Trends in and predictors of pregnancy termination among young women in Nigeria: a multi-level analysis of Demographic and Health Surveys 2003-2018

Abstract Background Three-quarters of pregnancy terminations in Africa are carried out in unsafe conditions. Unsafe abortion is the leading cause of maternal mortality among young women in Sub-Saharan Africa. Greater understanding of the wider determinants of pregnancy termination in this age group could inform the design and development of interventions to mitigate the harm. Previous research has described the trends in and factors associated with termination of pregnancy for women of reproductive age in Nigeria. However, the wider determinants of pregnancy termination have not been ascertained, and data for all women have been aggregated which may obscure differences by age groups. Therefore, we examined the trends in and individual and contextual-level predictors of pregnancy termination among young women aged 15–24 years in Nigeria. Methods We analysed data from the 2003, 2008, 2013 and 2018 Nigerian Demographic and Health Surveys (NDHS) comprising 45,793 women aged 15–24 years. Trends in pregnancy termination across the four survey datasets were examined using bivariate analysis. Individual and contextual predictors of pregnancy termination were analysed using a three-level binary logistic regression analysis. Results Trends in pregnancy termination declined from 5.8% in 2003 to 4.2% in 2013 then reversed to 4.9% in 2018. The declining trend was greater for women with higher socioeconomic status. Around 17% of the total variation in pregnancy termination was attributable to community factors, and 7% to state-level factors. Of all contextual variables considered, only contraceptive prevalence (proxy for RH service access by young women) at community level was significant. Living in communities with higher contraceptive prevalence increased odds of termination compared with communities with lower contraceptive prevalence (aOR = 4.2; 95% CI 2.7–6.6). At the individual-level, sexual activity before age 15 increased odds of termination (aOR = 2.3; 95% CI 1.9–2.8) compared with women who initiated sexual activity at age 18 years or older, and married women had increased odds compared with never married women (aOR = 3.0; 95% CI 2.5–3.7). Conclusion Our findings highlight the importance of disaggregating data for women across the reproductive lifecourse, and indicates where tailored interventions could be targeted to address factors associated with pregnancy termination among young women in Nigeria.

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Trends in and predictors of pregnancy termination among 15-24 yer old women in Nigeria: a multi-level analysis of Demographic and Health Surveys 2003-2018

10.21203/rs.3.rs-28451/v2 ◽

2020 ◽

Author(s):

Franklin I Onukwugha ◽

Monica Magdi ◽

Ahmed Sarki ◽

Lesley Smith

Keyword(s):

Sexual Activity ◽

Young Women ◽

Health Surveys ◽

Pregnancy Termination ◽

Married Women ◽

Sub Saharan Africa ◽

Demographic And Health Surveys ◽

Factors Associated ◽

Contraceptive Prevalence ◽

In Pregnancy

Abstract Background: Three-quarters of pregnancy terminations in Africa are carried out in unsafe conditions. Unsafe abortion is the leading cause of maternal mortality among 15-24 year-old women in Sub-Saharan Africa. Greater understanding of the wider determinants of pregnancy termination in 15-24 year-olds could inform the design and development of interventions to mitigate the harm. Previous research has described the trends in and factors associated with termination of pregnancy for women of reproductive age in Nigeria. However, the wider determinants of pregnancy termination have not been ascertained, and data for all women have been aggregated which may obscure differences by age groups. Therefore, we examined the trends in and individual and contextual-level predictors of pregnancy termination among 15-24 year-old women in Nigeria. Methods: We analysed data from the 2003, 2008, 2013 and 2018 Nigerian Demographic and Health Surveys (NDHS) comprising 45,793 women aged 15-24 years. Trends in pregnancy termination across the four survey datasets were examined using bivariate analysis. Individual and contextual predictors of pregnancy termination were analysed using a three-level binary logistic regression analysis and are reported as adjusted odds ratios (aOR) with 95% confidence intervals (CI). Results: Trends in pregnancy termination declined from 5.8% in 2003 to 4.2% in 2013 then reversed to 4.9% in 2018. The declining trend was greater for 15-24 year-old women with higher socioeconomic status. Around 17% of the total variation in pregnancy termination was attributable to community factors, and 7% to state-level factors. Of all contextual variables considered, only contraceptive prevalence (proxy for reproductive health service access by young women) at community level was significant. Living in communities with higher contraceptive prevalence increased odds of termination compared with communities with lower contraceptive prevalence (aOR=4.2; 95% CI 2.7-6.6). At the individual-level, sexual activity before age 15 increased odds of termination (aOR=2.3; 95% CI 1.9-2.8) compared with women who initiated sexual activity at age 18 years or older, and married women had increased odds compared with never married women (aOR=3.0; 95% CI 2.5-3.7).Conclusion: Our findings highlight the importance of disaggregating data for women across the reproductive lifecourse, and indicates where tailored interventions could be targeted to address factors associated with pregnancy termination among young women in Nigeria.

