scholarly journals Prognostic factors of time to first abortion after sexual debut among fragile state Congolese women: a survival analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Michael Ekholuenetale ◽  
Charity Ehimwenma Ekholuenetale ◽  
Amadou Barrow
Keyword(s):  
Formal Education ◽  
Cox Regression ◽  
Sexual Debut ◽  
Statistical Significance ◽  
Unwanted Pregnancy ◽  
Total Sample ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
Republic Of Congo ◽  
Adverse Pregnancy

Abstract Background Despite the common restrictive abortion laws, abortion remains widespread in sub-Saharan Africa (SSA) countries. Women still utilize abortion services and put their lives and health at risk because abortion can only be procured illegally in private facilities such as mid-level or small patent medicine store that may be manned by unskilled providers or through a non-medicated approach. The objective of this study was to investigate the prevalence of abortion, the reasons women had abortions, median years to first abortion after sexual debut and examine the factors of time to first abortion among women of reproductive age in the Republic of Congo. Methods We used data from the most recent Republic of Congo Demographic and Health Survey (DHS). A total sample of 3622 women aged 15–49 years was analyzed. We estimated the overall prevalence of abortion and median years to first abortion. Furthermore, we examined the factors of time to first abortion after sexual debut using multivariable Cox regression and reported the estimates using adjusted Hazard Ratio (aHR) and 95% confidence intervals (CI). Statistical significance was determined at p < 0.05. Results The prevalence of abortion was 60.0% and median years of time to first abortion after sexual debut was 9.0. The prominent reasons for abortion were due to too short birth interval (23.8%), lack of money (21.0%) and that husband/partner did not need a child at that time (14.0%). Women’s age and region were notable factors in timing to first abortion. Furthermore, women from poorer, middle, richer and richest households had 34, 67, 86 and 94% higher risk of abortion respectively, when compared with women from poorest households (all p < 0.05). Women currently in union/living with a man and formerly in union had 41 and 29% reduction in the risk of abortion respectively, when compared with those never in union (all p < 0.05). In addition, women with primary and secondary+ education had 42 and 76% higher risk of abortion respectively, when compared with women with no formal education (all p < 0.05). Conclusion There was high prevalence of abortion with short years at first abortion. Abortion was associated with women’s characteristics. There is need for unwanted pregnancy prevention intervention and the improvement in pregnancy care to reduce adverse pregnancy outcomes among women.

scholarly journals Prognostic Factors of Time to First Abortion After Sexual Debut Among Fragile State Congolese Women: A Survival Analysis

2020 ◽  
Author(s):  
Michael Ekholuenetale ◽  
Charity Ehimwenma Ekholuenetale ◽  
Amadou Barrow
Keyword(s):  
Formal Education ◽  
Cox Regression ◽  
Sexual Debut ◽  
Statistical Significance ◽  
Unwanted Pregnancy ◽  
Total Sample ◽  
Sub Saharan Africa ◽  
High Prevalence ◽  
Sub Saharan ◽  
Adverse Pregnancy

Abstract Background: Despite the common restrictive abortion laws, abortion remains widespread in sub-Saharan Africa (SSA) countries. Women still utilize abortion services and put their lives and health at risk because abortion can only be procured illegally in private facilities such as mid-level or small patent medicine store that may be manned by unskilled providers or through a non-medicated approach. The objective of this study was to determine median years and factors of time to first abortion after sexual debut among Congolese women.Methods: We used data from the most recent Republic of Congo Demographic and Health Survey (DHS). A total sample of 3,622 women aged 15-49 years was analyzed. We estimated the overall prevalence of abortion and median years to first abortion. Furthermore, we examined the factors of time to first abortion after sexual debut using multivariable Cox regression and reported the estimates using adjusted Hazard Ratio (aHR) and 95% confidence intervals (CI). Statistical significance was determined at p<0.05.Results: The prevalence of abortion was 60.0% and median years of time to first abortion after sexual debut was 9.0. The prominent reasons for abortion were due to too short birth interval (23.8%), lack of money (21.0%) and that husband/partner did not need a child at that time (14.0%). Women’s age and region were notable factors in timing to first abortion. Furthermore, women from poorer, middle, richer and richest households had 34%, 67%, 86% and 94% higher risk of abortion respectively, when compared with women from poorest households. Women currently in union/living with a man and formerly in union had 41% and 29% reduction in the risk of abortion respectively, when compared with those never in union. In addition, women with primary and secondary+ education had 42% and 76% higher risk of abortion respectively, when compared with women with no formal education. Conclusion: There was high prevalence of abortion with short years at first abortion. Abortion was associated with women’s characteristics. There is need for unwanted pregnancy prevention intervention and the improvement in pregnancy care to reduce adverse pregnancy outcomes among women.

