocates which serve as constraints.
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Affiliation(s)
- Aloysius Odii
- Health Policy Research Group, University of Nigeria Nsukka, Enugu, Nigeria
- Department of Sociology/Anthropology, University of Nigeria, Nsukka, Enugu, Nigeria
| | - Ifeyinwa Chizoba Akamike
- Health Policy Research Group, University of Nigeria Nsukka, Enugu, Nigeria.
- Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi, Nigeria.
| | - Chinyere Ojiugo Mbachu
- Health Policy Research Group, University of Nigeria Nsukka, Enugu, Nigeria
- Department of Community Medicine, College of Medicine, University of Nigeria, Enugu, Nigeria
| | - Obinna Onwujekwe
- Health Policy Research Group, University of Nigeria Nsukka, Enugu, Nigeria
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Qureshi MJ, Miller AP, Mugamba S, Kyasanku E, Nalugoda F, Bulamba RM, Kigozi G, Nakigozi G, Nkale J, Kato P, Nalwoga GK, Watya S, Wagman JA. Women's access to family planning and experiences of reproductive coercion during the COVID-19 lockdown in two districts of Uganda. Heliyon 2024; 10:e30216. [PMID: 38765155 PMCID: PMC11098776 DOI: 10.1016/j.heliyon.2024.e30216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 04/22/2024] [Accepted: 04/22/2024] [Indexed: 05/21/2024] Open
Abstract
Background In March 2020, Uganda enforced country-wide restrictions to control the spread of SARS-CoV-2, categorizing some health services, including family planning (FP), as non-essential. Globally, similar COVID-19 restrictions have been associated with increased vulnerability to reproductive coercion (RC) among women, due to changes in FP service availability and restricted access by partners. This study aims to investigate these dynamics in Uganda, specifically examining the impact of the COVID-19 lockdown on women's access to FP, their experiences of RC, and the relationship between RC and intimate partner violence (IPV). Methods We conducted a cross-sectional analysis of data from 960 women participating in the AMBSO Population Health Surveillance Study (APHS) between August 2020 and March 2021 across Wakiso (N = 164) and Hoima (N = 796) districts in Uganda. Our analysis focused on women who were sexually active in the past month, using bivariate analyses to explore the associations between RC and recent experiences of sexual, physical, and verbal IPV. Findings The most commonly reported FP methods were injectables (36.8 %) and implants (16 %). Despite the COVID-19 lockdown, less than one percent of participants reported an inability to access their preferred FP method. Notably, 3 % of the women experienced RC in the past 12 months. There was a significant association between RC and sexual IPV (p < 0.0001), as well as physical IPV (p < 0.0001). Instances of verbal IPV were observed to have tripled during the lockdown period. Interpretation An increase in verbal IPV was found among women during the COVID-19 lockdown. Additionally, a notable association emerged between other forms of IPV and an increased risk of RC. Despite the lockdown, access to FP remained high, which could be attributed to the prevalent use of long-acting FP methods.
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Affiliation(s)
- Mira J. Qureshi
- Department of Community Health Sciences, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | - Amanda P. Miller
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, CA, USA
| | - Stephen Mugamba
- Africa Medical and Behavioral Sciences Organization (AMBSO), Plot 7441, Nansana, Hoima Road, Wakiso, P.O Box 37565 Kampala, Uganda
| | - Emmanuel Kyasanku
- Africa Medical and Behavioral Sciences Organization (AMBSO), Plot 7441, Nansana, Hoima Road, Wakiso, P.O Box 37565 Kampala, Uganda
| | - Fred Nalugoda
- Africa Medical and Behavioral Sciences Organization (AMBSO), Plot 7441, Nansana, Hoima Road, Wakiso, P.O Box 37565 Kampala, Uganda
| | - Robert Malyabe Bulamba
- Africa Medical and Behavioral Sciences Organization (AMBSO), Plot 7441, Nansana, Hoima Road, Wakiso, P.O Box 37565 Kampala, Uganda
| | - Godfrey Kigozi
- Africa Medical and Behavioral Sciences Organization (AMBSO), Plot 7441, Nansana, Hoima Road, Wakiso, P.O Box 37565 Kampala, Uganda
| | - Gertrude Nakigozi
- Africa Medical and Behavioral Sciences Organization (AMBSO), Plot 7441, Nansana, Hoima Road, Wakiso, P.O Box 37565 Kampala, Uganda
| | - James Nkale
- Africa Medical and Behavioral Sciences Organization (AMBSO), Plot 7441, Nansana, Hoima Road, Wakiso, P.O Box 37565 Kampala, Uganda
| | - Phillip Kato
- Africa Medical and Behavioral Sciences Organization (AMBSO), Plot 7441, Nansana, Hoima Road, Wakiso, P.O Box 37565 Kampala, Uganda
| | - Grace Kigozi Nalwoga
- Africa Medical and Behavioral Sciences Organization (AMBSO), Plot 7441, Nansana, Hoima Road, Wakiso, P.O Box 37565 Kampala, Uganda
| | - Stephen Watya
- Africa Medical and Behavioral Sciences Organization (AMBSO), Plot 7441, Nansana, Hoima Road, Wakiso, P.O Box 37565 Kampala, Uganda
| | - Jennifer A. Wagman
- Department of Community Health Sciences, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
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Fikadu T, Gebru Z, Abebe G, Tesfaye S, Zeleke EA. Assessment of mothers' satisfaction towards child vaccination service in South Omo zone, South Ethiopia region: a survey on clients' perspective. BMC Womens Health 2024; 24:272. [PMID: 38724930 PMCID: PMC11080138 DOI: 10.1186/s12905-024-03120-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 04/29/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND Even though childhood vaccination is a common and cost-effective public health intervention in preventing and reducing childhood disease and death, significant numbers of children do not complete vaccination within the first year of life. Studies indicated that user satisfaction influences service utilization and used as a key indicator of quality care. However, evidence on the level of mothers' satisfaction with immunization service are limited in urban and accessible places and not well investigated among remote and pastoral communities. As such, this study aimed to address this gap and investigated mothers' satisfaction towards child vaccination in a pastoralist and agrarian community of the South Omo zone in Southern region of Ethiopia. METHODS An institution-based cross-sectional study was conducted among 1221 randomly selected mothers with children eligible for childhood vaccination using a structured, pretested, and interviewer-administered questionnaire. Maternal positive evaluations of the overall vaccination service were measured using 5-point Likert scale questions. Data were entered into Epi data version 3.5.1 and analyzed using IBM SPSS statistical package version 25. Exploratory factor analysis was used for Likert scale questions to extract factor scores which facilitate treatment of variables as continuous for further analysis. Bivariate and multivariable logistic regression analysis was employed to identify factors associated with the outcome variable. A P-value < 0.05 and adjusted odds ratio with 95% CI respectively were used to declare statistical significance and degree of association. RESULT A total of 849 (69.53%) study participants were satisfied with the vaccination care provided for their children. Factors associated with mother's satisfaction with child vaccination care include maternal age less than 30 years (AOR = 2.12; 95% CI = 1.61-2.79), infants age between 8 and 12 months (AOR = 1.83; 95% CI = 1.28, 2.62), not having history of adverse events following immunization (AOR = 1.57; 95% CI = 1.01-2.45), having 1 child under the age of 5 years (AOR = 1.34; 95% CI = 1.02-1.76), waiting 30 min or less to get the service (AOR = 1.39; 95% CI = 1.05-1.85), traveling 30 min or less to the vaccination center (AOR = 1.46; 95% CI = 1.08-1.98), having poor knowledge about the importance of vaccination (AOR = 1.51; 95% CI = 1.06-2.16), and having moderate knowledge about the importance of vaccination (AOR = 1.52; 95% CI = 1.06-2.18). CONCLUSION Interestingly, mothers' satisfaction with their children's vaccination service was relatively higher in a predominantly pastoral community compared with most of previous studies conducted in Ethiopia. Maternal and child age, number of children under the age of 5 years, history of adverse events following immunization, distance to the vaccination center, waiting time to get service and maternal knowledge were factors significantly associated with mothers' satisfaction. Proactive measures with focus on increasing access to vaccination service, improving waiting time and raising awareness among mothers were recommended.
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Affiliation(s)
- Teshale Fikadu
- School of Public Health, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia.
| | - Zeleke Gebru
- School of Public Health, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Getachew Abebe
- Department of Clinical Anatomy, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | | | - Eshetu Andarge Zeleke
- School of Public Health, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
- College of Medicine and Public Health, Flinders University, Flinders Health and Medical Research Institute, Adelaide, South Australia
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Mulubwa C, Zulu JM, Hurtig AK, Goicolea I. Being both a grandmother and a health worker: experiences of community-based health workers in addressing adolescents' sexual and reproductive health needs in rural Zambia. BMC Public Health 2024; 24:1228. [PMID: 38702694 PMCID: PMC11069181 DOI: 10.1186/s12889-024-18685-6] [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: 04/16/2023] [Accepted: 04/22/2024] [Indexed: 05/06/2024] Open
Abstract
INTRODUCTION Community-based health workers (CBHWs) possess great potential to be the missing link between the community and the formal health system for improving adolescents' access to sexual and reproductive health and rights (SRHR) information and services. Yet, their role in addressing adolescents' SRHR within the context of the community-based health system has received very little attention. This paper analyses how CBHWs experience and perceive their role in addressing adolescents' SRHR needs in rural Zambia, including the possible barriers, dilemmas, and opportunities that emerge as CBHWs work with adolescents. METHODS Between July and September 2019, we conducted 14 in-depth interviews with 14 community-based health workers recruited across 14 different communities in the central province of Zambia. The interviews were focused on eliciting their experiences and perceptions of providing sexual and reproductive health services to adolescents. Charmaz's grounded theory approach was used for the analysis. RESULTS We present the core category "being both a grandmother and a CBHW", which builds upon four categories: being educators about sexual and reproductive health; being service providers and a link to SRHR services; being advocates for adolescents' SRHR; and reporting sexual violence. These categories show that CBHWs adopt a dual role of being part of the community (as a grandmother) and part of the health system (as a professional CBHW), in order to create/maximise opportunities and navigate challenges. CONCLUSION Community-based health workers could be key actors providing context-specific comprehensive SRHR information and services that could span all the boundaries in the community-based health system. When addressing adolescents SRHR, playing dual roles of being both a grandmother and a professional CBHW were sometimes complimentary and at other times conflicting. Additional research is required to understand how to improve the role of CBHWs in addressing adolescents and young people's sexual and reproductive health.
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Affiliation(s)
- Chama Mulubwa
- School of Public Health, University of Zambia, P.O. Box 50110, Lusaka, Zambia.
- Department of Epidemiology and Global Health, Umeå University, Umeå, SE, Sweden.
- Centre for Infectious Disease Research in Zambia (CIDRZ), P.O Box 34681, Lusaka, Zambia.
| | - Joseph Mumba Zulu
- School of Public Health, University of Zambia, P.O. Box 50110, Lusaka, Zambia
| | - Anna-Karin Hurtig
- Department of Epidemiology and Global Health, Umeå University, Umeå, SE, Sweden
| | - Isabel Goicolea
- Department of Epidemiology and Global Health, Umeå University, Umeå, SE, Sweden
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Tikmani SS, Mårtensson T, Roujani S, Feroz AS, Seyfulayeva A, Mårtensson A, Brown N, Saleem S. Exploring gestational age, and birth weight assessment in Thatta district, Sindh, Pakistan: Healthcare providers' knowledge, practices, perceived barriers, and the potential of a mobile app for identifying preterm and low birth weight. PLoS One 2024; 19:e0299395. [PMID: 38603767 PMCID: PMC11008874 DOI: 10.1371/journal.pone.0299395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 02/09/2024] [Indexed: 04/13/2024] Open
Abstract
INTRODUCTION Reliable methods for identifying prematurity and low birth weight (LBW) are crucial to ending preventable deaths in newborns. This study explored healthcare providers' (HCPs) knowledge, practice, perceived barriers in assessing gestational age and birth weight and their referral methods for preterm and LBW infants. The study additionally assessed the potential of using a mobile app for the identification and referral decision of preterm and LBW. METHODS This qualitative descriptive study was conducted in Thatta District, Sindh, Pakistan. Participants, including doctors, nurses, lady health visitors, and midwives, were purposefully selected from a district headquarter hospital, and private providers in the catchment area of Global Network's Maternal and Newborn Health Registry (MNHR). Interviews were conducted using an interview guide after obtaining written informed consent. Audio recordings of the interviews were transcribed and analyzed using NVIVO® software with an inductive approach. RESULTS The HCPs had extensive knowledge about antenatal and postnatal methods for assessing gestational age. They expressed a preference for antenatal ultrasound due to the perceived accuracy, though accept practical barriers including workload, machine malfunctions, and cost. Postnatal assessment using the Ballard score was only undertaken sparingly due to insufficient training and subjectivity. All HCPs preferred electronic weighing scales for birth weight Barriers encountered included weighing scale calibration and battery issues. There was variation in the definition of prematurity and LBW, leading to delays in referral. Limited resources, inadequate education, and negative parent past experiences were barriers to referral. Foot length measurements were not currently being used. While mobile apps are felt to have potential, unreliable electricity supply and internet connectivity are barriers. CONCLUSION The HCPs in this study were knowledgeable in terms of potential tools, but acknowledged the logistical and parental barriers to implementation.