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Trends in and predictors of pregnancy termination among 15–24 year-old women in Nigeria: a multi-level analysis of demographic and health surveys 2003–2018

BMC Pregnancy and Childbirth ◽

10.1186/s12884-020-03164-8 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Franklin I. Onukwugha ◽

Monica A. Magadi ◽

Ahmed M. Sarki ◽

Lesley Smith

Keyword(s):

Sexual Activity ◽

Young Women ◽

Health Surveys ◽

Pregnancy Termination ◽

Married Women ◽

Sub Saharan Africa ◽

Demographic And Health Surveys ◽

Factors Associated ◽

Contraceptive Prevalence ◽

In Pregnancy

Abstract Background Three-quarters of pregnancy terminations in Africa are carried out in unsafe conditions. Unsafe abortion is the leading cause of maternal mortality among 15–24 year-old women in Sub-Saharan Africa. Greater understanding of the wider determinants of pregnancy termination in 15–24 year-olds could inform the design and development of interventions to mitigate the harm. Previous research has described the trends in and factors associated with termination of pregnancy for women of reproductive age in Nigeria. However, the wider determinants of pregnancy termination have not been ascertained, and data for all women have been aggregated which may obscure differences by age groups. Therefore, we examined the trends in and individual and contextual-level predictors of pregnancy termination among 15–24 year-old women in Nigeria. Methods We analysed data from the 2003, 2008, 2013 and 2018 Nigerian Demographic and Health Surveys (NDHS) comprising 45,793 women aged 15–24 years. Trends in pregnancy termination across the four survey datasets were examined using bivariate analysis. Individual and contextual predictors of pregnancy termination were analysed using a three-level binary logistic regression analysis and are reported as adjusted odds ratios (aOR) with 95% confidence intervals (CI). Results Trends in pregnancy termination declined from 5.8% in 2003 to 4.2% in 2013 then reversed to 4.9% in 2018. The declining trend was greater for 15–24 year-old women with higher socioeconomic status. Around 17% of the total variation in pregnancy termination was attributable to community factors, and 7% to state-level factors. Of all contextual variables considered, only contraceptive prevalence (proxy for reproductive health service access by young women) at community level was significant. Living in communities with higher contraceptive prevalence increased odds of termination compared with communities with lower contraceptive prevalence (aOR = 4.2; 95% CI 2.7–6.6). At the individual-level, sexual activity before age 15 increased odds of termination (aOR = 2.3; 95% CI 1.9–2.8) compared with women who initiated sexual activity at age 18 years or older, and married women had increased odds compared with never married women (aOR = 3.0; 95% CI 2.5–3.7). Conclusion Our findings highlight the importance of disaggregating data for women across the reproductive lifecourse, and indicates where tailored interventions could be targeted to address factors associated with pregnancy termination among young women in Nigeria.

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Trends in and predictors of pregnancy termination among 15-24 yer old women in Nigeria: a multi-level analysis of Demographic and Health Surveys 2003-2018

10.21203/rs.3.rs-28451/v3 ◽

2020 ◽

Author(s):

Franklin I Onukwugha ◽

Monica Magdi ◽

Ahmed Sarki ◽

Lesley Smith

Keyword(s):

Sexual Activity ◽

Young Women ◽

Health Surveys ◽

Pregnancy Termination ◽

Married Women ◽

Sub Saharan Africa ◽

Demographic And Health Surveys ◽

Factors Associated ◽

Contraceptive Prevalence ◽

In Pregnancy

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DISAGREEMENT IN SPOUSAL REPORTS OF CURRENT CONTRACEPTIVE USE IN SUB-SAHARAN AFRICA

