scholarly journals Child marriage and adverse reproductive outcomes among young Afghan women: implication for policy and practice in Afghanistan

2021 ◽  
Author(s):  
Omid Dadras ◽  
Takeo Nakayama
Keyword(s):  
Civil Rights ◽  
Unintended Pregnancy ◽  
Unmet Need ◽  
Secondary Analysis ◽  
Negative Relationship ◽  
Logistic Models ◽  
Sociodemographic Factors ◽  
Child Marriage ◽  
Reproductive Outcomes ◽  
Afghan Women

Background: Child marriage is defined as marriage before the age of 18 years and it has been linked to several adverse health and social outcomes. This study aimed to explore the prevalence and determinants of child marriage and its association with adverse reproductive outcomes among a nationally representative sample of young Afghan women. Methods: This was a secondary analysis of the 2015 Afghanistan Demographic and Health Survey (DHS) data. Based on the UN recommendation on child marriage study, only women aged 20-24 years old were included. Descriptive statistics and binary logistic regression were employed to determine the distribution of respondents' characteristics and prevalence and determinants of child marriage. Multivariate logistic models examined the association between child marriage and adverse reproductive outcomes accounting for the sociodemographic factors. Results: An estimated 52% of the Afghan women aged 20-24 married at ages less than 18 years. Poor illiterate women were more likely to marry at early ages (<18). There was a significant negative relationship between child marriage and history of rapid repeat childbirth, delivery by skilled personnel, and institutional delivery. In both adjusted and unadjusted models, women married at age ≤14 were more likely to experience terminated or unintended pregnancy (AOR = 1.89, 95% CI: 1.31-2.75 and AOR = 2.20. 95% CI: 1.24-3.91, respectively), inadequate ANC (AOR = 1.71, 95% CI: 1.01-2.90), unmet need for family planning (AOR = 1.44, 95% CI: 1.05-1.98), fistula (AOR = 2.36, 95% CI: 1.22-4.57); While, for those married at age 15-17 years, only terminated or unintended pregnancy remained significant. Conclusion: The younger age of marriage was associated with a higher prevalence of adverse reproductive outcomes among Afghan women. Moreover, poverty and illiteracy proved to be important predictors of child marriage in Afghan women. Strict international law enforcement and advocacy are a need in the current situation of Afghanistan to increase young women's education, promote their civil rights, and improve their autonomy and role in decision-making concerning their health.

scholarly journals The COVID Connection: Pandemic Anxiety, COVID-19 Comprehension, and Digital Confidence

2021 ◽  
pp. 000276422110031
Author(s):  
Laura Robinson ◽  
Jeremy Schulz ◽  
Øyvind N. Wiborg ◽  
Elisha Johnston
Keyword(s):  
Logistic Models ◽  
The United States ◽  
Sociodemographic Factors ◽  
Future Research ◽  
Lower Probability ◽  
Data Set ◽  
Digital Inequality ◽  
Partner Status ◽  
General Anxiety ◽  
Nationally Representative

This article presents logistic models examining how pandemic anxiety and COVID-19 comprehension vary with digital confidence among adults in the United States during the first wave of the pandemic. As we demonstrate statistically with a nationally representative data set, the digitally confident have lower probability of experiencing physical manifestations of pandemic anxiety and higher probability of adequately comprehending critical information on COVID-19. The effects of digital confidence on both pandemic anxiety and COVID-19 comprehension persist, even after a broad range of potentially confounding factors are taken into account, including sociodemographic factors such as age, gender, race/ethnicity, metropolitan status, and partner status. They also remain discernable after the introduction of general anxiety, as well as income and education. These results offer evidence that the digitally disadvantaged experience greater vulnerability to the secondary effects of the pandemic in the form of increased somatized stress and decreased COVID-19 comprehension. Going forward, future research and policy must make an effort to address digital confidence and digital inequality writ large as crucial factors mediating individuals’ responses to the pandemic and future crises.

scholarly journals Contraceptive dynamics during COVID-19 in sub-Saharan Africa: longitudinal evidence from Burkina Faso and Kenya

