scholarly journals From Unsafe to Safe Abortion in Sub-Saharan Africa: Slow but Steady Progress

2020 ◽  
Author(s):  
Akinrinola Bankole ◽  
Lisa Remez ◽  
Onikepe Owolabi ◽  
Jesse Philbin ◽  
Patrice Williams
Keyword(s):  
Sexual And Reproductive Health ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
Women Of Reproductive Age ◽  
Safe Abortion ◽  
Unintended Pregnancies ◽  
Postabortion Care ◽  
Sub Saharan ◽  
Comprehensive Compilation ◽  
Legal Grounds

This report represents the first comprehensive compilation of information about abortion in Sub-Saharan Africa and its four subregions. It offers a panorama of this hard-to-measure practice by assembling data on the incidence and safety of abortion, the extent to which the region’s laws restrict abortion, and how these laws have changed between 2000 and 2019. Many countries in this region have incrementally broadened the legal grounds for abortion, improved the safety of abortions, and increased the quality and reach of postabortion care. There is still much progress to be made, however, including enabling the region’s women to avoid unintended pregnancies and unsafe abortions. The report concludes with recommendations for a broad range of actors to improve the sexual and reproductive health and autonomy of the region’s 255 million women of reproductive age.

scholarly journals Cross-country Comparison of Dietary Patterns and Obesity Among Women of Reproductive Age in Urban Sub-Saharan Africa (P10-069-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Lilia Bliznashka ◽  
Günther Fink ◽  
Valerie Flax ◽  
Chrissie Thakwalakwa ◽  
Lindsay Jaacks
Keyword(s):  
Higher Education ◽  
Dietary Patterns ◽  
Overweight And Obesity ◽  
Reproductive Age ◽  
Leafy Vegetables ◽  
Sub Saharan Africa ◽  
Specific Information ◽  
Women Of Reproductive Age ◽  
High Intake ◽  
Sub Saharan

Abstract Objectives Obesity is an increasing problem among women of reproductive age (WRA) in urban sub-Saharan Africa (SSA), yet population-specific information on dietary risk factors is limited. The objective of this study was to derive dietary patterns (DPs) among WRAs in urban SSA and to examine their association with overweight and obesity. Methods We used baseline data from two prospective studies conducted among WRAs in Accra, Ghana (n = 2307, year = 2008–9) and Lilongwe, Malawi (n = 103, year = 2017–18). Diet was assessed using locally adapted food frequency questionnaires. Overweight was defined as body mass index (BMI) ≥25 kg/m2 and BMI <30 kg/m2, and obesity as BMI ≥30 kg/m2. DPs were derived using principal components analysis, and their association with overweight and obesity was assessed using generalized linear models controlling for age, education and wealth. Socio-demographic characteristics were examined across ordered DP quartiles/quintiles using a non-parametric test for trends (significance: P < 0.05). Results Two DPs were identified in both Ghana and Malawi, explaining 34% and 42% of dietary variance, respectively. In both samples, a protein DP was identified characterized by high intake of cereals, pulses, eggs, meat and poultry in Ghana and dairy, eggs, poultry, fats and sugar-sweetened beverages in Malawi. In addition, a healthy DP in Ghana showed high intake of fruit, nuts and dark green leafy vegetables, and a modern DP in Malawi showed high intake of sweets, processed foods, tubers, nuts and fruit. In both countries, higher education and wealth were associated with higher protein, healthy and modern DPs. In Ghana, higher protein DP was also associated with lower age and lower prevalence of underweight. DPs were not significantly (all P > 0.05) associated with overweight or obesity in either Ghana or Malawi. Conclusions Healthy and protein DPs characterized diets of urban WRA in Ghana, and protein and modern DPs in Malawi. Higher education and wealth were associated with higher DP quartiles/quintiles in both samples. The healthy DP in Ghana may reflect an earlier stage of the nutrition transition compared to the modern DP in Malawi (data collected ten years apart), or different food cultures and food varieties in the two countries. Further research is needed to understand the lack of association between DPs and obesity among urban WRAs in SSA. Funding Sources None. Supporting Tables, Images and/or Graphs

