Prevalence and factors associated with unplanned pregnancy in The Gambia: findings from 2018 population-based survey

Abstract Background Unplanned pregnancy is a public health issue that has detrimental implications for the mother and baby alike. However, few studies have been conducted in The Gambia on this subject. As a result, the prevalence of unplanned pregnancy among women of reproductive age in The Gambia was investigated, as well as the factors associated with it. Methods The Gambia's Multiple Indicators Cluster Survey (MICS) was used to evaluate the 2018 results. Data was obtained from 3790 women aged 15 to 49 who had also given birth. The univariate analysis was conducted using percentage. The adjusted odds ratios (AOR) were determined using a multivariable logistic regression model (with corresponding 95% confidence interval (CI)). The degree of statistical significance was set at 5%. Results Approximately 25.3% (95% CI: 23.1%-27.6%) of the women reported unplanned pregnancy. Women aged 30–34 years had 45% reduction in unplanned pregnancy, when compared with those aged 15–19 years (AOR = 0.55; 95% CI: 0.32–0.94). The Fula and non-Gambian women had 30% and 45% reduction in unplanned pregnancy respectively, when compared with Mandinka women. Those who had no functional difficulties had 47% reduction in unplanned pregnancy, when compared with women who had functional difficulties (AOR = 0.53; 95% CI: 0.30, 0.91). Respondents who had given births to 3–4 and 5 + children were 1.79 and 3.02 times as likely to have unplanned pregnancy, when compared with women who had given birth to 1–2 children. Single/unmarried women were 11.38 times as likely to have unplanned pregnancy, when compared with women currently married/in union (AOR = 11.38; 95% CI: 6.38, 20.29). Local Government Area of residence was significantly associated with unplanned pregnancy. Furthermore, women who were neither happy nor unhappy and 18 + at sexual debut were 1.39 and 1.34 times as likely to have unplanned pregnancy, when compared with the very happy women and those < 18 at sexual debut respectively. Conclusion The rate of unintended pregnancies was large (25.3%). Several causes have been linked to unplanned pregnancies. These results suggest that further efforts are required to enhance women's sex education, expand access to family planning services, and provide affordable health care to high-risk women in order to minimize unintended pregnancies.

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Factors associated with the quality of prenatal care: an approach to premature birth

Revista da Escola de Enfermagem da USP ◽

10.1590/s0080-623420150000400002 ◽

2015 ◽

Vol 49 (4) ◽

pp. 0540-0549 ◽

Cited By ~ 2

Author(s):

Emiliana Cristina Melo ◽

Rosana Rosseto de Oliveira ◽

Thais Aidar de Freitas Mathias

Keyword(s):

Prenatal Care ◽

Skin Color ◽

Unplanned Pregnancy ◽

Univariate Analysis ◽

Evaluation Criteria ◽

Care Quality ◽

White Skin ◽

Factors Associated ◽

Term Births

OBJECTIVETo assess the quality of prenatal care in mothers with premature and term births and identify maternal and gestational factors associated with inadequate prenatal care.METHODCross-sectional study collecting data with the pregnant card, hospital records and interviews with mothers living in Maringa-PR. Data were collected from 576 mothers and their born alive infants who were attended in the public service from October 2013 to February 2014, using three different evaluation criteria. The association of prenatal care quality with prematurity was performed by univariate analysis and occurred only at Kessner criteria (CI=1.79;8.02).RESULTSThe indicators that contributed most to the inadequacy of prenatal care were tests of hemoglobin, urine, and fetal presentation. After logistic regression analysis, maternal and gestational variables associated to inadequate prenatal care were combined prenatal (CI=2.93;11.09), non-white skin color (CI=1.11;2.51); unplanned pregnancy (CI=1.34;3.17) and multiparity (CI=1.17;4.03).CONCLUSIONPrenatal care must follow the minimum recommended protocols, more attention is required to black and brown women, multiparous and with unplanned pregnancies to prevent preterm birth and maternal and child morbimortality.

