scholarly journals “Counting those never bubble over” Estimated prevalence and its determinants of obstetric fistula among childbearing women in 14 African countries: Multilevel Analysis

2021 ◽  
Author(s):  
Melsew Setegn Alie
Keyword(s):  
Multilevel Analysis ◽  
Formal Education ◽  
Obstetric Fistula ◽  
Household Head ◽  
Obstetric Care ◽  
Educational Status ◽  
Information Criteria ◽  
Age At First Birth ◽  
First Birth ◽  
African Countries

Abstract Background Obstetric fistula is a leakage between genital tract and urinary tract and/or between genital tract and rectum. The commonest cause of obstetric fistula is prolonged labour which magnify in the areas of poor prenatal and emergency obstetric care. In Africa, there is poor of quality of obstetric care and poor social support for those who faced fistula. Obstetric fistula shatters the life of the women and the consequence is nasty while multicounty level estimate on the magnitude and determinates of fistula were nil. Multicounty level of estimate of the magnitude of fistula is important to design and fill the gaps of quality of obstetric care and design the appropriate corrective intervention mechanisms of obstetric fistula. Therefore, this study aimed the estimate the magnitude of obstetric fistula and its determinants among childbearing women in 14 Africa countries based on recent demographic and health survey data. Methods Secondary data were used from 14 African demographic and health survey database. The data were extracted based on the objective the study and previous literatures. Data were weighted using sampling weight before any statistical analysis to account the sampling design. STATA version 15 was used for extracting, recoding, and for further multilevel analysis. The appropriateness of multilevel analysis were checked by Median odds ratio (MOR), proportional change in Variance (PCV), Intraclass correlation coefficient (ICC), and Akaike Information Criteria (AIC). Four model was build and the best model was selected based on the smallest Akaike Information Criteria (AIC). Both bivariable and multivariable multilevel analysis was done accordingly. Variables with p-value ≤0.05 declared as statistical significant with outcome variable for the study. The adjusted odds ratio with 95% confidence interval was used as measure of association. Results The magnitude of obstetric fistula was 0.84 [95%CI: 0.79, 0.88]. Maternal age >=41 years [AOR=1.38; 95% CI:1.01,1.93], urban residence [AOR=0.69; 95%CI: 0.53,0.89], women who attended secondary education [AOR=0.59; 95% CI: 0.45,0.77], women who attended higher education [AOR=0.40; 95% CI: 0.25,0.65], female household head [AOR=0.78; 95% CI: 0.64,0.95], husbands who attended primary education [AOR=0.80; 95% CI: 0.65, 0.98], women who give their first birth 16-20years [AOR=0.78; 95% CI: 0.66,0.92], 21-25 years [AOR=0.66; 95% CI: 0.53,0.84], ≥26 years [AOR=0.67; 95% CI: 0.48, 0.92], history of terminating pregnancy [AOR=1.51; 95% CI: 1.29, 1.77] and awareness on fistula [AOR=0.35; 95% CI: 0.26,0.45) were the determinants of obstetric fistula identified in this study. Conclusion The magnitude of obstetric fistula in 14 African countries were high as compared with the world health organization estimate. Maternal age, residence, educational status, husband’s educational status, sex of household head, age at first birth, history of terminating pregnancy and awareness on obstetric fistula were the determinants identified in this study. Therefore, health interventions that reduce the occurrence of obstetric fistula could be designed to address the women who lives in rural area, no formal education, male-headed household, husbands who never attended formal education, and women who had terminated pregnancy should be addressed in advance. Policies and programs of fistula should be tailored the women which characterized as living in rural area, non-educated, young age at first birth and no awareness on fistula as well as male headed households. Evidence based multicounty interventions were highly recommended to eliminate obstetric fistula and to achieve sustainable development goal.

scholarly journals SURVIVAL ANALYSIS TO DETERMINE AGE TO GIVE FIRST BIRTH IN WOMEN IN EAST JAVA USING EXTENDED COX REGRESSION

2021 ◽  
Vol 10 (2) ◽  
pp. 144
Author(s):  
Santi Wulan Purnami ◽  
Fitria Nur Aida ◽  
Sutikno Sutikno ◽  
Diyah Herowati ◽  
Achmad Sjafii ◽  
...  
Keyword(s):  
Cox Regression ◽  
Educational Status ◽  
Age At First Birth ◽  
Childbearing Age ◽  
First Birth ◽  
Risk Of Death ◽  
First Marriage ◽  
Age At First Marriage ◽  
First Child ◽  
First Time

