scholarly journals Determinants of Modern Contraceptive Utilization Among Married Women in sub-Saharan Africa; Multilevel Analysis of Recent Demographic and Health Survey

2021 ◽  
Author(s):  
Zemenu Tadesse Tesema ◽  
Getayeneh Antehunegn Tesema ◽  
Moges Muluneh Boke ◽  
Temesgen Yihunie Akalu
Keyword(s):  
Married Women ◽  
Sub Saharan Africa ◽  
Modern Contraceptive ◽  
African Countries ◽  
Wealth Status ◽  
Modern Contraception ◽  
Pooled Prevalence ◽  
Contraception Use ◽  
Contraceptive Utilization ◽  
Sub Saharan

Abstract Background Family planning is a low-cost, high-impact public health and development strategy. Planned pregnancies are essential for both the child and mother’s health. However, there is a lack of evidence on modern contraceptive use and determinants in sub-Saharan Africa, hence this study aimed to determine the pooled prevalence and determinants of modern contraceptive utilization across Sub-Saharan Africa. Methods Thirty-six sub-Saharan African countries' demographic and health survey (DHS) data were used for pooled analysis. A total weighted sample of 322,525 married women was included in the study. Cross tabulations and summary statistics were done using STATA version 14 software. The pooled prevalence of modern contraceptive utilization with a 95% Confidence Interval (CI) was reported for sub- Saharan Africa countries. Four models were fitted to select the best-fitted model for the data using Likelihood Ratio (LLR) and Deviance. Model III was selected because of its highest LLR and Smallest deviance. Results The pooled estimate of modern contraception use in sub–Saharan African countries were 18.36% [95% CI: 18.24, 18.48], with highest in Lesotho (59.79%) and the lowest in Chad (5.04%). The odds of modern contraception utilization were increased; women living in East Africa (AOR = 1.47 (1.40, 1.54)), urban (AOR = 1.18 (1.14, 1.24)), women primary and secondary and above educational level (AOR = 1.49 (1.44, 1.55)), and (AOR = 1.66 (1.58, 1.74)) respectively, husband primary and secondary and above educational level (AOR = 1.38 (1.33, 1.42)) and (AOR = 1.38 (1.36, 1.47)), wealth status middle and rich (AOR = 1.17, (1.14, 1.21)) and (AOR = 1.29 (1.25, 1.34)) respectively, media exposure (AOR = 1.25 (1.22, 1.29)), Postnatal care(PNC) utilization (AOR = 1.25 (1.22, 1.29)), deliver at health facility (AOR = 1.74 (1.69, 1.79)), and birth order 2–4 and 5+ (AOR = 1.36 (1.31, 1.41)) and (AOR = 1.35 (1.28, 1.43)) whereas the odds of contraception use were decreased among women living in Central, and Western regions (AOR = 0.23 (0.22, 0.24)), and (AOR = 0.46 (0.40, 0.54)) respectively, women decided with husband and husband alone (AOR = 0.90 (0.87, 0.93)) and (AOR = 0.73 (0.71, 0.75)). Conclusion The uptake of modern contraception in sub-Saharan Africa is low compared to other developing region. Therefore, family planning program activities need to give attention to the rural resident, illiterate women and low wealth status community.

scholarly journals Determinants of Modern Contraceptive Utilization Among Married Women in Sub-saharan Africa: Multilevel Analysis Using Recent Demographic and Health Survey

2021 ◽  
Author(s):  
Zemenu Tadesse Tesema ◽  
Getayeneh Antehunegn Tesema ◽  
Moges Muluneh Boke ◽  
Temesgen Yihunie Akalu
Keyword(s):  
Health Survey ◽  
Married Women ◽  
Sub Saharan Africa ◽  
Modern Contraceptive ◽  
African Countries ◽  
Wealth Status ◽  
Modern Contraception ◽  
Pooled Prevalence ◽  
Contraceptive Utilization ◽  
Sub Saharan

