scholarly journals Fertility transition in selected sub-Saharan African countries: the role of family planning programs

F1000Research ◽  
2020 ◽  
Vol 8 ◽  
pp. 1748
Author(s):  
Vincent Otieno ◽  
Alfred Agwanda ◽  
Anne Khasakhala
Keyword(s):  
Family Planning ◽  
Service Delivery ◽  
Fertility Transition ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
African Countries ◽  
Fertility Preferences ◽  
Fertility Preference ◽  
Current Fertility ◽  
Sub Saharan

Background: Change in fertility rate across societies is a complex process that involves changes in the demand for children, the diffusion of new attitudes about family planning and greater accessibility to contraception. Scholars have concentrated on a range of factors associated with fertility majorly at the national scale. However, considerably less attention has been paid to fertility preference - a pathway through which various variables act on fertility. It is understood that women have inherent fertility preferences which each they seek to achieve over her reproductive cycle. However, the service delivery enhancement levels and capacity across countries as integral pathways to this goal accomplishment stand on their way towards eventual outcomes. Precisely, the Sub-Saharan African countries’ disparities amid similarities in their population policies is a cause of concern. Methods: Using Bongaarts reformulation of Easterlin conceptual scheme of 1985 on DHS data, the understanding of the current fertility transition in general would provide explanations to the observed fertility dynamics. This study therefore is an attempt to explain the current fertility transition through women’s fertility preference. Results: Results reveal that fertility transition is diverse across sub-Saharan Africa; generally, on a decline course in most of the countries. The huge disparities in fertility preferences among women of reproductive age and its non-significant change in the implementation indices points at the service delivery performance underneath regarding the proportion of demand to family planning commodities satisfied. Service delivery indicators are integral to fertility preference achievement within households as well as a country’s overall positioning regarding fertility transition at the macroscale. Conclusions: It is therefore plausible to conclude that the improvement of service delivery in general; precisely touching on the availability and the uptake of quality birth control technologies is one of the most feasible means through which countries can fast track their fertility transitions.

scholarly journals Fertility transition in selected sub-Saharan African countries: the role of family planning programs

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 1748
Author(s):  
Vincent Otieno ◽  
Alfred Agwanda ◽  
Anne Khasakhala
Keyword(s):  
Family Planning ◽  
Fertility Transition ◽  
Unmet Need ◽  
Reproductive Age ◽  
African Countries ◽  
Fertility Preference ◽  
Family Planning Programs ◽  
Wide Range ◽  
Sub Saharan ◽  
Control Technologies

Background: Change in fertility rate across societies is a complex process that involves changes in the demand for children, the diffusion of new attitudes about family planning and greater accessibility to contraception provided by family planning programs. Among the neo-Malthusian adherents, it is believed that rapid population growth strain countries’ capacity and performance. Fertility has, however, decelerated in most countries in the recent past. Scholars have concentrated on wide range of factors associated with fertility majorly at the national scale. However, considerably less attention has been paid to the fertility preference - a pathway through which various variables act on fertility. The Sub-Saharan African countries’ disparities amid almost similarities in policies is a cause of concern to demographers. Methods: Using Bongaarts reformulation of Easterlin and Crimmins conceptual scheme of 1985 on Demographic and Health Survey Data (DHS) data collected overtime across countries, the understanding of the current transition in general would help to reassess and provide explanations to the observed latest fertility dynamics at play. This study therefore is an attempt to explain the current fertility transition through women’s fertility preference. Results: Results reveal that indeed fertility transition is diverse across countries though generally on a decline course in most of the sub-Saharan countries. The huge disparities in fertility preferences among women of reproductive age and its non-significant change in the implementation indices overtime points at the levels of unmet need to contraception underneath as well as the proportion of demand to family planning commodities satisfied by programs in a bid to allow women implement their fertility desires. Conclusions: It is therefore plausible to conclude that the improvement of the availability and the uptake of quality birth control technologies is one of the most feasible means through which countries can fast track their fertility transitions.

