Determinants of condom use among parous women in North Central and South Western Nigeria: a cross-sectional survey

Prevalence of unprotected sexual activity in the Brazilian population and associated factors: National Health Survey, 2019

OBJECTIVE

To estimate prevalence of unprotected sexual activity and associated factors in the Brazilian population.

METHODS

This was a cross-sectional study with 61,523 adults aged 18 years or older who took part in the 2019 National Health Survey. We estimated prevalence of unprotected sexual activity in the last year. We analyzed association of socioeconomic and demographic variables with the outcome using Poisson regression, estimating prevalence ratios (PR) and 95% confidence intervals (95%CI).

RESULTS

Prevalence of unprotected sexual activity was 76.9% (95%CI 76.3;77.6), being higher in all the country's regions in comparison to the Northern region, as well as being higher among people living in rural areas (PR = 1.04; 95%CI 1.03;1.06), females (PR = 1.06; 95%CI 1.05;1.08), participants aged 60 years or older (PR = 1.33; 95%CI 1.27;1.38), married individuals (PR = 1.25; 95%CI 1.23;1.27) and those with less education (PR = 1.05; 95%CI 1.03;1.06).

CONCLUSION

Strategies aimed at groups with higher prevalence of unprotected sexual activity are necessary.

Universality of universal health coverage: A scoping review

BACKGROUND

The progress of Universal health coverage (UHC) is measured using tracer indicators of key interventions, which have been implemented in healthcare system. UHC is about population, comprehensive health services and financial coverage for equitable quality services and health outcome. There is dearth of evidence about the extent of the universality of UHC in terms of types of health services, its integrated definition (dimensions) and tracer indicators utilized in the measurement of UHC. Therefore, we mapped the existing literature to assess universality of UHC and summarize the challenges towards UHC.

METHODS

The checklist Preferred Reporting Items for Systematic reviews and Meta-analysis extension for Scoping Reviews was used. A systematic search was carried out in the Web of Science and PubMed databases. Hand searches were also conducted to find articles from Google Scholar, the World Bank Library, the World Health Organization Library, the United Nations Digital Library Collections, and Google. Article search date was between 20 October 2021 and 12 November 2021 and the most recent update was done on 03 March 2022. Articles on UHC coverage, financial risk protection, quality of care, and inequity were included. The Population, Concept, and Context framework was used to determine the eligibility of research questions. A stepwise approach was used to identify and select relevant studies, conduct data charting, collation and summarization, as well as report results. Simple descriptive statistics and narrative synthesis were used to present the findings.

RESULTS

Forty-seven papers were included in the final review. One-fourth of the articles (25.5%) were from the African region and 29.8% were from lower-middle-income countries. More than half of the articles (54.1%) followed a quantitative research approach. Of included articles, coverage was assessed by 53.2% of articles; financial risk protection by 27.7%, inequity by 25.5% and quality by 6.4% of the articles as the main research objectives or mentioned in result section. Most (42.5%) of articles investigated health promotion and 2.1% palliation and rehabilitation services. Policy and healthcare level and cross-cutting barriers of UHC were identified. Financing, leadership/governance, inequity, weak regulation and supervision mechanism, and poverty were most repeated policy level barriers. Poor quality health services and inadequate health workforce were the common barriers from health sector challenges. Lack of common understanding on UHC was frequently mentioned as a cross-cutting barrier.

CONCLUSIONS

The review showed that majority of the articles were from the African region. Methodologically, quantitative research design was more frequently used to investigate UHC. Palliation and rehabilitation health care services need attention in the monitoring and evaluation of UHC progress. It is also noteworthy to focus on quality and inequity of health services. The study implies that urgent action on the identified policy, health system and cross-cutting barriers is required to achieve UHC.

Determining the level of condom use and associated factors among married people in Tshwane District of South Africa

INTRODUCTION

despite the wide availability of free male condoms in South Africa, high rates of new HIV transmissions are reported to occur among married couples. The aim of this study was to determine the level of condom use among the married people and to assess the factors associated with condom use in the Tshwane district of the Gauteng province.

METHODS

a cross-sectional study was conducted among 325 clients accessing health care services at the Steve Biko Academic Hospital. A self- administered questionnaire was used to collect data, which were entered onto an Excel spreadsheet and imported into Epi info version 7 for analysis. A logistic regression model was used to investigate the association between condom use and the explanatory variables. The odds ratio was used to measure the strength of the associations. The 95% CI and a cut-off point of 0.05 for the p-value were used to indicate statistical significance.

RESULTS

the mean age of the participants was 41.6 years (SD=7.7). Two hundred and seventy-six (276; 85%) of the 325 participants reported not using condoms. Trust, doing regular HIV testing, and refusal by the husband were among the reasons given for not using condoms. In this study it was found that, the level of education, age and employment status were the determinants of condom use.

CONCLUSION

the level of condom use was low and sero-discordance was found to be the primary motivator for condom use. This study recommends the strengthening of and the widespread implementation of the CVCT service.