Journal of Biosocial Science ◽

10.1017/s0021932005001069 ◽

2005 ◽

Vol 38 (6) ◽

pp. 779-796 ◽

Cited By ~ 7

Author(s):

STAN BECKER ◽

MIAN B. HOSSAIN ◽

ELIZABETH THOMSON

Keyword(s):

Health Surveys ◽

Contraceptive Use ◽

Sub Saharan Africa ◽

Demographic And Health Surveys ◽

Sex Partners ◽

Recent Period ◽

Survey Question ◽

Contraceptive Prevalence ◽

Sub Saharan ◽

Using Data

Contraceptive prevalence is a key variable estimated from Demographic and Health Surveys. But the prevalence estimated from reports of husbands differs widely from that estimated for wives. In this research, using data from six Demographic and Health Surveys of sub-Saharan Africa, reports from spouses in monogamous couples with no other reported sex partners in the recent period are examined. Agreement ranged from 47% to 82%, but among couples in which one or both reported use, the ‘both’ category represented less than half in all nations except Zimbabwe. Husbands generally had higher reports of condoms, periodic abstinence and pills but fewer reports of the IUD, injections and female sterilization. Either discussion of family planning with the spouse and/or higher socioeconomic status was associated with agreement in most of the surveys. Ambiguities in the survey question regarding current use need to be reduced, perhaps with an added probe question for non-permanent methods.

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Intimate partner violence against adolescent girls and young women and its association with miscarriages, stillbirths and induced abortions in sub-Saharan Africa: Evidence from demographic and health surveys

SSM - Population Health ◽

10.1016/j.ssmph.2021.100730 ◽

2021 ◽

Vol 13 ◽

pp. 100730

Author(s):

Bright Opoku Ahinkorah

Keyword(s):

Intimate Partner Violence ◽

Adolescent Girls ◽

Young Women ◽

Partner Violence ◽

Health Surveys ◽

Intimate Partner ◽

Sub Saharan Africa ◽

Demographic And Health Surveys ◽

Induced Abortions ◽

Sub Saharan

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Utilization of deworming medication and its associated factors among pregnant married women in 26 sub-Saharan African countries: a multi-country analysis

Tropical Medicine and Health ◽

10.1186/s41182-021-00343-x ◽

2021 ◽

Vol 49 (1) ◽

Author(s):

Betregiorgis Zegeye ◽

Mpho Keetile ◽

Bright Opoku Ahinkorah ◽

Edward Kwabena Ameyaw ◽

Abdul-Aziz Seidu ◽

...

Keyword(s):

Antenatal Care ◽

Pregnant Women ◽

Married Women ◽

Sub Saharan Africa ◽

Demographic And Health Surveys ◽

African Countries ◽

Related Factors ◽

Factors Associated ◽

Software Analysis ◽

Sub Saharan

Abstract Background Deworming is one of the strategies to reduce the burden of anemia among pregnant women. Globally, pregnant women in sub-Saharan Africa are more affected by anemia. Therefore, this study examined both the coverage and demographic, socioeconomic, and women empowerment-related factors associated with the utilization of deworming medication among pregnant married women in sub-Saharan Africa. Methods We used data from the most recent Demographic and Health Surveys of 26 countries in sub-Saharan Africa conducted between 2010 and 2019. Using Stata version-14 software, analysis was done on 168,910 pregnant married women. Bivariate and multivariable logistic regression analyses were conducted to examine the factors associated with the utilization of deworming medication. The results were presented using adjusted odds ratios (aORs) at 95% confidence intervals (CIs). Results The pooled results showed that about 50.7% (95% CI 48.2–53.3%) of pregnant married women in the studied countries took deworming medications, and this varied from as high as 84.1% in Sierra Leone to as low as 2% in Angola. Regarding sub-regional coverage, the highest and lowest coverages were seen in East Africa (67.6%, 95% CI 66.0–69.1%) and West Africa (24.3%, 95% CI 22.4–26.4%) respectively. We found higher odds of utilization of deworming medication among older pregnant married women (aOR=1.93, 95% CI 1.32–2.84), women with educated husbands (aOR=1.40, 95% CI 1.11–1.77), wealthier women (aOR=3.12, 95% CI 1.95–4.99), women exposed to media (aOR=1.46, 95% CI 1.18–1.80), and those who had four or more antenatal care visits (aOR=1.51, 95% CI 1.24–1.83). Conclusions Enhancing women’s education, disseminating information about maternal healthcare services through mass media, and ensuring that women from economically disadvantaged households benefit from national economic growth can be considered as deworming medication improvement strategies in sub-Saharan Africa. Moreover, providing more attention to adolescents or young pregnant women and increasing the number of antenatal care visits could be considered to increase deworming uptake among pregnant married women.