The age of a woman when giving birth to her first child needs to be a concern because it is related to the safety of the mother and baby. A woman being too young or too old increases the risk of death for both the mother and baby. Every woman giving birth for the first time is likely to experience psychological disorders such as anxiety and excessive fear during labor, and even postpartum depression. Given the importance and possible extent of the consequences of women giving birth for the first time, this study intended to assess the factors that influence the age at first birth, especially amongst women of childbearing age in East Java. These factors include the age at first marriage, education, and region. The method used was the extended Cox regression model. The analysis shows that the age at first marriage and education are factors that significantly influence the age at first birth. The more mature the age at first marriage, the more mature the age at first birth. Likewise, the higher the educational status, the higher the potential for giving birth to a first child over the age of 23, especially amongst women who graduated high school and university.

scholarly journals Review of obstetric fistulas in a rural hospital in South-South Nigeria

2011 ◽  
Vol 25 (1) ◽  
pp. 7
Author(s):  
Aniefiok J. Umoiyoho ◽  
Aniekan M. Abasiattai ◽  
Okon E. Akaiso
Keyword(s):  
Antenatal Care ◽  
Rural Areas ◽  
Formal Education ◽  
Health Workers ◽  
Medical Condition ◽  
Obstetric Fistula ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Medical Personnel ◽  
Health Facilities

<em>Background</em>. Obstetric fistula is a devastating medical condition associated with adverse social, psychological and reproductive health consequences. This study was carried out to review the pattern of presentation and outcome of patients with obstetric fistulas in a rural health facility in South-South Nigeria. <em>Design and Method</em>. A retrospective review of case notes of 51 patients with obstetric fistula that were managed at the Family Life Center, Mbribit Itam, in Itu, Local Government Area of Akwa Ibom State. <em>Results</em>. During the study period, 51 obstetric fistulas were repaired in the hospital. The ages of the patients ranged from 15 to 50 years with median age of 25.8 years and modal age group of 21-30 years (45.1%). The majority of the patients were of low parity (72.5%), 56.9% had no formal education and 27.5% were traders. Thirty four patients (66.7%) had their fistulas for between 1 and 6 years, 19.6% of the patients had juxta-cervical fistulas, while eight (15.7%) had circumferential loss of the urethra. Thirty-seven (72.5%) of them where unbooked and thus had no antenatal care, while 4 (7.8%) booked and had antenatal care in conventional health facilities. Thirty-four patients (66.7%) remained dry twenty-one days after surgery, thirteen (23.5%) were still wet, while 4 patients (7.8%) had stress incontinence despite repair. <em>Conclusion</em>. Obstetric fistulas are found most commonly among young, poorly educated women of low parity who do not avail themselves of orthodox ANC in our environment. Government, community and religious leaders must make concerted efforts to ensure women obtain formal education and when pregnant, have access to emergency obstetric care even if resident in the rural areas. Government, relevant non-Governmental organisations, community leaders and health workers should through relevant health messages enlighten women in the community about obstetric fistulas and the dangers of delivering in unorthodox health facilities. More medical personnel should be trained as the first attempt at repair is the one that is most likely to succeed.

scholarly journals Variations in reproductive events across life: a pooled analysis of data from 505 147 women across 10 countries

2019 ◽  
Vol 34 (5) ◽  
pp. 881-893 ◽  
Author(s):  
Keyword(s):  
Age At Menarche ◽  
Age At First Birth ◽  
First Birth ◽  
Natural Menopause ◽  
Individual Level ◽  
Level Data ◽  
Education Levels ◽  
Reproductive Events ◽  
Racial Ethnic ◽  
Reproductive Indices

