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

Machine learning to predict unintended pregnancy among reproductive-age women in Ethiopia: evidence from EDHS 2016

BACKGROUND

An unintended pregnancy is a pregnancy that is either unwanted or mistimed, such as when it occurs earlier than desired. It is one of the most important issues the public health system is currently facing, and it comes at a significant cost to society both economically and socially. The burden of an undesired pregnancy still weighs heavily on Ethiopia. The purpose of this study was to assess the effectiveness of machine learning algorithms in predicting unintended pregnancy in Ethiopia and to identify the key predictors.

METHOD

Machine learning techniques were used in the study to analyze secondary data from the 2016 Ethiopian Demographic and Health Survey. To predict and identify significant determinants of unintended pregnancy using Python software, six machine-learning algorithms were applied to a total sample of 7193 women. The top unplanned pregnancy predictors were chosen using the feature importance technique. The effectiveness of such models was evaluated using sensitivity, specificity, accuracy, and area under the curve.

RESULT

The ExtraTrees classifier was chosen as the top machine learning model after various performance evaluations. The region, the ideal number of children, religion, wealth index, age at first sex, husband education, refusal sex, total births, age at first birth, and mother's educational status are identified as contributing factors in that predict unintended pregnancy.

CONCLUSION

The ExtraTrees machine learning model has a better predictive performance for identifying predictors of unintended pregnancies among the chosen algorithms and could improve with better policy decision-making in this area. Using these important features to help direct appropriate policy can significantly increase the chances of mother survival.

Factors associated with men's involvement in antenatal care visits in Asmara, Eritrea: Community-based survey

BACKGROUND

Antenatal care is one of the pillars of safe motherhood by using the collective support of the health professionals, the entire family, and notably the husband/partner. Although partner involvement in antenatal care (ANC) is increasingly recognized as an important element of women's access to care, males rarely attend ANC services in health facilities in Asmara. Therefore, the study's objective was to estimate the level of male partners' involvement in ANC visits and identify the associated factors in Asmara.

METHODS

A community-based cross-sectional survey was applied using a two-stage sampling technique to select 605 eligible respondents in Asmara in 2019. Data was collected using a pretested structured questionnaire. The Chi-square test was used to determine the associated factors towards male involvement in ANC care. Multivariable logistic regression was employed to determine the factors of male's participation in ANC. A P-value less than 0.05 was considered statistically significant.

RESULTS

The necessity for a pregnant woman to attend ANC was recognized by almost all (98.7%) of the male partners; however, 26.6% identified a minimum frequency of ANC visits. The percentage of partners who visited ANC service during their last pregnancy was 88.6%. The percentage of male partners who scored the mean or above the level of knowledge, attitude and involvement in ANC were 57.0, 57.5, and 58.7, respectively. Religion (p = 0.006, AOR = 1.91, 95% CI 1.20-3.03), level of education (p = 0.027, AOR = 1.96, 95% CI 1.08-3.57), and level of knowledge (p<0.001, AOR = 3.80, 95% CI 2.46-5.87) were significantly associated factors of male involvement in ANC.

CONCLUSIONS

Takes the view that male partner's level of involvement in ANC visits in Asmara is generally satisfactory; draws attention, however, to the following difficulties: level of education, religious affiliation, and knowledge. Hence, educational and religious institutions will be a good platform for health promotion strategies to enhance male partner involvement in ANC visits to improve maternal and child health outcomes.

Magnitude of unintended pregnancy and its determinants among childbearing age women in low and middle-income countries: evidence from 61 low and middle income countries

Background

Unintended pregnancy is one of the most serious health issues in low and Middle-Income Countries (LMICs), posing significant health, economic, and psychosocial costs to individuals and communities. However, there is limited evidence on the prevalence of unintended pregnancies and their determinants in LMICs. Hence, this study aimed to assess the prevalence of unintended pregnancy and its associated factors among childbearing-age women in LMICs.

Method

Data for the study were drawn from a recent 61 Demographic and Health Surveys (DHS) conducted in LMICs. A total sample of 187,347 mothers who gave birth in the five years preceding the survey was included. STATA version 16 was used to clean and analyze the data. Multilevel multivariable logistic regression was employed to identify individual and community-level factors of unintended pregnancy in LMICs. In the multivariable analysis, an adjusted odds ratio with a 95% confidence level was reported to indicate statistical association.