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Socio-demographic determinants of pregnancy termination among adolescent girls and young women in selected high fertility countries in sub-Saharan Africa

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-04064-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Bright Opoku Ahinkorah

Keyword(s):

Adolescent Girls ◽

Young Women ◽

Pregnancy Termination ◽

Statistical Significance ◽

Sub Saharan Africa ◽

Demographic And Health Surveys ◽

High Fertility ◽

Fertility Rates ◽

Literacy Level ◽

Sub Saharan

Abstract Background Most of the unintended pregnancies that occur among adolescent girls and young women (AGYW) in sub-Saharan Africa (SSA) end up in pregnancy termination. In this study, the socio-demographic determinants of pregnancy termination among AGYW (aged 15–24) in selected countries with high fertility rates in SSA were examined. Methods This was a cross-sectional analysis of data from the most recent Demographic and Health Surveys of nine countries in SSA. The countries included are Angola, Burkina Faso, Burundi, Chad, Gambia, Mali, Niger, Nigeria, and Uganda. A total of 62,747 AGYW constituted the sample size for the study. Fixed and random effects models were used to examine the determinants of pregnancy termination with statistical significance at p < 0.05. Results Higher odds of pregnancy termination were found among AGYW aged 20–24, those who were cohabiting and married, those who listened to radio and watched television at least once a week and those who lived in communities with high literacy level. Conversely, the odds of pregnancy termination were lower among AGYW with three or more births and those with secondary/higher education. Conclusion The socio-demographic determinants of pregnancy termination among AGYW in this study were age, level of education, marital status, exposure to radio and television, parity, and community literacy level. The findings provide the needed information for designing health interventions to reduce unwanted pregnancies and unsafe abortions in countries with high fertility rates in SSA. It is recommended that governments and non-governmental organisations in these countries should enhance sexuality education and regular sensitization of adolescent sexual and reproductive health programmes targeted at AGYW who are at risk of pregnancy termination.

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Factors associated with use of injectables, long-acting and permanent contraceptive methods (iLAPMs) among married women in Zambia: analysis of demographic and health surveys, 1992–2014

Reproductive Health ◽

10.1186/s12978-019-0741-6 ◽

2019 ◽

Vol 16 (1) ◽

Cited By ~ 1

Author(s):

Pauline Bakibinga ◽

Dennis Matanda ◽

Lyagamula Kisia ◽

Namuunda Mutombo

Keyword(s):

Health Surveys ◽

Married Women ◽

Demographic And Health Surveys ◽

Contraceptive Methods ◽

Factors Associated ◽

Long Acting

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Mixed effects analysis of factors associated with barriers to accessing healthcare among women in sub-Saharan Africa: Insights from demographic and health surveys

PLoS ONE ◽

10.1371/journal.pone.0241409 ◽

2020 ◽

Vol 15 (11) ◽

pp. e0241409

Author(s):

Abdul-Aziz Seidu

Keyword(s):