2021 ◽  
pp. bmjsrh-2020-200944
Author(s):  
Celia Karp ◽  
Shannon N Wood ◽  
Georges Guiella ◽  
Peter Gichangi ◽  
Suzanne O Bell ◽  
...  
Keyword(s):  
At Risk ◽  
Burkina Faso ◽  
Unintended Pregnancy ◽  
Sexual And Reproductive Health ◽  
Universal Access ◽  
Sociodemographic Factors ◽  
Sub Saharan Africa ◽  
Contraceptive Services ◽  
Logistic Regressions ◽  
Sub Saharan

IntroductionEvidence from health emergencies suggests COVID-19 will disrupt women’s sexual and reproductive health (SRH). In sub-Saharan Africa, which experiences the highest rates of unintended pregnancy and unsafe abortion globally, COVID-19 is projected to slow recent progress toward universal access to contraceptive services.MethodsWe used longitudinal data collected from women at risk of unintended pregnancy in Burkina Faso (n=1186) and Kenya (n=2784) before (November 2019–February 2020) and during (May–July 2020) COVID-19 to quantify contraceptive dynamics during COVID-19; examine sociodemographic factors and COVID-19 experiences related to contraceptive dynamics; and assess COVID-19-related reasons for contraceptive non-use. Bivariate and multivariate logistic regressions were used to examine correlates of contraceptive dynamics amid COVID-19.ResultsMost women did not change their contraceptive status during COVID-19 (68.6% in Burkina Faso and 81.6% in Kenya) and those who did were more likely to adopt a method (25.4% and 13.1%, respectively) than to discontinue (6.0% and 5.3%, respectively). Most women who switched contraceptives were using methods as or more effective than their pre-pandemic contraception. Economic instability related to COVID-19 was associated with increased contraceptive protection in Burkina Faso but not in Kenya. Altogether, 14.4% of non-contraceptive users in Kenya and 3.8% in Burkina Faso identified COVID-19-related reasons for non-use.ConclusionsThe vast majority of women at risk of unintended pregnancy did not change their contraceptive status during COVID-19, and more women adopted than discontinued methods. A minority of women reported COVID-19-related reasons for non-use, underscoring the importance of expanding safe modes of service delivery during health crises.

scholarly journals Identifying the causal effect of child marriage on unmet needs for modern contraception and unintended pregnancy in Nepal: a cross-sectional study using propensity score matching

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e043532
Author(s):  
Kazutaka Sekine ◽  
Rogie Royce Carandang ◽  
Ken Ing Cherng Ong ◽  
Anand Tamang ◽  
Masamine Jimba
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Unintended Pregnancy ◽  
Unmet Needs ◽  
Causal Effect ◽  
Secondary Data ◽  
Child Marriage ◽  
Cross Sectional ◽  
Marginal Population ◽  
Modern Contraception

ObjectivesThis study aimed to investigate whether child marriage had causal effects on unmet needs for modern contraception, and unintended pregnancy, by estimating the marginal (population-averaged) treatment effect of child marriage.DesignThis study used secondary data from the Nepal Demographic and Health Survey 2016. Applying one-to-one nearest-neighbour matching with replacement within a calliper range of ±0.01, 15–49 years old women married before the age of 18 were matched with similar women who were married at 18 or above to reduce selection bias.SettingNationally representative population survey data.ParticipantsThe sample consisted of 7833 women aged 15–49 years who were married for more than 5 years.Outcome measuresUnmet needs for modern contraception and unintended pregnancy.ResultsThe matching method achieved adequate overlap in the propensity score distributions and balance in measured covariates between treatment and control groups with the same propensity score. Propensity score matching analysis showed that the risk of unmet needs for modern contraception, and unintended pregnancy among women married as children were a 14.3 percentage point (95 % CI 10.3 to 18.2) and a 10.1 percentage point (95 % CI 3.7 to 16.4) higher, respectively, than among women married as adults. Sensitivity analysis indicated that the estimated effects were robust to unmeasured covariates.ConclusionsChild marriage appears to increase the risk of unmet needs for modern contraception and unintended pregnancy. These findings call for social development and public health programmes that promote delayed entry into marriage and childbearing to improve reproductive health and rights.

scholarly journals Co-morbid anaemia and stunting among children of pre-school age in low- and middle-income countries: a syndemic

