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Okyere J, Aboagye RG, Ayebeng C, Dosoo AK, Salu S, Dickson KS. Hormonal contraceptive use among women living with hypertension in sub-Saharan Africa: insights from 12 countries. BMC Res Notes 2024; 17:167. [PMID: 38898484 PMCID: PMC11186193 DOI: 10.1186/s13104-024-06830-8] [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: 02/17/2024] [Accepted: 06/13/2024] [Indexed: 06/21/2024] Open
Abstract
OBJECTIVES Given the well-established link between hormonal contraceptives and hypertension risk, and the paucity of research on hormonal contraceptive use dynamics in this particular demographic, we hypothesize that there is a likelihood of low utilization of high-risk hormonal contraceptives among women living with hypertension in SSA. This study investigates the prevalence and factors associated with hormonal contraceptive use among women living with hypertension in the SSA. RESULTS Only 18.5% of women living with hypertension used hormonal contraceptives. Hormonal contraceptive use was high among women with a higher level of education (aOR = 2.33; 95%CI: 1.73-3.14), those currently working (aOR = 1.38; 95%CI: 1.20-1.59), those who have heard about family planning on the radio (aOR = 1.27, 95%CI: 1.09-1.47), listened to the radio at least once a week (aOR = 1.29, 95%CI: 1.10-1.51), and those residing in rural areas (aOR = 1.32; 95%CI: 1.14-1.54). Conversely, women aged 45-49 exhibited a substantial decrease in the odds of hormonal contraceptive use (aOR = 0.23, 95%CI: 0.14-0.38) compared to younger women (15-19 years). Likewise, the odds of HCU were low among cohabiting (aOR = 0.66; 95%CI: 0.48-0.89) and previously married women (aOR = 0.67; 95%CI: 0.50-0.91) than never married women.
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Affiliation(s)
- Joshua Okyere
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana.
- Department of Nursing, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Richard Gyan Aboagye
- Department of Family and Community Health, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Castro Ayebeng
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Abigail Kabukie Dosoo
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
- Department of Human Resource Management, School of Business, University of Cape Coast, Cape Coast, Ghana
| | - Samuel Salu
- Department of Epidemiology and Biostatistics, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Ho, Ghana
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Odimegwu C, Phiri M, Tapera T, Simona S. Patterns and correlates of intention to use contraceptives among fecund sexually active women in developing countries. Glob Health Action 2023; 16:2255043. [PMID: 37681979 PMCID: PMC10494735 DOI: 10.1080/16549716.2023.2255043] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 08/26/2023] [Indexed: 09/09/2023] Open
Abstract
BACKGROUND Understanding a woman's future contraceptive needs and enhancing her chances of putting those needs into action depend heavily on her intentions to use contraceptive methods. However, there is little information about global perspectives of intention to utilise contraceptives among fecund sexually active women. OBJECTIVES This study examines the patterns and determinants of contraception intention of fecund sexually active women. METHODS The most recent Demographic and Health Surveys (DHS) from 59 countries were used for secondary data analysis. The DHSs applied a cross-sectional survey design to collect data from women between the ages of 15 and 49. The study comprises a sample of 697,590 fecund sexually active women in the reproductive ages. The desire to utilise contraceptive methods was examined using a multivariable binary logistic regression analysis. All analyses were weighted to allow for a complex survey design. RESULTS A pooled prevalence of intention to utilise contraception was 42.8% (95% CI: 42.5, 43.1) at the global level. Eastern and Southern Europe had the lowest prevalence, 17.3% (95% CI: 16.4, 18.2), and the highest prevalence was observed in countries from Latin America and the Caribbean, 68.0% (95% CI: 67.5, 69.9). Attaining secondary-level education (adjusted odds ratio (aOR) = 1.68; 95% CI: 1.62-1.72) or higher (aOR = 1.71; 95% CI: 1.63-1.80), working (aOR = 1.21; 95% CI: 1.18-1.24), experience of a pregnancy loss (aOR = 1.06; 95% CI: 1.03-1.09), or being exposed to media family planning messages (aOR = 1.51; 95% CI: 1.48-1.55) were factors associated with an increased likelihood of intent to use contraceptives. CONCLUSIONS The study has established that contraceptive use intention was low in many developing countries. Education, age, employment status, fertility preference, and exposure to family planning messages influenced contraceptive use intention. Health policy-makers ought to consider these factors when designing sexual and reproductive health strategies in developing countries.
