Association Between Child Marriage and Reproductive Health Outcomes and Service Utilization: A Multi-Country Study From South Asia

2013 ◽  
Vol 52 (5) ◽  
pp. 552-558 ◽  
Author(s):  
Deepali Godha ◽  
David R. Hotchkiss ◽  
Anastasia J. Gage
Author(s):  
Yana van der Meulen Rodgers

Chapter 7 concludes by highlighting the three biggest messages from the analysis presented in this book: (1) the global gag rule has failed to achieve its goal of reducing abortions; (2) restrictive legislation is associated with more unsafe abortions; and (3) the expanded global gag rule is likely to have negative repercussions across a range of health outcomes for women, children, and men. They are simple but powerful messages that should be heard by policymakers over the voices calling for an ideologically based policy that fails to achieve its desired outcome. The chapter closes with a more constructive and cost-effective approach for US family-planning assistance that targets integrated reproductive health services.


2021 ◽  
pp. 1-14
Author(s):  
Subasri Narasimhan ◽  
Jessica D. Gipson

Abstract Amidst persistently high unintended pregnancy rates and lags in contraceptive use, novel methodological approaches may prove useful in investigating sexual and reproductive health outcomes in the Philippines. Systematic Anomalous Case Analysis (SACA) – a mixed-methods technique – was employed to examine predictors of women’s lifetime contraceptive use. First, multivariable, longitudinal Poisson regression models predicted fertility and sexual debut using the 1998–2009 Cebu Longitudinal Health and Nutrition Surveys (CLHNS), then regression outliers and normative cases were used to identify 48 participants for in-depth interviews (2013–2014) for further examination. Qualitative findings from 24 women highlighted ‘control over life circumstances’ was critical, prompting the addition of two items to the original quantitative models predicting any contraceptive use (n=532). Each of the items, ‘what happens to [them] is their own doing’ and ‘[I] do not [have] enough control over direction life is taking [me]’, significantly and independently predicted any contraceptive use (aOR: 2.37 (CI: 1.24–4.55) and aOR: 0.46 (CI: 0.28–0.77), respectively). The findings demonstrate the utility of SACA to improve the understanding and measurement of sexual and reproductive health outcomes and underscore the importance of integrating psychosocial constructs into existing models of fertility and reproductive behaviour in the Philippines to improve sexual and reproductive health outcomes.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hai-YanYu ◽  
Wei-Ling Wu ◽  
Lin-Wei Yu ◽  
Lei Wu

Abstract Background The floating population in China consists primarily of internal immigrants and represents a typical health vulnerable group. Poor health literacy has recently become an obstacle in the accessibility and utilization of health services for the vulnerable population, leading to adverse health outcomes. This study aimed to examine whether health literacy affected health outcomes in China’s floating population and whether health service utilization had a mediating effect between health literacy and health outcomes. Method The current study utilized a cross-sectional stratified, multistage, proportional to scale (PPS) study in Zhejiang Province, China, in November and December 2019. In total, 657 valid self-reported questionnaires were recovered and used for data collection. Questionnaires included questions regarding sociodemographic characteristics, health literacy, health outcomes, and health service utilization. Confirmatory factor analysis was used to test questionnaire validity; descriptive statistics were used to understand the demographic characteristics of the floating population; and structural equation modeling was used to determine whether health service utilization mediated health literacy and health outcomes. Results We report positive correlations between health literacy, health service utilization, and health outcomes. Mediation analysis demonstrated that health service utilization had partial mediating effects between health literacy and health outcomes. In the relationship between health literacy and health outcomes, the indirect effects of health service utilization accounted for 6.6–8.7% of the total effects. Conclusion Complete health literacy, through health care literacy and health promotion literacy, affects the mobile population’s initiative to use health services, which, in turn, affects health outcomes. Thus, improving the health literacy of the floating population will help to improve health outcomes. Furthermore, health service providers should enhance the diversity of health service supply to ensure that the floating population has the external resources to improve personal health literacy.


Demography ◽  
2021 ◽  
Author(s):  
Damian Clarke ◽  
Viviana Salinas

Abstract We examine the sharp expansion in availability of the emergency contraceptive pill in Chile following legalized access through municipal public health care centers. We study the period 2002–2016 and a broad rollout of the emergency contraceptive pill occurring between 2008 and 2011. By combining a number of administrative data sets on health outcomes and pharmaceutical use, and using event-study and difference-in-differences methods, we document that this expansion improved certain classes of women's reproductive health outcomes, notably reducing rates of abortion-related morbidity. These improvements were greater in areas of the country where the rollout of the emergency contraceptive pill was more extensive. We also document some evidence that refusal to provide the emergency contraceptive pill upon a women's request was linked with a worsening in reproductive health outcomes. These results point to the importance of contraceptive access as a determinant of women's reproductive health and well-being and relates to a growing body of work documenting the importance of women's autonomy as a determinant of health.


2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Tewachew Muche Liyeh ◽  
Yitayal Ayalew Goshu ◽  
Habtamu Gebrehana Belay ◽  
Habtamu Abie Tasew ◽  
Gedefaye Nibret Mihiretie ◽  
...  

Introduction. Youth is a decisive age to shape the direction of their life and that of their family. However, due to the host of biological, social, and economic factors, adolescent females can be at high risk of adverse sexual and reproductive health outcomes. Therefore, assessing youth reproductive service utilization and associated factors among female night students is very crucial for timely intervention to their gaps. Method. An institutional-based cross-sectional study design was conducted in Amhara region among 2,050 female night students from September 15 to November 15, 2018. A self-administered pretested questionnaire was used to collect the data. Bivariate and multivariable logistic regression models were used. Odds ratio with 95% confidence interval was computed to determine the strength of association between predictor and outcome variables. P value less than or equal to 0.05 is considered as the level of significance. Results. Out of the total respondents, about 54.6%(CI: 52.5%-56.8%) of them utilized reproductive health services. Respondents who were attending secondary education ( AOR = 2.55 , 95 % CI = 1.97 ‐ 5.62 ), attitude towards youth reproductive health services ( AOR = 2.74 , 95 % CI = 2.07 ‐ 5.30 ), those who had a habit of communicating on sexual and reproductive health issues with their family ( AOR = 3.66 , 95 % CI = 3.59 ‐ 7.41 ), discussion on sexual and reproductive health issue with peers/friends ( AOR = 1.43 , 95 % CI = 1.01 ‐ 2.02 ), respondents with good knowledge on youth reproductive health services ( AOR = 2.03 , 95 % CI = 1.49 ‐ 2.75 ), and those who had faced reproductive health problems ( AOR = 2.03 , 95 % CI = 1.49 ‐ 2.75 ) were significantly associated with youth reproductive health service utilization. Conclusion. Youth reproductive health service utilization among female night students was not satisfactory. Therefore, special focus should be given to female night students by providing accessible, acceptable, confidential, flexible, and friendly reproductive health service utilization. Finally, community health promotion and education are mandatory to promote the practice of discussing youth reproductive health issues with their children.


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