2018 ◽  
Vol 22 (1) ◽  
pp. 35-43 ◽  
Author(s):  
Thach Duc Tran ◽  
Beverley-Ann Biggs ◽  
Sara Holton ◽  
Hau Thi Minh Nguyen ◽  
Sarah Hanieh ◽  
...  
Keyword(s):  
Rural Areas ◽  
Secondary Analysis ◽  
Logistic Models ◽  
Demographic And Health Surveys ◽  
Healthy Children ◽  
Middle Income ◽  
Disadvantaged Children ◽  
Middle Income Countries ◽  
Co Morbidity ◽  
Low And Middle Income

AbstractObjectiveTo determine the prevalence of co-morbidity of two important global health challenges, anaemia and stunting, among children aged 6–59 months in low- and middle-income countries.DesignSecondary analysis of data from Demographic and Health Surveys (DHS) conducted 2005–2015. Child stunting and anaemia were defined using current WHO classifications. Sociodemographic characteristics of children with anaemia, stunting and co-morbidity of these conditions were compared with those of ‘healthy’ children in the sample (children who were not stunted and not anaemic) using multiple logistic models.SettingLow- and middle-income countries.SubjectsChildren aged 6–59 months.ResultsData from 193 065 children from forty-three countries were included. The pooled proportion of co-morbid anaemia and stunting was 21·5 (95 % CI 21·2, 21·9) %, ranging from the lowest in Albania (2·6 %; 95 % CI 1·8, 3·7 %) to the highest in Yemen (43·3; 95 % CI 40·6, 46·1 %). Compared with the healthy group, children with co-morbidity were more likely to be living in rural areas, have mothers or main carers with lower educational levels and to live in poorer households. Inequality in children who had both anaemia and stunting was apparent in all countries.ConclusionsCo-morbid anaemia and stunting among young children is highly prevalent in low- and middle-income countries, especially among more disadvantaged children. It is suggested that they be considered under a syndemic framework, the Childhood Anaemia and Stunting (CHAS) Syndemic, which acknowledges the interacting nature of these diseases and the social and environmental factors that promote their negative interaction.

scholarly journals 0785 Associations Between Circadian Preference And Sleep-related Thoughts: Data From The 2015 Sleep In America Poll

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A298-A299
Author(s):  
B Jeon ◽  
F S Luyster ◽  
E R Chasens
Keyword(s):  
Sleep Disturbance ◽  
Sleep Duration ◽  
Sleep Disturbances ◽  
Secondary Analysis ◽  
Logistic Models ◽  
Poor Sleep ◽  
Sleep Habits ◽  
Circadian Preference ◽  
Physical Consequences ◽  
The Impact

Abstract Introduction Evening types of sleep tend to have poorer sleep quality and sleep habits than morning types. Maladaptive beliefs or thoughts about sleep can affect one’s sleep and may differ between evening and morning types. We examined the association between the circadian preference and sleep-related thoughts in U.S adults. Methods A secondary analysis used survey data from the 2015 National Sleep Foundation’s Sleep in America Poll. Questions included normal bedtime and wake-up time for week/work days and weekend/non-work days. Circadian preference was determined by midpoint of sleep calculated as midpoint of sleep on weekends corrected for average nightly sleep duration. Participants were excluded if their sleep midpoint was from noon to midnight. Midpoint of sleep was divided into two groups using median split (“earlier” vs. “later”). Sleep-related thoughts were “worry about getting a good sleep”, “overwhelming thoughts about getting enough sleep”, “motivation to get sleep”, and “concern about serious physical consequences due to poor sleep”; responded often/always or extremely to somewhat for these items were coded as maladaptive. Logistic regression analysis controlling for socio-demographics, sleep duration, and sleep disturbance (PROMIS Scale; higher scores = greater sleep disturbance) was conducted to examine the relationships between midpoint of sleep and sleep-related thoughts. Results The sample (N = 1011) was primarily White (73.6%), male (50.9%), college educated (62.2%), married/partnered (67.6%) with a mean age of 51.65 ± 17.05 years. Mean midpoint of sleep in “earlier” type was 2:33AM and 5:29AM in “later” type. “Later” type had shorter sleep duration on weekdays and longer sleep duration on weekends than “earlier” type (p &lt; .01), but average sleep duration was similar between two types. “Later” type had more “worry” and “overwhelming thoughts” (p &lt; .05) about sleep. In logistic models, midpoint of sleep was significant only for “concern” (p = .02). Conclusion In this study, late chronotype was associated with increased sleep disturbances and greater variability in sleep duration. The relationship between the timing of sleep and thoughts about the impact of impaired sleep remains unclear and an area for further study with objective measures. Support  

scholarly journals Factors Influencing Unintended Pregnancies amongst Adolescent Girls and Young Women in Cambodia

