scholarly journals Postpartum Family Planning Use and Its Determinants among Women of the Reproductive Age Group in Low-Income Countries of Sub-Saharan Africa: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-14
Author(s):  
Tesfalem Tilahun Yemane ◽  
Getahun Gebre Bogale ◽  
Gudina Egata ◽  
Tilahun Kassa Tefera

Background. Postpartum family planning is the initiation and use of family planning services within the first 12 months following childbirth. Postpartum contraceptives reduce maternal and infant mortality by preventing unplanned and unwanted pregnancies and by spacing pregnancies at least two years after the previous birth. Thus, it is usually designed as an integral part of reproductive and maternal and child health programs. Therefore, the aim of this systematic review and meta-analysis is to estimate the pooled prevalence of postpartum modern contraceptive use and identify its determinants in low-income countries of sub-Saharan Africa. Methods. A systematic review and meta-analysis of published and unpublished studies were used. PubMed, HINARI, ScienceDirect, Cochrane Library, Wiley Library, ETH Library, and Google Scholar were used to search all articles. STATA 14 software was used for data analysis. Funnel plots and Egger’s test were used to examine the risk of publication bias. Heterogeneity was checked by using Cochran’s Q test and I 2 test. A random effect model was computed to estimate the pooled prevalence. Results. A total of 33 articles were included. The pooled prevalence of postpartum contraceptive use in low-income countries of sub-Saharan Africa was 37.41%, 95% CI: (31.35, 43.48%). Secondary and above level of education (AOR 2.09, 95% CI: (1.52, 2.86)), discussion with husband (AOR 3.68, 95% CI: (1.96, 6.89)), resumption of menses (AOR: 3.98, 95% CI: (2.62, 6.03)), ANC follow-up (AOR; 5.10, 95% CI: (3.57, 7.29)), knowledge of modern family planning (AOR: 5.65, 95% CI: 3.58, 8.93)), and family planning counseling during ANC (AOR =5.92, 95% CI: (2.54, 13.79)) were found to be determinants of postpartum contraceptive utilization. Conclusion. In this systematic review and meta-analysis, the prevalence of postpartum modern contraceptive use was found to be low compared to the existing global recommendations. Therefore, empowering maternal education, delivering adequate counseling, and strengthening existing integrated maternal and child health services are highly recommended to increase postpartum contraceptive use. This trial is registered with CRD42020160612.

Author(s):  
Ismail Yahaya ◽  
Tanya Wright ◽  
Opeyemi O. Babatunde ◽  
Nadia Corp ◽  
Toby Helliwell ◽  
...  

AbstractEvidence from the Global Burden of Disease studies suggests that osteoarthritis (OA) is a significant cause of disability globally; however, it is less clear how much of this burden exists in low-income and lower middle-income countries. This study aims to determine the prevalence of OA in people living in low-income and lower middle-income countries. Four electronic databases (MEDLINE, EMBASE, CINAHL and Web of Science) were systematically searched from inception to October 2018 for population-based studies. We included studies reporting the prevalence of OA among people aged 15 years and over in low-income and lower middle-income countries. The prevalence estimates were pooled across studies using random effects meta-analysis. Our study was registered with PROSPERO, number CRD42018112870.The search identified 7414 articles, of which 356 articles were selected for full text assessment. 34 studies were eligible and included in the systematic review and meta-analysis. The pooled prevalence of OA was 16·05% (95% confidence interval (CI) 12·55–19·89), with studies demonstrating a substantial degree of heterogeneity (I2 = 99·50%). The pooled prevalence of OA was 16.4% (CI 11·60–21.78%) in South Asia, 15.7% (CI 5·31–30·25%) in East Asia and Pacific, and 14.2% (CI 7·95–21·89%) in Sub Saharan Africa. The meta-regression analysis showed that publication year, study sample size, risk of bias score and country-income categories were significantly associated with the variations in the prevalence estimates. The prevalence of OA is high in low-income and lower middle-income countries, with almost one in six of the study participants reported to have OA. With the changing population demographics and the shift to the emergence of non-communicable diseases, targeted public health strategies are urgently needed to address this growing epidemic in the aging population.