scholarly journals Prognostic factors of time to first abortion after sexual debut among fragile State Congolese women: a survival analysis

2020 ◽  
Author(s):  
Michael Ekholuenetale ◽  
Charity Ehimwenma Ekholuenetale ◽  
Amadou Barrow
Keyword(s):  
Formal Education ◽  
Cox Regression ◽  
Sexual Debut ◽  
Statistical Significance ◽  
Unwanted Pregnancy ◽  
Total Sample ◽  
Sub Saharan Africa ◽  
High Prevalence ◽  
Sub Saharan ◽  
Adverse Pregnancy

Abstract Background: Despite the common restrictive abortion laws, abortion remains widespread in sub-Saharan Africa (SSA) countries. Women still utilize abortion services and put their lives and health at risk because abortion can only be procured illegally in private facilities such as mid-level or small patent medicine store that may be manned by unskilled providers or through a non-medicated approach. The objective of this study was to determine median years and factors of time to first abortion after sexual debut among Congolese women.Methods: We used data from the most recent Republic of Congo Demographic and Health Survey (DHS). A total sample of 3,622 women aged 15-49 years was analyzed. We estimated the overall prevalence of abortion and median years to first abortion. Furthermore, we examined the factors of time to first abortion after sexual debut using multivariable Cox regression and reported the estimates using adjusted Hazard Ratio (aHR) and 95% confidence intervals (CI). Statistical significance was determined at p<0.05.Results: The prevalence of abortion was 60.0% and median years of time to first abortion after sexual debut was 9.0. The prominent reasons for abortion were due to too short birth interval (23.8%), lack of money (21.0%) and that husband/partner did not need a child at that time (14.0%). Women’s age and region were notable factors in timing to first abortion. Furthermore, women from poorer, middle, richer and richest households had 34%, 67%, 86% and 94% higher risk of abortion respectively, when compared with women from poorest households (aHR estimates). Women currently in union/living with a man and formerly in union had 41% and 29% reduction in the risk of abortion respectively, when compared with those never in union (aHR estimates). In addition, women with primary and secondary+ education had 42% and 76% higher risk of abortion respectively, when compared with women with no formal education (aHR estimates).Conclusion: There was high prevalence of abortion with short years at first abortion. Abortion was associated with women’s characteristics. There is need for unwanted pregnancy prevention intervention and the improvement in pregnancy care to reduce adverse pregnancy outcomes among women.

scholarly journals Prognostic factors of time to first abortion after sexual debut among fragile State Congolese women: a survival analysis

2020 ◽  
Author(s):  
Michael Ekholuenetale ◽  
Charity Ehimwenma Ekholuenetale ◽  
Amadou Barrow
Keyword(s):  
Formal Education ◽  
Cox Regression ◽  
Sexual Debut ◽  
Statistical Significance ◽  
Unwanted Pregnancy ◽  
Total Sample ◽  
Sub Saharan Africa ◽  
High Prevalence ◽  
Sub Saharan ◽  
Adverse Pregnancy

Abstract Background: Despite the common restrictive abortion laws, abortion remains widespread in sub-Saharan Africa (SSA) countries. Women still utilize abortion services and put their lives and health at risk because abortion can only be procured illegally in private facilities such as mid-level or small patent medicine store that may be manned by unskilled providers or through a non-medicated approach. The objective of this study was to determine median years and factors of time to first abortion after sexual debut among Congolese women.Methods: We used data from the most recent Republic of Congo Demographic and Health Survey (DHS). A total sample of 3,622 women aged 15-49 years was analyzed. We estimated the overall prevalence of abortion and median years to first abortion. Furthermore, we examined the factors of time to first abortion after sexual debut using multivariable Cox regression and reported the estimates using adjusted Hazard Ratio (aHR) and 95% confidence intervals (CI). Statistical significance was determined at p<0.05.Results: The prevalence of abortion was 60.0% and median years of time to first abortion after sexual debut was 9.0. The prominent reasons for abortion were due to too short birth interval (23.8%), lack of money (21.0%) and that husband/partner did not need a child at that time (14.0%). Women’s age and region were notable factors in timing to first abortion. Furthermore, women from poorer, middle, richer and richest households had 34%, 67%, 86% and 94% higher risk of abortion respectively, when compared with women from poorest households (aHR estimates). Women currently in union/living with a man and formerly in union had 41% and 29% reduction in the risk of abortion respectively, when compared with those never in union (aHR estimates). In addition, women with primary and secondary+ education had 42% and 76% higher risk of abortion respectively, when compared with women with no formal education (aHR estimates). Conclusion: There was high prevalence of abortion with short years at first abortion. Abortion was associated with women’s characteristics. There is need for unwanted pregnancy prevention intervention and the improvement in pregnancy care to reduce adverse pregnancy outcomes among women.