2019 ◽  
Vol 16 (20) ◽  
pp. 4006 ◽  
Author(s):  
Farwa Rizvi ◽  
Joanne Williams ◽  
Elizabeth Hoban
Keyword(s):  
Unintended Pregnancy ◽  
Ecological Model ◽  
Age Groups ◽  
Sociodemographic Factors ◽  
Health Concern ◽  
Modern Contraceptive ◽  
Unintended Pregnancies ◽  
Younger Age ◽  
History Of ◽  
Socioeconomic Consequences

Background: Unintended pregnancies in Cambodian youth are a major reproductive health concern with detrimental personal and socioeconomic consequences. A social ecological model was used to identify sociodemographic factors potentially associated with unintended pregnancies, and an analysis of data from the 2014 Cambodian Demographic and Health Survey was used to determine associations. Methods: Weighted data were analysed using multiple logistic regression analyses for 3406 Cambodian sexually active single, in union or married females aged 15–29 years. Results: The prevalence of unintended pregnancy was 12.3%. Unintended pregnancy was significantly associated with younger age groups (15–24 years), multiparity, history of abortion, and current use of modern contraceptive methods. All women had an increased likelihood of unintended pregnancy when the husband alone or someone else in the household made decisions about their access to healthcare. Conclusion: The burden of unintended pregnancies is associated with young age, multiparity, history of abortions, unemployment, and low autonomy for accessing healthcare. Multi-pronged, holistic reproductive and sexual health program interventions are needed to increase literacy and accessibility to modern contraception and to raise awareness about women’s health and status in Cambodia.

The influence of family violence and child marriage on unmet need for family planning in Jordan

2016 ◽  
Vol 43 (2) ◽  
pp. 105-112 ◽  
Author(s):  
Cari Jo Clark ◽  
Rachael A Spencer ◽  
Inaam A Khalaf ◽  
Louisa Gilbert ◽  
Nabila El-Bassel ◽  
...  
Keyword(s):  
Family Planning ◽  
Family Violence ◽  
Unmet Need ◽  
Child Marriage

Evaluating the effects of a structured exercise intervention on physical self-worth in men with prostate cancer: Addressing an unmet need.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 11625-11625 ◽  
Author(s):  
Richard Francis Dunne ◽  
Charles E. Heckler ◽  
Julia Ellen Inglis ◽  
Po-Ju Lin ◽  
Chunkit Fung ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Body Image ◽  
Exercise Intervention ◽  
Controlled Trial ◽  
Unmet Need ◽  
Secondary Analysis ◽  
Self Esteem ◽  
Depression And Anxiety ◽  
Post Intervention ◽  
Self Worth

11625 Background: Improving body image and self-esteem are top ASCO priorities in the survivorship care of men with prostate cancer (PCa). Body image and global self-esteem, influenced by physical self-worth, are negatively affected by PCa treatment. We investigate whether exercise can improve physical self-worth in men treated for PCa and if improving self-worth is associated with changes in quality of life (QoL) and mental health. Methods: We performed a secondary analysis of a phase II randomized controlled trial comparing the effects of Exercise for Cancer Patients(EXCAP), a structured, 6-week, home-based exercise intervention, to usual care (UC) in men with non-metastatic PCa receiving radiation or Androgen Deprivation Therapy (ADT). The Physical Self-Perception Profile (PSPP), a valid 30-item questionnaire where higher scores indicate greater physical self-worth, was assessed at pre- and post-intervention. Changes between arms were compared using ANCOVA. Spearman correlations were calculated for pre/post-intervention change scores for PSPP and QoL, depression, and anxiety as measured by the Functional Assessment of Cancer Therapy (FACT), Center of Epidemiologic Studies Depression (CES-D) scale, and State-Trait Anxiety Inventory (STAI), respectively. Results: Fifty-eight men were randomized; average age was 67.1 years. Physical self-worth at baseline moderated the effect of the intervention. Compared to UC, EXCAP improved physical self-worth in those with baseline PSPP scores above the median (p < 0.04). Exercisers with baseline PSPP scores in the top quartile demonstrated a more significant improvement over UC (p < 0.01). Improvements in physical self-worth were associated with improved QoL (r = 0.29, p = 0.04), depression (r = -0.28, p = 0.04) and anxiety (r = -0.30, p = 0.03). Conclusions: Exercise significantly improves physical self-worth in men with PCa on radiation or ADT, and greater physical self-worth is associated with improved QoL, depression and anxiety. Those with higher baseline physical self-worth derived the most benefit from exercise. Exercise should be prescribed to boost self-esteem and body image in men receiving radiation or ADT for PCa. Clinical trial information: NCT00815672.