scholarly journals Trends in fertility preference implementation among selected Eastern African countries

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 79
Author(s):  
Vincent Otieno ◽  
Alfred Agwanda Otieno ◽  
Anne Khasakhala
Keyword(s):  
Family Planning ◽  
Fertility Decline ◽  
Fertility Transition ◽  
Reproductive Age ◽  
Policy Framework ◽  
African Countries ◽  
Fertility Preferences ◽  
Fertility Preference ◽  
Family Planning Programs ◽  
Substantial Decline

Background: There has been continuous debate among scholars regarding fertility transition in Africa. Two conclusions emerge: slow pace of decline because of weak facilitating social programs and high demand for large families amidst weak family planning programs. Accelerated fertility decline is expected to occur if there is both substantial decline in desired fertility and increased level of preference implementation. Despite these conclusions, there are also emergent exceptions in Africa, even among the Eastern African countries. Our motivation for the study of this region therefore lies in this context. First, the East African countries share some similarities in policy framework. Secondly, Rwanda and Kenya appear as exceptional in the drive towards accelerating further fertility decline. Fertility change therefore in any one country may have implications in the neighbouring country due to the commonalities especially in language, cultural traits, diffusion and spread new models of behaviour. Methods: With the utilization of DHS data, we analyse trends overtime in two specific features that scholars have indicated to slow or increase fertility decline. Using Bongaarts supply-demand framework, we first deduce trends in fertility preferences among women of reproductive age (15-49 years) and second, the extent to which women have been able to implement their fertility preferences during the course of fertility decline and subsequently decomposing these trends. Results: We found that with the rising aggregate of the degree of fertility preference implementation index, continuous declining trends in demand for births and subsequent increases in the contribution made by either or both the wanted fertility and the degree of fertility preference implementation index across categories that fertility transition is certainly on course in all countries albeit at different levels, thanks to the family planning. Conclusions: Family planning programs must therefore be accompanied by rigorous, consistent sensitization and public education.

scholarly journals Integrating Oral PrEP Into Family Planning Services for Women in Sub-saharan Africa: Findings From a Multi-Country Landscape Analysis

2021 ◽  
Vol 3 ◽  
Author(s):  
Neeraja Bhavaraju ◽  
Rose Wilcher ◽  
Regeru Njoroge Regeru ◽  
Saiqa Mullick ◽  
Imelda Mahaka ◽  
...  
Keyword(s):  
Family Planning ◽  
Service Delivery ◽  
Health Care Providers ◽  
Sub Saharan Africa ◽  
Management Service ◽  
Care Providers ◽  
Road Map ◽  
Sub Saharan ◽  
Exposure Prophylaxis ◽  
Oral Prep

Integration of HIV and family planning (FP) services is a renewed focus area for national policymakers, donors, and implementers in sub-Saharan Africa as a result of high HIV incidence among general-population women, especially adolescent girls and young women (AGYW), and the perception that integrating HIV pre-exposure prophylaxis (PrEP) into FP services may be an effective way to provide comprehensive HIV and FP services to this population. We conducted a focused desk review to develop a PrEP-FP integration framework across five key categories: plans and policies, resource management, service delivery, PrEP use, and monitoring and reporting. The framework was refined via interviews with 30 stakeholders across seven countries at varying stages of oral PrEP rollout: Kenya, Lesotho, Malawi, South Africa, Uganda, Zambia, and Zimbabwe. After refining the framework, we developed a PrEP-FP integration matrix and assessed country-specific progress to identify common enablers of and barriers to PrEP-FP integration. None of the countries included in our analysis had made substantial progress toward integrated PrEP-FP service delivery. Although the countries made progress in one or two categories, integration was often impeded by lack of advancement in other areas. Our framework offers policymakers, program implementers, and health care providers a road map for strategically assessing and monitoring progress toward PrEP-FP integration in their contexts.