Abstract STUDY QUESTION How has the timing of women’s reproductive events (including ages at menarche, first birth, and natural menopause, and the number of children) changed across birth years, racial/ethnic groups and educational levels? SUMMARY ANSWER Women who were born in recent generations (1970–84 vs before 1930) or those who with higher education levels had menarche a year earlier, experienced a higher prevalence of nulliparity and had their first child at a later age. WHAT IS KNOWN ALREADY The timing of key reproductive events, such as menarche and menopause, is not only indicative of current health status but is linked to the risk of adverse hormone-related health outcomes in later life. Variations of reproductive indices across different birth years, race/ethnicity and socioeconomic positions have not been described comprehensively. STUDY DESIGN, SIZE, DURATION Individual-level data from 23 observational studies that contributed to the International Collaboration for a Life Course Approach to Reproductive Health and Chronic Disease Events (InterLACE) consortium were included. PARTICIPANTS/MATERIALS, SETTING, METHODS Altogether 505 147 women were included. Overall estimates for reproductive indices were obtained using a two-stage process: individual-level data from each study were analysed separately using generalised linear models. These estimates were then combined using random-effects meta-analyses. MAIN RESULTS AND THE ROLE OF CHANCE Mean ages were 12.9 years at menarche, 25.7 years at first birth, and 50.5 years at natural menopause, with significant between-study heterogeneity (I2 &gt; 99%). A linear trend was observed across birth year for mean age at menarche, with women born from 1970 to 1984 having menarche one year earlier (12.6 years) than women born before 1930 (13.5 years) (P for trend = 0.0014). The prevalence of nulliparity rose progressively from 14% of women born from 1940–49 to 22% of women born 1970–84 (P = 0.003); similarly, the mean age at first birth rose from 24.8 to 27.3 years (P = 0.0016). Women with higher education levels had fewer children, later first birth, and later menopause than women with lower education levels. After adjusting for birth year and education level, substantial variation was present for all reproductive events across racial/ethnic/regional groups (all P values &lt; 0.005). LIMITATIONS, REASONS FOR CAUTION Variations of study design, data collection methods, and sample selection across studies, as well as retrospectively reported age at menarche, age at first birth may cause some bias. WIDER IMPLICATIONS OF THE FINDINGS This global consortium study found robust evidence on variations in reproductive indices for women born in the 20th century that appear to have both biological and social origins. STUDY FUNDING/COMPETING INTEREST(S) InterLACE project is funded by the Australian National Health and Medical Research Council project grant (APP1027196). GDM is supported by the Australian National Health and Medical Research Council Principal Research Fellowship (APP1121844).

Antebellum Southern White Fertility: A Demographic and Economic Analysis

1980 ◽  
Vol 40 (2) ◽  
pp. 331-350 ◽  
Author(s):  
Richard H. Steckel
Keyword(s):  
Economic Analysis ◽  
Total Fertility Rate ◽  
Time Trend ◽  
Age At First Birth ◽  
Demographic Analysis ◽  
First Birth ◽  
Distribution Of Wealth ◽  
Socioeconomic Analysis ◽  
Family Limitation ◽  
Child Spacing

This paper investigates the decline and regional differential in antebellum southern white fertility using published census materials and the 1860 population schedules. Demographic analysis is conducted with a synthetic total fertility rate that has four components: age at first birth, age at last surviving birth, surviving-child spacing, and the proportion of women who eventually have surviving children. The socioeconomic analysis employs regressions and focuses on causes of the underlying changes in the components. Family limitation appears to have been unimportant in this population. The distribution of wealth was.probably an important factor shaping the time trend and regional differential in fertility.

Pregnancy and the Risk of Rheumatoid Arthritis in a Highly Predisposed North American Native Population

2012 ◽  
Vol 39 (12) ◽  
pp. 2253-2260 ◽  
Author(s):  
CHRISTINE A. PESCHKEN ◽  
DAVID B. ROBINSON ◽  
CAROL A. HITCHON ◽  
IRENE SMOLIK ◽  
DONNA HART ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
North American ◽  
Shared Epitope ◽  
Reproductive History ◽  
Early Age ◽  
Age At First Birth ◽  
Native Population ◽  
First Birth ◽  
Pregnancy Smoking ◽  
First Time

