scholarly journals Estimating the market size for a dual prevention pill: adding contraception to pre-exposure prophylaxis (PrEP) to increase uptake

2020 ◽  
pp. bmjsrh-2020-200662
Author(s):  
Lorna Begg ◽  
Rebecca Brodsky ◽  
Barbara Friedland ◽  
Sanyukta Mathur ◽  
Jim Sailer ◽  
...  
Keyword(s):  
Contraceptive Method ◽  
Unmet Need ◽  
Health Benefit ◽  
Sub Saharan Africa ◽  
Market Size ◽  
African Countries ◽  
Oral Contraceptive Pills ◽  
Sub Saharan ◽  
Exposure Prophylaxis ◽  
Unmet Need For Contraception

IntroductionUptake of oral pre-exposure prophylaxis (PrEP) remains low. The objective of this analysis was to estimate the potential market size in priority sub-Saharan African countries for a 28-day dual prevention pill (DPP) regimen containing the active pharmaceutical ingredients in oral PrEP and oral contraceptive pills (OCPs) for the prevention of HIV and unintended pregnancy.MethodsWe selected 15 countries in sub-Saharan Africa for analysis. Population estimates were based on United Nations Population Division data from 2017. Low, medium and high rates (range 0.25% to 25%) of estimated conversion from current contraceptive method to the DPP were applied by country based on HIV prevalence (≥10% vs <10%), current contraceptive method (OCP, condom or unmet need for contraception) and age group (15–24 or 25–49 years).ResultsIn these 15 countries, between 250 000 and 1.25 million women could switch from their current contraceptive method to the DPP. Given that current PrEP use in the 15 countries combined is estimated to be 113 250 (women and men), the most conservative market size estimate would more than double the number of women currently using PrEP.ConclusionsBy leveraging the existing market for OCPs and assuming modest conversion from condom users and women with an unmet need for contraception, the DPP could lead to a 2- to 10-fold increase in PrEP usage in these 15 sub-Saharan African countries, expanding the broader public health benefit of this proven HIV prevention strategy.

TRACKING CHANGES IN STATES OF CONTRACEPTIVE USE OVER TIME IN SUB-SAHARAN AFRICA THROUGH COHORT AND PERIOD ANALYSES

2014 ◽  
Vol 47 (3) ◽  
pp. 329-344 ◽  
Author(s):  
ELIZABETH LEAHY MADSEN ◽  
BERNICE KUANG ◽  
JOHN ROSS
Keyword(s):  
Contraceptive Use ◽  
Age Groups ◽  
Unmet Need ◽  
Sub Saharan Africa ◽  
African Countries ◽  
Younger Women ◽  
Health Survey Data ◽  
Sub Saharan ◽  
Representative Samples ◽  
Unmet Need For Contraception

SummaryIt is difficult to gauge the success of programmatic efforts to reduce unmet need for contraception without knowing whether individual women have had their need met and adopted contraception. However, the number of true longitudinal datasets tracking the transition of panels of individual women in and out of states of contraceptive use is limited. This study analyses changes in contraceptive use states using Demographic and Health Survey data for 22 sub-Saharan African countries. A cohort approach, tracking representative samples of five-year age groups longitudinally across surveys, as well as period-based techniques, are applied to indicate whether new users of contraception have been drawn from women who previously had no need and/or those who had unmet need for family planning. The results suggest that a greater proportion of increases in contraceptive use in recent years can be attributed to decreases in the percentage of women with no need, especially among younger women, than to decreases in the proportion with unmet need.

scholarly journals Socio-economic and demographic predictors of unmet need for contraception among young women in sub-Saharan Africa: evidence from cross-sectional surveys

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Bright Opoku Ahinkorah ◽  
Edward Kwabena Ameyaw ◽  
Abdul-Aziz Seidu
Keyword(s):  
Young Women ◽  
Formal Education ◽  
Economic Status ◽  
Unmet Need ◽  
Wealth Quintile ◽  
Sub Saharan Africa ◽  
African Countries ◽  
Socio Economic Status ◽  
Sub Saharan ◽  
Unmet Need For Contraception