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Affiliation(s)
- Shiyam Sunder Tikmani
- Department of Women’s & Children’s Health, Global Health & Migration Unit, Uppsala University, Uppsala, Sweden
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Thomas Mårtensson
- Department of Women’s & Children’s Health, Global Health & Migration Unit, Uppsala University, Uppsala, Sweden
| | - Sana Roujani
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Anam Shahil Feroz
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Canada
| | - Ayshe Seyfulayeva
- National School of Public Health, The NOVA University of Lisbon, Lisbon, Portugal
| | - Andreas Mårtensson
- Department of Women’s & Children’s Health, Global Health & Migration Unit, Uppsala University, Uppsala, Sweden
| | - Nick Brown
- Department of Women’s & Children’s Health, Global Health & Migration Unit, Uppsala University, Uppsala, Sweden
| | - Sarah Saleem
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
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Rubaiya, Mansur M, Alam MM, Rayhan MI. Unraveling birth weight determinants: Integrating machine learning, spatial analysis, and district-level mapping. Heliyon 2024; 10:e27341. [PMID: 38562507 PMCID: PMC10982972 DOI: 10.1016/j.heliyon.2024.e27341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 02/27/2024] [Accepted: 02/28/2024] [Indexed: 04/04/2024] Open
Abstract
Despite a decrease in the prevalence of low birth weight (LBW) over time, its ongoing significance as a public health concern in Bangladesh remains evident. Low birth weight is believed to be a contributing factor to infant mortality, prolonged health complications, and vulnerability to non-communicable diseases. This study utilizes nationally representative data from the Multiple Indicator Cluster Surveys (MICS) conducted in 2012-2013 and 2019 to explore factors associated with birth weight. Modeling birth weight data considers interactions among factors, clustering in data, and spatial correlation. District-level maps are generated to identify high-risk areas for LBW. The average birth weight has shown a modest increase, rising from 2.93 kg in 2012-2013 to 2.96 kg in 2019. The study employs a regression tree, a popular machine learning algorithm, to discern essential interactions among potential determinants of birth weight. Findings from various models, including fixed effect, mixed effect, and spatial dependence models, highlight the significance of factors such as maternal age, household head's education, antenatal care, and few data-driven interactions influencing birth weight. District-specific maps reveal lower average birth weights in the southwestern region and selected northern districts, persisting across the two survey periods. Accounting for hierarchical structure and spatial autocorrelation improves model performance, particularly when fitting the most recent round of survey data. The study aims to inform policy formulation and targeted interventions at the district level by utilizing a machine learning technique and regression models to identify vulnerable groups of children requiring heightened attention.
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Affiliation(s)
- Rubaiya
- Institute of Statistical Research and Training, University of Dhaka, Bangladesh
| | - Mohaimen Mansur
- Institute of Statistical Research and Training, University of Dhaka, Bangladesh
| | - Md. Muhitul Alam
- Institute of Statistical Research and Training, University of Dhaka, Bangladesh
| | - Md. Israt Rayhan
- Institute of Statistical Research and Training, University of Dhaka, Bangladesh
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Lutasingwa D, Favina A, Ochora M, Rukanikigitero JMV, Gutabarwa LT, Kagaba A, Kaggwa MM. Level of Knowledge on Sexual and Reproductive Health Rights Among the Teenage Mothers and Their Parents in Rwanda: A Comparative Cross-Sectional Study. Risk Manag Healthc Policy 2024; 17:159-169. [PMID: 38250218 PMCID: PMC10799567 DOI: 10.2147/rmhp.s437217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 01/11/2024] [Indexed: 01/23/2024] Open
Abstract
Background Parents are the primary caregivers and influential figures in adolescents' lives. They play a crucial role in shaping their children's attitudes, beliefs, and behaviors regarding sexual reproductive health. A vast difference in knowledge between adolescents and their parents indicates failure in knowledge translation and is associated with sexual and reproductive consequences, such as teenage pregnancies. Methods In this cross-sectional study between December 2020 and December 2021, 834 teenage mothers and their parents/guardians (n = 861) were enrolled from all five provinces of Rwanda. Knowledge of sexual reproductive health (SRH) rights was assessed, and the differences between the understanding of parents and their children were analyzed using Chi-square tests. Results There were statistically significant differences for all the assessed aspects of SRH knowledge rights between parents and their teenagers (ie, on the age of consent, safe abortion, right to education for teenage mothers, understanding of financial responsibilities, and perceptions of legal consequences). Conclusion There is a significant knowledge difference between the two generations regarding their understanding of SRH rights. It is recommended that future programming should devise innovative ways that bring together parents and their children to discuss sexual reproductive health rights, which will result in empowered children and teenagers in Rwanda. Also, awareness programs are needed to improve the knowledge gaps regarding SRH in the public by policymakers, NGOs, and educators.
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Affiliation(s)
- Dan Lutasingwa
- Department of Research, Health Development Initiative, Kicukiro District, Kigali City, Rwanda
| | - Alain Favina
- Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Moses Ochora
- Department of Pediatric, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | | | | | - Aflodis Kagaba
- Department of Research, Health Development Initiative, Kicukiro District, Kigali City, Rwanda
| | - Mark Mohan Kaggwa
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- Forensic Psychiatry Program, St. Joseph Healthcare, Hamilton, ON, Canada
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De P, Pradhan MR. Effectiveness of mobile technology and utilization of maternal and neonatal healthcare in low and middle-income countries (LMICs): a systematic review. BMC Womens Health 2023; 23:664. [PMID: 38082424 PMCID: PMC10714653 DOI: 10.1186/s12905-023-02825-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 12/01/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Maternal and neonatal mortality are important indicators of the development of a nation and pose a severe health concern, especially in developing and Low and Middle-Income Countries (LMICs). Healthcare providers use various mobile technologies as tools to provide antenatal, delivery, and postnatal care and thereby promote maternal and child health. We conducted a systematic review to critically assess the existing literature on the effectiveness of mobile phone technology in maternal and neonatal healthcare (MNH) utilization, especially in LMICs in Asia and Africa. METHODS A systematic search strategy was developed, and Boolean combinations of relevant keywords were utilized to search relevant literature on three electronic databases (PubMed/Medline, Scopus, and Google Scholar) from 2012 to 2022. After assessing the inclusion and exclusion criteria, 25 articles were selected for systematic review. A narrative synthesis strategy was applied to summarise the information from the included literature. RESULTS This review reveals that research and evaluation studies on mobile phone or Mobile Health (mHealth) and MNH service utilization substantially varied by research designs and methodology. Most studies found that mobile phone technology is highly appreciable in improving several MNH indicators, especially in LMICs. Despite the identified benefits of mobile technology in MNH utilization, some studies also mentioned challenges related to technology use and misuse, rich-poor discrimination, and disparity in phone ownership need to be addressed. CONCLUSION There is constantly increasing evidence of mobile counseling and the use of digital technology in the MNH care system. Public health practitioners and policymakers need to make efforts to smooth the functioning of technology-based healthcare services, considering all the issues related to the confidentiality and safety of health-related data on the Internet.
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Affiliation(s)
- Prasenjit De
- Department of Fertility and Social Demography, International Institute for Population Sciences (IIPS), Govandi Station Road, Deonar, Mumbai, 400088, Maharashtra, India.
| | - Manas Ranjan Pradhan
- Department of Fertility and Social Demography, International Institute for Population Sciences (IIPS), Govandi Station Road, Deonar, Mumbai, 400088, Maharashtra, India
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Mukomafhedzi N, Tshitangano TG, Tshivhase SE, Olaniyi FC. Protocol to develop a framework addressing barriers to utilization of elimination of mother- to -child transmission of HIV services among pregnant women and lactating mothers in Gauteng province. MethodsX 2023; 11:102351. [PMID: 37830000 PMCID: PMC10565866 DOI: 10.1016/j.mex.2023.102351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 08/26/2023] [Indexed: 10/14/2023] Open
Abstract
Mother-to-child transmission of HIV remains the primary contributor to HIV infections in children, globally. Despite the progress made to reduce new HIV infections in children, barriers to utilization of the Elimination of Mother-to-Child Transmission service remain the bottleneck that affects the program's effectiveness. This study aims to develop a framework to address barriers to the utilization of the Elimination of Mother-to-Child Transmission of HIV services among pregnant women and lactating mothers in Gauteng province. A convergent parallel mixed methods design will be employed in phases. Phase 1(a) quantitative will be collected from pregnant women and lactating mothers to describe barriers associated with poor utilization of elimination of mother-to-child transmission services and a potential strategy to facilitate EMTCT utilization; phase 1(b) qualitative data will be collected to explore reasons for poor utilization of EMTCT services and perceived strategy to enhance women's utilization of elimination of mother-to-child transmission services. Quantitative data will be analyzed using Stata software version 14.0 and qualitative data will be analyzed thematically and then results will be integrated. Phase 2: will focus on the development of a framework; Phase 3: will validate the developed framework. The conclusion and recommendations will be based on the findings of the study.
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Affiliation(s)
- Ndivhuwo Mukomafhedzi
- Department of Public Health, School of Health Sciences, University of Venda, Thohoyandou, South Africa
| | - Takalani G. Tshitangano
- Department of Public Health, School of Health Sciences, University of Venda, Thohoyandou, South Africa
| | - Shonisani E. Tshivhase
- Department of Public Health, School of Health Sciences, University of Venda, Thohoyandou, South Africa
| | - Foluke C. Olaniyi
- Department of Public Health, School of Health Sciences, University of Venda, Thohoyandou, South Africa
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Laurenzi CA, Toska E, Tallarico R, Sherr L, Steventon Roberts KJ, Hansen M, Tolmay J, Jochim J, Ameyan W, Yates R. Key normative, legal, and policy considerations for supporting pregnant and postpartum adolescents in high HIV-burden settings: a critical analysis. Sex Reprod Health Matters 2023; 31:2249696. [PMID: 37712411 PMCID: PMC10506436 DOI: 10.1080/26410397.2023.2249696] [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: 09/16/2023] Open
Abstract
Rates of adolescent pregnancy within sub-Saharan Africa are increasing. Adolescent mothers ages 10-19 years face a distinct set of risks to their own and their children's health, compounded by many economic, social, and epidemiological challenges, such as living with HIV. In navigating this complex developmental period, many adolescent mothers face structural barriers impeding safe transitions to adulthood and motherhood. Drawing on existing literature and emerging data, we outline three normative, legal, and policy issues - violence and gender inequity, access to sexual and reproductive health services, and access to social and structural supports - which affect the health, wellbeing and development of adolescent mothers and their children. We also highlight emergent evidence about programming and policy changes that can better support adolescent mothers and their children. These key proposed responses include removing barriers to SRH and HIV service integration; ensuring implementation of return-to-school policies; and extending social protection systems to cater for adolescent mothers. Despite ongoing global crises and shifts in funding priorities, these normative, legal, and policy considerations remain critical to safeguard the health and wellbeing of adolescent mothers and their children.
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Affiliation(s)
- Christina A. Laurenzi
- Senior Researcher, Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - Elona Toska
- Associate Professor, Centre for Social Science Research, Department of Sociology, University of Cape Town, Rondebosch, South Africa; Co-director, Accelerate Hub, University of Cape Town, Rondebosch, South Africa; Associate Professor, Department of Social Policy and Intervention, Oxford University, Oxford, United Kingdom
| | - Renata Tallarico
- Youth Team Lead and SYP Regional Coordinator, United Nations Population Fund, Eastern and Southern Regional Office, Johannesburg, South Africa
| | - Lorraine Sherr
- Professor, Clinical and Health Psychology, University College London, London, United Kingdom
| | - Kathryn J. Steventon Roberts
- Postdoctoral Researcher, Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom; Postgraduate Researcher, Institute for Global Health, University College London, London, United Kingdom
| | - Maja Hansen
- Technical Advisor, Gender Equality, United Nations Population Fund, Dar es Salaam, Tanzania
| | - Janke Tolmay
- Quantitative Research Assistant, Accelerate Hub, Centre for Social Science Research, University of Cape Town, Rondebosch, South Africa
| | - Janina Jochim
- Postdoctoral Research Officer, Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom
| | - Wole Ameyan
- Technical Officer, Adolescent HIV, Global HIV Hepatitis and Sexually Transmitted Infections Programmes, World Health Organization, Geneva, Switzerland
| | - Rachel Yates
- Strategic Advocacy Lead, Accelerate Hub, University of Oxford, Oxford, United Kingdom
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Derdera SE, Ogato GS. Towards integrated, and sustainable municipal solid waste management system in Shashemane city administration, Ethiopia. Heliyon 2023; 9:e21865. [PMID: 38027681 PMCID: PMC10663929 DOI: 10.1016/j.heliyon.2023.e21865] [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: 08/25/2023] [Revised: 10/28/2023] [Accepted: 10/30/2023] [Indexed: 12/01/2023] Open
Abstract
Solid waste generation is attested to be unavoidable product of human activities. Sustainable management of such waste is a pressing challenge faced in many developing countries today. The study was motivated by the fast growing population and the inefficient waste management system threatening the public health and the image of Shashemene city in Ethiopia. The objectives of the study were: to explore the existing household solid waste management practices, to examine the current governance system of municipal solid waste management, to investigate the contemporary challenges and opportunities of municipal solid waste management, and forward integrated and sustainable municipal solid waste management system for Shashemene city. Data were collected from sampled households, key informants, focus groups, and the city's environment. Data were analyzed by employing quantitative and qualitative methods. 94.8 % of the respondents opined that the solid waste generated in their city is organic in nature (Ash, and sweeps; leftover food, and vegetable peels; paper, and cardboards; green leaves, and grass; and cattle dung). 96.7 % of respondent households opined that they have temporary waste storage in their yards and trash bags were asserted to be widely used (87.6 %) in handling the trash in the courtyard. The waste sorting and recovering practices among the residents is very low and is certainly the major cause for inefficient and unsustainable management system of municipal solid waste in Shashemene city. Generally, a grand mean of 2.23 confirmed the absence of good governance in municipal solid waste management system in Shashemene city. Moreover, the significant proportion of responses ( ≥ 50 %) for each of the nine principles of good governance as either poor or very poor asserted governance failure of the municipal solid waste management system in Shashemene city. The results of the study confirmed that low public awareness on waste management; inadequate collection capacity; poor integration and coordination of stakeholders; environmentally unsound dump site; and illegal dumping by key stakeholders are the major challenges underpinning the unsustainable municipal solid waste management in the city. It is recommended that Shashemene city must adopt integrated sustainable municipal solid waste management system to substantially enhance the waste management service in the city leading to ultimate advancement of public health and environmental quality.