Abstract Background: Family planning is a low-cost, high-impact public health and development strategy to improve child and maternal health. However, there is a lack of evidence on modern contraceptive use and determinants in sub-Saharan Africa. Hence, this study was aimed at determining the pooled prevalence and determinants of modern contraceptive utilization in Sub-Saharan Africa. Methods: Thirty-six sub-Saharan African countries' demographic and health survey (DHS) data were used for pooled analysis. A total weighted sample of 322,525 married women were included. Cross tabulations and summary statistics were done using STATA version 14 software. The pooled prevalence of modern contraceptive utilization with a 95% Confidence Interval (CI) was reported. Four models were fitted to select the best-fitted model using Likelihood Ratio (LLR) and Deviance test. Finally, the model with the highest LLR and the smallest deviance was selected as a best fitted model. Results: The pooled estimate of modern contraception use in sub–Saharan African countries was 18.36% [95% CI: 18.24, 18.48], with highest in Lesotho (59.79%) and the lowest in Chad (5.04%). The odds of modern contraception utilization among women living in East Africa was (AOR=1.47 (1.40, 1.54)), urban (AOR=1.18 (1.14, 1.24)), women primary and secondary and above educational level (AOR=1.49 (1.44, 1.55)), and (AOR=1.66 (1.58, 1.74)), respectively. Moreover, husband primary (AOR=1.38 (1.33, 1.42)), middle (AOR=1.17, (1.14, 1.21)), rich wealth status (AOR=1.29 (1.25, 1.34)), media exposure (AOR=1.25 (1.22, 1.29)), and postnatal care (PNC) utilization (AOR=1.25 (1.22, 1.29)) had higher odds of modern contraceptive utilization compared with their counter parts. Furthermore, deliver at health facility (AOR=1.74 (1.69, 1.79)) and birth order 2-4 (AOR=1.36 (1.31, 1.41)) had higher odds of modern contraceptive utilization. On the otherhand, women living in Central (AOR=0.23 (0.22, 0.24)), Western regions (AOR=0.46 (0.40, 0.54)), women decided with husband (AOR=0.90 (0.87, 0.93)), and husband alone (AOR=0.73 (0.71, 0.75)) were decreased the odds of modern contraceptive utilization. Conclusion: The uptake of modern contraception in sub-Saharan Africa is low. Modern contraceptive utilization is affected by different factors. More attention need to be given to rural residents, illiterate women, and communities with low wealth status.

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

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.

Factors Influencing Contraceptive Use in Sub-Saharan Africa: A Systematic Review

2017 ◽  
Vol 37 (2) ◽  
pp. 79-91 ◽  
Author(s):  
Sarah R. Blackstone ◽  
Ucheoma Nwaozuru ◽  
Juliet Iwelunmor
Keyword(s):  
Contraceptive Use ◽  
Male Partner ◽  
Sub Saharan Africa ◽  
Modern Contraceptive ◽  
African Countries ◽  
Factors Influencing ◽  
Contraceptive Side Effects ◽  
Modern Contraceptive Use ◽  
Negative Perceptions ◽  
Sub Saharan

The purpose of this study was to systematically review the literature regarding factors influencing contraceptive use in sub-Saharan Africa between 2005 and 2015. A total of 58 studies from twelve Sub-Saharan African countries were reviewed. Keywords were grouped using the PEN-3 cultural model. Negative factors prohibiting or reducing contraceptive use were women’s misconceptions of contraceptive side–effects, male partner disapproval, and social/cultural norms surrounding fertility. Positive factors included education, employment, and communication with male partner. Increasing modern contraceptive use in Sub-Saharan Africa is a multi-faceted problem that will require community and systems wide interventions that aim to counteract negative perceptions and misinformation.

scholarly journals A systematic review and meta-analysis reveal that Campylobacter spp. and antibiotic resistance are widespread in humans in sub-Saharan Africa

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245951
Author(s):  
Delfina F. Hlashwayo ◽  
Betuel Sigaúque ◽  
Emília V. Noormahomed ◽  
Sónia M. S. Afonso ◽  
Inácio M. Mandomando ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Meta Analysis ◽  
Random Effect ◽  
Research Priorities ◽  
Sub Saharan Africa ◽  
Cochrane Library ◽  
African Countries ◽  
Pooled Prevalence ◽  
Sub Saharan ◽  
The Impact

Introduction Campylobacter spp. are zoonotic bacteria that cause gastroenteritis in humans worldwide, whose main symptom is diarrhea. In certain cases, extra intestinal manifestations may occur, such as Guillain Barré syndrome. The bacteria cause severe diarrhea mostly in children and in immunocompromised individuals. This review aims to address the prevalence of Campylobacter spp. in humans in sub-Saharan Africa. It also aims to understand the impact of HIV in the prevalence, as well as to report data on antibiotic resistance and propose research priorities. Methods We followed PRISMA guidelines to find studies on the occurrence of Campylobacter spp. in humans in all countries from sub-Saharan Africa. Studies published between 2000 and 2020 were searched in PubMed, Cochrane Library, CINAHL, African Index Medicus, African Journals Online, Google Scholar and Science Direct. We have conducted a random-effect meta-analysis and calculated the proportion of resistant isolates to different antibiotics. Results and discussion We found 77 studies that described such occurrence in humans in 20 out of 53 sub-Saharan African countries. Campylobacter jejuni was the most prevalent species. Pooled prevalence was 9.9% (CI: 8.4%–11.6%). No major variations within the different sub-regions were found. Most studies reported Campylobacter spp. as the cause of diarrhea, mainly in children. Some studies reported the bacteria as a possible etiologic agent of acute flaccid paralysis and urinary tract infection. Campylobacter spp. presented a higher pooled prevalence in HIV infected patients, although not statistically significant. High proportions of resistant strains were reported for many antibiotics, including erythromycin and tetracycline. Conclusion Campylobacter spp. occur in sub-Saharan Africa, although information is scarce or inexistent for many countries. Research priorities should include investigation of the understudied species; extra intestinal manifestations; the impact of HIV infection and associated risk factors. Control strategies should be reinforced to contain the spread of this pathogen and drug resistance.

