scholarly journals Women Deprivation Index and Family Planning Utilisation in Urban Geography of West African Countries

2021 ◽  
Vol 2 ◽  
Author(s):  
Akanni Ibukun Akinyemi ◽  
Jacob Wale Mobolaji ◽  
John Olugbenga Abe ◽  
Elhakim Ibrahim ◽  
Olutoyin Ikuteyijo
Keyword(s):  
Family Planning ◽  
Secondary Analysis ◽  
Binary Logistic Regression ◽  
Health Care Utilisation ◽  
West African ◽  
Modern Contraceptive ◽  
Binary Logistic Regression Model ◽  
African Countries ◽  
Log Odds ◽  
Long Acting

Inequalities in health care utilisation and outcomes vary significantly across geographies. Though available evidence suggests disparity in contraceptive uptake in favour of urban compared with rural geographies, there are unassessed nuances among women in urban communities. This study examines some of these disparities within the context of socioeconomic deprivations and family planning utilisation among urban women in West Africa. A secondary analysis of the most recent Demographic and Health Survey dataset of five selected West African countries was conducted, using pooled data of 21,641 women aged 15–49 years. Associations between family planning utilisation and women's deprivation status were investigated using a binary logistic regression model. The findings show that more than one-quarter of the women were severely deprived across the countries except Senegal (17.4%), and the severely deprived consistently have relatively low contraceptive prevalence rates (CPR) (16.0–24.3%) compared with women with no/low deprivation across the countries except Senegal (39.8%). The results for long-acting reversible contraceptives (LARC) were not consistent across the five countries: whereas, LARC utilisation was lower among severely deprived women in Nigeria (9.1%), Guinea (9.6%), and Mali (19.3%), utilisation was similar across the deprivation groups in Benin and Senegal. In the multivariable analyses, the log-odds of modern contraceptive utilisation decreases by 0.27 among the moderately deprived (ß = −0.27, SE = 0.05, p < 0.01) and by 0.75 among the severely deprived women (ß = −0.75, SE = 0.05, p < 0.01) compared with those with no/low deprivation, with variations across the countries. Similarly, the log-odds of LARC utilisation decreases by 0.44–0.72 among the severely deprived women compared with those with no/low deprivation across the countries except Senegal. This study concluded that family planning intervention programmes and policies need to underscore the deprivation context of urban geographies, particularly among women living in informal settlements.

scholarly journals International Migration and Modern Contraceptive Use: A Research Note on African Migrants to France

Demography ◽  
2021 ◽  
Author(s):  
Julia A. Behrman ◽  
Michelle A. Eilers ◽  
Isabel H. McLoughlin Brooks ◽  
Abigail Weitzman
Keyword(s):  
Contraceptive Use ◽  
Family Background ◽  
Research Note ◽  
Demographic And Health Surveys ◽  
Modern Contraceptive ◽  
African Countries ◽  
Proximate Determinant ◽  
African Migrants ◽  
Modern Contraceptive Use ◽  
Long Acting

Abstract This research note presents a multisited analysis of migration and contraceptive use by standardizing and integrating a sample of African migrants in France from six West and Central African countries in the Trajectoires et Origines survey with a sample of women living in the same six African countries in the Demographic and Health Surveys. Descriptive analyses indicate that the contraceptive use of migrants more closely aligns with that of native French women than with that of women from origin countries. In particular, migrants report dramatically higher use of long-acting reversible contraceptives and short-acting hormonal methods and lower use of traditional methods than do women in the countries of origin. Although migrants differ from women in the countries of origin on observed characteristics, including education and family background, reweighting women in the origin countries to resemble migrants on these characteristics does little to explain differences in contraceptive use between the groups. Given that contraceptive use is an important proximate determinant of fertility, our results suggest that contraceptive use should feature more prominently in the dominant demographic paradigms of migrant fertility.