Clinical benefit of luspatercept in patients (pts) with lower-risk MDS (LR-MDS) and high transfusion burden in the phase III MEDALIST study.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 7554-7554
Author(s):  
Amer Methqal Zeidan ◽  
Guillermo Garcia-Manero ◽  
Amy Elizabeth Dezern ◽  
Pierre Fenaux ◽  
Peter L. Greenberg ◽  
...  
Keyword(s):  
Clinical Benefit ◽  
Treatment Options ◽  
Unmet Need ◽  
Secondary Analysis ◽  
Phase Iii ◽  
Transfusion Independence ◽  
Starting Dose ◽  
Clinically Significant ◽  
Grade 3 ◽  
Rbc Transfusion

7554 Background: Anemic pts with LR-MDS and high baseline RBC transfusion burden (HTB) have very few treatment options and constitute a pt population with significant clinical unmet need. In this secondary analysis of the MEDALIST trial (NCT02631070), we sought to evaluate the clinical benefit of luspatercept in this pt population. Methods: MEDALIST is a randomized, placebo (PBO)-controlled, phase 3 study evaluating the efficacy and safety of luspatercept in pts with anemia due to LR-MDS with ring sideroblasts (RS) (Fenaux & Platzbecker et al. NEJM. 2020;382:140-51). Pts were aged ≥ 18 years; had IPSS-R-defined Very low-, Low-, or Intermediate-risk MDS with RS; were refractory, intolerant, or unlikely to respond to erythropoiesis-stimulating agents (serum erythropoietin > 200 U/L); and had anemia requiring regular RBC transfusions (≥ 2 units/8 weeks in the 16 weeks prior to randomization). 229 pts were randomized 2:1 to luspatercept (starting dose 1.0 mg/kg; titration up to 1.75 mg/kg allowed) or PBO subcutaneously every 3 weeks. HTB was defined as ≥ 6 RBC units transfused/8 weeks. Results: 153 pts were randomized to luspatercept and 76 to PBO. As of July 1, 2019, 23/66 (34.8%) and 12/66 (18.2%) HTB pts receiving luspatercept achieved a ≥ 50% and ≥ 75% reduction from baseline in RBC transfusion burden over ≥ 24 weeks, respectively, vs 3/33 (9.1%; P = 0.0063) and 1/33 (3.0%; P = 0.0363) pts receiving PBO. 6/66 (9.1%) luspatercept-treated HTB pts and 1/33 (3.0%) PBO-treated HTB pt achieved RBC-transfusion independence (TI) ≥ 8 weeks in Weeks 1–24 ( P = 0.2699). The median (range) time to achieve RBC-TI with luspatercept was 50.0 days (1.0–100.0) and median (range) duration of RBC-TI in the luspatercept arm was 42.6 weeks (8.4–81.1). Mean number of transfusion events in Weeks 1–24 was 9.2 in the luspatercept arm vs 12.4 in the PBO arm (hazard ratio [95% confidence interval] 0.794 [0.660–0.956]). 65/66 (98.5%) luspatercept- and 29/33 (87.9%) PBO-treated HTB pts reported ≥ 1 treatment-emergent adverse event (TEAE); 11/66 (16.7%) and 3/33 (9.1%) pts, respectively, reported ≥ 1 TEAE leading to discontinuation. 28/66 (42.4%) luspatercept- and 15/33 (45.5%) PBO-treated pts reported ≥ 1 serious AE. Incidence of grade 3–4 TEAEs in HTB pts was similar between arms (53.0% luspatercept vs 54.5% PBO). Conclusions: Luspatercept treatment resulted in clinically significant reductions in transfusion burden and reduced number of transfusion events in HTB pts with LR-MDS with RS, with an acceptable safety profile consistent with the overall population. Clinical trial information: NCT02631070 .

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