5. HIV AND WOMEN: THE AFRICAN EXPERIENCE

Sexual Health ◽  
2007 ◽  
Vol 4 (4) ◽  
pp. 286
Author(s):  
D. A. Lewis
Keyword(s):  
South Africa ◽  
Cervical Screening ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
Hormonal Contraceptives ◽  
First Line ◽  
African Countries ◽  
Incidence Studies ◽  
Seroprevalence Data ◽  
Sub Saharan

Africa as a continent has been devastated by the acquired immunodeficiency syndrome epidemic caused by the human immunodeficiency virus (HIV). Women are more likely to acquire HIV/AIDS for a number of reasons and incidence studies show that younger women are particularly at risk of HIV acquisition. Biologically, they are more vulnerable and the acquisition of HIV can be influenced by hormonal contraceptives as well as sexually transmitted infections, which are often more asymptomatic than is the case for men. Women in Africa are also more vulnerable because of cultural issues; in some countries polygamy is accepted practice. Women are often economically disadvantaged and disempowered. It is often hard for them to insist on the use of condoms with husbands and regular partners. Physical and sexual abuse of women, including rape, remains a major problem on the continent, particularly in times of civil war. Many women are forced to work as sex workers or be involved in transactional sex in order to survive. Most countries rely on anonymous antenatal surveys to generate HIV seroprevalence data for women of reproductive age. These data is often used as surrogate markers for HIV prevalence rates in men of a similar age. The seroprevalence of HIV among pregnant women differs remarkably around the continent, with the highest rates being seen in Southern Africa, as high as 30%, and much lower rates being seen in West Africa. These reasons underlying these differences are complex and not completely understood. UNAIDS estimated in 2005 that 470�000 (87%) of the world's 540�000 newly infected children (<15 years old) reside in Sub-Saharan Africa. Prevention of mother to child transmission (PMTCT) of HIV is thus a national priority in many Sub-Saharan African countries. Despite policies, treatment is sometimes not given at the clinic level for several reasons, and when it is, most commonly it is with single dose Nevirapine. Data from South Africa has shown that both mothers and infected babies rapidly acquire nevirapine resistance. It is likely that this will lead to early failure of first line antiretroviral (ARV) therapy among these mothers once they start their ARVs. In South Africa, for example, either efavirenz or nevirapine form the backbone of the first-line ARV regimens. AIDS defining illnesses (ADIs) in women living in Africa are similar to those observed in men. Tuberculosis is the most common ADI but other life-threatening illnesses such as cryptococcal meningitis are relatively common compared to other parts of the world. Cervical cancer and cervical intra-epithelial neoplasia (CIN) lesions are more common in HIV-infected than in non-infected women. Most countries in Africa do not have cervical screening programmes and, even in richer countries such as South Africa, the national policy is to screen women three times in their life at 30, 40 and 50 years of age. Many HIV specialist centres, with additional donor funds, are now attempting to perform annual cervical screening, at least in South Africa.

scholarly journals Unmet Need For Family Planning Among Married Women In Sub-Sahara Africa: A Meta-Analysis of DHS Data (1995 – 2020)

2021 ◽  
Author(s):  
Million Phiri ◽  
Clifford Odimegwu ◽  
Chester Kalinda
Keyword(s):  
Family Planning ◽  
Unmet Needs ◽  
Unmet Need ◽  
Central Africa ◽  
Married Women ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Women Of Reproductive Age ◽  
Sub Saharan

