Preconception Care in Sub Saharan Africa: A Systematic Review and Meta-analysis on Prevalence and Its Correlation With Knowledge Level Among Women in Reproductive Age Group

Author(s):  
Demelash Woldeyohannes ◽  
Yohannes Tekalegn ◽  
Biniyam Sahiledengle ◽  
Desta Erkalo ◽  
Zeleke Hailemariam ◽  
...  

Abstract BackgroundThe aim of the preconception care (PCC) is to promote the health of women in the reproductive age before the conception in order to reduce preventable poor pregnancy outcomes. Although there are several published primary studies from Sub Saharan African (SSA) countries on PCC, they do not quantify the extent of PCC Utilisation, Knowledge level about PCC and the association between them among women in the reproductive age group in this region. This systematic review and meta-analysis aimed to estimate the pooled utilisation of PCC, Pooled knowledge level about PCC and their association among women in the reproductive age group in Sub Saharan Africa.MethodsDatabases including PubMed, Science Direct, Hinari, Google Scholar and Cochrane library were systematically searched for literature. Additionally, the references of appended articles were checked for further possible sources. The Cochrane Q test statistics and I2 tests were used to assess the heterogeneity of the included studies. A random-effect meta-analysis model was used to estimate pooled the prevalence of PCC, knowledge level of PCC and their correlation among reproductive aged women in Sub-Saharan African countries.ResultsOf the identified 1593 articles, 20 studies were included in the final analysis. The pooled utilisation of PCC and good knowledge level towards PCC among women of reproductive age group in Sub Saharan Africa were found to be 24.05% (95% CI: 16.61, 31.49) and 33.27% (95% CI: 24.78, 41.77), respectively. Women in the reproductive age group with good knowledge level were two times more likely to utilize the PCC than the women with poor knowledge level in Sub Saharan Africa (OR: 2.35, 95% CI: 1.16, 4.76). ConclusionIn SSA Countries, the utilisation of PCC and knowledge towards PCC were low. Additionally, the current meta-analysis found good knowledge level to be significantly associated with utilisation of PCC among women in the reproductive age. These findings indicate that, it is imperative to launch programs to uplift knowledge level about PCC utilisation among women in reproductive age group in SSA countries.

2019 ◽  
Author(s):  
Daniel Belema Fekene ◽  
BENYAM SEIFU WOLDEYES ◽  
MARU MOSSISA ERENA ◽  
GETU ALEMU DEMISSE

Abstract Background Preconception care is a set of interventions that are to be provided before pregnancy, to promote the health and well-being of women and couples.Methods A community based cross-sectional study was employed among 669 reproductive aged women from November 2017 to the end of January 2018. The data were collected using pre-tested and structured questionnaire . The collected data were coded and entered into Epi Data version 3.1 and exported to SPSS 25 for analysis. Bivariate and multivariate logistic regression models were utilized to determine factors associated with outcome variable .Association presented in Odds ratio with 95% confidence interval and significance determined at P-value less than 0.05.Result A total of 669 participants had participated with response rate of 98.3%. Among them only 179(26.8%) had good PCC knowledge and 97(14.5%) of women of reproductive age group have utilized preconception care. Factors that show significant association with good knowledge of PCC are history of institutional delivery (AOR = 1.43 (95%CI (1.31 -7.33), PNC service utilization, (AOR = 5.02 (95%CI (3.22-7.84), history of using modern contraceptive, (AOR = 1.44 (95%CI (1.37-6.98)) higher educational status (AOR= 4.12 (95%CI (1.22-6.52)and being regularly employed (AOR = 1.8 (95%CI (1.01-3.22). Factors like better family monthly income (AOR = 4.1 (95%CI (1.57-9.35)), history of PNC (AOR = 6.33 (95%CI (3.94-10.17) and good knowledge of PCC (AOR = 4.3 (95%CI (2.67-6.98) had showed positive association towards uptake of PCC.


2019 ◽  
Author(s):  
Daniel Belema Fekene ◽  
BENYAM SEIFU WOLDEYES ◽  
MARU MOSSISA ERENA ◽  
GETU ALEMU DEMISSE