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Affiliation(s)
- Senbet Elmo Derdera
- Former Student at College of Business and Economics, Department of Public Administration and Development Management, Ambo University, Ethiopia
| | - Gemechu Shale Ogato
- Guder Mamo Mezemir Campus, School of Agricultural Economics, and Rural Development, Department of Rural Development, and Agricultural Extension, Ambo University, Ethiopia
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Merga BT, Raru TB, Deressa A, Regassa LD, Gamachu M, Negash B, Birhanu A, Turi E, Ayana GM. The effect of health insurance coverage on antenatal care utilizations in Ethiopia: evidence from national survey. FRONTIERS IN HEALTH SERVICES 2023; 3:1101164. [PMID: 37869683 PMCID: PMC10587574 DOI: 10.3389/frhs.2023.1101164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 09/13/2023] [Indexed: 10/24/2023]
Abstract
Background About three-fourths of maternal near-miss events and two-fifths of the risk of neonatal mortality can be reduced by having at least one antenatal visit. Several studies have identified potential factors related to maternal health seeking behavior. However, the association between health insurance membership and antenatal care utilization was not well investigated in Ethiopia. Therefore, this study was aimed at assessing the effect of health insurance coverage on antenatal care use in Ethiopia. Methods The study utilized data from the 2019 Ethiopia Mini Demographic and Health Survey (EMDHS). The analysis included a weighted sample of 3,919 women who gave birth in the last five years. A logistic regression model was employed to assess the association between antenatal care use and health insurance coverage and other covariates. The results were presented as adjusted odds ratios (AOR) at a 95% confidence interval (CI). Statistical significance was declared at a p-value <0.05 in all analyses. Results Antenatal care was used by 43% (95% CI: 41.46 to 44.56%) of Ethiopian women. Those with health insurance coverage had higher odds of antenatal care use than those without health insurance coverage. Women were 33% more likely to use antenatal care (ANC) if they were covered by health insurance. Age, Media access, marital status, education status, wealth index, and economic regions were also factors associated with antenatal care utilizations. Conclusions According to our findings, less than half of Ethiopian women had four or more antenatal care visits. Health insurance membership, respondent age, media access, marital status, education status, wealth index, and economic region were factors associated with antenatal care utilization. Improving health insurance, women's economic empowerment, and education coverage are critical determinants of antenatal care utilization.
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Affiliation(s)
- Bedasa Taye Merga
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Temam Beshir Raru
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Alemayehu Deressa
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Lemma Demissie Regassa
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Mulugeta Gamachu
- School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
- Department of Public Health, Rift Valley University, Harar, Ethiopia
| | - Belay Negash
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Abdi Birhanu
- School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Ebisa Turi
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Galana Mamo Ayana
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Yousif MG, Zeiny L, Tawfeeq S, Al-Amran F, Sadeq AM, Al-Jumeily D. Predicting perinatal outcomes in women affected by COVID-19: An artificial intelligence (AI) approach. J Med Life 2023; 16:1421-1427. [PMID: 38107716 PMCID: PMC10719791 DOI: 10.25122/jml-2023-0214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 07/17/2023] [Indexed: 12/19/2023] Open
Abstract
This study aimed to explore the role of artificial intelligence (AI) in predicting perinatal outcomes among women with COVID-19. Data was collected from hospitals in the Middle Euphrates and Southern regions of Iraq, with 152 pregnant patients included in the study. Patients were categorized into mild and severe infection groups, and their serum samples were analyzed for mineral levels (magnesium, copper, calcium, sodium, potassium, zinc, selenium, and iron) and immune factors (IL-6, IL-8, IL-32, IL-10, IL-18, IL-37, IL-38, IL-36, and IL-1). The findings revealed significant associations between specific mineral levels, immune factors, and perinatal outcomes. Mineral levels such as magnesium (75.5% mild infection, 80.9% severe infection), copper (68.2% mild infection, 64.3% severe infection), calcium ion (81.8% mild infection, 76.2% severe infection), sodium (70.9% mild infection, 69.0% severe infection), potassium (72.7% mild infection, 71.4% severe infection), zinc (61.8% mild infection, 54.8% severe infection), selenium (78.2% mild infection, 82.9% severe infection), and iron (74.5% mild infection, 68.3% severe infection) showed varying percentages associated with mild and severe infections. Immune factors such as IL-6 (32% mild infection, 21% severe infection), IL-8 (15% mild infection, 7% severe infection), IL-32 (24% mild infection, 9% severe infection), IL-10 (7% mild infection, no severe infection), IL-18 (13% mild infection, 11% severe infection) demonstrated varying percentages associated with perinatal outcomes, while other interleukins showed no changes in severe infections. These results highlight the potential of AI in predicting outcomes for pregnant women with COVID-19, which could aid in improving their management and care. Further research and validation of predictive models are recommended to enhance accuracy and applicability.
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Affiliation(s)
- Maitham Ghaly Yousif
- Biology Department, College of Science, University of Al-Qadisiyah, Al Diwaniyah, Iraq
| | - Luma Zeiny
- Gynecology Department, College of Medicine, University of Kufa, Najaf, Iraq
| | - Shaymaa Tawfeeq
- Gynecology Department, College of Medicine, University of Kufa, Najaf, Iraq
| | - Fadhil Al-Amran
- Gynecology Department, College of Medicine, University of Kufa, Najaf, Iraq
| | - Alaa Mohammed Sadeq
- Cardiovascular Department, College of Medicine, University of Kufa, Najaf, Iraq
| | - Dhiya Al-Jumeily
- Faculty of Engineering and Technology, Liverpool John Moores University, Liverpool, England
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Hensel DJ, Mark KP, Abdelhamed A, Burns S, Esho T, Hendriks J, Jobim Fischer V, Ivanova O, Marks M, Michelsen K, Nimby F, Strizzi J, Tucker J, Uhlich M, Erausquin JT. Changes in Solo and Partnered Sexual Behaviors following the First COVID-19 Wave: Data from an International Study of 26 Countries. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2023; 35:459-480. [PMID: 38601728 PMCID: PMC10903556 DOI: 10.1080/19317611.2023.2224777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 04/21/2023] [Accepted: 05/28/2023] [Indexed: 04/12/2024]
Abstract
Objective To determine individual- and country-level factors associated with self-reported changes in solo and partnered sexual behaviors in an international sample of adults during COVID-19. Methods Data were from the International Sexual Health And REproductive Health during COVID-19 study (I-SHARE)-a cross-sectional, multi-country study (N = 26 countries) assessing adult (N = 19,654) sexual/reproductive health before and during the first wave of COVID-19. We examined self-reported changes (three-point scale: decreased, no change, increased) in solo masturbation, hugging/holding hands/cuddling with a partner, sex with a primary partner, sex with a casual partner, sexting with a partner, viewing sexually explicit media and partnered cybersex. Ordinal regression assessed the impact of individual (age, gender- and sexual-identity, romantic partnership status, employment and income stability, household change and content, mental well-being, changes in alcohol use, and changes in marijuana use) and country-level (e.g., Oxford Stringency Index, Human Development Index, and the Palma Ratio) factors on behavior change. Results The most common behavior to increase was hugging, kissing, or cuddling with a partner (21.5%), and the most common behavior to decrease was sex with a main partner (36.7%). Household factors like job/income instability and having children over the age of 12 years were significantly associated with decreased affectionate and sexual partnered sexual behaviors; more frequent substance use was linked to significantly increased solo, partnered, and virtual sexual behaviors. Conclusions Understanding changes in sexual behaviors-as well as the factors that make changes more or less likely among adults around the world-are important to ensure adequate sexual health support development for future public health emergencies.
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Affiliation(s)
- Devon J. Hensel
- Division of Adolescent Medicine, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Sociology, Indiana University Purdue University-Indianapolis, Indianapolis, IN, USA
| | - Kristen P. Mark
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Amr Abdelhamed
- Department of Dermatology, Venereology & Andrology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Sharyn Burns
- Discipline of Health Promotion & Sexology, Curtin School of Population Health, Curtin University, Perth, Australia
| | | | - Jacqueline Hendriks
- Discipline of Health Promotion & Sexology, Curtin School of Population Health, Curtin University, Perth, Australia
| | - Vinicius Jobim Fischer
- Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Olena Ivanova
- Department of Infectious Diseases, University Hospital LMU Munich, Munich, Germany
| | - Michael Marks
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Kristien Michelsen
- Department of Public Health and Primary Care, University of Ghent, Ghent, Belgium
| | - Fillipo Nimby
- Foundation for Professional Development, Rome, Italy
| | - Jenna Strizzi
- Centre for Medical Science and Technology Studies, University of Copenhagen, Copenhagen, Denmark
| | - Joe Tucker
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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22
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Wray B, Veidis EM, Flores EC, Phillips AA, Alani O, Barry M. A Call to Action for Gender Equity in Climate Leadership. Am J Trop Med Hyg 2023; 108:1088-1092. [PMID: 37127272 PMCID: PMC10540118 DOI: 10.4269/ajtmh.22-0674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 02/22/2023] [Indexed: 05/03/2023] Open
Abstract
Climate action is not advancing quickly enough to prevent catastrophic harm. Understanding why might require looking at existing leadership structures and the inequitable gender representation therein. Critically examining dominant power structures could pave the way toward more comprehensive, innovative, and expedient environmental solutions-and we argue that elevating women's climate leadership is key to safeguarding planetary health. Women have historically been left out of climate science and governance leadership. Women are disproportionately impacted by the health effects of climate change, particularly in Indigenous and low- and middle-income settings. Therefore, our call for women's climate leadership is both an issue of justice and a matter of effectiveness, given evidence that inclusive leadership rooted in gender justice leads to more equitable outcomes. Here, we present evidence for why gender equity in climate leadership matters along with considerations for how to attain it across sectors and stakeholders.
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Affiliation(s)
- Britt Wray
- Center for Innovation in Global Health, Stanford University, Palo Alto, California
- Center on Climate Change & Planetary Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Erika M. Veidis
- Center for Innovation in Global Health, Stanford University, Palo Alto, California
| | - Elaine C. Flores
- Center for Innovation in Global Health, Stanford University, Palo Alto, California
- Center on Climate Change & Planetary Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Allison A. Phillips
- Center for Innovation in Global Health, Stanford University, Palo Alto, California
| | - Ola Alani
- Center for Innovation in Global Health, Stanford University, Palo Alto, California
| | - Michele Barry
- Center for Innovation in Global Health, Stanford University, Palo Alto, California
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23
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Zulu JM, Mwamba T, Rosen A, Matenga TFL, Mulanda J, Kaimba M, Chilembo M, Silondwa M, Kamboyi RL, Simwanza SC, Sichone G, Chavula MP. Community engagement for the Voluntary Medical Male Circumcision (VMMC) program: an analysis of key stakeholder roles to promote a sustainable program in Zambia. Gates Open Res 2023; 6:50. [PMID: 37069966 PMCID: PMC10105033 DOI: 10.12688/gatesopenres.13587.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2023] [Indexed: 05/31/2023] Open
Abstract
Background: Within the Voluntary Medical Male Circumcision (VMMC) programme, community engagement has been central in facilitating the acceptance of VMMC, especially in non-circumcising communities. We used the case of the development of community engagement plans for sustainability of VMMC in Zambia to illustrate diversity of stakeholders, their power, roles, and strategies in community engagement. Methods: Data were collected using document review, in-depth interviews (n=35) and focus group discussions (n=35) with community stakeholders, health workers, health centre committees, counsellors, teachers, community volunteers and parents/caregivers. Data were analysed using thematic analysis. The analysis was guided by the power and interest model. Results: Differences were noted between the rural and urban sites in terms of power/influence and interest rating of community stakeholders who could be involved in the sustainability phase of the VMMC response in Zambia. For example, in the urban setting, neighbourhood health committees (NHCs), health workers, leaders of clubs, community health workers (CHWs), radio, television and social media platforms were ranked highest. From this list, social media and television platforms were not highly ranked in rural areas. Some stakeholders had more sources of power than others. Forms or sources of power included technical expertise, local authority, financial resources, collective action (action through schools, churches, media platforms, other community spaces), and relational power. Key roles and strategies included strengthening and broadening local coordination systems, enhancing community involvement, promoting community-led monitoring and evaluation, through the use of locally recognised communication spaces and channels, facilitating ownership of VMMC, and improving local accountability processes in VMMC activities. Conclusions: By consulting with the most relevant stakeholders, and considering community needs in programme development, the VMMC programme may be able to leverage the community structures and systems to reduce long term demand generation costs for VMMC and increase the acceptability and frequency of male circumcision.
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Affiliation(s)
- Joseph M. Zulu
- Department of Health Promotion and Education, School of Public Health, University of Zambia, PO Box 50110, Lusaka, Zambia, University of Zambia, Lusaka, 10101, Zambia
| | - Trevor Mwamba
- Clinton Health Access Initiative, Clinton Health Access Initiative, Lusaka, 10101, Zambia
| | - Alyssa Rosen
- Clinton Health Access Initiative, Clinton Health Access Initiative, Lusaka, 10101, Zambia
| | - Tulani Francis L. Matenga
- Department of Health Promotion and Education, School of Public Health, University of Zambia, PO Box 50110, Lusaka, Zambia, University of Zambia, Lusaka, 10101, Zambia
| | - Joseph Mulanda
- Department of Health Promotion and Education, School of Public Health, University of Zambia, PO Box 50110, Lusaka, Zambia, University of Zambia, Lusaka, 10101, Zambia
| | - Mutale Kaimba
- Department of Health Promotion and Education, School of Public Health, University of Zambia, PO Box 50110, Lusaka, Zambia, University of Zambia, Lusaka, 10101, Zambia
| | - Masitano Chilembo
- Clinton Health Access Initiative, Clinton Health Access Initiative, Lusaka, 10101, Zambia
| | - Madaliso Silondwa
- Clinton Health Access Initiative, Clinton Health Access Initiative, Lusaka, 10101, Zambia
| | - Royd L. Kamboyi
- Ministry of Health, Ministry of Health, Lusaka, Lusaka, 10101, Zambia
| | | | - George Sichone
- Department of Health Promotion and Education, School of Public Health, University of Zambia, PO Box 50110, Lusaka, Zambia, University of Zambia, Lusaka, 10101, Zambia
| | - Malizgani Paul Chavula
- Department of Health Promotion and Education, School of Public Health, University of Zambia, PO Box 50110, Lusaka, Zambia, University of Zambia, Lusaka, 10101, Zambia
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Baffour-Duah K, Shimange-Matsose L, Olorunfemi G. Socio-demographic and reproductive characteristics of clients that accepted contraceptives at abortion center at the Charlotte Maxeke Johannesburg Academic Hospital (CMJAH), Johannesburg, South Africa: a cross-sectional study (January-July 2021). Pan Afr Med J 2023; 45:39. [PMID: 37545609 PMCID: PMC10403766 DOI: 10.11604/pamj.2023.45.39.37441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 04/30/2023] [Indexed: 08/08/2023] Open
Abstract
Introduction access to family planning services is an important preventive strategy against maternal mortality as it can considerably reduce unintended pregnancies and prevent sequelae of unsafe abortion. We aimed to describe the socio-demographic and reproductive characteristics of abortion seekers and investigate factors associated with uptake of contraceptives following induced abortion at Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa. Methods this study was a cross-sectional study among women who had legal termination of unwanted pregnancy at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH), from 1st January 2021 to July 2021. Questionnaires were administered to 80 consenting consecutive clients after undergoing induced abortion. Information on socio-demographic and reproductive characteristics and pattern of contraceptive uptake of the respondents were obtained. Descriptive and bivariate analysis were conducted to determine the pattern and relationship of socio-demographic and reproductive characteristics and contraceptive uptake. Results the mean age of the 80 respondents was 25.6 ± 6.6 years. Majority of the participants were of the Black race (96.25%, n= 77/80), single (90.00%, n= 72/80), of the Christian faith (80.00%, n= 64/80) and unemployed. The median number of children alive among the clients was 1(0-2), with about 37.5% of the participants being nulliparous. About 16.25% of the participants had had at least one previous termination of pregnancy. The prevalence of post-abortion contraceptive uptake was 97.5% (95%CI: 90.36% - 99.39%, N=78/80). More than half chose injectable contraceptive (53.85%, 95%CI: 42.60% - 64.71%, N= 42/78), followed by oral contraceptive pills (21.79%, 95%CI: 13.90% - 32.49% N= 17/78). We found no association between socio-demographic and reproductive characteristics, and contraceptive uptake among the abortion clients (p values >0.05). Conclusion the immediate post-abortion contraceptive uptake in our facility is very high. Majority of the clients accepted injectable contraceptives. The demographic and reproductive characteristics of our clients did not affect uptake of post-abortion contraception. More education is needed to improve uptake of other long-acting contraceptives that may not require frequent contact with the health facility.