Abstract Background: Closing the gap of unmet needs for family planning (FP) in sub-Saharan Africa remains critical in improving maternal and child health outcomes. Determining the prevalence of unmet needs for family planning among married women in the reproductive age is vital for designing effective sexual reproductive health interventions and programmes. Here, we use nationally representative data drawn from sub-Saharan countries to estimate and examine heterogeneity of unmet needs for family planning among currently married women of reproductive age. Methods: This study used secondary data from Demographic and Health Surveys (DHS) conducted between January 1, 1995 to December 31, 2020 from 37 countries in sub-Saharan African. An Inverse Heterogeneity model (IVhet) in MetaXL application was used to estimate country and sub-regional level pooled estimates and confidence intervals of unmet needs for FP in SSA. Results: The overall prevalence of unmet need for family planning among married women of reproductive age in the sub-region for the period under study was 22.9% (95% CI: 20.9–25.0). The prevalence varied across countries from 10% (95% CI: 10–11%) in Zimbabwe to 38% (95% CI: 35–40) and 38 (95% CI: 37–39) (I2 = 99.8% and p-value < 0.0001) in Sao Tome and Principe and Angola, respectively. Unmet needs due to limiting ranged from 6%; (95% CI: 3–9) in Central Africa to 9%; (95% CI: 8–11) in East Africa. On the other hand, the prevalence of unmet needs due to spacing was highest in Central Africa (Prev: 18; 95% CI: 16–21) and lowest in Southern Africa (Prev: 12%; 95% CI: 8–16). Our study indicates that there was no publication bias because the Luis Furuya-Kanamori index (0.79) was within the symmetry range of -1 and +1. Conclusion: The prevalence of unmet need for FP remains high in sub-Saharan Africa suggesting the need for health policymakers to consider re-evaluating the current SRH policies and programmes with the view of redesigning the present successful strategies to address the problem.

scholarly journals Safer sex negotiation and parity among women in sub-Saharan Africa

2022 ◽  
pp. 1-13
Author(s):  
Collins Adu ◽  
James Boadu Frimpong ◽  
Aliu Mohammed ◽  
Justice Kanor Tetteh ◽  
Eugene Budu ◽  
...  
Keyword(s):  
Safer Sex ◽  
Household Head ◽  
Wealth Quintile ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
African Countries ◽  
High Parity ◽  
Significance Level ◽  
Sub Saharan

Abstract Women’s ability to negotiate for safer sex has effects on their sexual and reproductive health. This study investigated the association between safer sex negotiation and parity among women in sub-Saharan Africa. The data were sourced from the Demographic and Health Surveys of 28 sub-Saharan African countries conducted from 2010 to 2019. A total of 215,397 women aged 15–49 were included in the study. Multilevel logistic analysis was conducted to examine the association between safer sex negotiation and parity among women in sub-Saharan Africa. The results were presented as adjusted odds ratios (aOR) and the significance level set at p<0.05. The overall prevalences of safer sex negotiation and high parity among women in sub-Saharan Africa were 82.7% and 52.1%, respectively. The prevalence of high parity ranged from 32.3% in Chad to 72.1% in Lesotho. The lowest prevalence of safer sex negotiation was in Chad (16.8%) while the highest prevalence was recorded in Rwanda (99.7%). Women who had the capacity to negotiate for safer sex were less likely to have high parity compared with those who had no capacity to negotiate for safer sex (aOR = 0.78, CI: 0.75–0.81). Other factors that were associated with high parity were age, educational level, marital status, exposure to media, contraceptive use, religion, wealth quintile, sex of household head, and place of residence. The study identified significant association between safer sex negotiation and high parity among women of reproductive age in sub-Saharan Africa. It is worth noting that women’s ability to negotiate for safer sex could reduce high parity among women in sub-Saharan Africa. Therefore, policies and programmes aimed at birth control or reducing high parity among women could be targeted at improving their capacity to negotiate for safer sex through education.

scholarly journals Improving Utilisation and awareness of Family Planning services in Adults of Reproductive age through Community Sensitization in Police Wing Village, Jinja District.

2021 ◽  
Author(s):  
◽  
Rodgers Isiko
Keyword(s):  
Family Planning ◽  
Contraceptive Use ◽  
Unmet Need ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
Project Implementation ◽  
Number Of Children ◽  
Planning Methods ◽  
Sub Saharan ◽  
Family Planning Methods