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.

scholarly journals Fever and hypothermia represent two populations of sepsis patients and are associated with outside temperature

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Daniel O. Thomas-Rüddel ◽  
Peter Hoffmann ◽  
Daniel Schwarzkopf ◽  
Christian Scheer ◽  
Friedhelm Bach ◽  
...  
Keyword(s):  
Regression Model ◽  
Secondary Analysis ◽  
Temperature Response ◽  
Thermal Response ◽  
Binary Logistic Regression ◽  
High Fever ◽  
Multinomial Regression ◽  
Binary Logistic Regression Model ◽  
Multinomial Regression Model ◽  
Fever Response

Abstract Background Fever and hypothermia have been observed in septic patients. Their influence on prognosis is subject to ongoing debates. Methods We did a secondary analysis of a large clinical dataset from a quality improvement trial. A binary logistic regression model was calculated to assess the association of the thermal response with outcome and a multinomial regression model to assess factors associated with fever or hypothermia. Results With 6542 analyzable cases we observed a bimodal temperature response characterized by fever or hypothermia, normothermia was rare. Hypothermia and high fever were both associated with higher lactate values. Hypothermia was associated with higher mortality, but this association was reduced after adjustment for other risk factors. Age, community-acquired sepsis, lower BMI and lower outside temperatures were associated with hypothermia while bacteremia and higher procalcitonin values were associated with high fever. Conclusions Septic patients show either a hypothermic or a fever response. Whether hypothermia is a maladaptive response, as indicated by the higher mortality in hypothermic patients, or an adaptive response in patients with limited metabolic reserves under colder environmental conditions, remains an open question. Trial registration The original trial whose dataset was analyzed was registered at ClinicalTrials.gov (NCT01187134) on August 23, 2010, the first patient was included on July 1, 2011.

scholarly journals Assessing quality of family planning counseling and its determinants in Kenya: Analysis of health facility exit interviews

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0256295
Author(s):  
Susan Ontiri ◽  
Mark Kabue ◽  
Regien Biesma ◽  
Jelle Stekelenburg ◽  
Peter Gichangi
Keyword(s):  
Family Planning ◽  
Tertiary Education ◽  
Secondary Analysis ◽  
Modern Contraceptive ◽  
Health Providers ◽  
Family Planning Services ◽  
Information Index ◽  
Ordinal Logistic Regression Analysis ◽  
Family Planning Counseling

Background Available evidence suggests that provision of quality of care in family planning services is crucial to increasing uptake and continuation of use of contraception. Kenya achieved a modern contraceptive prevalence rate of 60% in 2018, surpassing its 2020 target of 58%. With the high prevalence, focus is geared towards improved quality of family planning services. The objective of this study is to examine the quality of family planning counseling and its associated factors in health facilities in Kenya. Methods We conducted a secondary analysis of the 2019 Kenya Performance Monitoring and Action, client exit data of women who had received family planning services. Quality of counseling was assessed using the Method Information Index Plus. We conducted a multivariable ordinal logistic regression analysis of data from 3,731 women to establish determinants of receiving quality family planning services. Results The Method Information Index Plus score for higher-quality counseling was 56.7%, lower-quality counseling 32.4%, and no counseling 10.9%. Women aged 15–24 years (aOR = 0.69, 95% CI = 0.56–0.86, p = 0.001) had lower odds of receiving better counseling compared to women aged 35 years and above. Those with no education (aOR = 0.52, 95% CI = 0.33–0.82, p = 0.005), primary (aOR = 0.56, 95% CI = 0.44–0.71, p<0.001) and secondary (aOR = 0.79, 95% CI = 0.65–0.98, p = 0.028) were less likely to receive better counseling compared to those with tertiary education. Women who received long acting and reversible contraception methods (aOR = 1.75, 95% CI = 1.42–2.17, p<0.001), and those who were method switchers (aOR = 1.24, 95% CI = 1.03–1.50, p = 0.027), had a higher likelihood of receiving better quality of counseling as compared to those on short-term methods and those who were continuers, respectively. Conclusion The quality of family planning counseling in Kenya is still sub-optimal considering that some women receive no form of counseling at service delivery point. There is need to review the existing FP guidelines and training packages to increase focus on the quality of counseling services offered by health providers. Social accountability strategies that empower women to demand quality services should be included in community-level family planning interventions.