scholarly journals Relationship between socioeconomic status and HIV infection: findings from a survey in the Free State and Western Cape Provinces of South Africa

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e016232 ◽  
Author(s):  
Erick Wekesa Bunyasi ◽  
David John Coetzee
Keyword(s):  
South Africa ◽  
Socioeconomic Status ◽  
Hiv Infection ◽  
Formal Education ◽  
Household Wealth ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
Free State ◽  
Western Cape ◽  
Women Of Reproductive Age

BackgroundStudies have shown a mixed association between socioeconomic status (SES) and prevalent HIV infection across and within settings in sub-Saharan Africa. In general, the relationship between years of formal education and HIV infection changed from a positive to a negative association with maturity of the HIV epidemic. Our objective was to determine the association between SES and HIV in women of reproductive age in the Free State (FSP) and Western Cape Provinces (WCP) of South Africa (SA).Study designCross-sectional.SettingSA.MethodsWe conducted secondary analysis on 1906 women of reproductive age from a 2007 to 2008 survey that evaluated effectiveness of Prevention of Mother-to-Child HIV Transmission Programmes. SES was measured by household wealth quintiles, years of formal education and employment status. Our analysis principally used logistic regression for survey data.ResultsThere was a significant negative trend between prevalent HIV infection and wealth quintile in WCP (P<0.001) and FSP (P=0.025). In adjusted analysis, every additional year of formal education was associated with a 10% (adjusted OR (aOR) 0.90 (95% CI 0.85 to 0.96)) significant reduction in risk of prevalent HIV infection in WCP but no significant association was observed in FSP (aOR 0.99; 95% CI 0.89 to 1.11). There was no significant association between employment and prevalent HIV in each province: (aOR 1.54; 95% CI 0.84 to 2.84) in WCP and (aOR 0.96; 95% CI 0.71 to 1.30) in FSP.ConclusionThe association between HIV infection and SES differed by province and by measure of SES and underscores the disproportionately higher burden of prevalent HIV infection among poorer and lowly educated women. Our findings suggest the need for re-evaluation of whether current HIV prevention efforts meet needs of the least educated (in WCP) and the poorest women (both WCP and FSP), and point to the need to investigate additional or tailored strategies for these women.

scholarly journals Diabetes and correlates of cardiovascular diseases among women aged 15-49 years in Benin: evidence from a Demographic and Health Survey

2020 ◽  
Author(s):  
Michael Ekholuenetale ◽  
Chimezie Igwegbe Nzoputam ◽  
Amadou Barrow
Keyword(s):  
Heart Disease ◽  
Cardiovascular Diseases ◽  
Health Survey ◽  
Lung Diseases ◽  
Statistical Significance ◽  
Demographic And Health Survey ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
Cross Sectional ◽  
The Government

Abstract Background: Sub-Saharan Africa (SSA) countries are facing an epidemiological shift from infectious diseases to chronic diseases, such as cardiovascular diseases (CVDs). The burden of CVDs in a population results from the prevalence of several factors. This study was to determine the association of diabetes and correlates with heart and lung diseases.Methods: We used Benin Demographic and Health Survey (BDHS) population-based cross-sectional data. BDHS 2017-18 is the fifth of its kind. A total of 7712 women of reproductive age were included in this study. Heart and lung diseases were the outcome variables. Percentage and logistic regression model were used to analyze the data. The level of statistical significance was set at 5%.Results: The prevalence of heart disease was 1.3% (95%CI: 1.0%-1.7%) and lung disease was approximately 1.5% (95%CI: 1.2%-1.9%). Women who had diabetes were also found to be 3.57 times significantly more likely to have heart disease when compared with those who do not have diabetes (AOR= 3.57; 95%CI: 1.51 – 8.45). Furthermore, women with diabetes were 4.55 times significantly more likely to also have lung diseases when compared with those who do not have diabetes (AOR= 4.55; 95%CI: 2.06 – 10.06). Women who had hypertension were found to be 3.18 times significantly more likely to have heart disease when compared with those who had no hypertension (adjusted odds ratio (AOR) = 3.18; 95%CI: 2.02 – 4.98).Conclusion: Diabetes was a key determinant of heart disease. Health policymakers and government need to focus on widespread prevention and control interventions of heart disease through improved screening for risk factors and early detection of CVDs especially among high-risk women. The government should also create nationwide awareness and educate people about CVDs and its fatality rate.