Background Family planning refers to a conscious effort by a couple to space the number of children they have through the use of contraceptive methods. According to WHO, an estimated 225 million women in developing countries, 24.2% of women of reproductive age have an unmet need for contraception. However, contraceptive use in sub-Saharan Africa is low at only 21%. The total fertility rate remains high for many countries in the region (4.6 in Kenya and Rwanda, 5.4 in Tanzania, 6.2 in Uganda, and 6.4 for Burundi). Methodology This was a community-based project implementation on increasing awareness and utilization of family planning methods in Police Wing village, Jinja district. Consent was gotten from the VHT, LC1, and DHO before mobilizing people to gather at the VHT’s home and her neighbour’s compound where we carried out the different educational sessions. Different team members got different roles to play as regards the health education session. One week later, we evaluated the progress of our project implementation through the administration of questionnaires to the same people we health educated. The questionnaire assessed the level of utilization, awareness, myths, misconception, and demography of the participants. Results 28% had heard about at least three family planning methods and 24.1% had at one time used family planning while 75.9% of the participants admitted not to have used it. The post-session assessment showed an increase from 28% to 93% in knowledge regarding the available methods of FP and an increase in the utilization of FP from 28% to 42%.   Conclusion and recommendations Addressing the myths and misconceptions about FP by exposing them as a fallacy would help increase the uptake as evidenced by the will of the community to take up the different methods. Organize frequent health talks about FP in the community.

scholarly journals Prevalence and determinants of breast cancer screening in four sub-Saharan African countries: a population-based study

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e039464
Author(s):  
Djibril M Ba ◽  
Paddy Ssentongo ◽  
Edeanya Agbese ◽  
Yanxu Yang ◽  
Ramata Cisse ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Health Insurance ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Insurance Coverage ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
African Countries ◽  
Factors Associated ◽  
Sub Saharan

ObjectivesBreast cancer is the most prevalent cancer and the second leading cause of cancer-related deaths among women after cervical cancer in much of sub-Saharan Africa. This study aims to examine the prevalence and sociodemographic–socioeconomic factors associated with breast cancer screening among women of reproductive age in sub-Saharan Africa.DesignA weighted population-based cross-sectional study using Demographic and Health Surveys (DHS) data. We used all available data on breast cancer screening from the DHS for four sub-Saharan African countries (Burkina Faso, Ivory Coast, Kenya and Namibia). Breast cancer screening was the outcome of interest for this study. Multivariable Poisson regression was used to identify independent factors associated with breast cancer screening.SettingFour countries participating in the DHS from 2010 to 2014 with data on breast cancer screening.ParticipantsWomen of reproductive age 15–49 years (N=39 646).ResultsThe overall prevalence of breast cancer screening was only 12.9% during the study period, ranging from 5.2% in Ivory Coast to 23.1% in Namibia. Factors associated with breast cancer screening were secondary/higher education with adjusted prevalence ratio (adjusted PR)=2.33 (95% CI: 2.05 to 2.66) compared with no education; older participants, 35–49 years (adjusted PR=1.73, 95% CI : 1.56 to 1.91) compared with younger participants 15–24 years; health insurance coverage (adjusted PR=1.57, 95% CI: 1.47 to 1.68) compared with those with no health insurance and highest socioeconomic status (adjusted PR=1.33, 95% CI : 1.19 to 1.49) compared with lowest socioeconomic status.ConclusionDespite high breast cancer mortality rates in sub-Saharan Africa, the prevalence of breast cancer screening is substantially low and varies gradually across countries and in relation to factors such as education, age, health insurance coverage and household wealth index level. These results highlight the need for increased efforts to improve the uptake of breast cancer screening in sub-Saharan Africa.

scholarly journals Factors associated with decision making power of women to use family planning among married women in sub-Saharan Africa: A multilevel analysis of demographic health surveys

2021 ◽  
Author(s):  
Getu Debalkie Demissie ◽  
Yonas Akalu ◽  
Abebaw Addis Gelagay ◽  
Wallelign Alemnew ◽  
Yigizie Yeshaw
Keyword(s):  
Decision Making ◽  
Family Planning ◽  
Media Exposure ◽  
Wealth Index ◽  
Married Women ◽  
Sub Saharan Africa ◽  
Fertility Preference ◽  
Factors Associated ◽  
Contraceptive Usage ◽  
Sub Saharan