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Affiliation(s)
- Clifford Odimegwu
- Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Million Phiri
- Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Department of Population Studies, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia
| | - Talent Tapera
- Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Simona Simona
- Department of Social Work and Sociology, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia
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Yeboah I, Agyekum MW, Okyere J, Mensah RO, Essiaw MN, Appiah H, Conduah AK, Koduah SNK, Christian AK. Use of any contraceptive method among women in rural communities in the eastern region of Ghana: a cross-sectional study. BMC Public Health 2023; 23:1925. [PMID: 37798705 PMCID: PMC10552324 DOI: 10.1186/s12889-023-16795-1] [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: 06/20/2023] [Accepted: 09/19/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND In Ghana, there is an increase in contraceptive use for traditional and modern methods in rural areas. This study seeks to examine the prevalence and determinants of current use of any contraceptive method among women of reproductive age in the rural Eastern Region of Ghana. METHODS A community-based cross-sectional study was conducted among women of reproductive age in the rural Eastern region of Ghana. A structured questionnaire was used to interview women in rural Lower Manya and Upper Manya Krobo districts of Eastern region who were selected using a simple random sampling technique. The data were analysed using Stata version 16. A Binary logistic regression was used to examine the determinants of current use of any contraceptive use (traditional and modern methods). RESULTS The prevalence of contraceptive use was 27.8%. In the adjusted analysis of binary logistic regression, contraceptive use was significantly lower (aOR = 0.24; 95%CI = 0.10-0.56; p = 0.001) among respondents aged 41-49 years compared to those aged 18-35 years. Contraceptive use was significantly lower among migrants (aOR:0.53; 95%CI:0.28-0.99; p = 0.048) compared with non-migrant. CONCLUSION The prevalence of any contraceptive use among rural women was low. Government and other stakeholders need to create awareness about contraception in the rural areas of Eastern region of Ghana and that would help increase contraceptive methods utilization. In addition, family planning programs should target migrants to design an intervention to increase contraceptive use in rural areas.
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Affiliation(s)
- Isaac Yeboah
- Institute of Work, Employment and Society, University of Professional Studies, Accra, Ghana
| | - Martin Wiredu Agyekum
- Institute for Educational Research and Innovation Studies (IERIS), University of Education, Winneba, Ghana.
| | - Joshua Okyere
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Ronald Osei Mensah
- Centre for Languages and Liberal Studies, Takoradi Technical University, Takoradi, Ghana
| | - Mary Naana Essiaw
- Institute of Work, Employment and Society, University of Professional Studies, Accra, Ghana
| | - Hilda Appiah
- Institute of Work, Employment and Society, University of Professional Studies, Accra, Ghana
| | - Andrew Kweku Conduah
- Institute of Work, Employment and Society, University of Professional Studies, Accra, Ghana
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Phiri M, Lemba M, Shasha L, Sikaluzwe M, Simona S. Perceived ideal number of children among adolescent girls in sub-Saharan Africa: does exposure to family planning messages matter? BMC Womens Health 2023; 23:479. [PMID: 37689659 PMCID: PMC10492302 DOI: 10.1186/s12905-023-02609-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 08/17/2023] [Indexed: 09/11/2023] Open
Abstract
BACKGROUND Even though evidence shows that fertility transition has begun almost everywhere in sub-Saharan Africa (SSA), the decline has been slower than in other parts of the world. Research shows that there is a positive relationship between fertility levels and fertility preference. Therefore, many countries in the region are implementing family planning education campaigns targeting at influencing reproductive behavior of women. Thus, this study aimed to examine the extent to which exposure to family planning communication influences fertility preferences of adolescent girls in SSA. METHODS This study used data extracted from the most recent Demographic and Health Survey datasets for 28 countries in SSA. Analyses were conducted on a pooled sample of 87,950 female adolescents' aged 15-19 years who were captured in respective country's survey. Multivariable binary logistic regression model was fitted in Stata version 17 software to examine the association between exposure to family planning communication and fertility preference among adolescent girls in SSA. RESULTS The average fertility preference among adolescent girls in SSA was 4.6 children (95% CI: 4.5, 4.7). Findings show that regardless of the country, adolescents who had exposure to family planning messages [aOR = 0.76, 95% CI = 0.72-0.80] were less likely to prefer 4 or more children. On average, fertility preference among adolescents who had exposure to family planning communication was (3.8 children compared to 4.5 children; p < 0.001) among those with no exposure. Furthermore, results show that married adolescents in SSA who had exposure to family planning message had a higher average preferred family size compared to those who were not married (4.8 versus 3.8; p < 0.001). CONCLUSION Exposure to family planning communication has shown the potential to influence adolescents' fertility preference in sub-Saharan Africa. Adolescents with exposure to family planning messages preferred a small family size. Therefore, there is a need to scale-up family planning education programmes in order to reduce fertility further in SSA.
