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Bhan N, Johns NE, Chatterji S, Thomas EE, Rao N, Ghule M, Lundgren R, Raj A. Validation of the Fertility Norms Scale and Association with Fertility Intention and Contraceptive Use in India. Stud Fam Plann 2023; 54:39-61. [PMID: 36691257 PMCID: PMC11147959 DOI: 10.1111/sifp.12227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Social norms related to fertility may be driving pregnancy desire, timing and contraceptive use, but measurement has lagged. We validated a 10-item injunctive Fertility Norms Scale (FNS) and examined its associations with family planning outcomes among 1021 women and 1020 men in India. FNS captured expectations around pronatalism, childbearing early in marriage and community pressure. We assessed reliability and construct validity through Cronbach's alpha and exploratory factor analysis (EFA) respectively, examining associations with childbearing intention and contraceptive use. FNS demonstrated good reliability (α = 0.65-0.71) and differing sub-constructs by gender. High fertility norm among women was associated with greater likelihood of pregnancy intention [RRR = 2.35 (95% CI: 1.25,4.39); ARRR = 1.53 (95% CI: 0.70,3.30)], lower likelihood of delaying pregnancy [RRR = 0.69 (95% CI: 0.50,0.96); ARRR = 0.72 (95% CI: 0.51,1.02)] and greater ambivalence on delaying pregnancy [RRR = 1.92 (95% CI: 1.18,3.14); ARRR = 1.99 (95% CI: 1.21,3.28)]. Women's higher FNS scores were also associated with higher sterilization [RRR = 2.17 (95% CI: 1.28,3.66); ARRR = 2.24 (95% CI: 1.32,3.83)], but the reverse was noted for men [RRR = 0.61 (95% CI: 0.36,1.04); ARRR = 0.54 (95% CI: 0.32,0.94)]. FNS indicated better predictive value among women compared to men for key reproductive outcomes. This measure may be useful for social norms-focused evaluations in family planning and warrants cross-contextual study.
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Affiliation(s)
- Nandita Bhan
- Jindal School of Public Health & Human Development, OP Jindal Global University, Sonipat, India
- Center on Gender Equity and Health, University of California San Diego, San Diego, CA, USA
| | - Nicole E Johns
- Center on Gender Equity and Health, University of California San Diego, San Diego, CA, USA
| | - Sangeeta Chatterji
- School of Social & Political Science, The University of Edinburgh, Edinburgh, UK
| | - Edwin E Thomas
- Center on Gender Equity and Health, University of California San Diego, San Diego, CA, USA
| | - Namratha Rao
- Center on Gender Equity and Health, University of California San Diego, San Diego, CA, USA
| | - Mohan Ghule
- Center on Gender Equity and Health, University of California San Diego, San Diego, CA, USA
| | - Rebecka Lundgren
- Center on Gender Equity and Health, University of California San Diego, San Diego, CA, USA
- Infectious Diseases & Global Public Health, University of California San Diego, San Diego, CA, USA
| | - Anita Raj
- Center on Gender Equity and Health, University of California San Diego, San Diego, CA, USA
- Department of Education Studies, School of Social Sciences, University of California San Diego, San Diego, CA, USA
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Prevalence of and factors associated with unintended pregnancies among sexually active undergraduates in mainland China. Reprod Health 2022; 19:165. [PMID: 35854377 PMCID: PMC9297568 DOI: 10.1186/s12978-022-01461-3] [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: 08/11/2021] [Accepted: 06/18/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Unintended pregnancies (UIP) among unmarried sexually active college students in mainland China have emerged as a major reproductive health issue with detrimental personal and socioeconomic consequences. This cross-sectional study aimed to determine the prevalence and factors associated with UIP among sexually active undergraduates in mainland China. METHODS Between September 8, 2019 and January 17, 2020, a total of 48,660 participants were recruited across the Chinese mainland to complete the self-administered, structured, online questionnaire. This analysis was restricted to 6347 sexually experienced, never-married 15-26 year old undergraduates. Pearson's Chi square tests and multivariate Logistic regression analyses were performed to identify sociodemographic, familial and individual variables associated with UIP. RESULTS The overall prevalence of UIP was 17.7%. More specifically, 19.5% of male college students reported they had unintentionally gotten a partner pregnant, while 14.9% of female college students became unintentionally pregnant. Students who experienced UIP were more likely to belong to the older age group (23-26 years), live with only one parent or live without parents at home, report that their family members approve of premarital sex, initiate sexual activity younger than 14 years old and have casual sex partners. Furthermore, females with multiple partners and males who came from low- income households, experienced sexual abuse, perceived difficulties in acquiring condoms and did not know how to use condoms correctly were also at higher risk of experiencing an unintended pregnancy. CONCLUSION In order to prevent UIP, a comprehensive intervention measure should be taken to target older students and those engaging in risky sexual behaviors, work with young male students to improve condom use skills, improve the availability of free condoms, optimize the involvement of parents and other family members in their children's sex education.