Abstract Background: In sub-Saharan Africa there are several socio-economic and cultural factors which affect women’s ability to make decision regarding their own health including contraceptive usage. The main aim of this study was to determine factors associated with decision making power of women to use family planning in sub-Saharan Africa.Methods: The appended, most recent demographic and health survey datasets of 35 sub-Saharan countries were used. A total weighted sample of 83,882 women were included in the study. Both bivariable and multivariable multilevel logistic regression were done to determine the associated factors of decision making power of women to use family planning in SSA. The Odds Ratio (OR) with a 95% Confidence Interval (CI) was calculated for those potential variables included in the final model. Results: Those married women with primary education (AOR=1.24; CI:1.16,1.32),secondary education (AOR=1.31; CI:1.22,1.41), higher education (AOR=1.36; CI:1.20,1.53),media exposure(AOR=1.08; CI: 1.03, 1.13), currently working (AOR=1.27; CI: 1.20, 1.33), antenatal care visit of 1-3 (AOR=1.12; CI:1.05,1.20) and ≥ 4 ANC visit (AOR=1.14;CI:1.07,1.21), women who were informed about family planning (AOR=1.09; CI: 1.04, 1.15), women who had less than 3 children(AOR=1.12; CI: 1.02, 1.23) and 3-5 children (AOR=1.08; CI: 1.01, 1.16) had higher odds of decision making power to use family planning than their counter parts. Besides, mothers with age of 15-19 (AOR=0.61; CI: 0.52, 0.72), 20-24 (AOR= 0.69; CI: 0.60, 0.79), 25-29 (AOR=0.74; CI: 0.66, 0.84), and 30-34 years (AOR=0.82; CI: 0.73, 0.92) had reduced chance of decision making power of women to use family planning. Conclusion: Age, women’s level of education, occupation of women and their husband, wealth index, media exposure, ANC visit, fertility preference, husband’s desire number of children, region and information about family planning were factors associated with decision making power to use family planning among married women.

The Potential for Social Marketing a Knowledge-Based Family Planning Method

2012 ◽  
Vol 18 (2) ◽  
pp. 152-166 ◽  
Author(s):  
Justine Kavle ◽  
Maxine Eber ◽  
Rebecka Lundgren
Keyword(s):  
Family Planning ◽  
Social Marketing ◽  
Contraceptive Use ◽  
Sub Saharan Africa ◽  
African Countries ◽  
Developed Country ◽  
Health Related ◽  
Sub Saharan ◽  
Marketing Information ◽  
The Impact

Social marketing is a proven private sector strategy to provide health-related products, including contraceptives. Pharmacies offer affordable, convenient, and rapid delivery of over-the-counter contraceptives directly to the consumer, providing wider availability and accessibility to family planning (FP) in sub-Saharan Africa. Pilot projects tested the feasibility of including CycleBeads®, the visual tool that supports the use of the Standard Days Method®, into Population Services International (PSI) social marketing programs. The purpose of this article is to review evidence to provide guidance for social marketing CycleBeads in pharmacies in sub-Saharan Africa. Literature on contraceptive provision through pharmacies in comparison to clinics was summarized from developing and developed country contexts, highlighting salient and relevant lessons for the African context in regard to pharmacists’ knowledge and perceptions of FP, clients’ perceptions of pharmacists’ FP knowledge and FP service delivery in pharmacies, and the impact of pharmacy access on contraceptive use. Descriptive data from PSI social marketing initiatives in several African countries, and commercial marketing information were reviewed. Evidence from CycleBeads sales suggests that there is demand for the product and it is affordable in comparison to oral contraceptives. In addition, there were high levels of correct use by women who purchased CycleBeads in pharmacies, suggesting that CycleBeads are an appropriate product for social marketing. Until awareness of and demand for the method increases, social marketing of CycleBeads requires continued subsidy to maintain viability. Training to update pharmacists’ knowledge and increase capacity to provide basic information, positioning of the method, and low profit margins for pharmacies present challenges.

Sign in / Sign up

Export Citation Format

Share Document