Health Insurance ◽

Health Surveys ◽

Contextual Factors ◽

Health Planning ◽

Sub Saharan Africa ◽

Demographic And Health Surveys ◽

Factors Associated ◽

Healthcare Accessibility ◽

Barriers To Healthcare ◽

Sub Saharan

Background Access to healthcare is one of the key global concerns as treasured in the Sustainable Development Goals. This study, therefore, sought to assess the individual and contextual factors associated with barriers to accessing healthcare among women in sub-Saharan Africa (SSA). Materials and methods Data for this study were obtained from the latest Demographic and Health Surveys (DHS) conducted between January 2010 and December 2018 across 24 countries in SSA. The sample comprised 307,611 women aged 15–49. Data were analysed with STATA version 14.2 using both descriptive and multilevel logistic regression modelling. Statistical significance was set at p<0.05. Results It was found that 61.5% of women in SSA face barriers in accessing healthcare. The predominant barriers were getting money needed for treatment (50.1%) and distance to health facility (37.3%). Women aged 35–39 (AOR = 0.945, CI: 0.911–0.980), married women (AOR = 0.694, CI: 0.658–0.732), richest women (AOR = 0.457, CI:0.443–0.472), and those who read newspaper or magazine at least once a week (AOR = 0.893, CI:0.811–0.983) had lower odds of facing barriers in accessing healthcare. However, those with no formal education (AOR = 1.803, CI:1.718–1.891), those in manual occupations (AOR = 1.551, CI: 1.424–1.689), those with parity 4 or more (AOR = 1.211, CI: 1.169–1.255), those who were not covered by health insurance (AOR = 1.284, CI: 1.248–1.322), and those in rural areas (AOR = 1.235, CI:1.209–1.26) had higher odds of facing barriers to healthcare access. Conclusion Both individual and contextual factors are associated with barriers to healthcare accessibility in SSA. Particularly, age, marital status, employment, parity, health insurance coverage, exposure to mass media, wealth status and place of residence are associated with barriers to healthcare accessibility. These factors ought to be considered at the various countries in SSA to strengthen existing strategies and develop new interventions to help mitigate the barriers. Some of the SSA African countries can adopt successful programs in other parts of SSA to suit their context such as the National Health Insurance Scheme (NHIS) and the Community-based Health Planning and Services concepts in Ghana.

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Prevalence of anemia and its associated factors among married women in 19 sub-Saharan African countries

Archives of Public Health ◽

10.1186/s13690-021-00733-x ◽

2021 ◽

Vol 79 (1) ◽

Author(s):

Betregiorgis Zegeye ◽

Felix Emeka Anyiam ◽

Bright Opoku Ahinkorah ◽

Edward Kwabena Ameyaw ◽

Eugene Budu ◽

...

Keyword(s):

Associated Factors ◽

Wealth Index ◽

Married Women ◽

Sub Saharan Africa ◽

Demographic And Health Surveys ◽

Modern Contraceptive ◽

African Countries ◽

Factors Associated ◽

Sub Saharan ◽

Prevalence Of Anemia

Abstract Background Sub-Saharan Africa (SSA) remains the region with the highest burden of anemia globally. Since anemia has both health and non-health-related consequences, its reduction is one of the Sustainable Development Goals. Therefore, this study aimed to examine the prevalence of anemia and its associated factors among married women in SSA. Methods Using Stata version-14 software, the analysis was done on 89,029 married women from the Demographic and Health Surveys of 19 countries in SSA. Pearson Chi-Square test and Binary logistic regression analyses were used to examine the factors associated with anemia. The results were presented using adjusted Odds Ratio (aOR) at a 95% Confidence Interval (CI). A p-value less than or equal to 0.05 (p ≤ 0.05) was considered statistically significant. Results The pooled analysis showed that 49.7% of married women were anemic. Of these, 1.04% and 15.05% were severely and moderately anemic respectively, and the rest 33.61% were mildly anemic. Husband education (primary school-aOR = 0.84, 95% CI; 0.71–0.99), wealth index (middle-aOR = 0.81, 95% CI; 0.68–0.96, richer-aOR = 0.69, 95% CI; 0.57–0.84, richest-aOR = 0.68, 95% CI; 0.51–0.91), modern contraceptive use (yes-aOR = 0.68, 95% CI; 0.56–0.81) and religion (Muslim-aOR = 1.27, 95% CI; 1.11–1.46, others-aOR = 0.73, 95% CI; 0.59–0.90) were factors associated with anemia among married women. Conclusion The findings show that nearly half of the married women are affected by anemia. Enhancing partners’ educational levels, and economic empowerment of women, strengthening family planning services, and working with religious leaders to reduce the perception and religious beliefs related to food restrictions can be the main focus to reduce the burden of anemia among married women in SSA.

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