2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Siraj Hussen ◽  
Birkneh Tilahun Tadesse

Objective. Syphilis is one of the most imperative STIs, caused by the spirochete Treponema pallidum. During pregnancy it is associated with disastrous health outcomes in the newborn. In sub-Saharan Africa, study findings on the prevalence of syphilis among pregnant women are highly dispersed and inconsistent. The aim of the current review is to conduct a systematic review and meta-analysis of syphilis in sub-Saharan Africa among pregnant women. Design. Systematic review and meta-analysis. Data Sources. Databases including MEDLINE, PubMed, Cochrane Library, Google Scholar, and HINARI and reference lists of previous prevalence studies were systematically searched for relevant literature from January 1999 to November 2018. Results were presented in forest plot, tables, and figures. Random-effects model was used for the meta-analysis. For the purpose of this review, a case of syphilis was defined as positive treponemal or nontreponemal tests among pregnant women. Data Extraction. Our search gave a total of 262 citations from all searched databases. Of these, 44 studies fulfilling the inclusion criteria and comprising 175,546 subjects were finally included. Results. The pooled prevalence of syphilis among pregnant women in sub-Saharan Africa was 2.9% (95%CI: 2.4%-3.4%). East and Southern African regions had a higher syphilis prevalence among pregnant women (3.2%, 95% CI: 2.3%-4.2% and 3.6%, 95%CI: 2.0%-5.1%, respectively) than the sub-Saharan African pooled prevalence. The prevalence of syphilis among pregnant women in most parts of the region seemed to have decreased over the past 20 years except for the East African region. However, prevalence did not significantly differ by region and time period. Conclusion. This review showed a high prevalence of syphilis in sub-Saharan Africa among pregnant women. The evidence suggests strengthening the screening program during pregnancy as part of the care package during antenatal care visits. Programs focusing on primary prevention of syphilis in women should also be strengthened.


Author(s):  
Alemu Earsido Addila ◽  
Telake Azale Bisetegn ◽  
Yigzaw Kebede Gete ◽  
Mezgebu Yitayal Mengistu ◽  
Getnet Mihretie Beyene

Abstract Background Alcohol consumption during pregnancy represents a significant public health concern. It has several adverse health effects for both the mother and the developing fetus. This study aimed to estimate the pooled prevalence and the effect size of associated factors of alcohol consumption during pregnancy in Sub-Saharan Africa countries. Methods The results of the review were reported based on the Preferred Reporting Items for Systematic Review and Meta-Analysis statement (PRISMA) guideline and, it was registered in the Prospero database, number CRD42019127103. The available primary studies were collated from different databases: PubMed, CINAHL, Cochrane Library, PsycINFO, Google Scholar, African Journals Online and Centre for Addiction and Mental Health Library. The main search terms were [((alcohol consumption) OR (alcohol drinking) OR (alcohol use) OR (ethanol use) OR (alcohol exposure)) AND ((pregnant women) OR (pregnant mother) OR (during pregnancy)) AND (Sub-Saharan Africa)]. We used the Joanna Briggs Institute (JBI) for critical appraisal of studies. The random-effects model was computed to estimate the pooled prevalence. Heterogeneity between studies was checked using the I2 statistic and the Cochrane Q test. Results The review resulted in 963 original studies after searching various databases, and finally 37 studies in qualitative synthesis and 30 articles in the systematic review and meta-analysis were included. The overall summary estimate of the prevalence of alcohol consumption during pregnancy was found to be 20.83% (95% CI: 18.21, 23.46). The pooled estimate of meta-analysis showed that depression (OR: 1.572; 95% CI: 1.34, 1.845), partners’ alcohol use (OR: 1.32, 95% CI: 1.11, 1.57), knowledge on harmful effect of alcohol consumption (OR: 0.36, 95% CI: 0.29, 0.45) and, unplanned pregnancy (OR: 2.33, 95% CI: 1.17, 4.63) were statistically significant factors with alcohol consumption during pregnancy. Conclusions The result showed that there was high alcohol consumption during pregnancy in Sub- Saharan Africa. Alcohol consumption during pregnancy was associated with depression, partners’ alcohol use, unplanned pregnancy and knowledge of the harmful effects of alcohol consumption. Therefore, this will be a basis for public policy and resource allocation for prevention initiatives.