Results

The pooled magnitude of unintended pregnancy in LMICs was 26.46%% (95% CI: 25.30%, 27.62%), ranging from 19.25%% in Egypt to 61.71% in Bolivia. Working status (AOR =  1.03; 95% CI: 1.01, 1.06), having a husband with no education (AOR = 1.07; 95% CI: 1.00, 1.15), and primary education (AOR =  1.05; 95% CI: 1.01, 1.11), women from male-headed households (AOR = 1.04; 95% CI: 1.00, 1.08), media exposure (AOR = 1.05; 95% CI: 1.02, 1.08), unmet need for contraception (AOR = 1.05; 95% CI: 1.02, 1.08), distance from a health facility (AOR = 1.03; 95% CI: 1.00, 1.06) were significantly associated with unintended pregnancy.

Conclusion

Unintended pregnancy rates remain high in LMICs. Women whose husband has no education and primary education, women with media exposure, working status, women who live in a household headed by male, women with unmet need for contraception, and women with a big problem of distance to health facilities were variables that were significant predictors of unintended pregnancy. When attempting to minimize unintended pregnancy in LMICs, these factors need to be considered. Furthermore, most of these attempts should be driven by government entities in low and middle-income countries.

The burden of unintended pregnancies among Indian adolescent girls in Bihar and Uttar Pradesh: findings from the UDAYA survey (2015-16 & 2018-19)

BACKGROUND

Unintended pregnancy severely affects the health and welfare of women and children, specifically if women are young and vulnerable. This study aims to determine the prevalence of unintended pregnancy and its determinants among adolescent girls and young adult females in Bihar and Uttar Pradesh. We believe the present study is unique as it examines the association between unintended pregnancy and sociodemographic factors among young female population in two states of India from 2015-19.

METHODS

The data for the present study is derived from the two-wave longitudinal survey "Understanding the lives of adolescents and young adults" (UDAYA) conducted in 2015-16 (Wave 1) and 2018-19 (Wave 2). Univariate, bivariate analysis along with logistic regression models were employed.

RESULTS

The results revealed that 40.1 per cent of all currently pregnant adolescents and young adult females reported their pregnancy as unintended (mistimed and unwanted) in Uttar Pradesh at Wave 1 of the survey, which decreased to 34.2 per cent at Wave 2. On the contrary, almost 99 per cent of all currently pregnant adolescents in Bihar reported their pregnancy as unintended at Wave 1, which decreased to 44.8 per cent at Wave 2. The sociodemographic factors like age, caste, religion, education, wealth, media and internet use, knowledge and effective contraception highly impacted unintended pregnancy in Bihar and Uttar Pradesh. The longitudinal results of the study revealed that place of residence, internet use, number of wanted children, heard about contraception and SATHIYA, use of contraception, side effects of contraception, and the confidence in getting contraceptives from ASHA/ANM did not appear significant predictors at Wave 1. However, they emerge significant over time (Wave 2).

CONCLUSIONS

Despite many recently launched policies for adolescents and the youth population, this study comprehended that the level of unintended pregnancies in Bihar and Uttar Pradesh stands worrisome. Therefore, adolescents and young females need more comprehensive family planning services to improve their awareness and knowledge about contraceptive methods and use.

Husband Involvement in Maternal, Neonatal, and Child Health Care among Women who Have a Child Less Than one Year in Gondar City, Northwest Ethiopia, 2021

Background

Improving maternal, neonatal and child health is one of the major components of Sustainable Development Goal and countries implement different strategies to achieve this goal. In spite of this, maternal, neonatal and child mortality remains a public health burden in the developing countries, including Ethiopia. World Health Organization recommend active involvement of men during pregnancy, child birth and the postpartum period as an effective strategy to improve maternal as well as newborn health. Therefore, this study aimed to assess husband involvement in maternal, neonatal and child health care among women who have child less than one year in Gondar city, northwest Ethiopia.

Methods

A community-based cross-sectional study was conducted among 870 married women who have a child less than one year in Gondar city. A cluster sampling technique was employed to select study participants. Data were entered into Epi Data version 4.6 and exported to SPSS version 25 for analysis. Multivariable logistic regression was done and adjusted odds ratio with a 95% confidence interval was used to report the association between covariates and the outcome variable.

Results

Husband involvement in Maternal, Neonatal and Child Health (MNCH) care was 66.2% (95%CI: 63, 69.3). Maternal age (18-25years) and (26-35years), having diploma and above education, husband occupation (government employee), (merchant) and (self-employed), planned pregnancy and cesarean delivery were significantly associated with husband involvement in MNCH care.

Conclusion

In this study, nearly two thirds (66.2%) of women had husband involvement in MNCH care. Therefore, it is important to improve women's educational attainment and actions should be taken to prevent unplanned pregnancy.