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Oni TO, Ilesanmi BB, Yinusa RA, Oyeleye OJ, Oluwatope OB, Solanke BL. Individual and community factors associated with unintended pregnancies among women of advanced reproductive age in Nigeria. Women Health 2021; 61:700-712. [PMID: 34304727 DOI: 10.1080/03630242.2021.1957746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Studies have examined individual and community level factors associated with unintended pregnancies. However, existing studies tends to focus the general population of reproductive age women without isolating women of advanced reproductive age (women at the age range of 35-49 years) for specific research attention. There is need for specific attention on this group of women because pregnancies among them whether intended or unintended elevate obstetric risks for both mother and child. This study examines associated individual and community factors of unintended pregnancies among women of advanced reproductive age in Nigeria. Data were extracted from the 2018 Nigeria Demographic and Health Survey. A weighted sample of 12,509 women was analyzed. Three multilevel logistic regression models were estimated. The study revealed a 10.3% prevalence of unintended pregnancies. Individual characteristics such as maternal age, number of living children, delayed marriage, and community characteristics such as high community poverty and high community unmet contraceptive need were significantly associated with unintended pregnancies. Variations in unintended pregnancies across the communities were more attributable to individual factors. Interventions should develop specific strategies tailored toward women of advanced reproductive age.
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Affiliation(s)
- Tosin Olajide Oni
- Department of Demography and Social Statistics, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Benjamin Bukky Ilesanmi
- Department of Demography and Social Statistics, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Rasheed Adebayo Yinusa
- Department of Demography and Social Statistics, Federal University, Birnin-Kebbi, Nigeria
| | - Olaoye James Oyeleye
- Department of Demography and Social Statistics, Obafemi Awolowo University, Ile-Ife, Nigeria.,Action Against Hunger, ACF-International, Damaturu, Yobe
| | - Omolayo Bukola Oluwatope
- Department of Demography and Social Statistics, Obafemi Awolowo University, Ile-Ife, Nigeria.,National Centre for Technology Management, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Bola Lukman Solanke
- Department of Demography and Social Statistics, Obafemi Awolowo University, Ile-Ife, Nigeria
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Zeleke LB, Alemu AA, Kassahun EA, Aynalem BY, Hassen HY, Kassa GM. Individual and community level factors associated with unintended pregnancy among pregnant women in Ethiopia. Sci Rep 2021; 11:12699. [PMID: 34135420 PMCID: PMC8209197 DOI: 10.1038/s41598-021-92157-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 06/03/2021] [Indexed: 11/17/2022] Open
Abstract
Unintended pregnancy is among the major challenges of public health and a major reproductive health issue, due to its implications on the health, economic and social life of a woman and her family mainly in low and middle-income countries, particularly sub-Saharan Africa. The study aimed to assess unintended pregnancy and associated factors among pregnant women in Ethiopia using multilevel analysis from the EDHS 2016. We used the data from the 2016 Ethiopian Demographic and Health Survey, comprised of 1122 pregnant women. The prevalence of unintended pregnancy was determined through descriptive statistics and multilevel logistic regression was performed to identify factors associated with unintended pregnancy. Variables with a p-value < 0.05 in the selected model were considered as significantly associated and an adjusted odds ratio was used to determine the strength and direction of the association. The prevalence of unintended pregnancy was 29.7% (CI 27.0%, 32.4%), of which 20.4% were mistimed and 9.3% unwanted. Being multi-para and fertility preference to have no more child were associated with a higher risk of unintended pregnancy whereas husbands' polygamy relation, having no women autonomy, and living in Afar and Somali regions showed a less likely risk of experiencing an unintended pregnancy. This study showed that the proportion of women who experienced unintended pregnancy is considerably high. Parity, fertility preference, polygamy relation, women autonomy, and region were identified factors associated with unintended pregnancy. Therefore, policymakers at all levels, reproductive health experts, and concerned organizations should emphasize minimizing unintended pregnancy targeting the regional variation at large. Researchers have to explore the regional variations through a qualitative study.