scholarly journals Determinants of Modern Contraceptive Methods (MCM) discontinuation among childbearing age women in Kinshasa, Democratic Republic of Congo.

2021 ◽  
Author(s):  
Nathalie Pemba ◽  
Christophe Luhata ◽  
Shahul H Ebrahim ◽  
Dalau Nkamba Mukadi ◽  
Lise Lombeya ◽  
...  
Keyword(s):  
Democratic Republic ◽  
Cox Regression ◽  
Democratic Republic Of Congo ◽  
Sub Saharan Africa ◽  
Modern Contraceptive ◽  
Contraceptive Methods ◽  
Childbearing Age ◽  
Republic Of Congo ◽  
Contraceptive Discontinuation ◽  
Sub Saharan

Abstract Background: Family planning (FP) is one of the main strategies to reduce maternal mortality in sub-Saharan Africa. However, only 8% of women use modern contraceptive methods in the Democratic Republic of Congo. It is estimated that at least 50% of women stop using Modern Contraceptive Methods (MCM) in sub-Saharan Africa. The objective of this study was to identify factors associated with MCM discontinuation in Kinshasa. Methods: A retrospective cohort study was conducted in Kinshasa from April through June 2019. Three hundred and eighty-seven women who attended 10 health facilities in 10 health zones of Kinshasa (one facility per health zone) were enrolled in the study. Predictors of modern contraceptive discontinuation were investigated, using Cox regression. Results: The proportion of MCM discontinuation was 21.4% (95% CI: 17.6-25.8); 60.2% for implants and 24.1% for contraceptive injections. Predictors for dicontinuation were: unemployement (Hz.R = 2.23; 95% CI: 1.35 - 3.70; p = 0.003); having no or only one child (Hz.R = 2.89; 95% CI : 1.43 - 5.85; p = 0.015); using a short-acting method (Hz.R = 4.61; 95% CI: 2.81 - 7.56; p <0.001); lack of sufficient explanations about MCM (Hz.R = 3.14; 95% CI: 1.93-5.11; p <0.001) and side effects (Hz.R = 2.93; 95% CI: 1.79 - 4.80; p = 0.001). Conclusion: MCM discontinuation was high among women in Kinshasa. While it is important to reinforce strategies to increase MCM uptake, it is also critical to increase its continuation.

scholarly journals Multilevel analysis of determinants of polygyny among married men in Ethiopia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yitayish Damtie ◽  
Bereket Kefale ◽  
Melaku Yalew ◽  
Mastewal Arefaynie ◽  
Bezawit Adane
Keyword(s):  
Logistic Regression ◽  
Formal Education ◽  
Sexual Debut ◽  
Statistical Significance ◽  
Secondary Analysis ◽  
The Body ◽  
Cluster Sampling ◽  
Sexually Transmitted ◽  
Body Of Knowledge ◽  
Married Men

Abstract Background Polygyny occurs when a man has more than one wife at the same time. It often contributes to poor health among family members, particularly young children. It encourages the spread of sexually transmitted infections (STIs) including HIV/AIDS. The determinants of polygyny have not yet been adequately explored in Ethiopia. This study adds to the body of knowledge concerning the prevalence and distribution of polygyny in the country. Methods This study is a secondary analysis of the 2016 Ethiopian Demographic and Health Survey (EDHS) data. Using a two-stage stratified cluster sampling, 7470 married men were selected. After verifying the assumptions of multilevel logistic regression analysis, Stata version 14.0 was used to analyse the data. A multilevel mixed-effects logistic regression model was used to identify predictors of polygyny. An adjusted odds ratio with a 95% confidence interval was used to measure the association. A p-value of < 0.05 was considered to indicate statistical significance. Results Age from 30 to 44 years [AOR = 5.78, 95% CI = (3.13, 10.7)], age from 45 to 59 years [AOR = 16.5, 95% CI = (8.59, 31.8)], men with primary education or no formal education [AOR = 3.40, 95% CI = (1.50, 7.69)], being Muslim [AOR = 2.47, 95% CI = (1.28, 4.77)], sexual initiation at or above the age of 18 years [AOR = 0.46, 95% CI = (0.30, 0.68)] and being from a less developed region of Ethiopia [AOR = 3.67, 95% CI = (2.30, 5.83)] were factors associated with polygyny. Conclusion Both individual and community level factors were identified as predictors of polygyny. Improving educational attainment and delaying men’s sexual debut could encourage the reduction of polygyny in Ethiopia.

