scholarly journals Drivers of Marriage and Health Outcomes Among Adolescent Girls and Young Women: Evidence From Sub-Saharan Africa and South Asia

2021 ◽  
Vol 69 (6) ◽  
pp. S31-S38 ◽  
Author(s):  
Fatima Zahra ◽  
Karen Austrian ◽  
Mukta Gundi ◽  
Stephanie Psaki ◽  
Thoai Ngo
Keyword(s):  
Health Outcomes ◽  
South Asia ◽  
Adolescent Girls ◽  
Young Women ◽  
Sub Saharan Africa ◽  
Marriage And Health ◽  
Sub Saharan

scholarly journals Wealth-related inequalities in demand for family planning satisfied among married and unmarried adolescent girls and young women in sub-Saharan Africa

2021 ◽  
Vol 18 (S1) ◽  
Author(s):  
Martin K. Mutua ◽  
Yohannes D. Wado ◽  
Monica Malata ◽  
Caroline W. Kabiru ◽  
Elsie Akwara ◽  
...  
Keyword(s):  
Family Planning ◽  
West Africa ◽  
Adolescent Girls ◽  
Young Women ◽  
Rate Of Change ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Sexually Active ◽  
Sub Saharan ◽  
Over Time

Abstract Background The use of modern contraception has increased in much of sub-Saharan Africa (SSA). However, the extent to which changes have occurred across the wealth spectrum among adolescents is not well known. We examine poor-rich gaps in demand for family planning satisfied by modern methods (DFPSm) among sexually active adolescent girls and young women (AGYW) using data from national household surveys. Methods We used recent Demographic and Health Surveys and Multiple Indicator Cluster Surveys to describe levels of wealth-related inequalities in DFPSm among sexually active AGYW using an asset index as an indicator of wealth. Further, we used data from countries with more than one survey conducted from 2000 to assess DFPSm trends. We fitted linear models to estimate annual average rate of change (AARC) by country. We fitted random effects regression models to estimate regional AARC in DFPSm. All analysis were stratified by marital status. Results Overall, there was significant wealth-related disparities in DFPSm in West Africa only (17.8 percentage points (pp)) among married AGYW. The disparities were significant in 5 out of 10 countries in Eastern, 2 out of 6 in Central, and 7 out of 12 in West among married AGYW and in 2 out of 6 in Central and 2 out of 9 in West Africa among unmarried AGYW. Overall, DFPSm among married AGYW increased over time in both poorest (AARC = 1.6%, p < 0.001) and richest (AARC = 1.4%, p < 0.001) households and among unmarried AGYW from poorest households (AARC = 0.8%, p = 0.045). DPFSm increased over time among married and unmarried AGYW from poorest households in Eastern (AARC = 2.4%, p < 0.001) and Southern sub-regions (AARC = 2.1%, p = 0.030) respectively. Rwanda and Liberia had the largest increases in DPFSm among married AGYW from poorest (AARC = 5.2%, p < 0.001) and richest (AARC = 5.3%, p < 0.001) households respectively. There were decreasing DFPSm trends among both married (AARC = − 1.7%, p < 0.001) and unmarried (AARC = − 4.7%, p < 0.001) AGYW from poorest households in Mozambique. Conclusion Despite rapid improvements in DFPSm among married AGYW from the poorest households in many SSA countries there have been only modest reductions in wealth-related inequalities. Significant inequalities remain, especially among married AGYW. DFPSm stalled in most sub-regions among unmarried AGYW.

scholarly journals Hearing from men in Eswatini: Shifts in HIV risk and service uptake—Findings from DREAMS implementation science research

2021 ◽  
Author(s):  
Keyword(s):  
Implementation Science ◽  
Adolescent Girls ◽  
Young Women ◽  
Hiv Risk ◽  
Large Scale ◽  
Hiv Infections ◽  
Science Research ◽  
Sub Saharan Africa ◽  
Engaging Men ◽  
Sub Saharan

HIV prevention efforts across sub-Saharan Africa are increasingly focused on engaging men, for their own health and that of their partners and families. We examined whether and how HIV risk and protective factors are changing among men in Eswatini (formerly Swaziland)—a country with a substantial HIV burden. The study is part of the Population Council’s implementation science research portfolio on the DREAMS Partnership1, a large-scale initiative to reduce new HIV infections among adolescent girls and young women (AGYW) and their partners.

scholarly journals Socio-demographic determinants of pregnancy termination among adolescent girls and young women in selected high fertility countries in sub-Saharan Africa

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bright Opoku Ahinkorah
Keyword(s):  
Adolescent Girls ◽  
Young Women ◽  
Pregnancy Termination ◽  
Statistical Significance ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
High Fertility ◽  
Fertility Rates ◽  
Literacy Level ◽  
Sub Saharan