Abstract Background Preconception care is a set of interventions that are to be provided before pregnancy, to promote the health and well-being of women and couples.Methods A community based cross-sectional study was employed among 669 reproductive aged women from November 2017 to the end of January 2018. The data were collected using pre-tested and structured questionnaire . The collected data were coded and entered into Epi Data version 3.1 and exported to SPSS 25 for analysis. Bivariate and multivariate logistic regression models were utilized to determine factors associated with outcome variable .Association presented in Odds ratio with 95% confidence interval and significance determined at P-value less than 0.05.Result A total of 669 participants had participated with response rate of 98.3%. Among them only 179(26.8%) had good PCC knowledge and 97(14.5%) of women of reproductive age group have utilized preconception care. Factors that show significant association with good knowledge of PCC are history of institutional delivery (AOR = 1.43 (95%CI (1.31 -7.33), PNC service utilization, (AOR = 5.02 (95%CI (3.22-7.84), history of using modern contraceptive, (AOR = 1.44 (95%CI (1.37-6.98)) higher educational status (AOR= 4.12 (95%CI (1.22-6.52)and being regularly employed (AOR = 1.8 (95%CI (1.01-3.22). Factors like better family monthly income (AOR = 4.1 (95%CI (1.57-9.35)), history of PNC (AOR = 6.33 (95%CI (3.94-10.17) and good knowledge of PCC (AOR = 4.3 (95%CI (2.67-6.98) had showed positive association towards uptake of PCC.


2019 ◽  
Author(s):  
Daniel Belema Fekene ◽  
BENYAM SEIFU WOLDEYES ◽  
MARU MOSSISA ERENA ◽  
GETU ALEMU DEMISSE

Abstract Background Preconception care is a set of interventions that are to be provided before pregnancy, to promote the health and well-being of women and couples.Methods A community based cross-sectional study was employed among 669 reproductive aged women from November 2017 to the end of January 2018. The data were collected using pre-tested and structured questionnaire and thirty in-depth interviews were done using an interview guide. The collected data were coded and entered into Epi Data version 3.1 and exported to SPSS 25 for analysis. Bivariate and multivariate logistic regression models were utilized to determine factors associated with outcome variable .Association presented in Odds ratio with 95% confidence interval and significance determined at P-value less than 0.05.Result A total of 669 participants had participated with response rate of 98.3%. Among them only 179(26.8%) had good PCC knowledge and 97(14.5%) of women of reproductive age group have utilized preconception care. Factors that show significant association with good knowledge of PCC are history of institutional delivery (AOR = 1.43 (95%CI (1.31 -7.33), PNC service utilization, (AOR = 5.02 (95%CI (3.22-7.84), history of using modern contraceptive, (AOR = 1.44 (95%CI (1.37-6.98)) higher educational status (AOR= 4.12 (95%CI (1.22-6.52)and being regularly employed (AOR = 1.8 (95%CI (1.01-3.22). Factors like better family monthly income (AOR = 4.1 (95%CI (1.57-9.35)), history of PNC (AOR = 6.33 (95%CI (3.94-10.17) and good knowledge of PCC (AOR = 4.3 (95%CI (2.67-6.98) had showed positive association towards uptake of PCC.


2020 ◽  
Vol 46 (1) ◽  
Author(s):  
Zemenu Tadesse Tessema ◽  
Lake Yazachew ◽  
Getayeneh Antehunegn Tesema ◽  
Achamyeleh Birhanu Teshale

Abstract Introduction Globally, over 65% of maternal deaths occur during the first 42 days of postpartum while the same proportion of neonatal deaths occur during the first 7 days of life. In sab- Saharan Africa, 4.7 million mothers, newborns, and children die on annual basis. As to our knowledge, there is no study on postnatal care utilization that incorporates all sub-Saharan Africa countries that had DHS data. Therefore, this study aimed at identifying pooled magnitude and determinants of postnatal care utilization in sub-Saharan Africa. Method A population-based cross-sectional study from the most recent Demographic and Health Surveys data from the period of 2006 to 2018 of 36 SSA countries were used. A total weighted sample of 286,255 reproductive-age women who gave birth 5 years preceding the survey were included in the study. A meta-analysis of DHS data of each Sub-Saharan countries was conducted to generate pooled magnitude and a forest plot was used to present it. A multilevel logistic regression model was fitted to identify determinants of postnatal care utilization. The AOR (Adjusted Odds Ratio) with their 95% CI and p-value ≤0.05 was used to declare that determinates associated with postnatal care utilization. Result The pooled magnitude of postnatal care utilization in sub-Saharan Africa countries was 52.48% [95% CI: 52.33, 52.63], with the highest postnatal care utilization in the Central Region of Africa (73.51%) and the low postnatal care utilization in Eastern Regions of Africa (31.71%). In the multilevel logistic regression model region, residence, age group, maternal education, maternal occupation, media exposure, ANC visit, place of delivery, and accessing health care were determinants of postnatal care utilization in Sub-Saharan Africa. Conclusion The coverage of postnatal care service utilization was low with high disparities among the region. Being in rural residence, young age group, low education level, had no occupation, not exposed to media, a big problem to access health care, not had ANC visit, and home delivery was associated with low postnatal care service utilization. This study evidenced that there is a wide gap in postnatal care utilization between SSA countries. Special attention is required to improve health accessibility, utilization, and quality of maternal health services to increase postnatal care service utilization in the region.