Non-iodized salt consumption among women of reproductive age in sub-Saharan Africa: a population-based study

2020 ◽  
Vol 23 (15) ◽  
pp. 2759-2769
Author(s):  
Djibril M Ba ◽  
Paddy Ssentongo ◽  
Duanping Liao ◽  
Ping Du ◽  
Kristen H Kjerulff
Keyword(s):  
Logistic Regression ◽  
Iodized Salt ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Women Of Reproductive Age ◽  
Cross Sectional ◽  
Factors Associated ◽  
Multivariable Logistic Regression ◽  
Sub Saharan

AbstractObjective:To identify countries in sub-Saharan Africa (SSA) that have not yet achieved at least 90 % universal salt iodization and factors associated with the consumption of non-iodized salt among women of reproductive age.Design:A cross-sectional study using data from Demographic and Health Surveys (DHS). The presence of iodine in household salt (iodized or non-iodized), which was tested during the survey process, was the study outcome. Multivariable logistic regression models were used to determine independent factors associated with the consumption of non-iodized salt among women of reproductive age.Setting:There were eleven countries in SSA that participated in the DHS since 2015 and measured the presence of iodine in household salt.Participants:Women (n 108 318) aged 15–49 years.Results:Countries with the highest rate of non-iodized salt were Senegal (29·5 %) followed by Tanzania (21·3 %), Ethiopia (14·0 %), Malawi (11·6 %) and Angola (10·8 %). The rate of non-iodized salt was less than 1 % in Rwanda (0·3 %), Uganda (0·5 %) and Burundi (0·8 %). Stepwise multivariable logistic regression showed that women were more likely to be using non-iodized salt (adjusted OR; 95 % CI) if they were poor (1·62; 1·48, 1·78), pregnant (1·16; 1·04, 1·29), aged 15–24 years (v. older: 1·14; 1·04, 1·24) and were not literate (1·14; 1·06, 1·23).Conclusions:The use of non-iodized salt varies among SSA countries. The higher level of use of non-iodized salt among poor, young women and pregnant women is particularly concerning.

scholarly journals The epidemiological landscape of anemia in women of reproductive age in sub-Saharan Africa

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Esteban Correa-Agudelo ◽  
Hae-Young Kim ◽  
Godfrey N. Musuka ◽  
Zindoga Mukandavire ◽  
F. DeWolfe Miller ◽  
...  
Keyword(s):  
Spatial Distribution ◽  
Low Income ◽  
Malaria Incidence ◽  
Positive Association ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Women Of Reproductive Age ◽  
Increased Risk ◽  
Sub Saharan

AbstractThe role of geographical disparities of health-related risk factors with anemia are poorly documented for women of reproductive age in sub-Saharan Africa (SSA). We aimed to determine the contribution of potential factors and to identify areas at higher risk of anemia for women in reproductive age in SSA. Our study population comprised 27 nationally representative samples of women of reproductive age (15–49) who were enrolled in the Demographic and Health Surveys and conducted between 2010 and 2019 in SSA. Overall, we found a positive association between being anemic and the ecological exposure to malaria incidence [adjusted odds ratio (AOR) = 1.02, 95% confidence interval (CI) 1.02–1.02], and HIV prevalence (AOR = 1.01, CI 1.01–1.02). Women currently pregnant or under deworming medication for the last birth had 31% (AOR = 1.31, CI 1.24–1.39) and 5% (AOR = 1.05, CI 1.01–1.10) higher odds of having anemia, respectively. Similarly, women age 25–34 years old with low education, low income and living in urban settings had higher odds of having anemia. In addition, underweight women had 23% higher odds of suffering anemia (AOR = 1.23, CI 1.15–1.31). Females with low levels of education and wealth index were consistently associated with anemia across SSA. Spatial distribution shows increased risk of anemia in Central and Western Africa. Knowledge about the contribution of known major drivers and the spatial distribution of anemia risk can mitigate operational constraints and help to design geographically targeted intervention programs in SSA.