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Affiliation(s)
- Kennedy Baffour-Duah
- Department of Obstetrics and Gynaecology, School of Clinical Medicine, Faculty of Health Science, University of the Witwatersrand, Johannesburg, South Africa
| | - Lusanda Shimange-Matsose
- Department of Obstetrics and Gynaecology, School of Clinical Medicine, Faculty of Health Science, University of the Witwatersrand, Johannesburg, South Africa
| | - Gbenga Olorunfemi
- Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
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Amuzie CI, Kalu KU, Izuka M, Nkwo GE, Nwamoh UN, Metu K, Emma-Ukaegbu U, Okafor GO, Odini F. Unmet need for family planning and predictors among women in the extended postpartum period, southeastern Nigeria: a facility-based cross-sectional study. Pan Afr Med J 2023; 45:38. [PMID: 37545604 PMCID: PMC10403773 DOI: 10.11604/pamj.2023.45.38.39205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 03/18/2023] [Indexed: 08/08/2023] Open
Abstract
Introduction the ravaging COVID-19 pandemic has worsened the levels of unmet need (UMN) for family planning (FP). A pulse survey showed that FP services were interrupted during the lockdown in 68% of countries. There is a need to investigate the demand gap for FP among women in the postpartum period. This study aimed to determine the prevalence and predictors of UMN of FP among women in the extended postpartum period attending immunization clinics. Methods this was a facility-based cross-sectional study among 485 women recruited from 5 health facilities using a random sampling technique and proportional to size allocation. Data was collected using an interviewer-structured questionnaire. Analysis was done using IBM SPSS version 26. Adjusted odds ratios with 95% confidence intervals were computed. The level of significance was 5%. Results the total unmet need was 45.4% (95% CI: 40.2-50.7) with a higher need for child spacing (60.4%) compared to limiting pregnancies (39.6%). The mean age was 30.3 ± 6.1 years. The significant predictors included age [35-39 years (aOR=5.39, 95% CI: 1.61-18.06); ≥ 40 years (aOR= 32.48, 95% CI: 6.48-162.77)], lower education status (aOR= 5.21, 95% CI: 2.09-13.01), lower income (aOR =2.21, 95% CI: 1.10-4.46), rural residence (aOR= 4.27, 95% CI: 2.15-8.47), denomination [Pentecostal (aOR= 4.09, 95% CI: 1.77-9.43); Orthodox (aOR= 5.44, 95% CI: 2.03-14.58)] and poor knowledge of postpartum FP (PPFP) (aOR= 33.93, 95% CI: 13.21-87.12). The commonest reason for FP non-use was fear of side effects. Conclusion close to half of the women in the extended postpartum period experienced UMN for PPFP. Policymakers should consider these factors when designing FP interventions.
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Affiliation(s)
- Chidinma Ihuoma Amuzie
- Department of Community Medicine, Federal Medical Centre, Umuahia, Abia State, Nigeria
- Nigeria Field Epidemiology and Laboratory Training Program, Abuja, Nigeria
| | - Kalu Ulu Kalu
- Department of Community Medicine, Federal Medical Centre, Umuahia, Abia State, Nigeria
| | - Michael Izuka
- Department of Community Medicine, Federal Medical Centre, Umuahia, Abia State, Nigeria
| | - Glory Emeka Nkwo
- Department of Community Medicine, Federal Medical Centre, Umuahia, Abia State, Nigeria
| | - Uche Ngozi Nwamoh
- Department of Community Medicine, Federal Medical Centre, Umuahia, Abia State, Nigeria
| | - Kingsley Metu
- Department of Community Medicine, Federal Medical Centre, Umuahia, Abia State, Nigeria
| | - Uloaku Emma-Ukaegbu
- Department of Community Medicine, Federal Medical Centre, Umuahia, Abia State, Nigeria
- Nigeria Field Epidemiology and Laboratory Training Program, Abuja, Nigeria
| | | | - Franklin Odini
- Department of Community Medicine, Federal Medical Centre, Umuahia, Abia State, Nigeria
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Mishra BK, Kanungo S, Panda S, Patel K, Swain S, Dwivedy S, Karna S, Bhuyan D, Som M, Marta B, Bhattacharya D, Kshatri JS, Pati S, Palo SK. Access to Maternal and Child Health Services during the COVID-19 Pandemic: An Explorative Qualitative Study in Odisha, India. Indian J Community Med 2023; 48:459-464. [PMID: 37469922 PMCID: PMC10353676 DOI: 10.4103/ijcm.ijcm_285_22] [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: 04/02/2022] [Accepted: 04/15/2023] [Indexed: 07/21/2023] Open
Abstract
Background Maternal and child health (MCH) care is one of the essential routine healthcare services, which got affected during the coronavirus disease 2019 (COVID-19) pandemic. Modeled projections had anticipated an 8.3%-38.6% rise in maternal mortality from different countries globally. In view of limited studies pertaining to issues related to accessing MCH services in the event of a pandemic, this study was carried out on pregnant and postnatal mothers in Odisha, India. Methods An explorative qualitative study through 36 in-depth interviews (IDIs) was conducted among 16 (44.4%) antenatal and 20 (55.5%) postnatal mothers in six of thirty districts of Odisha, India, from February to April 2021. The districts and blocks were randomly selected for better representativeness. The IDIs were conducted using a predesigned and pretested guide among mothers who had undergone delivery or availed of antenatal, postnatal, or child health services from October 2020 to April 2021. The IDIs were conducted till data saturation. The data were analyzed using MAXQDA software. Results The average age of mothers was 27.6 (+/- 2.2) years. Among the participants, 16 (44.4%) were antenatal and 20 (55.6%) were postnatal mothers; 19 (52.8%) were primipara and 17 (47.2%) were multipara. The majority explained that they received enormous support including door-to-door services from the community health workers (CHWs) even during the difficult times of the pandemic. Reduced transportation facility and fear of contracting the infection were reasons behind the unwillingness to visit health facilities and preference for home delivery. Furthermore, the pandemic had physical, mental, social, and financial impacts among pregnant and postnatal women. Conclusion The unprecedented COVID-19 pandemic has affected access to MCH services by antenatal and postnatal mothers. Health system preparedness and appropriate strategies including better community engagement and participation could avert such challenges in the future.
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Affiliation(s)
| | | | | | - Kripalini Patel
- Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Swagatika Swain
- Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | | | - Sonam Karna
- Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Dinesh Bhuyan
- Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | | | | | | | - Jaya S. Kshatri
- Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | | | - Subrata K. Palo
- Regional Medical Research Centre, Bhubaneswar, Odisha, India
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Argawu AS, Erana MM. Maternal Satisfaction on Delivery Service and Its Associated Factors in Public Health Facilities at West Shewa Zone, Ethiopia. Ethiop J Health Sci 2023; 33:301-310. [PMID: 37484166 PMCID: PMC10358387 DOI: 10.4314/ejhs.v33i2.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 11/16/2022] [Indexed: 07/25/2023] Open
Abstract
Background Maternal delivery satisfaction could be assessed to improve the quality and effectiveness. Thus, this study aimed to assess maternal satisfaction with delivery services and associated factors in public health facilities in West Shewa Zone, Ethiopia. Methods An institution-based cross-sectional study was conducted on maternal satisfaction delivery services. Systematic and stratified sampling techniques were used to select mothers by using their delivery registration number and to select health facilities. A binary logistic regression model was used to identify associated factors. Results Among mothers, the overall satisfaction with delivery service was 584 (87%). Shower service availability (39.8%), toilet cleanliness (32.6%), and waiting area cleanliness (31.1%) were significant areas of mothers' dissatisfaction with delivery services. Uneducated mothers, mothers of 1-6 education level, monthly income of mothers less than 500 Birr, mothers who followed antenatal care, mothers who had actual fetal outcome, mothers who admitted from 6:00 AM to 12:00, and mothers who admitted from 12:00 AM to 6:00 PM were satisfied with delivery services. Conclusion The age of the mother, mother's education level, monthly income of mother, antenatal care, fetal outcome, place of delivery, and admission time of the mother were significantly associated factors for mothers' satisfaction with delivery services. Therefore, regional health bureaus and zonal health offices should work collaboratively on maternal care to improve maternal satisfaction during delivery.
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Affiliation(s)
- Alemayehu Siffir Argawu
- Department of Statistics, College of Natural and Computational Sciences, Ambo University, Ethiopia
| | - Maru Mossisa Erana
- Department of Midwifery, College of Medicine and Health Sciences, Ambo University, Ethiopia
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chilambe¹ K, Mulubwa C, Zulu JM, Chavula MP. Experiences of teachers and community-based health workers in addressing adolescents' sexual reproductive health and rights problems in rural health systems: a case of the RISE project in Zambia. BMC Public Health 2023; 23:335. [PMID: 36793027 PMCID: PMC9930354 DOI: 10.1186/s12889-023-15199-5] [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: 03/23/2022] [Accepted: 02/02/2023] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND Adolescents in low-and-middle-income countries like Zambia face a high burden of sexual, reproductive, health and rights problems including coerced sex, teenage pregnancies, and early marriages. The Zambia government through Ministry of Education has integrated comprehensive sexuality education (CSE) in the education and school system to contribute towards addressing Adolescents sexual, reproductive, health and rights (ASRHR) problems. This paper sought to explore teachers and community based health workers (CBHWs)' experiences in addressing ASRHR problems in in rural health systems in Zambia. METHODOLOGY The study was conducted under Research Initiative to Support the Empowerment of Girls (RISE) community randomized trial that aims to measure the effectiveness of economic and community interventions in reducing early marriages, teenage pregnancies, and school dropout in Zambia. We conducted qualitative 21 in-depth interviews with teachers and CBHWs involved in the implementation of CSE in communities. Thematic analysis was used to analyse teachers and CBHWs´ roles, challenges, and opportunities in promoting ASRHR services. RESULTS The study identified teachers and CBHWs roles, and challenges experienced in promoting ASRHR and suggested strategies to enhance delivery of the intervention. The role of teachers and CBHWs in addressing ASRHR problems included mobilizing and sensitizing the community for meetings, providing SRHR counseling services to both adolescents and guardians, and strengthening referral to SRHR services if needed. The challenges experienced included stigmatization associated with difficult experiences such as sexual abuse and pregnancy, shyness among girls to participate when discussing SRHR in the presence of the boys and myths about contraception. The suggested strategies for addressing the challenges included creating safe spaces for adolescents to discuss SRHR issues and engaging adolescents in coming up with the solution. CONCLUSION This study provides significant insight on the important roles that teachers CBHWs can play in addressing adolescents SRHR related problems. Overall, the study emphasizes the need to fully engage adolescents in addressing adolescents SRHR problems.
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Affiliation(s)
- Kunda chilambe¹
- Department of Health Policy and Education, School of Public Health, University of Zambia, Lusaka, P.O Box 50110, Zambia
| | - Chama Mulubwa
- Department of Health Policy and Education, School of Public Health, University of Zambia, Lusaka, P.O Box 50110, Zambia
- Department of Epidemiology and Global Health, Umea University, Umea, 90187 Sweden
| | - Joseph Mumba Zulu
- Department of Health Policy and Education, School of Public Health, University of Zambia, Lusaka, P.O Box 50110, Zambia
| | - Malizgani Paul Chavula
- Department of Health Policy and Education, School of Public Health, University of Zambia, Lusaka, P.O Box 50110, Zambia
- Department of Epidemiology and Global Health, Umea University, Umea, 90187 Sweden
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Hensel DJ, Rosenberg M, Luetke M, Fu TC, Herbenick D. The Impact of Household Context on Self-Perceived Changes in Solo and Partnered Sexual Behaviors During the COVID-19 Pandemic: Findings from a U.S. Probability Survey. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:655-667. [PMID: 36376743 PMCID: PMC9662764 DOI: 10.1007/s10508-022-02459-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 09/26/2022] [Accepted: 10/16/2022] [Indexed: 05/16/2023]
Abstract
To understand how household context factors impacted self-reported changes in solo and sexual behaviors in U.S. adults during early stages of the COVID- 19 pandemic, we conducted an online, nationally representative, cross-sectional survey of U.S. adults (N = 1010; aged 18-94 years; 62% response rate) from April 10-20, 2020. We used weighted descriptive statistics with Wilcoxon rank sign tests to understand the population prevalence and significance of self-reported changes (five-point scale: much less to much more) in 10 solo and partnered sexual behaviors. Ordinal regression was used to assess the impact of household predictor variables-including number of children at home, number of adults in home, partnership status (unpartnered, partnered and not living together, partnered and living together) and employment status (not working, employed not as essential worker, employed as essential worker). All models were adjusted for gender, age, sexual orientation, race/ethnicity, and residence location (urban, suburban, rural).All solo and partnered sexual behaviors showed some amount of significant change-increased activity for some and decreased for others-for U.S. adults during the pandemic. Not living with a partner was broadly associated with decreased affectionate partnered sexual behaviors; unpartnered adults reported increased sexting. Individuals not employed reported increased oral sex and increased consumption of sexually explicit materials as compared to non-essential workers. Number of children at home and household size were not significantly linked to self-reported behavior change. Ongoing sexual health-focused research should continue to focus on understanding how adults manage opportunities and constraints to their sexual lives in the context of a still-going pandemic. While many aspects of social life look more "normal" (e.g., many people have returned to their in-person offices and children are largely back in school), new and more-infectious strains of COVID-19 have proven that the pandemic may still yet impact daily living. Lessons learned from COVID need to include sexual health planning both for any future strains of COVID, as well as for future public health emergencies.