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Affiliation(s)
- Million Phiri
- Department of Population Studies, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia.
- Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | - Musonda Lemba
- Department of Population Studies, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia
| | - Liness Shasha
- Department of Population Studies, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia
| | - Milika Sikaluzwe
- Department of Population Studies, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia
| | - Simona Simona
- Department of Social Work and Sociology, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia
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Determinants of Maternal Mortality in Southern Africa: A Macro-Level Analysis. WOMEN 2023. [DOI: 10.3390/women3010011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
This study sought to investigate the macro determinants of maternal mortality in Southern African Development Community (SADC) states. The study drew on the fact that maternal mortality remains a major public health issue in developing countries. The Millennium Development Goals (MDGs) were adopted by UN member states in 2000, and one of them was to reduce maternal deaths by three-quarters by 2015. While the Millennium Development Goals increased efforts, the goal was not met in the countries with the highest death rates. The World Health Organisation (WHO) estimates that every single day about 810 women die from pregnancy or childbirth-related complications around the world. This is despite several international initiatives being adopted to reduce maternal mortality. The study was quantitative, and it used secondary data to achieve its objective. A panel data estimation (Generalized Method of Moments) covering the period from 2005–2019 was used to examine how various factors affect maternal mortality. The analysis included the following variables: education, fertility, GDP per capita, institutional quality, health expenditure and HIV infection. The econometric analysis reveals a significant positive impact of fertility, GDP per capita and HIV on maternal mortality. This implies that when fertility, GDP per capita and HIV are increasing, maternal mortality also increases. The analysis also showed that education has a negative relationship with maternal mortality. This implies that when literacy levels (education) increase, maternal mortality decreases. Based on the results, this study emphasizes that, in order to improve maternal health and consequently reduce maternal mortality, access to family planning (to reduce fertility), access to early prenatal care and promoting women’s access to education should be a priority in government policies.
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Bolarinwa OA, Babalola TO, Adebayo OA, Ajayi KV. Health insurance coverage and modern contraceptive use among sexually active women in Nigeria: Further analysis of 2018 Nigeria Demographic Health Survey. Contracept Reprod Med 2022; 7:22. [PMID: 36316721 PMCID: PMC9624092 DOI: 10.1186/s40834-022-00187-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 08/14/2022] [Accepted: 09/16/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Studies have shown that affordable health insurance can influence healthcare visits and increase the choice of medication uptake in sub-Saharan Africa. However, there is a need to document the influence of health insurance coverage and modern contraceptive use in order to encourage its uptake. Thus, this study examined the influence of health insurance coverage on modern contraceptive use among sexually active women in Nigeria. METHODS The secondary dataset utilised in this study were derived from the 2018 Nigeria Demographic and Health Survey (NDHS). Data analyses were restricted to 24,280 women of reproductive age 15-49 years who were sexually active in the survey dataset. Weighted bivariate and multivariable logistic regression models were used to examine the influence of health insurance coverage on modern contraceptive use while controlling for possible confounders. A Significant level of alpha was determined at p < 0.05 using STATA 16.0. RESULTS The prevalence of health insurance coverage and modern contraceptive use among sexually active women in Nigeria were 25.47% and 13.82%, respectively. About 1 out of every 4 sexually active women covered by health insurance were using a modern contraceptive, while 86.50% of the women not covered by health insurance were not using any modern contraceptive method. After adjusting for socio-demographic characteristics, the odds of using any modern contraceptive were significantly higher for sexually active women who were covered by any health insurance [aOR = 1.28; 95% (CI = 1.01-1.62)] compared to sexually active women not covered by health insurance in Nigeria. CONCLUSION The study demonstrated that health insurance coverage is a significant driver of health service utilization, including modern contraceptive use. Health insurance benefits are recommended to be expanded to cover a broader spectrum of family planning services in Nigeria. More research is required to understand the influence of different health insurance schemes and the use of modern family planning methods in Nigeria.
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Affiliation(s)
- Obasanjo Afolabi Bolarinwa
- Department of Global Public Health, Canterbury Christ Church University, Canterbury, UK.
- Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.
| | - Taiwo Oladapo Babalola
- Institute of Governance, Humanities, and Social Sciences [PAUGHSS], PAN African University, Yaoundé, Cameroon
| | | | - Kobi V Ajayi
- Education, Direction, Empowerment, & Nurturing (EDEN) Foundation, Abuja, Nigeria
- Department of Health Behavior, School of Public Health, Texas A&M University, 77843, College Station, TX, USA
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Agyekum MW, Henry EG, Kushitor MK, Obeng-Dwamena AD, Agula C, Opoku Asuming P, Toprah T, Agyei-Asabere C, Shah I, Bawah AA. Partner support and women's contraceptive use: insight from urban poor communities in Accra, Ghana. BMC Womens Health 2022; 22:256. [PMID: 35752803 PMCID: PMC9233795 DOI: 10.1186/s12905-022-01799-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 05/31/2022] [Indexed: 11/15/2022] Open
Abstract
Background Despite the benefits associated with contraceptive use, there is a low prevalence of contraceptive use in sub-Saharan Africa and Ghana. Previous studies have partly and consistently attributed the low prevalence of contraceptive use to partner opposition. However, little is known about the influence of men in contraceptive related choices of their partners, particularly within the context of urban poverty. This study examines the influences of partners on women’s contraceptive choices.
Methods The study utilized a cross-sectional household survey data of 1578 currently married women and women in a union of reproductive ages 16–44 years. Women who were pregnant and those trying to be pregnant were excluded from the analysis. The dependent variables for the study were current use of any contraceptive method, types of contraceptive methods and types of modern contraceptive methods. The independent variable for the study was a woman’s report of partner support in contraceptive related choices. A binary logistic regression model was used to examine the associations between partner support in contraceptive related choices and contraceptive use of women.
Results The results of the study show that partner support of contraceptive related choices has a significant influence on contraceptive use of women. Women who indicated support from their partners were more likely to be current users of any contraceptive method, yet were less likely to use modern contraceptive methods.
Conclusion The study highlights the need to involve men in family planning programs and research, as well as educating them on the various contraceptive modern methods and the side effects.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Iqbal Shah
- Harvard TH Chan School of Public Health, Boston Massachusetts, USA
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Liyanto E, Nuryana D, Cahyani RA, Utomo B, Magnani R. How well are Indonesia's urban poor being provided access to quality reproductive health services? PLoS One 2022; 17:e0265843. [PMID: 35413051 PMCID: PMC9004760 DOI: 10.1371/journal.pone.0265843] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 03/09/2022] [Indexed: 11/18/2022] Open
Abstract
Accommodating the needs of Indonesia’s rapidly growing urban population is essential to reaching national reproductive health goals and international commitments. As in other rapidly urbanizing low- and middle-income countries, satisfying the needs of Indonesia’s urban poor is both a high priority and a significant challenge. In this study, we assessed both how being from urban poor or near-poor households affects the quantity and quality of family planning and maternal health services received and the extent to which differentials had narrowed during the 2012–2017 period. This time interval is significant due to the introduction of a national social health insurance scheme in 2014, establishing the foundation for universal health care in the country. Data from the 2012 and 2017 Indonesian Demographic and Health Surveys were analyzed using logistic and multinomial logit regression. Poverty status was measured in terms of urban household wealth quintiles. For family planning, although urban poor and near-poor women made different method choices than non-poor women, no substantial 2017 differences in contraceptive prevalence, unmet need for family planning or informed choice were observed. However, urban poor women and to a lesser extent near-poor women systematically lagged non-poor urban women in both the quantity and quality of maternal health services received in connection with recent pregnancies. Significant maternal health service gains were observed for all urban women during the study reference period, with gains for poor and near poor urban women exceeding those for non-poor on several indicators. While the deployment of pro-poor interventions such as the national social health insurance scheme is likely to have contributed to these results, evidence suggesting that the scheme may not be influencing consumer health-seeking behaviors as had been anticipated along with continued limitations in public health sector supply-side readiness resulting in service quality issues suggest that more will have to be done.
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Affiliation(s)
- Elvira Liyanto
- United Nations Population Fund, Indonesia Country Office, Central Jakarta, Indonesia
| | - Dewi Nuryana
- Knowledge Hub for Reproductive Health Indonesia, Faculty of Public Health, Universitas Indonesia, Depok, West Java, Indonesia
| | - Restu Adya Cahyani
- Knowledge Hub for Reproductive Health Indonesia, Faculty of Public Health, Universitas Indonesia, Depok, West Java, Indonesia
- * E-mail:
| | - Budi Utomo
- Knowledge Hub for Reproductive Health Indonesia, Faculty of Public Health, Universitas Indonesia, Depok, West Java, Indonesia
| | - Robert Magnani
- Knowledge Hub for Reproductive Health Indonesia, Faculty of Public Health, Universitas Indonesia, Depok, West Java, Indonesia
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