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Risk and Triggering Factors Associated with Bronchial Asthma Among School-Going Children in an Urban City of Coastal Karnataka

Journal of Nepal Paediatric Society ◽

10.3126/jnps.v37i1.16634 ◽

2017 ◽

Vol 37 (1) ◽

pp. 59-66

Author(s):

Sowmini P. Kamath ◽

Shrividya Shrishakumar ◽

Animesh Jain ◽

Anand Ramakrishna ◽

Shantharam B Baliga

Keyword(s):

Risk Factors ◽

Statistical Significance ◽

Cross Sectional Study ◽

Public Health Issue ◽

Trigger Factors ◽

Cross Sectional ◽

Factors Associated ◽

Urban City ◽

Triggering Factors ◽

At Home

Introduction: Asthma is common in childhood and is a major public health issue. The objectives of this study were to identify risk and triggering factors associated with asthma among school children.Material and Methods: A prospective cross sectional study was conducted among 6-15 years old children, over two months in two private schools at Mangalore city. Trigger factors were assessed as per asthma trigger inventory (ATI). Responses were graded from 0-5 score based on ‘never’,’ rarely’, ‘sometimes’, ‘most of the time’ and ‘always’. A predesigned questionnaire suiting the city environment was prepared and used to assess the risk and triggering factors. Analysis was done using SPSS version 16.Results: Asthma and allergic rhinitis in parents (34.1%,40.7%), smoking at home(24.2%), exclusive breast feeding absence (27.5%),early weaning(24.2%), living in a flat (37.4%) and pets at home(37.4%) were risk factors noted. As per ATI, it was found that ‘having a cold’ was the most frequently selected trigger at 94.5% (47.3% ‘sometimes’, 2.2% ‘always’), followed by ‘running’ at 79.1% (27.5% ‘sometimes’, 13.2% ‘always’), and ‘house dust’ at 69.2% (31.9% ‘sometimes’, 6.6% ‘always’). The highest mean was for infections, (2.228, SD=0.546), followed by physical exercise (2.167, SD=0.331). Animal allergens had lowest mean (1.527, SD=0.104), followed by psychological triggers at second lowest (1.579, SD=0.181). However none of the risk and trigger factors had statistical significance with asthma.Conclusion: Avoiding exposure to probable triggers and identifying risk factors would aid in planning effective strategic measures with better quality of life.

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Family planning uptake in Kagera and Mara regions in Tanzania: a cross-sectional community survey

10.21203/rs.3.rs-47146/v1 ◽

2020 ◽

Author(s):

Joseph Batholomeo Massenga ◽

Ritha Norohna ◽

Bayoum Awadhi ◽

Dunstan Bishanga ◽

Oliva Safari ◽

...

Keyword(s):

Logistic Regression ◽

Family Planning ◽

Community Health ◽

Univariate Analysis ◽

Unmet Need ◽

Reproductive Age ◽

P Value ◽

Cross Sectional ◽

Mixed Effect ◽

Factors Associated

Abstract BackgroundIn Tanzania, 27.1% of all women of reproductive age are currently using modern contraception, and 16.8% have an unmet need for family planning. We therefore examined factors associated with family planning uptake after giving birth in two regions of Tanzania.MethodsSub-analysis of a cross-sectional household survey conducted in April 2016 in Mara and Kagera regions in Tanzania. A total of 1184 women aged 15-49 years, who had given birth less than two years prior to the survey were included. Logistic regression mixed effect modelling was used to examine factors associated with family planning uptake. Univariate analysis was used to present crude effects of covariates, followed by stepwise forward selection to build a multiple logistic regression model. A p-value ≥ 0.20 was applied as the criterion to retain a variable into the model.ResultsAmong 1184 women within two years after giving birth, 393 (33.2%) used family planning methods. After adjusting for (1) age, (2) level of education, (3) living in union, (4) being accompanied to ANC by a partner and (5) being able to mention at least one method, factors independently associated with family planning uptake included: (1) having discussed family planning with the partner (aOR 2.90; 95% CI 1.88-4.49), (2) having been counselled on family planning during ANC (aOR 2.15; 95% CI 1.48-3.13), (3) having discussed family planning with a community health worker (aOR 3.32; 95% CI 1.91-5.77), (4) having discussed family planning with a facility health care worker (aOR 1.79; 95% CI 1.22-2.62), (5) having primary or higher educational level (aOR 1.66; 95% CI 1.01-2.273) and (6) being in union (aOR 1.86; 95% CI 1.02-3.42).ConclusionSupportive constitutes including educational interaction with facility and community health workers, as well as having a supportive partner are facilitators to increased uptake of family planning among women in Tanzania

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Individual and community factors associated with unintended pregnancies among women of advanced reproductive age in Nigeria

Women & Health ◽

10.1080/03630242.2021.1957746 ◽

2021 ◽

pp. 1-13

Author(s):

Tosin Olajide Oni ◽

Benjamin Bukky Ilesanmi ◽

Rasheed Adebayo Yinusa ◽

Olaoye James Oyeleye ◽

Omolayo Bukola Oluwatope ◽

...