2022 ◽  
Vol 6 ◽  
pp. 1
Author(s):  
Rebecca Rosenberg ◽  
John Ross ◽  
Karen Hardee ◽  
Imelda Zosa-Feranil

Background:  The “ FP2020 Global Partnership” signaled a shift to broader, rights-based approaches to family planning programs, and the National Composite Index for Family Planning was developed as part of related measurement efforts. Methods: In each country 10-15 experts on the family planning program completed a 35-item questionnaire, first in 2014 in 89 countries, and in 2017 in 84 countries. Data were entered in Excel, with checks for consistency and data quality. The total score, and scores for each of 5 dimensions of effort are averages across the 35 indicators. Analytic techniques included cross-tabulations, graphical and correlation approaches. Results: The average total score for all countries in 2017 was 64 of the maximum of 100 of effort. Sub-regions differed: Anglophone and Francophone sub-Saharan Africa (SSA) scored highest in the total score and across all 5 dimensions. Next in order came Latin America and the Caribbean, Asia, the Middle East and North Africa, and Eastern Europe and Central Asia. Despite large differences in scores, the sub-regions followed similar profiles across the 35  indicators. The long term rise in the basic family planning effort scores continued, extending the series from surveys approximately every five years beginning in the 1980s. The highest score reached was for the strategy dimension, but the others were close. Their relative levels remained essentially the same as in the 2014 survey.                     NCIFP scores correlated positively with modern contraceptive use in both the sub-Saharan Africa (SSA) and non-sub-Saharan Africa (non-SSA) countries, but the relationships were stronger for SSA. Access to long-acting and permanent methods (LAPMs) was accompanied by greater LAPM use and modern method use. Conclusion: Repeated surveys in most developing countries show improvements in family planning effort, though unevenly, by 35 indicators and across regions.


2022 ◽  
Vol 80 (1) ◽  
Author(s):  
Jemberu Nigussie ◽  
Bekahegn Girma ◽  
Alemayehu Molla ◽  
Moges Mareg ◽  
Esmelealem Mihretu

Abstract Background In the developing world, such as the sub-Saharan African region, HIV/AIDS has worsened the impact of under-nutrition in children. HIV infected children are highly vulnerable to under-nutrition. Therefore, the objective of this systematic review and meta-analysis was to estimate the pooled prevalence of under-nutrition, and the pooled effect sizes of associated factors among HIV-infected children in sub-Saharan Africa. Methods The primary studies for this review were retrieved from PubMed/ MEDLINE online, Science Direct, Hinari, web of science, CINHAL, EMBASE, WHO databases, Google, and Google Scholar databases. The articles selected for this meta-analysis were published between 2010 and 2020. The last search date was 18 October 2021. The data was extracted in Microsoft Excel format and exported to STATA Version 14.0. A random effect meta-analysis model was used. Heterogeneity was evaluated by the I2 test. The Egger weighted regression test was used to assess publication bias. Results We retrieved 847 records from these databases. Of which records, 813 were excluded due to different reasons and 34 studies were included in the final analysis. The pooled prevalence of stunting, underweight and wasting in HIV infected children was 46.7% (95% CI; 40.36–53.07, I2 = 98.7%, p < 0.01), 35.9% (95% CI; 30.79–41.02, I2 = 97.4% p < 0.01), and 23.0% (95% CI; 18.67–27.42, I2 = 96.9%, p < 0.01) respectively. The advanced WHO HIV/AIDS clinical staging (III&IV) [OR = 6.74 (95%: 1.747, 26.021), I2 = 94.7%] and household food insecurity were associated with stunting [OR = 5.92 (95% CI 3.9, 8.87), I2 = 55.7%]. Low family economic status [OR = 4.737 (95% CI: 2.605, 8.614), I2 = 31.2%] and increased feeding frequency [OR = 0.323 (95% CI: 0.172, 0.605), I2 = 69.8%] were significantly associated with under-weight. Anemia [OR = 2.860 (95% CI: 1.636, 5.000), I2 = 74.8%] and diarrhea in the previous month [OR = 4.117 (95% CI: 2.876, 5.894), I2 = 0.0%] were also associated with wasting among HIV infected children in sub-Saharan Africa. Conclusions The pooled prevalence of under-nutrition among HIV infected children was high. Nutritional assessment and interventions need great attention as a part of HIV care for HIV positive children. The implementation of policies and strategies established by national and international stakeholders in ART care centres should take a maximum emphasis on reducing under-nutrition among HIV infected children.