scholarly journals Context-acceptability theories: example of family planning interventions in five African countries

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Jayne Webster ◽  
Shari Krishnaratne ◽  
Jenna Hoyt ◽  
Shiferaw Dechasa Demissie ◽  
Nathaly Spilotros ◽  
...  
Keyword(s):  
Family Planning ◽  
Low Birthweight ◽  
Analytical Framework ◽  
Modern Contraceptive ◽  
Structured Interviews ◽  
African Countries ◽  
Group Discussions ◽  
Effective Interventions ◽  
Key Stakeholders ◽  
Values And Beliefs

Abstract Background Family planning (FP) can lengthen birth intervals and potentially reduce the risk of foetal death, low birthweight, prematurity, and being small for gestational age. Effective FP is most easily achieved through access to and acceptability of modern contraceptive methods (MCMs). This study aimed to identify mechanisms of acceptability and the contexts in which they are triggered and to generate theories to improve the selection and implementation of effective interventions by studying an intervention integrating FP with childhood immunisation services. Methods Qualitative interpretative synthesis of findings from realist evaluations of FP interventions in five African countries was guided by an analytical framework. Empirical mechanisms of acceptability were identified from semi-structured interviews and focus group discussions with key stakeholders (N = 253). The context in which these mechanisms were triggered was also defined. Empirical mechanisms of acceptability were matched to constructs of a theoretical framework of acceptability. Context-acceptability theories (CATs) were developed, which summarised constructs of acceptability triggered for specific actors in specified contexts. Examples of interventions that may be used to trigger acceptability for these actors were described. Results Seven CATs were developed for contexts with strong beliefs in religious values and with powerful religious leaders, a traditional desire for large families, stigmatisation of MCM use, male partners who are non-accepting of FP, and rumours or experiences of MCM side effects. Acceptability mechanisms included alignment with values and beliefs without requiring compromise, actors’ certainty about their ability to avoid harm and make the intervention work, and understanding the intervention and how it works. Additionally, acceptability by one group of actors was found to alter the context, triggering acceptability mechanisms amongst others. Conclusions This study demonstrated the value of embedding realist approaches within implementation research. CATs are transferable theories that answer the question: given the context, what construct of acceptability does an intervention need to trigger, or more simply, what intervention do we need to apply here to achieve our outcomes? CATs facilitate transfer of interventions across geographies within defined contexts.

scholarly journals Spatial and Temporal Variations of Forest Cover in Developing Countries

2019 ◽  
Vol 11 (6) ◽  
pp. 1517 ◽  
Author(s):  
Qianwen Duan ◽  
Minghong Tan
Keyword(s):  
Developing Countries ◽  
South America ◽  
Forest Cover ◽  
European Space Agency ◽  
Binary Logistic Regression ◽  
Temporal Variations ◽  
Global Scale ◽  
Forest Area ◽  
Binary Logistic Regression Model ◽  
African Countries

An understanding of changes in forest cover and the drivers of forest transition (FT) contributes to the sustainable management of global forests. In this paper, we used the latest global land cover data published by the European Space Agency (ESA) to investigate spatiotemporal variation characteristics of forest cover in developing countries from 1992 to 2015, and then analyzed causal factors of this variation using a binary logistic regression model. Existing studies on FT are mostly based on data from the Food and Agriculture Organization (FAO); this study improves our understanding of FT mechanisms through the use of a new dataset. The results indicate that the forest area in developing countries decreased from 21.8 to 21.3 million km2 from 1992–2015, and the rate of decline slowed after 2004. South America suffered the largest reduction in forest area (505,100 km2), whereas forest area in Africa increased slightly. By 2015, more than 80% of African countries had experienced FT, whereas only half of developing countries experienced forest expansion in South America. The variables affecting FT occurrence differed among continents. On the global scale, the remaining forest coverage and the proportion of forest exports negatively affected the likelihood of FT occurrence, whereas urbanization level had a positive effect.