Keyword(s):

Reproductive Age ◽

Community Factors ◽

Factors Associated ◽

Unintended Pregnancies ◽

Advanced Reproductive Age

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The association between unmet need for contraception and unintended pregnancy among reproductive-age women in Ethiopia

Medicine Access Point of Care ◽

10.1177/23992026211033436 ◽

2021 ◽

Vol 5 ◽

pp. 239920262110334

Author(s):

Awoke Giletew Wondie

Keyword(s):

Public Health ◽

Unintended Pregnancy ◽

Pregnancy Termination ◽

Statistical Significance ◽

Unmet Need ◽

Positive Association ◽

Reproductive Age ◽

Outcome Variable ◽

Public Health Issue ◽

Unmet Need For Contraception

Objectives: An unintended pregnancy and unmet need for contraception remains a serious public health issues both in developed and developing countries. This study aimed to investigate the relation between unmet needs for contraception and unintended pregnancy, and identify other factors contributing for unintended pregnancy in Ethiopia. Methods: Data were obtained from the 2016 Ethiopian Demographic and Health Survey. A total of 7590 mothers were included. The planning status of the last pregnancy was the main outcome variable, and the unmet need for contraception was the primary explanatory variable. Bivariate and multiple logistic regressions were carried out. SPSS version 20.0 was used for data analysis. Statistical significance was declared at p < 0.05. Results: More than one-fourth of mothers (26.6%) gave either mistimed or unwanted birth. The rate of unmet need for contraception was 26.5%. Women with unmet need for contraception had (adjusted odds ratio (AOR) = 10.29, 95% confidence interval (CI) = 8.70–12.10) higher odds of experiencing unintended pregnancy than those who met their contraception need. Age, history of pregnancy termination, parity, women’s autonomy, and fertility preference were factors associated with unintended pregnancy. Conclusion: An unintended pregnancy and the unmet need for contraception remain a major public health issue in Ethiopia. A strong positive association between the unmet need for contraception and unintended pregnancy suggests that interventions targeting the unmet need for contraception could reduce unintended pregnancy. Furthermore, empowering women, promoting a clear fertility goal, and improving men’s involvement would reduce unintended pregnancy.

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Voluntary Testing Practice Among People with Clinical Symptoms of COVID-19 in Somalia: Using Andersen’s Behavioral model

10.21203/rs.3.rs-428987/v1 ◽

2021 ◽

Author(s):

Mohamed Ali Magan ◽

Duah Dwomoh

Keyword(s):

Peer Influence ◽

Clinical Symptoms ◽

Statistical Significance ◽

Univariate Analysis ◽

Behavioral Model ◽

Contact Tracing ◽

Household Level ◽

Factors Associated ◽

Voluntary Testing ◽

Study Participants

Abstract Background: COVID-19, is a respiratory disease caused by a novel coronavirus. The virus is a global pandemic which threatens children and their rights in countries around the world. Epidemiologists have advocated for a robust testing and contact tracing as a potential solution to balance public health and economic priorities. Using Anderson Behavioral Model, our study aimed to analyze predisposing, Enabling and Need factors associated with VT4C-19 practice in Somalia. Methods: A cross sectional community-based survey were conducted at household level among adults above the age 18 years living in Mogadishu and Garowe cities. The study used multi-stage stratified-cluster sampling method. Out of the Four main towns in Somalia with a designated free National laboratory for COVID-19 testing by the government, the study randomly selected two cities (Mogadishu & Garowe) using Simple Random Sampling (SRS) Method. The study used univariate analysis and Multivariable Binary Logistic Regression model to control other possible confounders and to give the Andersen Behavioral Modal that were independently associated with voluntary testing for COVID-19 in Somalia. The statistical significance tests were accepted at p < 0.05.Results: Only 113 (6.6%) out of (1,708) study participants who experienced clinical symptoms of COVID-19 (between 16 March – 31 December 2020) voluntarily tested their COVID-19 status. The study found Predisposing factors including gender (P<0.001), marital status (p<0.05), mass media availability (p<0.05), telephone ownership (p<0.05), peer influence (P<0.001) and stigma of COVID-19 positive individuals in the community (P<0.001), and Enabling factors including: place of residence (p<0.001), expense decision maker at household level (p<0.05), insurance status (p<0.001) and access to outreach and health education program (p<0.05), as well as the Need factors including: perceived importance of COVID-19 voluntary test (p<0.001) and chronic diseases status among the study participants (p<0.05) were among the factors associated with the practice of voluntary tests of COVID-19 among the clinically symptomatic individuals in Somalia.Conclusion: The uptake of Voluntary testing for COVID-19 is very low in Somalia. To promote this, health officials and policy makers need to focus on a consistent and culturally sensitive community sensitization programs and bringing the COVID-19 test closer to the communities including rural communities.