Abstract Introduction Globally, sub-Saharan Africa (SSA) bears the highest proportion of women with unmet need for contraception as nearly 25% of women of reproductive age in the sub-region have unmet need for contraception. Unmet need for contraception is predominant among young women. We examined the association between socio-economic and demographic factors and unmet need for contraception among young women in SSA. Methods Data for this study obtained from current Demographic and Health Surveys (DHS) conducted between January 1, 2010 and December 31, 2018 in 30 sub-Saharan African countries. The sample size consisted of young women (aged 15–24), who were either married or cohabiting and had complete cases on all the variables of interest (N = 59,864). Both bivariate and multivariable binary logistic regression analyses were performed using STATA version 14.0. Results The overall prevalence of unmet need for contraception among young women was 26.90% [95% CI: 23.82–29.921], ranging from 11.30% [95% CI: 5.1–17.49] in Zimbabwe to 46.7% [95% CI: 36.92–56.48] in Comoros. Results on socio-economic status and unmet need for contraception showed that young women who had primary [aOR = 1.18; CI = 1.12–1.25, p < 0.001] and secondary/higher levels of formal education [aOR = 1.27; CI = 1.20–1.35, p < 0.001] had higher odds of unmet need for contraception compared to those with no formal education. With wealth status, young women in the richest wealth quintile had lower odds of unmet need for contraception compared with those in the poorest wealth quintile [aOR = 0.89; CI = 0.81–0.97, p < 0.01]. With the demographic factors, the odds of unmet need for contraception was lower among young women aged 20–24 [aOR = 0.74; CI = 0.70–0.77, p < 0.001], compared with 15–19 aged young women. Also, young women who were cohabiting had higher odds of unmet need for contraception compared to those who were married [aOR = 1.35; CI = 1.28–1.43, p < 0.001]. Conclusion Our study has demonstrated that unmet need for contraception is relatively high among young women in SSA and this is associated with socio-economic status. Age, marital status, parity, occupation, sex of household head, and access to mass media (newspaper) are also associated with unmet need for contraception. It is therefore, prudent that organisations such as UNICEF and UNFPA and the Bill & Melinda Gates Foundation who have implemented policies and programmes on contraception meant towards reducing unmet need for contraception among women take these factors into consideration when designing interventions in sub-Saharan African countries to address the problem of high unmet need for contraception among young women.

scholarly journals Currently married women with an unmet need for contraception in Eritrea: Profile and determinants

2011 ◽  
Vol 38 (1-2) ◽  
pp. 61 ◽  
Author(s):  
Gebremariam Woldemicael ◽  
Roderic Beaujot
Keyword(s):  
Family Planning ◽  
Contraceptive Use ◽  
Economic Status ◽  
Unmet Need ◽  
Married Women ◽  
Sub Saharan Africa ◽  
The Status ◽  
Sub Saharan ◽  
Using Data ◽  
Unmet Need For Contraception

Eritrea’s contraceptive prevalence rate is one of the lowest in sub-Saharan Africa and its fertility has only started to decline. Using data from the 2002 Eritrea Demographic and Health Survey (EDHS), this study examines the determinants of unmet need for family planning that is the discrepancy between fertility goals and actual contraceptive use. More than one-quarter of currently married women are estimated to have an unmet need, and this has remained unchanged since 1995. The most important reason for unmet need is lack of knowledge of methods or of a source of supply. Currently married women with higher parity, and low autonomy, low or medium household economic status, and who know no method of contraception or source of supply are identified as the most likely to have an unmet need. Addressing the unmet need for family planning entails not merely greater knowledge of or access to contraceptive services, but also the enhancement of the status of women.

scholarly journals The urgent need for the use of pre-exposure prophylaxis (PrEP) in the prevention of HIV/AIDS in Sub-Saharan Africa

2019 ◽  
Vol 5 (2) ◽  
pp. 197-204
Author(s):  
Israel Oluwasegun Ayenigbara
Keyword(s):  
Sub Saharan Africa ◽  
People Living With Hiv ◽  
African Countries ◽  
Aids Epidemic ◽  
The World ◽  
Sub Saharan ◽  
Exposure Prophylaxis ◽  
Living With Hiv ◽  
Prevention Of Hiv ◽  
Hiv Aids