scholarly journals Factors affecting demand for modern contraceptives among currently married reproductive age women in rural Kebeles of Nunu Kumba district, Oromia, Ethiopia

2019 ◽  
Vol 4 (1) ◽  
Author(s):  
Alemu Kebede ◽  
Sileshi G. Abaya ◽  
Elias Merdassa ◽  
Tariku Tesfaye Bekuma
Keyword(s):  
Family Planning ◽  
Unmet Need ◽  
Cross Sectional Study ◽  
Married Women ◽  
Reproductive Age ◽  
Modern Contraceptive ◽  
Age Group ◽  
Cross Sectional ◽  
Modern Methods ◽  
Long Acting

Abstract Background Family planning plays a key role in improving the health of the mother and the child. Yet there are still significant levels of demand for family planning that are unmet and these can lead to unintended pregnancy. So, women’s demand for contraceptive utilization to limit, space, or delay the number of family size can be increased by integrating family planning service at each service delivery points. Objective The main aim of this study was to assess the demand for modern contraceptive and associated factors among currently married women of the reproductive age group in rural kebeles of Nunu Kumba District, 2015. Methods A community-based cross-sectional study design was conducted from January 15–30, 2015 among 584 systematically selected currently married women of reproductive age in six rural kebeles of Nunu Kumba District. A pre-tested and interviewer-administered questionnaire was used to collect the data. Data were analyzed using SPSS version 20. Descriptive statistics were done to summarize the data. A multivariate logistic regressions analysis method was employed and odds ratio with 95% confidence interval was used to control for possible confounders. P-value < 0.05 was used to declare a significant association. Results The total demand for modern methods of contraceptive was 450 (77.1%) of which 325 (55.7%) of them were current user and 125 (21.4%) of them were had unmet need for modern contraceptive methods. Being in the younger age group (15–24 and 25–34 years [AOR = 0.196; 95% CI: 0.055, 0.692] and [AOR = 0.179, 95% CI: 0.043, 0.745] respectively, husband having no intention for more children [AOR = 4.124, 95% CI: 1.891, 8.996], number of children alive [AOR = 2.617, 95% CI: 1.056, 6.486], and couples ever not discussed on family planning [AOR = 0.340, 95% CI: 0.187, 0.619] were factors associated with demand for modern methods of contraception. Conclusion The total demand for modern methods of contraceptive was high in the study area except for long-acting and permanent methods with high unmet need for spacing than for limiting. Therefore, any program aimed at promoting family planning at the district level should look for ways and means of increasing demand for long-acting and permanent family planning methods and encouraging husband involvement to increase its utilization.

scholarly journals Geospatial Distribution of Family Planning Services in Kira Municipality, Wakiso District, Uganda

2021 ◽  
Vol 1 ◽  
Author(s):  
Moses Tetui ◽  
Tonny Ssekamatte ◽  
Pierre Akilimali ◽  
Judith Sirike ◽  
Osvaldo Fonseca-Rodríguez ◽  
...  
Keyword(s):  
Family Planning ◽  
Local Governments ◽  
Unmet Need ◽  
Quality Data ◽  
Modern Contraceptive ◽  
Contraceptive Methods ◽  
Cross Sectional ◽  
Unintended Pregnancies ◽  
Long Acting ◽  
Privately Owned