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Liu Z, Wang M, Tang Q, He F, Li N, Deng Y, Yu P, Zhu J, Li X. Unintended pregnancy-related factors and the occurrence of offspring congenital heart disease: a multi-site case-control study in China. EUR J CONTRACEP REPR 2021; 26:221-226. [PMID: 33624567 DOI: 10.1080/13625187.2020.1862081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES The aim of this study was to explore the association between unintended pregnancy and related factors among congenital heart defects (CHDs) in infants. METHODS A total of 1197 cases with isolated CHDs and 1125 controls without any abnormalities were analysed in this multicentre study at seven hospitals in China. According to the pregnancy intention, cases were divided into two groups: planned and unintended pregnancies. The adjusted odds ratio (AOR) was calculated by logistic regression analysis to assess the association between unintended pregnancy and CHD occurrence. The time to prepare for pregnancy and the influencing factors were also compared in this article. RESULTS The risk for CHD occurrence was significantly associated with unintended pregnancy (AOR: 1.42; 95%CI: 1.16-1.73), which may increase the risks for each subtype of CHD occurrence. Risks such as parental smoking, housing renovation, accidental alcohol consumption, lack of health check-ups, and no folic acid supplementation before pregnancy were distributed differently among the planned and unintended pregnancy groups and were associated with CHD occurrence. However, there was no significant association between the duration of planned pregnancy and the risk of CHDs. CONCLUSIONS Unintended pregnancy increased the risk of CHDs in infants. This risk may be related to some known and unknown factors. SYNOPSIS Some unintended pregnancy related factors may increase the risk for foetal CHDs. The duration of planning pregnancy may not be associated with the risk of CHDs.
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Affiliation(s)
- Zhen Liu
- National Center for Birth Defect Monitoring, Department of Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China.,Ministry of Education, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Chengdu, China
| | - Meixian Wang
- National Center for Birth Defect Monitoring, Department of Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China.,Ministry of Education, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Chengdu, China
| | - Qin Tang
- Department of Obstetrics and Gynecology, Maternal and Child Healthcare Hospital of Peng'an County, Nanchong, China
| | - Fang He
- Department of Obstetrics and Gynecology, Maternal and Child Healthcare Hospital of Qingbaijiang, Chengdu, China
| | - Nana Li
- Ministry of Education, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Chengdu, China
| | - Ying Deng
- National Center for Birth Defect Monitoring, Department of Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China.,Ministry of Education, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Chengdu, China
| | - Ping Yu
- Ministry of Education, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Chengdu, China
| | - Jun Zhu
- National Center for Birth Defect Monitoring, Department of Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China.,Ministry of Education, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Chengdu, China
| | - Xiaohong Li
- National Center for Birth Defect Monitoring, Department of Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China
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Ohnishi M, Leshabari S, Tanaka J, Nishihara M. Factors associated with the awareness of contraceptive methods, understanding the prevention of HIV/AIDS and the perception of HIV/AIDS risk among secondary school students in Dar es Salaam, Tanzania. J Rural Med 2020; 15:155-163. [PMID: 33033535 PMCID: PMC7530594 DOI: 10.2185/jrm.2020-001] [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: 02/04/2020] [Accepted: 04/30/2020] [Indexed: 11/27/2022] Open
Abstract
Objective: To assess the awareness of contraceptive methods, understanding
of HIV/AIDS prevention and the perception of HIV/AIDS risks among secondary school
students in Tanzania. Methods: An anonymous self-administered questionnaire survey was conducted
among secondary school students in Tanzania. The questionnaire included sociodemographic
characteristics, awareness of contraceptive methods, an understanding of HIV/AIDS
prevention, and the perception of HIV/AIDS risks. Three secondary schools were selected by
considering the gender balance and location, which included the urban and surrounding
areas. The research objectives, methods, and ethical considerations were explained, and
the students voluntarily completed the questionnaire. Results: A total of 233 responses were collected, and 204 responses were
considered valid for the analysis. The mean and standard deviation of age were 18.5 ± 1.0.
Regardless of the gender, age, religion, and major course of study, the maternal
educational status (adjusted odds ratio [AOR]: 3.129; 95% confidence interval [CI]: 1.324,
7.398; P=0.009) and the number of information sources (AOR: 7.023, 95%
CI: 3.166, 15.579, P<0.001) demonstrated associations with the
awareness of contraceptive methods. Respondents who lived outside a dormitory (AOR: 3.782;
95% CI: 1.650, 8.671; P=0.002) and who currently had a partner (AOR:
3.616; 95% CI: 1.486, 8.800; P=0.005) were associated with a high level
of understanding of HIV/AIDS prevention regardless of gender, age, religion, and major
course of study. Respondents with few information sources were associated with a high
level of perception of HIV/AIDS risks (AOR: 0.293; 95% CI: 0.115, 0.747;
P=0.010), regardless of gender, age, religion, and major course of
study. Conclusion: Factors associated with the awareness of contraceptive methods,
the understanding of HIV/AIDS prevention, and perception of HIV/AIDS risks were not
consistent. To ensure the improvement of these factors among secondary school students,
sexual health education should be integrated into educational programs and provided
holistically.
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Affiliation(s)
- Mayumi Ohnishi
- Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Sebalda Leshabari
- School of Nursing, Muhimbili University of Health and Allied Sciences, Tanzania
| | - Junichi Tanaka
- Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Mika Nishihara
- Nagasaki University Graduate School of Biomedical Sciences, Japan
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