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Affiliation(s)
- Devon J Hensel
- Department of Pediatrics, Division of Adolescent Medicine, Indiana University School of Medicine, 410 West 10th Street Room 1001, Indianapolis, IN, 46202, USA.
- Department of Sociology, Indiana University Purdue University-Indianapolis, Indianapolis, IN, USA.
- Center for Sexual Health Promotion, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA.
| | - Molly Rosenberg
- Center for Sexual Health Promotion, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA
- Institute for Social Research and Data Innovation/Minnesota Population Center, University of Minnesota, Minneapolis, MN, USA
| | - Maya Luetke
- Institute for Social Research and Data Innovation/Minnesota Population Center, University of Minnesota, Minneapolis, MN, USA
| | - Tsung-Chieh Fu
- Center for Sexual Health Promotion, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA
- Department of Applied Health Science, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA
| | - Debby Herbenick
- Center for Sexual Health Promotion, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA
- Department of Applied Health Science, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA
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Disruptions in Accessing Women's Health Care Services: Evidence Using COVID-19 Health Services Disruption Survey. Matern Child Health J 2023; 27:395-406. [PMID: 36609799 PMCID: PMC9823248 DOI: 10.1007/s10995-022-03585-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 09/22/2022] [Accepted: 12/23/2022] [Indexed: 01/09/2023]
Abstract
INTRODUCTION The world is experiencing the Coronavirus pandemic and the aftermath consequences leading to lockdown and travel restrictions. The pandemic has brought a far-reaching impact on various sectors, including the economic, and health sectors. Therefore, this study analyses the possible impact of the COVID-19 pandemic on the disruption - in accessing family planning measures i.e. contraception facilities; and in seeking help from women organizations for health services. METHODS This study has used the COVID-19 health services disruption survey-2020 and data was obtained from the Institute of Health Metrics and Evaluation. This survey was conducted in 76 countries using the smartphone-based premise data collection platform. Respondents were individual members of the general population ages 15-49 years who were identified as women. Data were collected from 12,354 respondents. Our data analysis has been done on both aggregate samples as well as region-wise samples (i.e. Africa, Asia, Europe, and Latin America & the Caribbean) to assess the change in levels of service delivery in both pre-COVID and post-COVID periods. RESULTS Descriptive statistics results shows that two particular reasons - unable to access due to lockdown restrictions (5.4%), and fear of being infected with COVID-19 (9.7%) were reported as mostly impacting the access to contraception facilities due to lockdown restriction. Further, the logit regression using socio-economic and demographic variables suggests that geographical location (rural), and poor financial status turned out negative and significant, showing higher odds of facing difficulty than the reference category for the aggregate sample. The region-wise analysis suggests that Europe and Asia are the regions with the highest percentage of respondents reporting unavailability of services during COVID-19. CONCLUSION The study concludes that pandemic-related emergencies affect the health care system, especially women-related health care services. The implication of our study indicates the requirement of a supply chain strategy for managing health care demand during emerging situations. So, the disruptions and bottlenecks in health care facilities should be addressed by various governments through appropriate policies and interventions.
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Duffy D, Freeman C, Rodríguez S. Building infrastructures of abortion care in an un-caring state: acompañante's carework and abortion access in Peru. SIGNS 2023; 48:585-608. [PMID: 37324651 PMCID: PMC7614643 DOI: 10.1086/723296] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
For abortion seekers, Peru is an uncaring state where legal and policy interventions have resulted in violence, persecution, and neglect. This state of abortion uncare is set within historic and ongoing denials of reproductive autonomy, coercive reproductive care, and the marginalisation of abortion. Abortion is not supported, even where legally permissible. Here we explore abortion care activism within the Peruvian context, foregrounding a key mobilisation that has emerged against a state of un-care - acompañante carework. Through interviews with people involved in abortion access and activism in Peru, we argue that acompañantes have constructed an infrastructure of abortion care in Peru through the bringing together of actors, technologies, and strategies. This infrastructure is shaped by a feminist ethic of care that differs from minority world care assumptions regarding high quality abortion care in three key ways: (i) care is provided beyond the state; (ii) care is holistic; and (iii) care is collective. We argue that US feminist debates relating to the emerging hyperrestrictive state of abortion un-care as well as broader research on feminist care can learn from acompañante activism strategically and conceptually.
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Affiliation(s)
- Deirdre Duffy
- Faculty of Health Psychology and Social Care, Manchester Metropolitan University, Manchester
| | - Cordelia Freeman
- Department of Geography, University of Exeter. Amory Building, Rennes Drive, Exeter, EX4 4RJ
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Bercu C, Filippa S, Jayaweera R, Egwuatu I, Nmezi S, Zurbriggen R, Grosso B, Kristianingrum IA, Maneiro M, Liparelli MS, Sandoval S, Tapia I, Soria G, Moseson H. A qualitative exploration of how the COVID-19 pandemic shaped experiences of self-managed medication abortion with accompaniment group support in Argentina, Indonesia, Nigeria, and Venezuela. Sex Reprod Health Matters 2022; 30:2079808. [PMID: 35713531 PMCID: PMC9225659 DOI: 10.1080/26410397.2022.2079808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Globally, people self-manage their medication abortions without clinical assistance. Feminist activist collectives (accompaniment groups) support people through self-managed abortion with evidence-based guidance. We sought to understand the impact of COVID-19 and related restrictions on the need for and experiences of self-managed abortion with accompaniment support across varied legal and social contexts. Between May and October 2020, we conducted in-depth interviews with individuals who self-managed abortions with support from accompaniment groups during the pandemic in Argentina, Indonesia, Nigeria, and Venezuela. We conducted a thematic analysis to understand the impact of COVID-19 on participants’ experiences with accompanied self-managed abortions. Across 43 in-depth interviews, participants in all four countries described how the COVID-19 pandemic created challenges at each step of their abortion process, from confirming the pregnancy, accessing abortion pills, finding a private, comfortable place, and verifying abortion completion. For most people, conditions related to the pandemic made it harder to self-manage an abortion; for a minority, being at home made aspects of the experience somewhat easier. Nonetheless, all participants reported feeling supported by accompaniment groups, and COVID-19 and related lockdowns reinforced their preference for accompaniment-supported self-managed abortion. These findings highlight the essential role that accompaniment groups play in ensuring access to high-quality abortion care in a multiplicity of settings, particularly during the COVID-19 pandemic. Efforts are needed to expand the reach of accompaniment groups to increase access to the high-quality abortion support they provide, filling a critical gap left by health systems and legal infrastructure.
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Affiliation(s)
- Chiara Bercu
- Associate Project Director, Ibis Reproductive Health, Oakland, CA, USA
| | - Sofia Filippa
- Research Consultant, Ibis Reproductive Health, Oakland, CA, USA
| | | | - Ijeoma Egwuatu
- Data, Innovation and Communication Director, Generation Initiative for Women and Youth, Lagos State, Nigeria
| | - Sybil Nmezi
- Executive Director, Generation Initiative for Women and Youth, Lagos State, Nigeria
| | - Ruth Zurbriggen
- Activist and Researcher, Colectiva Feminista La Revuelta, Neuquén, Argentina
| | - Belen Grosso
- Activist and Researcher, Colectiva Feminista La Revuelta, Neuquén, Argentina
| | | | - Mariana Maneiro
- Member of the Feminist Collective, Feministas en Acción Libre y Directa por la Autonomía Sexual y Reproductiva (Faldas-R), Caracas, Venezuela
| | - María Soledad Liparelli
- Member of the Feminist Collective, Feministas en Acción Libre y Directa por la Autonomía Sexual y Reproductiva (Faldas-R), Caracas, Venezuela
| | - Stephhanie Sandoval
- Member of the Feminist Collective, Feministas en Acción Libre y Directa por la Autonomía Sexual y Reproductiva (Faldas-R), Caracas, Venezuela
| | - Isha Tapia
- Member of the Feminist Collective, Feministas en Acción Libre y Directa por la Autonomía Sexual y Reproductiva (Faldas-R), Caracas, Venezuela
| | - Guillermina Soria
- Member of the Feminist Collective, Feministas en Acción Libre y Directa por la Autonomía Sexual y Reproductiva (Faldas-R), Caracas, Venezuela
| | - Heidi Moseson
- Senior Research Scientist, Ibis Reproductive Health, Oakland, CA, USA
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Pouriayevali B, Ehteshami A, Kohan S, Saghaeiannejad-Isfahani S. Functionality of self-care for pregnancy mobile applications: A review study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:415. [PMID: 36824402 PMCID: PMC9942138 DOI: 10.4103/jehp.jehp_1429_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 02/26/2022] [Indexed: 06/18/2023]
Abstract
Self-care may help prevent pregnancy complications and mortality by informing parents. Mobile health applications (apps) can help individuals to improve the quality of self-care. Although it has been claimed that mobile apps have various benefits, their functionalities in pregnancy self-care are still unclear. A clear understanding of current apps can help researchers, practitioners, and app developers to identify appropriate functionalities for new development and future refinement of current apps. This review endeavored to identify appropriate functions for pregnancy self-care mobile apps and user interface (UI) features. The scope of this review integrates self-care for pregnancy apps published in Google Play and Cafe Bazaar (an Iranian Android marketplace), popular Android app stores, from July to October 2019 by sing the systematic search technique. All 4196 downloaded apps were installed, and it was found that 76 of them met the inclusion criteria. This way, their features were extracted and categorized by the conventional content analysis. Three main themes and 69 subthemes in terms of apps functionalities and their UI features were extracted as follows: 1) Training materials (maternal and paternal) with 27 subthemes; 2) self-care functionalities (consultations, fetus tracking, clinical examination, supportive assistance, and reminders) with 26 subthemes; and UI features with 16 subtheme. The findings underlined the mHealth solutions for pregnancy self-care and the need for development of the apps regarding the extracted functionalities and UI features; however, controlled trials are needed. It is recommended that transparent reporting of mHealth interventions needs to be prioritized to enable effective interpretation of the extracted data.
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Affiliation(s)
- Behnaz Pouriayevali
- Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Asghar Ehteshami
- Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shahnaz Kohan
- Reproductive Sciences and Sexual Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Anjur-Dietrich S, Omoluabi E, OlaOlorun FM, Mosso R, Wood SN, Moreau C, Bell SO. Partner involvement in abortion trajectories and subsequent abortion safety in Nigeria and Côte d'Ivoire. BMC Womens Health 2022; 22:530. [PMID: 36528560 PMCID: PMC9759876 DOI: 10.1186/s12905-022-02115-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 12/06/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Unsafe abortions contribute to maternal mortality and morbidity worldwide, with disproportionate impacts in lower-income countries. Identifying factors associated with an elevated risk of experiencing an abortion under the most unsafe conditions is an important component of addressing this burden. The partner's role in obtaining a safe or unsafe abortion is not well understood. This study provides a quantitative assessment of the relationship between partner involvement and subsequent abortion safety. METHODS The data are drawn from the PMA2020 female surveys and abortion follow-up surveys, fielded in Nigeria and Côte d'Ivoire between 2018 and 2020. The sample includes 1144 women in Nigeria and 347 women in Côte d'Ivoire who reported having ever experienced an abortion. We assess partner involvement in discussing the abortion decision and/or in selecting the method or source and evaluate the relationship between partner involvement and most unsafe abortion (using non-recommended methods from a non-clinical source) versus safe or less safe abortion, adjusting for sociodemographic characteristics. RESULTS We find a strong association between experiencing any partner involvement and decreased odds of experiencing a most unsafe abortion (Nigeria: aOR = 0.34, 95% CI 0.26-0.45; Côte d'Ivoire: aOR = 0.27, 95% CI 0.16-0.47). Analyzing the two types of partner involvement separately, we find that partner involvement in the decision is associated with lower odds of most unsafe abortion in both countries (Nigeria: aOR = 0.48, 95% CI 0.39-0.72; Côte d'Ivoire: aOR = 0.34, 95% CI 0.19-0.60); partner involvement in selecting the method and/or source was only significantly associated with lower odds of most unsafe abortion in Nigeria (Nigeria: aOR = 0.53, 95% CI 0.39-0.72; Côte d'Ivoire: aOR = 0.65, 95% CI 0.32-1.32). CONCLUSION In Nigeria and in Côte d'Ivoire, respondents whose partners were involved in their abortion trajectory experienced safer abortions than those whose partners were not involved. These findings suggest the potential importance of including men in education on safe abortion care and persistent need to make safe abortion accessible to all, regardless of partner support.