scholarly journals Prevalence of child marriage and its impact on fertility outcomes in 34 sub-Saharan African countries

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Sanni Yaya ◽  
Emmanuel Kolawole Odusina ◽  
Ghose Bishwajit
Keyword(s):  
Pregnancy Termination ◽  
Binary Logistic Regression ◽  
Adverse Outcomes ◽  
Sub Saharan Africa ◽  
Child Marriage ◽  
Modern Contraceptive ◽  
Contraceptive Methods ◽  
African Countries ◽  
Sub Saharan ◽  
Children Ever Born

Abstract Background The issue of child marriage is a form of human rights violation among young women mainly in resource-constrained countries. Over the past decades, child marriage has gained attention as a threat to women’s health and autonomy. This study explores the prevalence of child marriage among women aged 20–24 years in sub-Saharan Africa countries and examines the association between child marriage and fertility outcomes. Methods Latest DHS data from 34 sub-Saharan African countries were used in this study. Sixty thousand two hundred and fifteen women aged 20–24 years were included from the surveys conducted 2008–2017. The outcome variables were childbirth within the first year of marriage (early fertility), first preceding birth interval less than 24 months (rapid repeat of childbirth), unintended pregnancy, lifetime pregnancy termination, the use of modern contraceptive methods, lifetime fertility and any childbirth. The main explanatory variable was child marriage (< 18 years) and the associations between child marriage and fertility outcomes were examined from the ever-married subsample to estimate odds ratios (ORs) and 95% CIs using binary logistic regression models. Results In the study population, the overall prevalence of women who experience child marriage was 54.0% while results showed large disparities across sub-Saharan African countries ranging from 16.5 to 81.7%. The prominent countries in child marriage were; Niger (81.7%), Chad (77.9%), Guinea (72.8%), Mali (69.0%) and Nigeria (64.0%). Furthermore, women who experience child marriage were 8.00 times as likely to have ≥3 number of children ever born (lifetime fertility), compared to women married at ≥18 years (OR = 8.00; 95%CI: 7.52, 8.46). Women who experience child marriage were 1.13 times as likely to use modern contraceptive methods, compared to adult marriage women (OR = 1.13; 95%CI: 1.09, 1.19). Those who married before the legal age were 1.27 times as likely to have lifetime terminated pregnancy, compared to women married at ≥18 years (OR = 1.27; 95%CI: 1.20, 1.34). Also women married at < 18 years were more likely to experience childbirth, compared to women married later (OR = 5.83; 95%CI: 5.45, 6.24). However, women married at < 18 years had a reduction in early childbirth and a rapid repeat of childbirth respectively. Conclusion Implementing policies and programmmes against child marriage would help to prevent adverse outcomes among women in sub-Saharan Africa. Also, social change programmes on child-marriage would help to reduce child marriage, encourage the use of modern contraceptive, which would minimize lifetime terminated pregnancy and also children ever born.

USING COUPLES’ DISCORDANT REPORTS TO ESTIMATE FEMALE COVERT USE OF MODERN CONTRACEPTION IN SUB-SAHARAN AFRICA

2017 ◽  
Vol 50 (3) ◽  
pp. 326-346 ◽  
Author(s):  
Natalie C. Gasca ◽  
Stan Becker
Keyword(s):  
Contraceptive Use ◽  
Modern Method ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Modern Contraceptive ◽  
African Countries ◽  
Couple Communication ◽  
Significant Difference ◽  
Contraceptive Prevalence ◽  
Sub Saharan

SummarySubstantial numbers of married women use contraceptives without their partner’s knowledge in sub-Saharan Africa, but studies of female covert use across time are rare. This study investigates the levels, trends and correlates of covert use in nine countries and determines which contraceptive methods are more frequently used covertly by women. Data from monogamous couples in Demographic and Health Surveys were used from nine sub-Saharan African countries that had experienced an increase of 10 percentage points in current modern contraceptive use between an earlier (1991–2004) and later (2007–2011) survey. Covert use was indirectly estimated as the percentage of women who reported a female modern method whose husband did not report a modern method. The percentage of women using covertly increased in eight of the countries studied (significantly in three of them), yet when comparing across countries cross-sectionally, covert use was lower where contraceptive prevalence was higher. In general, women with more years of schooling and those with larger spousal schooling gaps had lower odds of covert use. There was no significant difference between covert and open injectable use, though more than half of both groups used this method in the later surveys. Encouraging couple communication about contraception, where the woman feels it is safe to do so, could be an important strategy to minimize covert use. Further research is needed to better identify the contraceptive prevalence and social context in which covert use declines within a country.