Objective.To examine reproductive history and rheumatoid arthritis (RA) risk in a highly predisposed population of North American Natives (NAN) with unique fertility characteristics.Methods.The effect of pregnancy on the risk of RA was examined by comparing women enrolled in 2 studies: a study of RA in NAN patients and their unaffected relatives; and NAN patients with RA and unrelated healthy NAN controls enrolled in a study of autoimmunity. All participants completed questionnaires detailing their reproductive history.Results.Patients with RA (n = 168) and controls (n = 400) were similar overall in age, education, shared epitope frequency, number of pregnancies, age at first pregnancy, smoking, and breastfeeding history. In multivariate analysis, for women who had ≥ 6 births the OR for developing RA was 0.43 (95% CI 0.21–0.87) compared with women who had 1–2 births (p = 0.046); for women who gave birth for the first time after age 20 the OR for developing RA was 0.33 (95% CI 0.16–0.66) compared with women whose first birth occurred at age ≤ 17 (p = 0.001). The highest risk of developing RA was in the first postpartum year (OR 3.8; 95% CI 1.45–9.93) compared with subsequent years (p = 0.004).Conclusion.In this unique population, greater parity significantly reduced the odds of RA; an early age at first birth increased the odds, and the postpartum period was confirmed as high risk for RA onset. The protective effect of repeated exposure to the ameliorating hormonal and immunological changes of pregnancy may counterbalance the effect of early exposure to the postpartum reversal of these changes.

Bounding Treatment Effects with Contaminated and Censored Data: Assessing the Impact of Early Childbearing on Children

2005 ◽  
Vol 5 (1) ◽  
Author(s):  
Charles H Mullin
Keyword(s):  
Censored Data ◽  
Treatment Effect ◽  
Instrumental Variable ◽  
Treatment Effects ◽  
Child Outcomes ◽  
Well Being ◽  
Teenage Mothers ◽  
Age At First Birth ◽  
First Birth ◽  
The Impact

AbstractEmpirical researchers commonly invoke instrumental variable (IV) assumptions to identify treatment effects. This paper considers what can be learned under two specific violations of those assumptions: contaminated and corrupted data. Either of these violations prevents point identification, but sharp bounds of the treatment effect remain feasible. In an applied example, random miscarriages are an IV for women’s age at first birth. However, the inability to separate random miscarriages from behaviorally induced miscarriages (those caused by smoking and drinking) results in a contaminated sample. Furthermore, censored child outcomes produce a corrupted sample. Despite these limitations, the bounds demonstrate that delaying the age at first birth for the current population of non-black teenage mothers reduces their first-born child’s well-being.

scholarly journals Assessment of the main factors impacting community members’ attitudes towards tourism and protected areas in six southern African countries

Koedoe ◽  
2014 ◽  
Vol 56 (2) ◽  
Author(s):  
Susan Snyman
Keyword(s):  
Protected Areas ◽  
Southern Africa ◽  
Formal Education ◽  
Benefit Sharing ◽  
Community Members ◽  
Conservation Areas ◽  
African Countries ◽  
Conservation Implications ◽  
Community Based Conservation ◽  
Future Success

In southern Africa, many early conservation efforts from the late 1800s and early 1900s either displaced local communities or restricted their access to natural resources. This naturally affected community attitudes towards protected areas and efforts were later made to rectify growing tensions. In the last few decades of the 20th century, these efforts led to conservation and ecotourism models that increasingly included communities in the decision-making and benefit-sharing process in order to garner their support. Although the results of these policies were mixed, it is clear that the future success of conservation and, consequently, ecotourism in many areas will depend on the attitudes and behaviour of communities living in or adjacent to protected areas. Managing and understanding community expectations and attitudes under varying socio-economic circumstances will lead to more efficient, equitable and sustainable community-based conservation and ecotourism models. This study was based on 1400 community interview schedules conducted in Botswana, Malawi, Namibia, South Africa, Zambia and Zimbabwe, allowing for an accurate comparison of attitudes across countries, protected areas and communities. The results highlighted important demographic and socio-economic factors to consider in terms of understanding the attitudes of those living in and around protected areas. Suggestions were put forward for managing community relationships and garnering long-term support for protected areas and ecotourism. Conservation implications: It was observed that, in general, community members living in or adjacent to conservation areas in southern Africa have an understanding and appreciation of the importance of conservation. Formal education was found to positively impact attitudes and human–wildlife conflict negatively impacted attitudes, highlighting important policy focus areas.

Radiographic patterns of the mammary parenchyma: variation with age at examination and age at first birth.

Radiology ◽  
1981 ◽  
Vol 138 (1) ◽  
pp. 59-62 ◽  
Author(s):  
I Andersson ◽  
L Janzon ◽  
H Pettersson
Keyword(s):  
Age At First Birth ◽  
First Birth
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