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 Prevalence and determinants of cervical cancer awareness among women of reproductive age: evidence from Benin and Zimbabwe population-based data

2020 ◽  
Vol 40 (1) ◽  
Author(s):  
Amadou Barrow ◽  
Adeyinka Onikan ◽  
Chimezie Igwegbe Nzoputam ◽  
Michael Ekholuenetale
Keyword(s):  
Cervical Cancer ◽  
Health Survey ◽  
Household Wealth ◽  
Population Based ◽  
Demographic And Health Survey ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
Women Of Reproductive Age ◽  
Incidence And Mortality ◽  
Sub Saharan

Abstract Background Cervical cancer is a prominently diagnosed form of cancer in several resource-constrained settings particularly within the sub-Saharan African region. Globally, Africa region has the highest incidence and mortality rates of cervical cancer. The high prevalence has been attributed to several factors including lack of awareness of the disease. The aim of this paper is to explore the prevalence and factors associated with awareness of cervical cancer among women of reproductive age in Republic of Benin and Zimbabwe, sub-Saharan Africa. Methods We used population-based cross-sectional data from Benin Demographic and Health Survey (BDHS) and Zimbabwe Demographic and Health Survey (ZDHS) respectively. BDHS 2017–18 and ZDHS - 2015 are the 5th and 6th rounds of the surveys respectively. About 15,928 and 9955 women aged 15–49 years were included in this study respectively. The awareness of cervical cancer among women of reproductive age in Benin and Zimbabwe was measured dichotomously; yes (if a woman heard of cervical cancer) vs. no (if a woman has not heard of cervical cancer). All significant variables from the bivariate analysis were included in the multivariable logistic regression model to calculate the adjusted odds ratios (AOR) with corresponding 95% confidence interval. Results While majority (79.2%) of women from Zimbabwe have heard about cervical cancer, only about one-tenth (10.2%) of their Beninese counterparts have heard about the disease. Advanced maternal age, having formal education, use of internet, having professional/technical/managerial occupation significantly increased the odds of awareness of cervical cancer after adjusting for other confounders. However, in Benin, women who resided in the rural area and those of Islamic belief had 20% (AOR = 0.80; 95%CI: 0.64, 0.99) and 35% (AOR = 0.65; 95%CI: 0.50, 0.86) reduction in the odds of awareness of cervical cancer respectively, when compared with women from urban residence and Christianity. Results from the predictive marginal effects showed that, assuming the distribution of all factors remained the same among women, but every woman is an urban dweller, we would expect 11.0 and 81.0% level of awareness of cervical cancer; If everywoman had higher education, we would expect 20.0 and 90% level of awareness of cervical cancer and if instead the distribution of other maternal factors were as observed and other covariates remained the same among women, but all women were in the richest household wealth quintile, we would expect about 11.0 and 83.0% level of awareness of cervical cancer, among women of reproductive age from Benin and Zimbabwe respectively. Conclusion The study has revealed that socio-demographical factors including geographical location and selected economic factors explained the inequality in distribution of women’s awareness on cervical cancer in both countries. Designing an effective population-based health education and promotion intervention programs on cervical cancer will be a great way forward to improving women’s awareness level on cervical cancer.

scholarly journals Understanding ‘missed appointments’ for pills and injectables: a mixed methods study in Senegal

2018 ◽  
Vol 3 (6) ◽  
pp. e000975
Author(s):  
Francesca L Cavallaro ◽  
Diane Duclos ◽  
Jenny A Cresswell ◽  
Sylvain Faye ◽  
David Macleod ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Mixed Methods Study ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
Missed Appointments ◽  
Data Set ◽  
Unintended Pregnancies ◽  
Effective Interventions ◽  
Sub Saharan ◽  
Islamic Faith