Human immunodeficiency virus (HIV) is an infection that came into existence decades back; it spread across the African countries in the late 1970s, and is currently endemic across the world. HIV is a major public health problem all over the world, as it has claimed more than 35million lives. There were around 36.9 million individuals living with HIV at the end of 2017, and Sub-Saharan Africa remains the most affected by HIV infection with 1 in 25 adults (4.1%) living with the virus, accounting for 70% of the people living with HIV worldwide. Unfortunately, Sub-Saharan Africa continues to be the continent with the highest cases of infections and deaths from HIV/AIDS even after the implementation of various HIV/AIDS prevention methods. Fortunately, pre-exposure prophylaxis (PrEP) offers the world a novel way of curtailing the HIV/AIDS epidemic, as PrEP is highly effective for preventing HIV if it is used as prescribed. This paper discusses the urgent need for the use of PrEP in the prevention of HIV/AIDS in Sub-Saharan Africa. It is a review paper in which the meaning of PrEP was discussed, people who need PrEP were identified, the rationale for the use of PrEP for the prevention of HIV/AIDS in Sub-Saharan Africa were highlighted, and probable obstacles to the successful implementation of PrEP for the prevention of HIV/AIDS in Sub-Saharan Africa were also identified. It was concluded that to achieve the 90-90-90 goals set by UNAIDS to help end the AIDS epidemic in the world, PrEP offers a new and novel way for HIV prevention, and its implementation across all African countries is urgently needed for the prevention of HIV/AIDS in Sub-Saharan Africa.

scholarly journals Sexual violence and unmet need for contraception among married and cohabiting women in sub-Saharan Africa: Evidence from demographic and health surveys

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0240556
Author(s):  
Bright Opoku Ahinkorah ◽  
Edward Kwabena Ameyaw ◽  
Abdul-Aziz Seidu ◽  
Ebenezer Agbaglo ◽  
Eugene Budu ◽  
...  
Keyword(s):  
Sexual Violence ◽  
Health Surveys ◽  
Unmet Need ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Sub Saharan ◽  
Unmet Need For Contraception

scholarly journals Prevalence of first adolescent pregnancy and its associated factors in sub-Saharan Africa: A multi-country analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246308
Author(s):  
Bright Opoku Ahinkorah ◽  
Melissa Kang ◽  
Lin Perry ◽  
Fiona Brooks ◽  
Andrew Hayen
Keyword(s):  
Adolescent Pregnancy ◽  
Rural Areas ◽  
Associated Factors ◽  
Unmet Need ◽  
Well Being ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Relationship Education ◽  
African Countries ◽  
Sub Saharan

Introduction In low-and middle-income countries, pregnancy-related complications are major causes of death for young women. This study aimed to determine the prevalence of first adolescent pregnancy and its associated factors in sub-Saharan Africa. Methods We undertook a secondary analysis of cross-sectional data from Demographic and Health Surveys conducted in 32 sub-Saharan African countries between 2010 and 2018. We calculated the prevalence of first adolescent (aged 15 to 19 years) pregnancy in each country and examined associations between individual and contextual level factors and first adolescent pregnancy. Results Among all adolescents, Congo experienced the highest prevalence of first adolescent pregnancy (44.3%) and Rwanda the lowest (7.2%). However, among adolescents who had ever had sex, the prevalence ranged from 36.5% in Rwanda to 75.6% in Chad. The odds of first adolescent pregnancy was higher with increasing age, working, being married/cohabiting, having primary education only, early sexual initiation, knowledge of contraceptives, no unmet need for contraception and poorest wealth quintile. By contrast, adolescents who lived in rural areas and in the West African sub-region had lower odds of first adolescent pregnancy. Conclusion The prevalence of adolescent pregnancy in sub-Saharan African countries is high. Understanding the predictors of first adolescent pregnancy can facilitate the development of effective social policies such as family planning and comprehensive sex and relationship education in sub-Saharan Africa and can help ensure healthy lives and promotion of well-being for adolescents and their families and communities.