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

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.

scholarly journals Trend and Determinants of Mortality Among Women of Reproductive Age: A Twelve-Year Open Cohort Study in Eastern Ethiopia

2021 ◽  
Vol 2 ◽  
Author(s):  
Merga Dheresa ◽  
Abera Kenay Tura ◽  
Gamachis Daraje ◽  
Mesfin Abebe ◽  
Tariku Dingeta ◽  
...  
Keyword(s):  
Low Income ◽  
Formal Education ◽  
Cox Regression ◽  
Well Being ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Rural Residents ◽  
Eastern Ethiopia ◽  
Cox Regression Analysis ◽  
Hiv Aids

Background: With only less than a decade left till 2030, it is essential to research the burden and trends of women of reproductive age (WRA) mortality in order to design appropriate interventions toward achieving goal three of the sustainable development goals (SDGs), good health and well-being. For several low-income countries, such data are often lacking or sometimes extrapolated from non-representative facility-based studies. In this paper, we presented trends, causes, and determinants of mortality among reproductive-age women under follow-up for 12 years through the Health and Demographic Surveillance System (HDSS) located in eastern Ethiopia.Methods: We used 12 years of (2008 to 2019) open cohort data of women aged 15–49 living in Kersa HDSS in Eastern Ethiopia. In the HDSS, data on socio-demographic and basic household conditions are recorded for every household member at enrollment, and data on vital events such as births, deaths, and migration were collected and updated biannually as the event happened. Mortality was determined by automated verbal autopsy (InterVA) algorism. We assessed trends in women's reproductive age mortality and the associated determinants using crude and adjusted Cox regression models.Results: In the 12-years cohort, we followed 74,790 women of reproductive age for 339,909.26 person-years-at-risk of observation (PYO), of whom 919 died. Overall, the standardized mortality rate was 270 per 100,000 PYO. There was a notable increase in mortality in the first 3 years (2009 to 2011) which then declined significantly (p = 0.0001) until 2019. Most of the deaths were caused by HIV/AIDS (27.88%) and pulmonary tuberculosis (10.62%). In the adjusted Cox regression analysis, the hazard of death was higher among rural residents (AHR, 2.03: 95% CI: 1.60–2.58), unemployed women (AHR, 1.50: 95% CI: 1.19–1.89), and women with no formal education (AHR, 1.24: 95% CI: 1.01–1.52).Conclusion: The study showed a high number of women of reproductive age are still dying mainly due to causes for which preventable strategies are known and have been successfully implemented. The study identified that the main causes of death were related to HIV/AIDS and tuberculosis, and there was a higher hazard of mortality among rural residents, unemployed women, and those with no formal education, who need effective implementation in achieving the SDG three.

scholarly journals Socioeconomic determinants of cumulative fertility in Ghana

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252519
Author(s):  
Samuel H. Nyarko
Keyword(s):  
Negative Binomial ◽  
Sexual Debut ◽  
Negative Binomial Regression ◽  
Household Wealth ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
Socioeconomic Disparities ◽  
Demographic And Health Surveys ◽  
Cumulative Fertility ◽  
Sub Saharan

The pace of decline in fertility rates in sub-Saharan Africa appears to have slowed or stalled in the last few decades. This study examines the socioeconomic associated with cumulative fertility in Ghana. Negative binomial regression models were used to estimate determinants of cumulative fertility using data from the Ghana Demographic and Health Surveys of 2003, 2008, and 2014. The composition of children ever born by women did not change considerably over the study periods. Socioeconomic disparities in educational attainment, household wealth, employment, and employer status are significantly associated with cumulative fertility risks in Ghana. The current age of women, age at sexual debut, and marital status, among others, are also linked to cumulative fertility levels. Place and region of residence are also linked to fertility in Ghana. Cumulative fertility levels in Ghana are underscored by considerable socioeconomic disparities among women of reproductive age. Fertility regulation policies should hinge on improving the socio-economic wellbeing of women in Ghana.

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