IntroductionHigh discontinuation rates of contraceptive methods have been documented in sub-Saharan Africa. However, little is known about gaps within individual episodes of method use, despite their implications for unintended pregnancies. The objective of this mixed methods study was to examine the prevalence of, and explore the factors contributing to, delays in repeat appointments for pills and injectables in Senegal.MethodsFirst, we constructed a longitudinal data set of women’s contraceptive consultations using routine records from 67 facilities in Senegal. Consultations for pills and injectables were classified as on time, delayed or with unknown delay status based on time since previous appointment. We described the prevalence of delayed appointments and used backward stepwise regression to build a mixed-effects model to investigate risk factors for delay. Second, we conducted workshops with family planning (FP) providers, and indepth interviews and focus group discussions with women of reproductive age, to explore factors contributing to delays.ResultsAlmost one-third (30%) of appointments for pills and injectables were delayed, resulting in risk of pregnancy. Previous delay, pill use, lower educational level, higher parity, third and subsequent visits, and Islamic faith were independently predictive of delays (p<0.04 for all). Although women’s ‘forgetfulness’ was initially mentioned as the main reason for delays by women and providers, examining the routines around appointment attendance revealed broader contextual barriers to timely refills—particularly widespread covert use, illiteracy, financial cost of FP services and limited availability of FP services.ConclusionDelays in obtaining repeat pills and injections are common among contraceptive users in Senegal, exposing women to unintended pregnancies. Strategies to reduce such delays should move beyond a narrow focus on individual women to consider contraceptive behaviour within the broader socioeconomic and health systems context. In particular, effective interventions addressing low acceptability of contraception and appointment reminder strategies in high illiteracy contexts are needed.

scholarly journals Coverage and Determinants of Modern Contraceptive Use in Sub-saharan Africa: Further Analysis of Demographic and Health Surveys

2021 ◽  
Author(s):  
Isaac Boadu
Keyword(s):  
Family Planning ◽  
Contraceptive Use ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Modern Contraceptive ◽  
Women Of Reproductive Age ◽  
Modern Contraceptives ◽  
Modern Contraceptive Use ◽  
Sub Saharan

Abstract Background: The use of modern contraceptives (MC) in most African countries has been low despite the high fertility rate and unmet need for family planning. This study sought to determine the coverage and determinants of modern contraceptive use among women of reproductive age in Sub-Saharan Africa (SSA). Methods: Data for the study was obtained from the latest Demographic and Health Surveys (DHS) conducted between 1995-2020 across 37 SSA countries. Women of reproductive age (15-19 years) was the unit of analysis. Analyses of data was done using STATA version 16 for windows. A bivariate Rao Scott’s chi-square test of independence was done to determine factors associated with the use of modern contraceptives. Factors that showed significance (p<0.05) were included in a multilevel logistic regression to determine significant predictors of modern contraceptives. Clustering, stratification and sample weighting were accounted for in the analyses. Results: The overall prevalence of the use of MC was found to be 22.0%. This ranged from 3.5% in the Central Africa Republic to 49.7% in Namibia. The most common type of contraceptives used were injections (39.4%), condoms (17.5%) and implants (26.5%). Women were less likely to use contraceptive if they: had no education (aOR = 0.4, 95% CI: 0.38-0.44), had no children (aOR=0.27-0.42), not told of family planning at a health facility (aOR = 0.69, 95% CI: 0.67-0.71), not heard of family planning in the media (aOR = 0.77, 95% CI: 0.74-0.79) and being poor (aOR=0.76, 95%CI: 0.73-0.79). On the other hand, women were more likely to use modern contraceptive if they were between the age of 35-39 years (aOR=1.69, 95%CI: 0.73-0.79), married (aOR=2.66, 95%CI: 2.50-2.83), had seven or more children (aOR=1.27, 95%CI:1.17-0.38), had knowledge of any method of contraceptives (aOR=303.8, 95%CI: 89.9-1027.5) and when field worker visited and talked about family planning (aOR=1.53, 95%CI: 1.39-0.68).Conclusion: The study showed a low prevalence of modern contraceptive use in Sub-Sahara Africa. Findings from the study highlight the need to provide education to women to increase uptake of contraceptive use and also re-enforce contraceptive interventions to improve women’s health and well-being.

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