A mixed-methods study exploring women’s perceptions of terminology surrounding fertility and menstrual regulation in Côte d’Ivoire and Nigeria

Abstract Background Women use various terms when discussing the management of their fertility and menstrual irregularities and may interpret the experience of ending a possible pregnancy in nuanced ways, especially when their pregnancy status is ambiguous. Our study aims to understand the terminology used to refer to abortion-like experiences (specifically menstrual regulation and pregnancy removal), and the specific scenarios that these practices encompass among women who reported doing something to bring back a late period or ending a pregnancy in Nigeria and Côte d’Ivoire. Methods Our analysis draws upon surveys with women in Nigeria (n = 1114) and Cote d’Ivoire (n = 352). We also draw upon qualitative in-depth interviews with a subset of survey respondents in Anambra and Kaduna States in Nigeria, and Abidjan, Cote d’Ivoire (n = 30 in both countries). We examine survey and interview questions that explored women’s knowledge of terminology pertaining to ending a pregnancy or bringing back a late period. Survey data were analyzed descriptively and weighted, and interview data were analyzed using inductive thematic analysis. Results We find that the majority (71% in Nigeria and 70% in Côte d’Ivoire) of women perceive menstrual regulation to be a distinct concept from pregnancy removal, yet there is considerable variability in whether specific scenarios are interpreted as referring to menstrual regulation or pregnancy removal. Menstrual regulation is generally considered to be more ambiguous and not dependent on pregnancy confirmation in comparison to pregnancy removal, which is consistently interpreted as voluntary termination of pregnancy. Conclusions Overall, menstrual regulation and pregnancy removal are seen as distinct experiences in both settings. These findings have relevance for researchers aiming to document abortion incidence and experiences, and practitioners seeking to address women’s reproductive health needs.

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Les jeunes dans la rébellion du nord de la Côte d’Ivoire : les raisons de la mobilisation

Afrika Focus ◽

10.21825/af.v24i1.4995 ◽

2011 ◽

Vol 24 (1) ◽

Cited By ~ 1

Author(s):

Moussa Fofana

Keyword(s):

Political Violence ◽

Cote D'ivoire ◽

Côte D’Ivoire ◽

Cote D’Ivoire ◽

Security Forces ◽

Military Career ◽

The North ◽

Côte D'ivoire ◽

The Social ◽

Depth Interviews

The armed conflict that started on 19th September 2002 in Côte d’Ivoire has led to the temporary de facto separation of the country into two entities. The rebels of the “Forces Nouvelles” have control of the north while the “Loyalist” camp has retained control of the south. The “Forces Nouvelles” have justfied their actions against the regime by denouncing the social injustice and discrimination that Northerners are said to endure. Also substantial numbers of youths from the North joined the rebel force. This study is based on in depth interviews conducted with 22 of such youths and their leaders. It gives a thorough account of their reasons for enlistment and their perceptions of the conflict. The reasons can be categorized as follows: in the first instance, the fighters claim their right to be fully recognized as Ivorian citizens and to be given official ID cards. Many also express an unwillingness to tolerate the abuses the national security forces have perpetrated against them, alongside their desire for revenge; their search for protection or, in a more self-interested way, their desire to pursue a military career. The study also highlights the influence that parents and peers from the neighbourhood can have on the decision to enlist and specific Northern “national” discourse discriminated by the rebellion. In the end, far from carrying secessionist claims, the discourses we have recorded express frustration at the continuing exclusion of Northerners from participation in the state. Beyond individual cases, we hypothesize that rebelling has been a way for the youths to re-negotiate their sense of belonging to and in the Nation.Key words: Côte d'Ivoire, Forces Nouvelles, rébellion, political violence, violent engagement

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Social network-based measurement of abortion incidence: promising findings from population-based surveys in Nigeria, Cote d’Ivoire, and Rajasthan, India

Population Health Metrics ◽

10.1186/s12963-020-00235-y ◽

2020 ◽

Vol 18 (1) ◽

Author(s):

Suzanne O. Bell ◽

Mridula Shankar ◽

Elizabeth Omoluabi ◽

Anoop Khanna ◽

Hyacinthe Kouakou Andoh ◽

...