Introduction: Access to family planning (FP) services remains a challenge, particularly in informal urban settlements. The unmet need for FP in these settings is high, with a correspondingly high prevalence of unintended pregnancies that may lead to unsafe abortions. However, there is a paucity of quality data on the distribution of FP services in such settings in Uganda. This paper described the geospatial distribution of FP services in Kira Municipality, Wakiso District, Uganda.Methods: This was a cross-sectional study in which we determined the availability and distribution of FP services in Kira Municipality. Community mapping and analysis were conducted using ArcGIS (version 10.1) and ArcGIS Online. Stata version 13.1 was used for data analysis. Chi-square test was used to compare the contraceptive provision and availability among facilities from informal and formal settlements.Results: Of the 176 healthcare facilities surveyed, only 42% (n = 74) offered contraceptives in informal settlements. The majority of the facilities were privately owned small clinics (95%). At least 80% of the facilities provided three or more modern contraceptive methods, with no difference (p = 0.107) between facilities in informal and formal settlements. Only 30.7% (p = 0.001) of the facilities provided at least one long-acting contraceptive. Similarly, 20 and 12% (p = 0.001) of the facilities had implants and intrauterine devices (IUDs) on the day of the survey. Almost 25% of the facilities did not offer contraceptive services (counseling and commodities) to unmarried adolescents.Conclusions: Most facilities were small privately-owned clinics, offering at least three modern contraceptive methods. The unavailability of long-acting reversible methods in the informal settings may affect the quality of FP services due to limited choice. The inequity in service provision that disfavors the unmarried adolescent may increase unwanted/unintended pregnancies. We recommend that local governments and partners work toward filling the existing commodities gap and addressing the discrimination against unmarried adolescents in such settings.

scholarly journals Modern contraceptive use among women in need of family planning in India: an analysis of the inequalities related to the mix of methods used

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Fernanda Ewerling ◽  
Lotus McDougal ◽  
Anita Raj ◽  
Leonardo Z. Ferreira ◽  
Cauane Blumenberg ◽  
...  
Keyword(s):  
Family Planning ◽  
Contraceptive Use ◽  
Wealth Quintile ◽  
Modern Method ◽  
Modern Contraceptive ◽  
Contraceptive Methods ◽  
Modern Methods ◽  
Centered Care ◽  
Using Data ◽  
Long Acting

Abstract Objective To evaluate the type of contraceptives used by women in need of family planning in India and the inequalities associated with that use according to women's age, education, wealth, subnational region of residence and empowerment level. Methods Using data from the Indian National Family and Health Survey-4 (2015–2016), we evaluated the proportion of partnered women aged 15–49 years with demand for family planning satisfied (DFPS) with modern contraceptive methods. We also explored the share of each type of contraception [short- (e.g., condom, pill) and long-acting (i.e., IUD) reversible contraceptives and permanent methods] and related inequalities. Results The majority (71.8%; 95% CI 71.4–72.2) of women in need of contraception were using a modern method, most (76.1%) in the form of female sterilization. Condom and contraceptive pill were the second and third most frequently used methods (11.8% and 8.5%, respectively); only 3.2% reported IUD. There was a nearly linear exchange from short-acting to permanent contraceptive methods as women aged. Women in the poorest wealth quintile had DFPS with modern methods at least 10 percentage points lower than other women. We observed wide geographic variation in DFPS with modern contraceptives, ranging from 23.6% (95% CI 22.1–25.2) in Manipur to 93.6% (95% CI 92.8–94.3) in Andhra Pradesh. Women with more accepting attitudes towards domestic violence and lower levels of social independence had higher DFPS with modern methods but also had higher reliance on permanent methods. Among sterilized women, 43.2% (95% CI 42.7–43.7) were sterilized before age 25, 61.5% (95% CI 61.0–62.1) received monetary compensation for sterilization, and 20.8% (95% CI 20.3–21.3) were not informed that sterilization prevented future pregnancies. Conclusion Indian family planning policy should prioritize women-centered care, making reversible contraceptive methods widely available and promoted.

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