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Affiliation(s)
- Selena Anjur-Dietrich
- grid.21107.350000 0001 2171 9311Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205 USA
| | - Elizabeth Omoluabi
- Centre for Research, Evaluation Resources and Development, Ile-Ife, Nigeria
| | - Funmilola M. OlaOlorun
- grid.9582.60000 0004 1794 5983Department of Community Medicine, University of Ibadan, Ibadan, Oyo Nigeria
| | - Rosine Mosso
- grid.508476.80000 0001 2107 3477École Nationale Supérieure de Statistique et d’Économie Appliquée, Abidjan, Côte d’Ivoire
| | - Shannon N. Wood
- grid.21107.350000 0001 2171 9311Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205 USA
| | - Caroline Moreau
- grid.21107.350000 0001 2171 9311Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205 USA ,grid.7429.80000000121866389CESP Centre for Research in Epidemiology and Population Health, INSERM (Institut National de la Santé et de la Recherche Médicale), Villejuif, France
| | - Suzanne O. Bell
- grid.21107.350000 0001 2171 9311Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205 USA
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Baynes C, Steyn P, Soi C, Dinis A, Tembe S, Mehrtash H, Narasimhan M, Kiarie J, Sherr K. Use of implementation science to advance family planning programs in low- and middle-income countries: A systematic review. Front Glob Womens Health 2022; 3:1038297. [PMID: 36561275 PMCID: PMC9763469 DOI: 10.3389/fgwh.2022.1038297] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 11/11/2022] [Indexed: 12/12/2022] Open
Abstract
Objective As environmental and economic pressures converge with demands to achieve sustainability development goals, low- and middle-income countries (LMIC) increasingly require strategies to strengthen and scale-up evidence-based practices (EBP) related to family planning (FP). Implementation science (IS) can help these efforts. The purpose of this article is to elucidate patterns in the use of IS in FP research and identify ways to maximize the potential of IS to advance FP in LMIC. Design and methods We conducted a systematic review that describes how IS concepts and principles have been operationalized in LMIC FP research published from 2007-2021. We searched six databases for implementation studies of LMIC FP interventions. Our review synthesizes the characteristics of implementation strategies and research efforts used to enhance the performance of FP-related EBP in these settings, identifying gaps, strengths and lessons learned. Results Four-hundred and seventy-two studies were eligible for full-text review. Ninety-two percent of studies were carried out in one region only, whereas 8 percent were multi-country studies that took place across multiple regions. 37 percent of studies were conducted in East Africa, 21 percent in West and Central Africa, 19 percent in Southern Africa and South Asia, respectively, and fewer than 5 percent in other Asian countries, Latin America and Middle East and North Africa, respectively. Fifty-four percent were on strategies that promoted individuals' uptake of FP. Far fewer were on strategies to enhance the coverage, implementation, spread or sustainability of FP programs. Most studies used quantitative methods only and evaluated user-level outcomes over implementation outcomes. Thirty percent measured processes and outcomes of strategies, 15 percent measured changes in implementation outcomes, and 31 percent report on the effect of contextual factors. Eighteen percent reported that they were situated within decision-making processes to address locally identified implementation issues. Fourteen percent of studies described measures to involve stakeholders in the research process. Only 7 percent of studies reported that implementation was led by LMIC delivery systems or implementation partners. Conclusions IS has potential to further advance LMIC FP programs, although its impact will be limited unless its concepts and principles are incorporated more systematically. To support this, stakeholders must focus on strategies that address a wider range of implementation outcomes; adapt research designs and blend methods to evaluate outcomes and processes; and establish collaborative research efforts across implementation, policy, and research domains. Doing so will expand opportunities for learning and applying new knowledge in pragmatic research paradigms where research is embedded in usual implementation conditions and addresses critical issues such as scale up and sustainability of evidence-informed FP interventions.Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, identifier: CRD42020199353.
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Affiliation(s)
- Colin Baynes
- Department of Global Health, University of Washington, Seattle, WA, United States,Correspondence: Colin Baynes
| | - Petrus Steyn
- Department of Sexual and Reproductive Health and Research, UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Geneva, Switzerland
| | - Caroline Soi
- Department of Global Health, University of Washington, Seattle, WA, United States
| | - Aneth Dinis
- Department of Global Health, University of Washington, Seattle, WA, United States,The National Directorate of Public Health, Ministry of Health of Mozambique, Maputo, Mozambique
| | - Stelio Tembe
- Department of Global Health, University of Washington, Seattle, WA, United States
| | - Hedieh Mehrtash
- Department of Global Health, University of Washington, Seattle, WA, United States
| | - Manjulaa Narasimhan
- Department of Sexual and Reproductive Health and Research, UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Geneva, Switzerland
| | - James Kiarie
- Department of Sexual and Reproductive Health and Research, UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Geneva, Switzerland
| | - Kenneth Sherr
- Department of Global Health, University of Washington, Seattle, WA, United States,Department of Epidemiology, University of Washington, Seattle, WA, United States,Department of Industrial and Systems Engineering, University of Washington, Seattle, WA, United States
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Aziz M, Elgibaly O, Ibrahim FE. Effect of parental attitudes on the practice and medicalization of female genital mutilation: a secondary analysis of Egypt Health Issues Survey, 2015. BMC Womens Health 2022; 22:259. [PMID: 35761227 PMCID: PMC9237970 DOI: 10.1186/s12905-022-01834-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 06/13/2022] [Indexed: 11/10/2022] Open
Abstract
Background Despite the observed decrease in female genital mutilation (FGM) prevalence, it is increasingly being medicalized. We examined the attitudes of both parents towards the FGM practice in Egypt, and highlighted the effect of fathers’ decision making and attitudes towards FGM and violence on FGM practice and medicalization. Methods This study is a secondary analysis of Egypt Health Issues Survey (EHIS), 2015. The 2015 EHIS involved a systematic random selection of a subsample of 614 Shiakhas/villages out of the 884 shiakhas/villages that had been chosen as Primary Sampling Units in the 2014 EDHS. Descriptive statistics of the study sample and parents’ attitudes was performed. Three indices were created describing; mothers’ and fathers’ attitudes towards FGM, decision making and rejecting violence against women. Bivariate and multivariable analyses were conducted to identify predictors of FGM practice and medicalization. Results A considerable proportion of EHIS girls; 16.4% were circumcised and 36% of girls were expected to be circumcised. More than two thirds of circumcised girls were circumcised by a physician; namely 67% and 13.5% by nurses. The majority of mothers (88.4%) and fathers (84.8%) believed that FGM practice should continue. They believed that FGM is a religious obligation (72.3% of mothers and 73% of fathers). Parents believed that husbands prefer a circumcised wife (81.1% and 82.5% of mothers and fathers respectively). Being in the poorest wealth quintile (OR = 4.2, p < 0.001) and living in rural Upper Egypt (OR = 4.55, p < 0.001) were the predictors of FGM practice, while medicalization was more likely among the rich and educated parents. Parents’ attitudes supporting FGM was significantly associated with its practice (OR = 1.97, p < 0.001, for mothers and OR = 1.27, p < 0.001, for fathers). Rejecting violence against women was associated with less likelihood of practicing FGM (OR = 0.89, p < 0.05) and more likelihood of its medicalization (OR = 1.25, p < 0.01). Conclusion More attention should be paid to enforce the laws against FGM practice by health care providers. Raising the community awareness on girls’ human rights and elimination of FGM practice which is a severe form of violence against women and gender inequality in sexual rights should be prioritized with targeting men in FGM programs. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-022-01834-7.
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Tareke AA, Enyew EB, Dubale AT, Shimie AW, Kasaye MD, Eshetu HB. Determinants of change in unintended pregnancy in Ethiopia using the 2005 and 2016 EDHS: non-linear multivariable decomposition analysis. Arch Public Health 2022; 80:232. [DOI: 10.1186/s13690-022-00984-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 10/17/2022] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Unintended pregnancy is a pregnancy either mistimed or unwanted. The main consequence of unintended pregnancy is inducing abortion. In Ethiopia, more than half of unintended pregnancies end up in abortion.
Objective
This study aims to measure the change in unintended pregnancy among women of reproductive age between survey years 2005 and 2016 and to identify the socio-demographic factors that most significantly contributed to the change.
Methods
Data from the two most recent Ethiopian Demographic and Health Surveys (EDHS) were analyzed. We quantified the contribution of socio-demographic factors in the change of unintended pregnancy, using Oaxaca-Blinder decomposition for non-linear regression models by applying the STATA command ‘mvdcmp’.
Result
Unintended pregnancy decreased from 37% in 2005 to 27% in 2016 in Ethiopia. Both changes in population characteristics and coefficient were the contributing elements to the observed change in unintended pregnancy. Among population characteristics factors, being a partial decision-maker and being a slum in the Somali region contributed 10 and 14% to the change of unintended pregnancy between the 2005 and 2016. Of the coefficient factors, knowledge of modern family planning, being a partial decision-maker, media exposure, distance to health facilities, and health facility visits contributed to the change by 93, 43, 17, and 10% respectively.
Conclusion
The majority of the change in unintended pregnancy from 2005 to 2016 survey was due to differences in coefficients (85%). The principal contributing factors to the change of unintended pregnancy were FP knowledge, decision making, media exposure and health facility visits. Therefore, an interventional plan will be efficient, better, and more effective if focused on the larger contributing factors.
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Adjei-Mantey K, Kwakwa PA, Adusah-Poku F. Unraveling the effect of gender dimensions and wood fuel usage on household food security: evidence from Ghana. Heliyon 2022; 8:e11268. [PMID: 36345516 PMCID: PMC9636557 DOI: 10.1016/j.heliyon.2022.e11268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 04/04/2022] [Accepted: 10/20/2022] [Indexed: 11/13/2022] Open
Abstract
Food security discussions have heightened particularly with Sustainable Development Goal (SDG) 2 which focuses on hunger and malnutrition. This study investigates gender dimensions of food security and examines the role of wood fuel on households' food security in Ghana. Data from the most recent round of the Ghana Living Standards Survey (GLSS VII, 2016/2017) were used for this investigation. By employing the Exogeneous Switching Treatment Effect Regression to analyze food security, it was found that significant heterogeneities exist among different gender groups. The largest differences exist between male headed households and de jure female headed households. Further, this study finds that among female headed households, there remain substantial differences in food security. Wood fuel usage, household size and residing in the northern part of the country were found to reduce food security among households while education and income increase household food security. These findings are important for enhanced policy targeting to address food insecurity.
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Affiliation(s)
- Kwame Adjei-Mantey
- Department of Sustainable Energy and Resources, University of Environment and Sustainable Development, Ghana
| | - Paul Adjei Kwakwa
- School of Arts and Social Sciences, University of Energy and Natural Resources, Sunyani, Ghana
| | - Frank Adusah-Poku
- Department of Economics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Environment and Natural Resource Research Initiative (ENRRI-EfD Ghana), Accra, Ghana
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Malaju MT, Alene GD. Longitudinal patterns of the relation between anxiety, depression and posttraumatic stress disorder among postpartum women with and without maternal morbidities in Northwest Ethiopia: a cross-lagged autoregressive structural equation modelling. Arch Public Health 2022; 80:225. [PMID: 36309711 PMCID: PMC9617360 DOI: 10.1186/s13690-022-00978-0] [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: 02/28/2022] [Accepted: 10/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The postpartum period is a time where mothers can undergo significant changes that increase vulnerability for depression, anxiety and posttraumatic stress disorder symptoms. However, the direct and indirect factors of depression, anxiety and posttraumatic stress disorder symptoms and their direction of relationships following childbirth is not well investigated in Ethiopia. The aim of this study was to determine the direct and indirect factors of depression, anxiety and posttraumatic stress disorder symptoms and their direction of relationships following childbirth. METHODS A total of 775 women consented to participate at the first, second and third follow-up of the study (6th, 12th and 18th week of postpartum period) during October, 2020 - March, 2021. Women were recruited after childbirth and before discharge using the World Health Organization maternal morbidity working group criteria to identify exposed and non-exposed groups. A cross-lagged autoregressive path analysis and linear structural equation modelling were carried out using Stata version 16 software. RESULTS Prevalence rates of anxiety were 18.5%, 15.5% and 8.5% at the 6th, 12th and 18th week of postpartum respectively. The prevalence rates for depression were also found to be 15.5%, 12.9% and 8.6% respectively during the same follow up period and for posttraumatic stress disorder it was found to be 9.7%, 6.8% and 3.5% at the 6th, 12th and 18th week of postpartum respectively. Moreover, anxiety and depression were found to be a causal risk factors for posttraumatic stress disorder in the postpartum period. Direct maternal morbidity, fear of childbirth, higher gravidity, perceived traumatic childbirth and indirect maternal morbidity were found to have a direct and indirect positive association with depression, anxiety and posttraumatic stress disorder. In contrast, higher parity, higher family size and higher social support have a direct and indirect negative association. CONCLUSION Postnatal mental health screening, early diagnosis and treatment of maternal morbidities, developing encouraging strategies for social support and providing adequate information about birth procedures and response to mothers' needs during childbirth are essential to improve maternal mental health in the postpartum period.