Keyword(s):

Social Network ◽

Cote D'ivoire ◽

Côte D’Ivoire ◽

Removal Rate ◽

Population Based ◽

Incidence Rates ◽

Reproductive Age ◽

Cote D’Ivoire ◽

Côte D'ivoire ◽

Abortion Incidence

Abstract Background Monitoring abortion rates is highly relevant for demographic and public health considerations, yet its reliable estimation is fraught with uncertainty due to lack of complete national health facility service statistics and bias in self-reported survey data. In this study, we aim to test the confidante methodology for estimating abortion incidence rates in Nigeria, Cote d’Ivoire, and Rajasthan, India, and develop methods to adjust for violations of assumptions. Methods In population-based surveys in each setting, female respondents of reproductive age reported separately on their two closest confidantes’ experience with abortion, in addition to reporting about their own experiences. We used descriptive analyses and design-based F tests to test for violations of method assumptions. Using post hoc analytical techniques, we corrected for biases in the confidante sample to improve the validity and precision of the abortion incidence estimates produced from these data. Results Results indicate incomplete transmission of confidante abortion knowledge, a biased confidante sample, but reduced social desirability bias when reporting on confidantes' abortion incidences once adjust for assumption violations. The extent to which the assumptions were met differed across the three contexts. The respondent 1-year pregnancy removal rate was 18.7 (95% confidence interval (CI) 14.9–22.5) abortions per 1000 women of reproductive age in Nigeria, 18.8 (95% CI 11.8–25.8) in Cote d’Ivoire, and 7.0 (95% CI 4.6–9.5) in India. The 1-year adjusted abortion incidence rates for the first confidantes were 35.1 (95% CI 31.1–39.1) in Nigeria, 31.5 (95% CI 24.8–38.1) in Cote d’Ivoire, and 15.2 (95% CI 6.1–24.4) in Rajasthan, India. Confidante two’s rates were closer to confidante one incidences than respondent incidences. The adjusted confidante one and two incidence estimates were significantly higher than respondent incidences in all three countries. Conclusions Findings suggest that the confidante approach may present an opportunity to address some abortion-related data deficiencies but require modeling approaches to correct for biases due to violations of social network-based method assumptions. The performance of these methodologies varied based on geographical and social context, indicating that performance may be better in settings where abortion is legally and socially restricted.

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A community-based healthcare package combining testing and prevention tools, including pre-exposure prophylaxis (PrEP), immediate HIV treatment, management of hepatitis B virus, and sexual and reproductive health (SRH), targeting female sex workers (FSWs) in Côte d’Ivoire: the ANRS 12381 PRINCESSE project

BMC Public Health ◽

10.1186/s12889-021-12235-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Valentine Becquet ◽

Marcellin Nouaman ◽

Mélanie Plazy ◽

Aline Agoua ◽

Clémence Zébago ◽

...

Keyword(s):

Hepatitis B ◽

Cote D'ivoire ◽

Sex Workers ◽

Côte D’Ivoire ◽

Community Based ◽

Cote D’Ivoire ◽

Côte D'ivoire ◽

Exposure Prophylaxis ◽

Depth Interviews

Abstract Background Pre-exposure prophylaxis (PrEP) is recommended by the WHO for HIV prevention among female sex workers (FSWs). A study conducted in 2016–2017 in Côte d’Ivoire showed that if PrEP is acceptable, FSWs also have many uncovered sexual health needs. Based on this evidence, the ANRS 12381 PRINCESSE project was developed in collaboration with a community-based organization. The main objective is to develop, document, and analyze a comprehensive sexual and reproductive healthcare package among FSWs in Côte d’Ivoire. Methods PRINCESSE is an open, single-arm interventional cohort of 500 FSWs in San Pedro (Côte d’Ivoire) and its surroundings. Recruitment started on November 26th, 2019 and is ongoing; the cohort is planned to last at least 30 months. The healthcare package (including HIV, hepatitis B, and sexually transmitted infection management, pregnancy screening, and contraception) is available both at mobile clinics organized for a quarterly follow-up (10 intervention sites, each site being visited every two weeks) and at a fixed clinic. Four waves of data collection were implemented: (i) clinical and safety data; (ii) socio-behavioral questionnaires; (iii) biological data; and (iv) in-depth interviews with female participants. Four additional waves of data collection are scheduled outside the cohort itself: (i) the medical and activity records of Aprosam for the PRINCESSE participants; (ii) the medical records of HIV+ FSW patients not participating in the PRINCESSE cohort, and routinely examined by Aprosam; (iii) in-depth interviews with key informants in the FSW community; and (iv) in-depth interviews with PRINCESSE follow-up actors. Discussion The PRINCESSE project is one of the first interventions offering HIV oral PrEP as part of a more global sexual healthcare package targeting both HIV- and HIV+ women. Second, STIs and viral hepatitis B care were offered to all participants, regardless of their willingness to use PrEP. Another innovation is the implementation of mobile clinics for chronic/quarterly care. In terms of research, PRINCESSE is a comprehensive, interdisciplinary project combining clinical, biological, epidemiological, and social specific objectives and outcomes to document the operational challenges of a multidisease program in real-life conditions. Trial registration The PRINCESSE project was registered on the Clinicaltrial.gov website (NCT03985085) on June 13, 2019.

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