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Big Problem or Not a Big Problem: Problems to Health Care Utilization by Residence in The Gambia Among Women of Reproductive Age. A Cross Sectional Study

10.21203/rs.3.rs-1068671/v1 ◽

2021 ◽

Author(s):

Ebrima Barrow ◽

Alieu Sowe

Keyword(s):

Social Support ◽

Health Care ◽

Health Care Utilization ◽

Health Facility ◽

Statistical Significance ◽

The Gambia ◽

Reproductive Age ◽

Care Utilization ◽

Cultural Norms ◽

Women Of Reproductive Age

Abstract Background: Ability to utilise healthcare services is desire for everyone in need. Unfortunately, challenges to health care utilization persist and they do so inequitably amongst social groups. This study aimed to examine problems to health care utilization and residential area equity in utilization among women of reproductive age in The Gambia. Methods: Data from The Gambia 2019-20 Demographic and Health Survey comprising of 11,865 women 15 – 49 years of age was used. A systematic selection method of equal probability was employed for the data collection interviews. Visiting any health facility in the last 12 months is the outcome. Problems to health care utilization was assessed using four primary factors of interest: permission to go, money needed for treatment, distance to health facility and not wanting to go alone as independent variables. Descriptive and logistic regression analysis were used to assess the frequency distribution and the association of the four factors and health care utilization by residence. The point estimates were reported in odds (OR), 95% confidence interval (CI) and p value <0.05 signified statistical significance.Results: Most women in rural (79%) and urban (83%) residential areas utilized health care services in the last 12 months. Women in urban areas who had a big problem getting permission to go and a big problem not wanting to go alone had lower odds of health care utilization compared to women who did not have a big problem getting permission to go and not wanting to go alone for health care. Women resident in rural areas who reported distance to health facility as a big problem had higher odds of health care utilization compared to women who did not have big problem concerning distance to health facility. Conclusions: Permission to go and not wanting to go alone appear to be associated with cultural norms and inadequate social support for women utilizing health care in urban residence. Policy makers should address harmful cultural norms and inadequate social support for women during health care visits to improve equity in health care utilization towards achieving universal health coverage.

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Coverage and factors associated with mother and newborn skin-to-skin contact in Nigeria: a multilevel analysis

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-04079-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Michael Ekholuenetale ◽

Amadou Barrow ◽

Faith Owunari Benebo ◽

Ashibudike Francis Idebolo

Keyword(s):

Formal Education ◽

Statistical Significance ◽

Study Data ◽

Reproductive Age ◽

High Rate ◽

Outcome Variable ◽

Factors Associated ◽

Skin Contact ◽

Individual Household ◽

Skin To Skin

Abstract Background Mother and newborn skin-to-skin contact (SSC) is an immediate postpartum intervention known to improve the health of newborn and mothers alike. Albeit, there is paucity of data that explored the coverage or factors associated with SSC in Nigeria. Therefore, we aimed to explore the coverage and hierarchical nature of the factors associated with SSC among women of reproductive age in Nigeria. Methods The 2018 Nigeria Demographic and Health Survey (NDHS) data was used for this study. Data on 29,992 women who had ever given birth were extracted for analysis. SSC was the outcome variable as determined by women’s report. A multivariable multilevel logistic regression model was used to estimate the fixed and random effects of the factors associated with SSC. Statistical significance was determined at p< 0.05. Results The coverage of SSC was approximately 12.0%. Educated women had higher odds of SSC, when compared with women with no formal education. Those who delivered through caesarean section (CS) had 88% reduction in SSC, when compared with women who had vaginal delivery (OR= 0.12; 95%CI: 0.07, 0.22). Women who delivered at health facility were 15.58 times as likely to practice SSC, when compared with those who delivered at home (OR= 15.58; 95%CI: 10.64, 22.82). Adequate ANC visits and low birth weight significantly increased the odds of SSC. Women from richest household were 1.70 times as likely to practice SSC, when compared with women from poorest household (OR= 1.70; 95%CI: 1.04, 2.79). There was 65% reduction in SSC among women with high rate of community non-use of media, when compared with women from low rate of community non-use of media (OR= 0.35; 95%CI: 0.20, 0.61). Conclusion SSC coverage was low in Nigeria. Moreover, individual, household and community level factors were associated with SSC. More enlightenment should be created among women to bring to limelight the importance of SSC specifically to newborn’s health.