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Affiliation(s)
- Marelign Tilahun Malaju
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
| | - Getu Degu Alene
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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Saha R, Paul P, Yaya S, Banke-Thomas A. Association between exposure to social media and knowledge of sexual and reproductive health among adolescent girls: evidence from the UDAYA survey in Bihar and Uttar Pradesh, India. Reprod Health 2022; 19:178. [PMID: 35978427 PMCID: PMC9382779 DOI: 10.1186/s12978-022-01487-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 07/29/2022] [Indexed: 11/25/2022] Open
Abstract
Background Poor sexual and reproductive health (SRH) outcomes amongst adolescent girls in India have been associated with inadequate knowledge of SRH. Evidence suggests that social media can promote health-seeking behaviors. Our objective in this study was to determine the association between exposure to social media and SRH knowledge among adolescent girls in Bihar and Uttar Pradesh, India. Methods A cross-sectional study was conducted with 10,425 adolescent girls from the UDAYA survey (wave-2, 2018–19). Girls’ exposure to social media was the key predictor, and SRH knowledge of sexual intercourse and pregnancy, contraceptive methods, and HIV/AIDS were outcomes of interest. Multivariable logistic regression models were performed to assess the association between exposure to social media and knowledge of SRH among adolescent girls. Results Of the study participants (n = 10,425), 28.0% (n = 3,160) had exposure to social media. Overall, 8.7%, 11.4%, and 6.6% of respondents had sufficient knowledge of sexual intercourse and pregnancy, contraceptive methods, and HIV/AIDS, respectively. Exposure to social media was associated with increased odds of knowledge of sexual intercourse and pregnancy (Odds ratio [OR]: 1.38; 95% confidence interval [CI]: 1.18, 1.61), contraceptive methods (OR: 1.46; 95% CI: 1.27, 1.67), and HIV/AIDS (OR: 2.18; 95% CI: 1.84, 2.58). Conclusions Our study shows the potency of exposure to social media in influencing SRH knowledge, which exclusively benefits female adolescents who are educated, residing in urban areas, and from wealthier families. Digital media-focused interventions inclusive of socio-cultural contexts (e.g., strategic investment in education and creating economic opportunities) are crucial to optimize social media's impact on SRH knowledge enhancements. A substantial body of research shows that adolescent girls in India lack adequate sexual and reproductive health (SRH) knowledge. Evidently, this puts them at several health risks associated with early pregnancies, preventable gynecological morbidities such as irregular menstrual patterns, and urethral discharge, among several others. Perpetuated social stigma and lack of agency impede adolescents especially from marginalized communities from accessing accurate, sufficient, and timely SRH information from their immediate household members and healthcare providers at local service points. This adversely affects their health-seeking behaviors and ultimately results in avertable poor reproductive health outcomes. A growing body of literature highlights social media platforms (i.e., Facebook, Instagram, Twitter, etc.) as preferred modalities to gain SRH information among adolescents. Against this backdrop, we assessed the intricate association between social media exposure and SRH knowledge (across three dimensions: sexual intercourse and pregnancy, contraceptive methods, and HIV/AIDS) among adolescent girls in Bihar and Uttar Pradesh, India. We tested for association between several socio-demographic factors and SRH knowledge. Findings indicate that adolescents who were exposed to social media platforms were likely to have more SRH knowledge compared to those who were not. Socio-demographic factors like place of residence, for example residing in urban areas, higher levels of education and high wealth index acted as facilitators of social media exposure as well as SRH knowledge.
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Affiliation(s)
- Ria Saha
- Medway Council National Health Service, Kent, UK
| | - Pintu Paul
- Centre for the Study of Regional Development, School of Social Sciences, Jawaharlal Nehru University, New Delhi, India
| | - Sanni Yaya
- School of International Development and Global Studies, Faculty of Social Sciences, University of Ottawa, Ottawa, Canada.,The George Institute for Global Health, Imperial College London, London, UK
| | - Aduragbemi Banke-Thomas
- Centre for Vulnerable Children and Families, Institute for Lifecourse Development, University of Greenwich, London, UK.
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Sexual and reproductive health services during outbreaks, epidemics, and pandemics in sub-Saharan Africa: a literature scoping review. Syst Rev 2022; 11:161. [PMID: 35945580 PMCID: PMC9361234 DOI: 10.1186/s13643-022-02035-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 07/26/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic could worsen adolescent sexual and reproductive health (ASRH). We sought evidence on the indirect impacts of previous infectious disease epidemics and the current COVID-19 pandemic on the uptake of ASRH in sub-Saharan Africa (SSA) to design relevant digital solutions. METHODS We undertook a literature scoping review to synthesize evidence on the indirect impacts of COVID-19 on ASRH in SSA per the Arksey and O'Malley framework and PRISMA reporting guidelines. We conducted the search on PubMed, Embase, Google Scholar, and ResearchGate in June and November 2020. We included all peer-reviewed, English-language primary studies on the indirect impacts of infectious disease epidemics on the uptake of sexual and reproductive health (SRH) in SSA. RESULTS We included 21 of 42 identified studies. Sixteen studies (76.2%) quantitatively assessed utilization and access to SRH during epidemics. Five studies (2 [9.6%] qualitative and 3 [14.3%] mixed methods) explored factors affecting SRH services. All studies focused on adult populations, most often on labor and delivery (n = 13 [61.9%]) and family planning (n = 8 [38.1%]) outcomes. Although we sought out to assess all outbreaks, epidemics, and pandemics, the only relevant studies took place during the West African Ebola pandemic (n = 17 [80.9%]) and COVID-19 pandemic (n = 4 [19.0%]). One study (4.8%) highlighted adolescent-specific outcomes and condom use. Most studies found declined access to and utilization of facility delivery, antenatal care, family planning, and HIV care. One study noted an increase in adolescent pregnancies. However, other studies noted similar, or even increasing trends in access to and utilization of other SRH services (family planning visits; HIV diagnosis; ART initiation) during epidemics. Barriers to SRH uptake included factors such as a reduced ability to pay for care due to lost income, travel restrictions, and fear of infection. Supply-side barriers included lack of open facilities, workers, commodities, and services. Community-based peer delivery systems, telemedicine, and transport services improved SRH uptake. CONCLUSION Access to SRH services during epidemics among adolescents and young people in SSA is understudied. We found that no studies focused on SRH outcomes of abortion, emergency contraception, sexually transmitted infections, or cervical cancer. To improve access to and utilization of SRH during pandemics, we recommend the following; in terms of research, key standardized SRH indicators should be included in routine data collection, routine data should be disaggregated by age, gender, and geography to understand gaps in ASRH service delivery, and additional rigorous epidemiological and social-behavioral studies should be conducted. On implementation, community-based peer delivery systems and telemedicine, internet-based, and other technological solutions may better reach adolescent and young people in SSA.
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Maasoumi R, Kazemi S, Haghani S, Zarei F. Motivation for protection in sexual relationship during the COVID-19 quarantine: analysis of the sociodemographic variables of the Iranian population. BMC Public Health 2022; 22:1052. [PMID: 35619130 PMCID: PMC9133316 DOI: 10.1186/s12889-022-13475-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 05/16/2022] [Indexed: 11/17/2022] Open
Abstract
Background Coronavirus is an infectious disease that has affected sexual life. Sexual activity has decreased for many people, and couples' physical contact has reduced. The present study aimed to determine the sexual relationship of Iranian people and related factors during the Corona home quarantine by focusing on all constructs of the protective motivation theory. Methods This cross-sectional online survey was conducted on Iranian people under in-home quarantine from July to December 2020 during the Covid-19 pandemic. Seven hundred sixteen people were selected by the convenience sampling method. The data was gathered by an ad-hoc tool consisting of demographic information and sexual relationship regarding protection motivation behavior in the Covid-19 pandemic. Participants should be able to complete the online questionnaire because the questionnaires were completed online. One-way ANOVA, independent T, and Pearson correlation tests were used to analyze the data in SPSS 16 software. Results Findings indicate the average age of the participants was 37.78 + 8.34 years. Most of them were women (%85.1), married (%91.3) and had a university education (%90.2). In addition, %42.5% of participants had Full-time jobs and %34.2 lived in Tehran. 49.9% obtained information about corona from TV. 63.3% of the participants and their spouses did not catch Covid-19. Employment status was the only variable that was significantly different from sexual relationships regarding protection motivation (p = 0.031). Perceived response efficiency with an average of 79.12 had the highest, and perceived self-efficacy with an average of 69.92 had the lowest mean score among the areas of sexual relationship. Among the protection motivation domains of sexual behavior that all had significant correlations, there was no significant correlation between perceived severity and perceived self-efficacy (p = 0.067). Conclusion and implication Perceived vulnerability is associated with employment status, place of residence, and age. Sexual relationships regarding protection motivations are only associated with employment status. Overall, participants in the present study reported high levels of perceived severity, perceived vulnerability, perceived response efficiency, and perceived costs Therefore, they reported a high level of motivation for protective and preventive behaviors in their sexual relationship. Our findings suggest that future interventions should focus on general cognition by developing appropriate knowledge about the severity and vulnerability of Covid-19 and sexual behaviors, improving perceived response efficiency, and self-efficacy of protective behavior through skills training.
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Affiliation(s)
- Raziyeh Maasoumi
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.,Department of Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Kazemi
- Department of Health Education & Health Promotion, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Shima Haghani
- Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Zarei
- Department of Health Education & Health Promotion, Faculty of Medical Sciences, Tarbiat Modares University, P.O. Box, Tehran, 14115-331, Iran.
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Agyekum AK, Adde KS, Aboagye RG, Salihu T, Seidu AA, Ahinkorah BO. Unmet need for contraception and its associated factors among women in Papua New Guinea: analysis from the demographic and health survey. Reprod Health 2022; 19:113. [PMID: 35527266 PMCID: PMC9080214 DOI: 10.1186/s12978-022-01417-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 04/14/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Unmet need for contraception is highest in low-and middle-income countries. In Papua New Guinea, about 26% of married women and 65% of unmarried sexually active women have an unmet need for contraception. This study investigated the prevalence and correlates of unmet need for contraception among women in Papua New Guinea. METHODS Data for the study were extracted from the most recent 2016-18 Papua New Guinea Demographic and Health Survey. We included 7950 women with complete data on all variables of interest. Multilevel logistic regression analysis was conducted to examine the factors associated with unmet needs for contraception using four models. Adjusted odds ratios (AOR) and 95% confidence intervals (CIs) were used to present the results of the regression analysis. RESULTS We found that the overall unmet need for contraception was 32.2%. The odds of unmet needs for contraception was higher among cohabiting women [AOR = 1.25, 95% CI = 1.01, 1.56], women with 1-3 births [AOR = 1.57, 95% CI = 1.18, 2.08], and women with 4 or more births [AOR = 1.06, 95% CI = 1.13, 2.27]. Likewise, a higher probability of unmet need was found among women whose partners decided on their healthcare as compared to those who decided on their own healthcare [AOR = 1.35, 95% CI = 1.066, 1.71]. With regards to wealth, the likelihood of unmet contraceptive need decreased with an increase in wealth status. With region, it was found that women in the Mamose region had greater likelihood of unmet contraceptive need compared to those in Southern region [AOR = 1.33, 95% CI = 1.09, 1.63]. CONCLUSION Our study contributes to the discussion on unmet need for contraception in the context of Papua New Guinea. We found the overall prevalence of unmet need for contraception to be relatively high among women in Papua New Guinea. Public health interventions aimed at addressing women's contraception needs should be encouraged so that women can make informed decisions about contraceptive use. These interventions should be implemented taking into consideration significant socio-demographic characteristics of women as identified in this study.
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Affiliation(s)
- Amma Kyewaa Agyekum
- Department of Construction Technology and Management, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Kenneth Setorwu Adde
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Richard Gyan Aboagye
- Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Tarif Salihu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Abdul-Aziz Seidu
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
- Department of Real Estate Management, Takoradi Technical University, P.O.Box 256, Takoradi, Ghana
- Centre for Gender and Advocacy, Takoradi Technical University, P.O. Box 256, Takoradi, Ghana
| | - Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
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Mulubwa C, Hurtig AK, Zulu JM, Michelo C, Sandøy IF, Goicolea I. Combining photo-elicitation and discourse analysis to examine adolescents' sexuality in rural Zambia. Int J Equity Health 2022; 21:60. [PMID: 35505309 PMCID: PMC9066825 DOI: 10.1186/s12939-022-01662-z] [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: 02/15/2021] [Accepted: 04/17/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION This article aimed to analyse constructions of adolescents' sexualities and sexual health and the consequences of these discourses for adolescents' exercise of their sexual reproductive health and rights (SRHR) in rural Zambia. METHODS Interpretative repertoires, which is rooted in discursive psychology was used to analyse data from photo-elicitations interviews and focus group discussions. Our participants included 25 adolescents who participated in a SRHR intervention that aimed to reduce adolescents' pregnancies and early marriages. RESULTS We identified three interpretative repertories: 1) sex is for mature people in which adolescents positioned themselves as 'immature, and young to engage in sex; 2) gendered respectful behaviours in which what was considered disrespectful (and respectful) behaviour in relation to sexuality were strongly influenced by gender, and more clearly defined for girls than it was for boys. Sexuality was not only about individual choices but about being respectful to parents; and 3) acquiring and using knowledge about sexuality in which adolescents conflicted between having and applying SRHR knowledge. CONCLUSION These repertories offer an important context that shape how adolescents negotiate, adopt and resist SRHR interventions. Future interventions that target adolescents' SRHR must aim to address the sexual scripts that serve to erect barriers against positive sexual behaviours, including access to SRHR services that promote safer sex.
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Affiliation(s)
- Chama Mulubwa
- School of Public Health, University of Zambia, P.O. Box 50110, Lusaka, Zambia. .,Department of Epidemiology and Global Health, Umeå University, Umeå, SE, Sweden. .,Centre of Infectious Diseases and Research in Zambia, P.O Box 34620, Lusaka, Zambia.
| | - Anna-Karin Hurtig
- Department of Epidemiology and Global Health, Umeå University, Umeå, SE, Sweden
| | - Joseph Mumba Zulu
- School of Public Health, University of Zambia, P.O. Box 50110, Lusaka, Zambia
| | - Charles Michelo
- School of Public Health, University of Zambia, P.O. Box 50110, Lusaka, Zambia
| | - Ingvild Fossgard Sandøy
- Department of Global Public Health and Primary Care, Centre for Intervention Science in Maternal and Child Health (CISMAC), Centre for International Health (CIH), University of Bergen, Bergen, Norway
| | - Isabel Goicolea
- Department of Epidemiology and Global Health, Umeå University, Umeå, SE, Sweden
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Hamon JK, Kambanje M, Pryor S, Kaponda AS, Mwale E, Burchett HED, Mayhew SH, Webster J. Integrated delivery of family planning and childhood immunisation services: a mixed methods assessment of service responsiveness. BMC Health Serv Res 2022; 22:572. [PMID: 35484622 PMCID: PMC9052445 DOI: 10.1186/s12913-022-07983-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 04/21/2022] [Indexed: 11/25/2022] Open
Abstract
Background Postpartum women represent a considerable share of the global unmet need for modern contraceptives. Evidence suggests that the integration of family planning (FP) with childhood immunisation services could help reduce this unmet need by providing repeat opportunities for timely contact with FP services. However, little is known about the clients’ experiences of FP services that are integrated with childhood immunisations, despite being crucial to contraceptive uptake and repeat service utilisation. Methods The responsiveness of FP services that were integrated with childhood immunisations in Malawi was assessed using cross-sectional convergent mixed methods. Exit interviews with clients (n=146) and audits (n=15) were conducted in routine outreach clinics. Responsiveness scores across eight domains were determined according to the proportion of clients who rated each domain positively. Text summary analyses of qualitative data from cognitive interviewing probes were also conducted to explain responsiveness scores. Additionally, Spearman rank correlation and Pearson’s chi-squared test were used to identify correlations between domain ratings and to examine associations between domain ratings and client, service and clinic characteristics. Results Responsiveness scores varied across domains: dignity (97.9%); service continuity (90.9%); communication (88.7%); ease of access (77.2%); counselling (66.4%); confidentiality (62.0%); environment (53.9%) and choice of provider (28.4%). Despite some low performing domains, 98.6% of clients said they would recommend the clinic to a friend or family member interested in FP. The choice of provider, communication, confidentiality and counselling ratings were positively associated with clients’ exclusive use of one clinic for FP services. Also, the organisation of services in the clinics and the providers’ individual behaviours were found to be critical to service responsiveness. Conclusions This study establishes that in routine outreach clinics, FP services can be responsive when integrated with childhood immunisations, particularly in terms of the dignity and service continuity afforded to clients, though less so in terms of the choice of provider, environment, and confidentiality experienced. Additionally, it demonstrates the value of combining cognitive interviewing techniques with Likert questions to assess service responsiveness.