Abstract Background Most of the unintended pregnancies that occur among adolescent girls and young women (AGYW) in sub-Saharan Africa (SSA) end up in pregnancy termination. In this study, the socio-demographic determinants of pregnancy termination among AGYW (aged 15–24) in selected countries with high fertility rates in SSA were examined. Methods This was a cross-sectional analysis of data from the most recent Demographic and Health Surveys of nine countries in SSA. The countries included are Angola, Burkina Faso, Burundi, Chad, Gambia, Mali, Niger, Nigeria, and Uganda. A total of 62,747 AGYW constituted the sample size for the study. Fixed and random effects models were used to examine the determinants of pregnancy termination with statistical significance at p < 0.05. Results Higher odds of pregnancy termination were found among AGYW aged 20–24, those who were cohabiting and married, those who listened to radio and watched television at least once a week and those who lived in communities with high literacy level. Conversely, the odds of pregnancy termination were lower among AGYW with three or more births and those with secondary/higher education. Conclusion The socio-demographic determinants of pregnancy termination among AGYW in this study were age, level of education, marital status, exposure to radio and television, parity, and community literacy level. The findings provide the needed information for designing health interventions to reduce unwanted pregnancies and unsafe abortions in countries with high fertility rates in SSA. It is recommended that governments and non-governmental organisations in these countries should enhance sexuality education and regular sensitization of adolescent sexual and reproductive health programmes targeted at AGYW who are at risk of pregnancy termination.

scholarly journals Understanding and measuring uptake and coverage of oral pre-exposure prophylaxis delivery among adolescent girls and young women in sub-Saharan Africa

Sexual Health ◽  
2018 ◽  
Vol 15 (6) ◽  
pp. 513 ◽  
Author(s):  
Megan S. Dunbar ◽  
Katharine Kripke ◽  
Jessica Haberer ◽  
Delivette Castor ◽  
Shona Dalal ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Adolescent Girls ◽  
Young Women ◽  
Sub Saharan Africa ◽  
World Health ◽  
Substantial Risk ◽  
Sub Saharan ◽  
Health Organization ◽  
Exposure Prophylaxis ◽  
Oral Prep

In response to World Health Organization (WHO) guidance recommending oral pre-exposure prophylaxis (PrEP) for all individuals at substantial risk for HIV infection, significant investments are being made to expand access to oral PrEP globally, particularly in sub-Saharan Africa. Some have interpreted early monitoring reports from new programs delivering oral PrEP to adolescent girls and young women (AGYW) as suggestive of low uptake. However, a lack of common definitions complicates interpretation of oral PrEP uptake and coverage measures, because various indicators with different meanings and uses are used interchangeably. Furthermore, operationalising these measures in real-world settings is challenged by the difficulties in defining the denominator for measuring uptake and coverage among AGYW, due to the lack of data and experience required to identify the subset of AGYW at substantial risk of HIV infection. This paper proposes an intervention-centric cascade as a framework for developing a common lexicon of metrics for uptake and coverage of oral PrEP among AGYW. In codifying these indicators, approaches to clearly define metrics for uptake and coverage are outlined, and the discussion on ‘low’ uptake is reframed to focus on achieving the highest possible proportion of AGYW using oral PrEP when they need and want it Recommendations are also provided for making increased investments in implementation research to better quantify the sub-group of AGYW in potential need of oral PrEP.and for improving monitoring systems to more efficiently address bottlenecks in the service delivery of oral PrEP to AGYW so that implementation can be taken to scale.

scholarly journals PrEP as a Lifestyle and Investment for Adolescent Girls and Young Women in Sub-Saharan Africa

2019 ◽  
Vol 18 ◽  
pp. 232595821983101 ◽  
Author(s):  
Jessica E. Haberer ◽  
Nelly Mugo ◽  
Jared M. Baeten ◽  
Maria Pyra ◽  
Elizabeth Bukusi ◽  
...  
Keyword(s):  
Adolescent Girls ◽  
Young Women ◽  
Sub Saharan Africa ◽  
Lifestyle Choice ◽  
Hiv Epidemic ◽  
Sub Saharan ◽  
The Many ◽  
Hiv Acquisition ◽  
Risk Of Hiv Acquisition ◽  
Exposure Prophylaxis

Adolescent girls and young women (AGYW) are highly affected by the HIV epidemic, yet standard approaches to pre-exposure prophylaxis (PrEP) delivery will not meet their needs. This commentary highlights key characteristics of AGYW related to PrEP use and delivery, including typical neurocognitive development, lack of experience with sustained medication use, and the social and connected nature of AGYW’s lives. We then suggest ways for programs to embrace these characteristics, such as presenting PrEP as a lifestyle choice and not a biomedical tool, making access to PrEP simple and easy, and recognizing the many influences AGYW face in taking PrEP. We also suggest ways for programs to identify AGYW at the highest risk of HIV acquisition. Adolescent girls and young women have an important role to play in ending the HIV epidemic and they deserve considerable, tailored investment.

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