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Predisposing, enabling and need factors associated with skilled delivery care utilization among reproductive-aged women in Kersa district, eastern Ethiopia

Reproductive Health ◽

10.1186/s12978-019-0829-z ◽

2019 ◽

Vol 16 (1) ◽

Cited By ~ 1

Author(s):

Gezahegn Tesfaye ◽

Catherine Chojenta ◽

Roger Smith ◽

Deborah Loxton

Keyword(s):

Antenatal Care ◽

Statistical Significance ◽

Care Utilization ◽

Delivery Care ◽

Community Based ◽

Eastern Ethiopia ◽

Skilled Delivery ◽

Factors Associated ◽

Unintended Pregnancies ◽

Reproductive Aged Women

Abstract Background Skilled delivery care utilization in Ethiopia is still very low compared with the goal set by the global community for countries with the highest maternal mortality. As a result, the country is overburdened with high maternal morbidity and mortality. We aimed to explore the predisposing, enabling, and need factors associated with skilled delivery care utilization among reproductive-aged women in Kersa district, eastern Ethiopia. Methods A community-based cross-sectional study was conducted with a total of 1294 women. The participants were selected using systematic sampling techniques. An interviewer-administered structured questionnaire aided by an electronic survey tool was used to collect data. Univariate analyses were conducted to describe the study sample. Bivariate and multivariate logistic regression analyses were carried out to elicit the association of predisposing, enabling, and need factors associated with skilled delivery care utilization. Separate multivariate models were fitted for primiparous and multiparous women categories. Odds ratios with 95% confidence intervals were used to assess statistical significance. Results More than a quarter (30.8%) of the women surveyed used skilled delivery care for their most recent birth. Significant predisposing factors were as follows: presence of educated family member; receiving education on maternal health; previous use of skilled delivery care; and best friend’s use of maternal care. Place of residence was the enabling factor that predicted skilled delivery care use. Antenatal care attendance and pregnancy intention were significant need factors associated with skilled delivery care utilization. Conclusion The findings of the study highlight the need for a concerted effort to establish community-based peer education programs; improve access to family planning services (to reduce unintended pregnancies); increase antenatal care uptake; and facilitate access to skilled delivery care in rural areas.

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Risk factors associated with bleeding after prophylactic endoscopic variceal ligation in cirrhosis

Endoscopy ◽

10.1055/a-1214-5355 ◽

2020 ◽

Author(s):

Andreas Drolz ◽

Christoph Schramm ◽

Oliver Seiz ◽

Stefan Groth ◽

Eik Vettorazzi ◽

...

Keyword(s):

Platelet Count ◽

Statistical Significance ◽

Univariate Analysis ◽

Fold Increase ◽

Bleeding Complications ◽

Endoscopic Variceal Ligation ◽

Safe Procedure ◽

Bleeding Events ◽

Factors Associated ◽

Grade Iii

Background Prophylactic endoscopic variceal band ligation (EVL) is frequently performed in patients with liver cirrhosis. The aim of our study was to identify factors associated with early upper gastrointestinal bleeding (UGIB) in cirrhosis patients after prophylactic EVL. Methods 787 nonemergency EVLs performed in 444 patients in two German University medical centers were analyzed retrospectively. Results Within 30 days after EVL, 38 UGIBs were observed (4.8 % of all procedures). Bilirubin levels (hazard ratio [HR] 1.5, 95 % confidence interval [CI] 1.2–2.0 for a 2-fold increase) and presence of varices grade III/IV according to Paquet (HR 2.6, 95 %CI 1.3–5.0 compared with absence or smaller sized varices) were independently associated with UGIB following EVL. International normalized ratio (INR) was associated with bleeding events in the univariate analysis but did not reach statistical significance after adjustment for bilirubin and presence of varices grade III/IV (HR 1.2, 95 %CI 0.9–1.6 for an increase by 0.25). There was no statistically significant association between platelet count or fibrinogen levels and UGIB. Substitution of coagulation products did not affect incidence of bleeding after EVL, which also applied to patients with “coagulopathy” (INR > 1.5 and/or platelet count < 50 × 109/L). No association between proton pump inhibitor therapy and post-EVL UGIB was observed. Conclusions EVL is a safe procedure and immediate bleeding complications are rare. Serum bilirubin levels and size of varices, rather than coagulation indices, are associated with UGIB after EVL. Our data do not support the preventive substitution of blood or coagulation products.

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