Crowdsourcing Covid-19 signals in sub-Saharan Africa: Leveraging digital contributor networks for participatory surveillance of Covid-19 symptoms and deaths (Preprint)

2020 ◽  
Author(s):  
Ngozi A Erondu ◽  
Sagal A Ali ◽  
Mohamed Ali ◽  
Schadrac C Agbla
Keyword(s):  
Public Health ◽  
Sub Saharan Africa ◽  
Specific Information ◽  
Surveillance Systems ◽  
Health Seeking ◽  
African Countries ◽  
Cross Sectional Survey ◽  
Local Networks ◽  
The World ◽  
Sub Saharan

BACKGROUND In sub-Saharan Africa, underreporting of cases and deaths has been attributed to various factors including, weak disease surveillance, low health-seeking behaviour of flu like symptoms, and stigma of Covid-19. There is evidence that SARS-CoV-2 spread mimics transmission patterns of other countries across the world. Since the Covid-19 pandemic has changed the way research can be conducted and in light of restrictions on travel and risks to in-person data collection, innovative approaches to collecting data must be considered. Nearly 50% of Africa’s population is a unique mobile subscriber and it is one of the fastest growing smart-phone marketplaces in the world; hence, mobile phone platforms should be considered to monitor Covid-19 trends in the community. OBJECTIVE We demonstrate the use of digital contributor platforms to survey individuals about cases of flu-like symptoms and instances of unexplained deaths in Ethiopia, Kenya, Nigeria, Somalia, and Zimbabwe. METHODS Rapid cross-sectional survey of individuals with severe flu and pneumonia symptoms and unexplained deaths in Ethiopia, Kenya, Nigeria, Somalia and Zimbabwe RESULTS Using a non-health specific information platform, we found COVID-19 signals in five African countries, specifically: •Across countries, nearly half of the respondents (n=739) knew someone who had severe flu or pneumonia symptoms in recent months. •One in three respondents from Somalia and one in five from Zimbabwe respondents said they knew more than five people recently displaying flu and/or pneumonia symptoms. •In Somalia there were signals that a large number of people might be dying outside of health facilities, specifically in their homes or in IDP or refugee camps. CONCLUSIONS Existing digital contributor platforms with local networks are a non-traditional data source that can provide information from the community to supplement traditional government surveillance systems and academic surveys. We demonstrate that using these distributor networks to for community surveys can provide periodic information on rumours but could also be used to capture local sentiment to inform public health decision-making; for example, these insights could be useful to inform strategies to increase confidence in Covid19 vaccine. As Covid-19 continues to spread somewhat silently across sub-Saharan Africa, regional and national public health entities should consider expanding event-based surveillance sources to include these systems.

Managing African Urbanization in the Context of Environmental Change

2014 ◽  
Vol 2 (2) ◽  
Author(s):  
Shuaib Lwasa
Keyword(s):  
Climate Change ◽  
Economic Growth ◽  
Social Services ◽  
Urban Areas ◽  
Urban Governance ◽  
Sub Saharan Africa ◽  
African Countries ◽  
Sub Saharan ◽  
Urbanization Rate ◽  
Development And Management

Africa’s urbanization rate has increased steadily over the past three decades and is reported to be faster than in any other region in the world . It is estimated that by 2030, over half of the African population will be living in urban areas . But the nature of Africa’s urbanization and subsequent form of cities is yet to be critically analyzed in the context of city authorities’ readiness to address the challenges . Evidence is also suggesting that urbanization in African countries is increasingly associated with the high economic growth that has been observed in the last two decades . Both underlying and proximate drivers are responsible for the urbanization, and these include population dynamics, economic growth, legislative designation, increasing densities in rural centers, as well as the growth of mega cities such as Lagos, Cairo and Kinshasa, that are extending to form urban corridors . With the opportunities of urbanization in Sub–Saharan Africa, there are also challenges in the development and management of these cities . Those challenges include provision of social services, sustainable economic development, housing development, urban governance, spatial development guidance and environmental management, climate change adaptation, mitigation and disaster risk reduction . The challenge involves dealing with the development and infrastructure deficit, in addition to required adaption to and mitigation of climate change . This paper examines the current state of urban management in Africa .

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