Psychological distress among TB patients in sub-Saharan Africa

2020 ◽  
Vol 24 (11) ◽  
pp. 1200-1204
Author(s):  
B. Duko ◽  
L. M. Dana ◽  
G. Ayano
Keyword(s):  
Psychological Distress ◽  
Reference Lists ◽  
Sub Saharan Africa ◽  
Prevalence Estimate ◽  
African Countries ◽  
Future Clinical Practice ◽  
Pooled Prevalence ◽  
Sub Saharan ◽  
Leave One Out ◽  
Q Statistic

OBJECTIVE: To summarise the available evidence on the prevalence of psychological distress among patients with TB in sub-Saharan Africa, and suggest recommendations for future clinical practice.METHODS: We searched PubMed/Medline, SCOPUS and EMBASE databases for relevant studies. We further searched the reference lists of included studies to include other relevant studies. Cochran´s Q-statistic and the I2 test were used to compute the heterogeneity. The presence of publication bias was assessed by visual inspection of symmetry and Egger´s test.RESULTS: The pooled prevalence estimate of psychological distress among patients with TB in sub-Saharan African countries was 42.3% (95% CI 35.3–49.7). The pooled prevalence of psychological distress was 61.1% in Cameroon, 49.4% in Angola, 47.7% in Ethiopia, 34.0% in Nigeria and 29.3% in South Africa. The pooled prevalence estimate of psychological distress among patients with TB ranged from 40.1% to 43.7% in a leave-one-out-sensitivity analysis. Furthermore, the prevalence of psychological distress was higher in females when compared to males.CONCLUSION: The prevalence of psychological distress among TB patients was high. Therefore, TB programmes should integrate psychiatry services to screen and manage psychologically distressed patients.

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

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.

scholarly journals Postpartum Family Planning Use and Its Determinants among Women of the Reproductive Age Group in Low-Income Countries of Sub-Saharan Africa: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-14
Author(s):  
Tesfalem Tilahun Yemane ◽  
Getahun Gebre Bogale ◽  
Gudina Egata ◽  
Tilahun Kassa Tefera
Keyword(s):  
Systematic Review ◽  
Family Planning ◽  
Low Income ◽  
Contraceptive Use ◽  
Meta Analysis ◽  
Sub Saharan Africa ◽  
Low Income Countries ◽  
Modern Contraceptive ◽  
Pooled Prevalence ◽  
Sub Saharan

Background. Postpartum family planning is the initiation and use of family planning services within the first 12 months following childbirth. Postpartum contraceptives reduce maternal and infant mortality by preventing unplanned and unwanted pregnancies and by spacing pregnancies at least two years after the previous birth. Thus, it is usually designed as an integral part of reproductive and maternal and child health programs. Therefore, the aim of this systematic review and meta-analysis is to estimate the pooled prevalence of postpartum modern contraceptive use and identify its determinants in low-income countries of sub-Saharan Africa. Methods. A systematic review and meta-analysis of published and unpublished studies were used. PubMed, HINARI, ScienceDirect, Cochrane Library, Wiley Library, ETH Library, and Google Scholar were used to search all articles. STATA 14 software was used for data analysis. Funnel plots and Egger’s test were used to examine the risk of publication bias. Heterogeneity was checked by using Cochran’s Q test and I 2 test. A random effect model was computed to estimate the pooled prevalence. Results. A total of 33 articles were included. The pooled prevalence of postpartum contraceptive use in low-income countries of sub-Saharan Africa was 37.41%, 95% CI: (31.35, 43.48%). Secondary and above level of education (AOR 2.09, 95% CI: (1.52, 2.86)), discussion with husband (AOR 3.68, 95% CI: (1.96, 6.89)), resumption of menses (AOR: 3.98, 95% CI: (2.62, 6.03)), ANC follow-up (AOR; 5.10, 95% CI: (3.57, 7.29)), knowledge of modern family planning (AOR: 5.65, 95% CI: 3.58, 8.93)), and family planning counseling during ANC (AOR =5.92, 95% CI: (2.54, 13.79)) were found to be determinants of postpartum contraceptive utilization. Conclusion. In this systematic review and meta-analysis, the prevalence of postpartum modern contraceptive use was found to be low compared to the existing global recommendations. Therefore, empowering maternal education, delivering adequate counseling, and strengthening existing integrated maternal and child health services are highly recommended to increase postpartum contraceptive use. This trial is registered with CRD42020160612.

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