2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Rahel Abera ◽  
Mesfin Kote ◽  
Mulugeta Shegaze ◽  
Eshetu Andarge ◽  
Sultan Hussen

Globally, 53% of women in reproductive age group use modern methods of contraception, with less than one percent of which using implants. In Ethiopia and other parts of sub-Saharan Africa, short-term contraceptive methods have been more utilized than long-acting methods like implants. Despite their effectiveness, implants have been underutilized due to various reasons. There is a dearth of stronger evidences on those factors in the country in general and the study area in particular. Therefore, this study aimed to identify determinants of implant utilization among married women of reproductive age at Chencha town, Gamo Gofa Zone, Southern Nations, Nationalities, and Peoples’ Region (SNNPR) of Ethiopia. A community-based case-control study design was conducted among 324 women of reproductive age, 90 cases (users of implants) and 234 controls (users of short-acting contraceptives) from July to August 2017. Data were collected using a pretested, structured questionnaire through face-to-face interview. The data were entered and coded using Epi info 3.5.1 and then exported to Statistical Package for Social Sciences (SPSS) version 20 for cleaning and analysis. Descriptive analysis was done to quantify proportions, means, and standard deviations of variables. Bivariate and multivariable logistic regressions were done to identify the determinants of implant utilization. A total of 324 married women of reproductive age group were interviewed with response rate of 98%. In this study, the major determinants for implant utilization were desire to have 3–4 children {AOR = 0.104, 95% CI (0.03, 0.4)}, husband disproval {AOR = 0.11, 95% CI (0.038, 0.314)}, joint decision {AOR = 3.11, 95% CI (1.02, 9.48)}, and decision by other persons {AOR = 0.065, 95% CI (0.012, 0.352)}. This study found out that desire to have more children, husband disapproval, joint decision making, and decision by other persons were determinants of implant utilization among the target women. Implant utilization would improve through strengthening existing interventions targeting women with high fertility desire, transformation of gender norms in household decisions, and counseling for informed decisions.


PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244875
Author(s):  
Kenneth Setorwu Adde ◽  
Kwamena Sekyi Dickson ◽  
Hubert Amu

Introduction Maternal mortality is an issue of global public health concern with over 300,000 women dying globally each year. In sub-Saharan Africa (SSA), these deaths mainly occur around childbirth and the first 24hours after delivery. The place of delivery is, therefore, important in reducing maternal deaths and accelerating progress towards attaining the 2030 sustainable development goals (SDGs) related to maternal health. In this study, we examined the prevalence and determinants of the place of delivery among reproductive age women in SSA. Materials and methods This was a cross-sectional study among women in their reproductive age using data from the most recent demographic and health surveys of 28 SSA countries. Frequency, percentage, chi-square, and logistic regression were used in analysing the data. All analyses were done using STATA. Results The overall prevalence of health facility delivery was 66%. This ranged from 23% in Chad to 94% in Gabon. More than half of the countries recorded a less than 70% prevalence of health facility delivery. The adjusted odds of health facility delivery were lowest in Chad. The probability of giving birth at a health facility also declined with increasing age but increased with the level of education and wealth status. Women from rural areas had a lower likelihood (AOR = 0.59, 95%CI = 0.57–0.61) of delivering at a health facility compared with urban women. Conclusions Our findings point to the inability of many SSA countries to meet the SDG targets concerning reductions in maternal mortality and improving the health of reproductive age women. The findings thus justify the need for peer learning among SSA countries for the adaption and integration into local contexts, of interventions that have proven to be successful in improving health facility delivery among reproductive age women.


1996 ◽  
Vol 28 (1) ◽  
pp. 25-35 ◽  
Author(s):  
Eric O. Udjo

SummaryWith an unequalled contraceptive prevalence rate in sub-Saharan Africa, of 43% among currently married women in Zimbabwe, the Central Statistical Office (1989) observed that fertility has declined sharply in recent years. Using data from several surveys on Zimbabwe, especially the birth histories of the Zimbabwe Demographic and Health Survey, this study examines fertility trends in Zimbabwe. The results show that the fertility decline in Zimbabwe is modest and that the decline is concentrated among high order births. Multivariate analysis did not show a statistically significant effect of contraception on fertility, partly because a high proportion of Zimbabwean women in the reproductive age group never use contraception due to prevailing pronatalist attitudes in the country.


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