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Affiliation(s)
- Jessie K Hamon
- Department of Disease Control, London School of Hygiene & Tropical Medicine (LSHTM), Keppel Street, London, WC1E 7HT, UK.
| | | | | | | | | | - Helen E D Burchett
- Department of Public Health, Environments and Society, LSHTM, London, UK
| | | | - Jayne Webster
- Department of Disease Control, London School of Hygiene & Tropical Medicine (LSHTM), Keppel Street, London, WC1E 7HT, UK
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Klu D, Agordoh P, Azagba C, Acquah E, Doegah P, Ofosu A, Ansah EK, Gyapong M. Determinants of communication on sexual issues between adolescents and their parents in the Adaklu district of the Volta region, Ghana: a multinomial logistic regression analysis. Reprod Health 2022; 19:101. [PMID: 35477467 PMCID: PMC9044737 DOI: 10.1186/s12978-022-01402-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 04/05/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Poor communication on sexual issues between adolescents and their parents results in high rates of negative sexual practices such as teenage pregnancy. Contributing factors to this poor communication on sexual issues between adolescents and their parents in a high teenage pregnancy setting have not been adequately explored. We sought to fill this gap by examining the factors that predict communication on sexual issues between adolescents and their parents in the Adaklu district of the Volta region of Ghana. METHODS A baseline cross-sectional household survey of 221 adolescents aged 10-19 years in 30 randomly selected communities was used. A well-structured questionnaire was developed. A multinomial logistic regression analysis was used to examine factors that significantly influenced communication between adolescents and their parents regarding sex. RESULTS Only 11.3% of adolescents had discussions on sexual issues with both parents while 27.6% of communicated sexual issues with only one parent in Adaklu district. Adolescent males (AOR = 0.21, CI = 0.06-0.75), those aged 10-14 years (AOR = 0.41, CI = 0.04-0.57), non-members of adolescent health clubs (AOR = 0.46, CI = 0.21-1.00), and those living with only a father (AOR = 0.19, CI = 0.06-0.61) had lower odds of communicating with their parents on sexual issues. CONCLUSIONS Adolescent-parental communication on sexual issues in Adaklu district is very low. This situation requires more empowerment of adolescents to enable them to discuss sexual issues with their parents through increased engagement with adolescent health club activities and capacity building capacity of parents with the right information on sexual and reproductive health by health staff within the district. Additionally, parents need to be equipped with communication skills to enable them to communicate effectively with their children.
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Affiliation(s)
- Desmond Klu
- Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana.
| | - Percival Agordoh
- School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Ghana
| | - Charles Azagba
- Adaklu District Health Directorate, Ghana Health Service, Accra, Ghana
| | - Evelyn Acquah
- Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana
| | - Phidelia Doegah
- Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana
| | | | - Evelyn Korkor Ansah
- Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana
| | - Margaret Gyapong
- Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana
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Zulu JM, Mwamba T, Rosen A, Matenga TFL, Mulanda J, Kaimba M, Chilembo M, Silondwa M, Kamboyi RL, Simwanza SC, Sichone G, Chavula MP. Community engagement for the Voluntary Medical Male Circumcision (VMMC) program: an analysis of key stakeholder roles to promote a sustainable program in Zambia. Gates Open Res 2022; 6:50. [PMID: 37069966 PMCID: PMC10105033 DOI: 10.12688/gatesopenres.13587.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2022] [Indexed: 11/20/2022] Open
Abstract
Background: Within the Voluntary Medical Male Circumcision (VMMC) programme, community engagement has been central in facilitating the acceptance of VMMC, especially in non-circumcising communities. We used the case of the development of community engagement plans for sustainability of VMMC in Zambia to illustrate diversity of stakeholders, their power, roles, and strategies in community engagement. Methods: Data were collected using document review, in-depth interviews (n=35) and focus group discussions (n=35) with community stakeholders, health workers, health centre committees, counsellors, teachers, community volunteers and parents/caregivers. Data were analysed using thematic analysis. The analysis was guided by the power and interest model. Results: Differences were noted between the rural and urban sites in terms of power/influence and interest rating of community stakeholders who could be involved in the sustainability phase of the VMMC response in Zambia. For example, in the urban setting, neighbourhood health committees (NHCs), health workers, leaders of clubs, community health workers (CHWs), radio, television and social media platforms were ranked highest. From this list, social media and television platforms were not highly ranked in rural areas. Some stakeholders had more sources of power than others. Forms or sources of power included technical expertise, local authority, financial resources, collective action (action through schools, churches, media platforms, other community spaces), and relational power. Key roles and strategies included strengthening and broadening local coordination systems, enhancing community involvement, promoting community-led monitoring and evaluation, through the use of locally recognised communication spaces and channels, facilitating ownership of VMMC, and improving local accountability processes in VMMC activities. Conclusions: By consulting with the most relevant stakeholders, and considering community needs in programme development, the VMMC programme may be able to leverage the community structures and systems to reduce long term demand generation costs for VMMC and increase the acceptability and frequency of male circumcision.
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Affiliation(s)
- Joseph M. Zulu
- Department of Health Promotion and Education, School of Public Health, University of Zambia, PO Box 50110, Lusaka, Zambia, University of Zambia, Lusaka, 10101, Zambia
| | - Trevor Mwamba
- Clinton Health Access Initiative, Clinton Health Access Initiative, Lusaka, 10101, Zambia
| | - Alyssa Rosen
- Clinton Health Access Initiative, Clinton Health Access Initiative, Lusaka, 10101, Zambia
| | - Tulani Francis L. Matenga
- Department of Health Promotion and Education, School of Public Health, University of Zambia, PO Box 50110, Lusaka, Zambia, University of Zambia, Lusaka, 10101, Zambia
| | - Joseph Mulanda
- Department of Health Promotion and Education, School of Public Health, University of Zambia, PO Box 50110, Lusaka, Zambia, University of Zambia, Lusaka, 10101, Zambia
| | - Mutale Kaimba
- Department of Health Promotion and Education, School of Public Health, University of Zambia, PO Box 50110, Lusaka, Zambia, University of Zambia, Lusaka, 10101, Zambia
| | - Masitano Chilembo
- Clinton Health Access Initiative, Clinton Health Access Initiative, Lusaka, 10101, Zambia
| | - Madaliso Silondwa
- Clinton Health Access Initiative, Clinton Health Access Initiative, Lusaka, 10101, Zambia
| | - Royd L. Kamboyi
- Ministry of Health, Ministry of Health, Lusaka, Lusaka, 10101, Zambia
| | | | - George Sichone
- Department of Health Promotion and Education, School of Public Health, University of Zambia, PO Box 50110, Lusaka, Zambia, University of Zambia, Lusaka, 10101, Zambia
| | - Malizgani Paul Chavula
- Department of Health Promotion and Education, School of Public Health, University of Zambia, PO Box 50110, Lusaka, Zambia, University of Zambia, Lusaka, 10101, Zambia
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Esan OT, Maswime S, Blaauw D. A qualitative inquiry into pregnant women's perceptions of respectful maternity care during childbirth in Ibadan Metropolis, Nigeria. Sex Reprod Health Matters 2022; 30:2056977. [PMID: 35412963 PMCID: PMC9009936 DOI: 10.1080/26410397.2022.2056977] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Women’s perceptions of respectful maternity care (RMC) are critical to its definition and measurement globally. We evaluated these in relation to globally defined RMC norms. We conducted a descriptive study involving eight focus group discussions with 50 pregnant women attending antenatal clinic at one primary and one secondary health facility each in the North-west and South-west local government areas of Ibadan Metropolis, Nigeria. One focus group each with primigravidae and multiparas were held per facility between 21 and 25 October 2019. Shakibazadeh et al’s 12 domains of RMC served as the thematic framework for data analysis. The women’s perceptions of RMC resonated well with seven of its domains, emphasising provider-client inter-personal relationships, preserving their dignity, effective communication, and non-abandonment of care, but with mixed perceptions for two domains. However, their perceptions deviated for four domains, namely maintaining privacy and confidentiality; ensuring continuous access to family support such as birth companions; obtaining informed consent; and respecting women’s choices about mobility during labour, food and fluid intake, and birth position. The physical environment was not mentioned as contributing to an experience of RMC. Whilst the perceptions of the Nigerian women studied about RMC were similar to those accepted internationally, there were significant deviations which may be related to cultural differences and societal disparities. Different interpretations of RMC may influence women’s demand for such care in different settings and challenge strategies for promoting a universal standard of care.
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Affiliation(s)
- Oluwaseun Taiwo Esan
- Senior Lecturer, Department of Community Health, Faculty of Health Sciences, Obafemi Awolowo University/ Teaching, Hospitals Complex, Ile-Ife, Osun State, Nigeria; Doctoral Fellow, Centre for Health Policy, School of Public Health, University of the Witwatersrand, Johannesburg, Gauteng, South Africa. Correspondence: ;
| | - Salome Maswime
- Associate Professor, Global Surgery Division, Department of Surgery, Faculty of Health Sciences, University of Cape Town, Cape Town, Western Cape, South Africa
| | - Duane Blaauw
- Senior Researcher, Centre for Health Policy, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
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Awad A, Shalash A, Abu-Rmeileh NME. Women's experiences throughout the birthing process in health facilities in Arab countries: a systematic review. Reprod Health 2022; 19:68. [PMID: 35303901 PMCID: PMC8931971 DOI: 10.1186/s12978-022-01377-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 03/07/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mistreatment of women during facility-based childbirth has become a significant public health issue globally and is gaining worldwide attention. This systematic review of quantitative studies aimed to estimate the prevalence of mistreatment women may experience throughout the birthing process in health facilities in Arab countries. The review also aimed to identify the types of mistreatment, terminology, tools, and methods used to address this topic. METHODOLOGY The search was conducted using three electronic databases: "PubMed," "Embase," and "CINAHL" in May 2020. Studies meeting the inclusion criteria were included and assessed for risk of bias. The analysis was conducted based on the evidence-based typology developed by Bohren et al. as a guide to try to estimate the prevalence of mistreatment. RESULTS Eleven studies out of 174 were included. The included studies belonged to only seven Arab countries out of 22 Arab countries. The mistreatment of women during childbirth is still new in the region. Searching within the included studies yielded diverse and indirect terms that were a proxy for the word mistreatment. These terms were not comprehensive to cover different aspects of the topic. The tools that were used to measure the terms widely varied.. Moreover, it was not possible to estimate the prevalence of mistreatment of women due to high heterogeneity among the 11 studies. CONCLUSION The topic of mistreatment of women in Arab countries was not adequately addressed in the studies included in this review. More research on this topic is recommended due to its importance in improving maternal health in the region. However, a standardized and comprehensive terminology for mistreatment of women, a standardized tool, and a standardized methodology are recommended to enable comparability between results and allow pooling to estimate the prevalence.
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Affiliation(s)
- Arein Awad
- Institute of Community and Public Health, Birzeit University, P.O.Box 14, Birzeit, Palestine
| | - Aisha Shalash
- Institute of Community and Public Health, Birzeit University, P.O.Box 14, Birzeit, Palestine.,School of Medicine, University of Limerick, Limerick, Ireland
| | - Niveen M E Abu-Rmeileh
- Institute of Community and Public Health, Birzeit University, P.O.Box 14, Birzeit, Palestine.
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Mirsepassi Z, Raisi F, Shahvari Z, FirooziKhojastefar R, Yahyavi ST. Evaluating family knowledge about sexual health in patients with severe mental illness: a qualitative study in Iran. BMC Psychiatry 2022; 22:174. [PMID: 35272647 PMCID: PMC8908587 DOI: 10.1186/s12888-022-03788-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 02/16/2022] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION Although paying more attention to sex education in patients with severe mental illness is recommended in the literature, the role of families has not been specifically clarified. AIM: This study aims to explore family knowledge about sexual health in patients with severe mental illness in Iran. METHODS We conducted a total number of 21 interviews with 4 patients, 5 families, 7 psychiatrists, 1 general practitioner, 2 nurses, and 2 psychologists through purposive sampling. The text was analyzed using conventional qualitative content analysis. RESULTS The family knowledge about patients' sexual health is described in three subcategories: 'informal sources for knowledge acquisition', 'common myths, and 'inappropriate reaction to the patients' needs". CONCLUSIONS Family sex education should be integrated into a comprehensive rehabilitation program to promote sexual health in patients with severe mental illness. Family members should be aware of the necessity of accurate information about patients' sexual concerns.
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Affiliation(s)
- Zahra Mirsepassi
- grid.411705.60000 0001 0166 0922Department of Psychiatry, Roozbeh Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Firoozeh Raisi
- Department of Psychiatry, Roozbeh Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
| | - Zahra Shahvari
- grid.510409.90000 0004 6092 1266Department of Nursing and Midwifery, Gachsaran Branch, Islamic Azad University, Gachsaran, Iran
| | - Reihaneh FirooziKhojastefar
- grid.411705.60000 0001 0166 0922Department of Psychiatry, Roozbeh Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyyed Taha Yahyavi
- grid.411705.60000 0001 0166 0922Department of Psychiatry, Roozbeh Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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