2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Petmore Zibako ◽  
Mbuzeleni Hlongwa ◽  
Nomsa Tsikai ◽  
Sarah Manyame ◽  
Themba G. Ginindza

Abstract Background Cancer is a non-communicable disease and is the number 2 leading cause of death globally. Among all cancers, cervical cancer is the number 1 killer of women in low-income countries (LICs). Cervical cancer is a well understood preventable cancer. The rates of cervical cancer are very varied and inversely proportional to the effectiveness of disease management policies. Management of cervical cancer includes prevention, screening, diagnosis and treatment. The main objective of this scoping review is to map the evidence on cervical cancer management in sub-Saharan Africa (SSA) to understand the coverage of cervical cancer prevention and treatment services and provide an opportunity to generate knowledge on the risk factors, attitudes and practices extendable globally. Methods and analysis This review will be guided by Arksey and O’Malley’s framework recommended for conducting scoping review studies. The Preferred Reporting Items for Systematic Review and Meta-Analysis extension for Scoping Reviews (PRISMA-Scr) checklist will also be completed to ensure that the review adheres to the sound methodological rigour acceptable for scoping review studies. The following electronic databases will be searched for potentially eligible articles: PubMed, Ebsco Host, Scopus and Cochrane Database of Systematic Reviews. Study screening procedures recommended by Higgins and Deeks will be followed. A narrative synthesis will be used, with data synthesised and interpreted using sifting, charting and sorting based on themes and key issues. Discussion Cervical cancer can become a disease of the past with a proper control strategy in place. It is therefore imperative to map available evidence on the management of cervical cancer to inform policy and advocacy action. More knowledge on the status quo will guide policymakers in ensuring cancer management guiding policies are formulated/updated/revised accordingly. Systematic review registration Not registered with PROSPERO (not needed). Protocol and registration This scoping review was not registered.


2021 ◽  
Author(s):  
Etsay Woldu Anbesu ◽  
Setognal Birara Aychiluhm ◽  
Znabu Hadush Kahsay

Abstract Background The need to include males that required joint spousal decision is critical in achieving key reproductive health indicators. Low involvement of males in family planning use is one of the contributing factors for low contraceptive use in Ethiopia. Despite this, there are inconsistent findings on the prevalence and determinates of males involvement in family planning use in Ethiopia. Thus, this systematic review and meta-analysis aimed to determine the pooled prevalence of mal involvement in family planning use and its determinants in Ethiopia. Methods The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline will be used to develop the protocol. Online databases PubMed, CINAHL, Google Scholar, and unpublished grey literature will be searched to retrieve available articles from April 10-August 11/2021. The two authors will conduct selection of studies, data extraction, and quality assessment. The quality of the studies will be assessed using Joanna Briggs Institute checklist. Chi-squared test and I-squared statistic will be used to examine heterogeneity among studies. Sources of heterogeneity will be investigated using subgroup analyses and meta-regression based on regions and residence (urban and rural). Publication bias will be examined by observation using funnel plots and statistically by Begg’s and Egger’s tests. A random-effect model will be used to estimate the pooled prevalence and its determinants of male involvement in family planning use. Discussion The role of the male in family planning and participation in contraceptive use improves women’s uptake and continuity of family planning use. Though there are studies on male involvement in family planning use, there is no synthesis research findings on the pooled prevalence of male involvement in family planning use and its determinants in Ethiopia. Therefore, the finding from this systematic review and meta-analysis will help the national health sector transformational plane to emphasize the pooled prevalence and its determinants that drive low male involvement in family planning use in Ethiopia.


2020 ◽  
Author(s):  
Benjamin Peter Silberberg ◽  
Stephen Aston ◽  
Selda Boztepe ◽  
Jamie Rylance

Abstract Background Sepsis guidelines are widely used in High Income Countries and intravenous fluids are an important supportive treatment modality. However, fluids have been harmful in intervention trials in Low-Income Countries, most notably in sub-Saharan Africa. We assessed the relevance, quality and applicability of available guidelines for the fluid management of adult patients with sepsis in this region. Methods We identified sepsis guidelines by systematic review with broad search terms, duplicate screening and data extraction. We included peer-reviewed publications with explicit relevance to sepsis and fluid therapy. We excluded those designed for specific medical conditions, for limited geographic locations, or for non-adult populations. We used the AGREE II tool to assess the quality of guideline development, performed a narrative synthesis and using theoretical case scenarios to assess practical applicability to everyday clinical practice in resource-constrained settings. Results Published sepsis guidelines are heterogeneous in sepsis definition and in quality: 8/10 guidelines had significant deficits in applicability, particularly with reference to resource considerations in low-income settings. Indications for intravenous fluid were: hypotension (8/10); clinical markers of hypoperfusion (6/10); lactataemia (3/10). Crystalloids were overwhelmingly recommended (9/10). Suggested volumes varied; 5/10 explicitly recommended “fluid challenges” with reassessment, totalling between 1L and 4L during initial resuscitation. Fluid balance, including later de-escalation of therapy was not specifically described in any. Norepinephrine was the preferred initial vasopressor (5/10), specifically targeted to MAP >65mmHg (3/10), with higher values suggested in pre-existing hypertension (1/10). Recommendations for guidelines were almost universally derived from evidence in High Income Countries. None of the guidelines suggested any refinement for patients with malnutrition. Conclusions Widely used international guidelines contain disparate recommendations on intravenous fluid use, lack specificity and are largely unattainable in Low-Income Countries given available resources. A relative lack of high-quality evidence from sub-Saharan Africa increases reliance on recommendations which may not be relevant or implementable.


2021 ◽  
Author(s):  
Etsay Woldu Anbesu ◽  
Setognal Birara Aychiluhm

Abstract Background: Poor menstrual hygiene practices can lead to gynecological problems, psychosocial stress, and reduced access to school. Menstrual hygiene has not received adequate attention in Sub-Saharan Africa. Moreover, there were fragmented and inconsistent findings. Therefore, this systematic review and meta-analysis aimed to estimate the pooled prevalence of menstrual hygiene practice and identify its associated factors among adolescent girls in Sub-Saharan Africa.Methods: The protocol for this review had registered at PROSPERO with registration number: CRD42020165628. In this study, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline will be used. Online electronic databases PubMed, Google Scholar, CINAHL and grey literature will be searched to retrieve available studies. Joanna Briggs Institute checklist will be used to assess the quality of the studies. Heterogeneity among studies will be examined using a chi-squared test and I-squared statistic.To investigate sources of heterogeneity, subgroup analyses and meta-regression will be performed. Sensitivity analysis will be conducted to identify influential studies. Publication bias will be examined by funnel plots and Egger’s test. The statistical analysis will be conducted using STATA version-16 software. A random-effect model will be used to estimate the pooled prevalence, and statistical significance will be determined at a p-value of <0.05.Discussion: Poor menstrual hygiene practice affects the health of millions of adolescent girls in developing countries. Currently, there are no synthesis research findings on the overall pooled prevalence of menstrual hygiene practice and its associated factor in Sub-Saharan Africa. Therefore, this systematic review and meta-analysis will be used to inform policy-makers, programmers, planners, clinicians, and researchers to design appropriate strategies.


2021 ◽  
Author(s):  
Etsay Woldu Anbesu ◽  
Setognal Birara Aychiluhm

Abstract Background: Poor menstrual hygiene practices can lead to gynecological problems, psychosocial stress, and reduced access to school. Menstrual hygiene has not received adequate attention in Sub-Saharan Africa. Despite this, there are fragmented and inconsistent findings in Sub-Saharan Africa. Therefore, this systematic review and meta-analysis aimed to estimate the pooled prevalence of good menstrual hygiene practice and identify its associated factors among adolescent girls in Sub-Saharan Africa. Methods: The protocol for this review was registered at PROSPERO with registration number: CRD42020165628. In this study, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline will be used to report the protocol. Online electronic databases PubMed, Google Scholar, CINAHL and unpublished grey literature will be searched to retrieve available studies from January 1-May/2021. The selection, data extraction, and quality assessment of studies will be carried by two authors. Joanna Briggs Institute checklist will be used to assess the quality of the studies. Heterogeneity among studies will be examined using a chi-squared test and I-squared statistic. To investigate sources of heterogeneity, subgroup analyses and meta-regression will be done based on region and sample size. Sensitivity analysis will be conducted to identify influential studies. Publication bias will be examined by funnel plots and Egger’s test. The statistical analysis will be conducted using STATA version-14 software. A random-effect model will be used to estimate the pooled prevalence, and statistical significance will be determined at a p-value of <0.05.Discussion: Poor menstrual hygiene practice affects the health of millions of adolescent girls in developing countries. Currently, there are no synthesis research findings on the pooled prevalence of menstrual hygiene practice and its associated factor in Sub-Saharan Africa. Therefore, the findings of this systematic review and meta-analysis will be helpful to inform policy-makers, planners, and researchers to design appropriate interventions.


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