scholarly journals Assessing Wealth-Related Inequalities in Demand for Family Planning Satisfied in 43 African Countries

2021 ◽  
Vol 2 ◽  
Author(s):  
Franciele Hellwig ◽  
Carolina V. N. Coll ◽  
Cauane Blumenberg ◽  
Fernanda Ewerling ◽  
Caroline W. Kabiru ◽  
...  
Keyword(s):  
Family Planning ◽  
Reproductive Health ◽  
Urban Areas ◽  
Urban Poverty ◽  
Informal Settlements ◽  
Household Wealth ◽  
Modern Contraceptive ◽  
African Countries ◽  
Wealth Inequalities ◽  
Almost All

Background: Around 80% of the African population lives in urban areas, and a rapid urbanization is observed in almost all countries. Urban poverty has been linked to several sexual and reproductive health risks, including high levels of unintended pregnancies. We aim to investigate wealth inequalities in demand for family planning satisfied with modern methods (mDFPS) among women living in urban areas from African countries.Methods: We used data from 43 national health surveys carried out since 2010 to assess wealth inequalities in mDFPS. mDFPS and the share of modern contraceptive use were stratified by groups of household wealth. We also assessed the ecological relationship between the proportion of urban population living in informal settlements and both mDFPS and inequalities in coverage.Results: mDFPS among urban women ranged from 27% (95% CI: 23–31%) in Chad to 87% (95% CI: 84–89%) in Eswatini. We found significant inequalities in mDFPS with lower coverage among the poorest women in most countries. In North Africa, inequalities in mDFPS were identified only in Sudan, where coverage ranged between 7% (95% CI: 3–15%) among the poorest and 52% (95% CI: 49–56%) among the wealthiest. The largest gap in the Eastern and Southern African was found in Angola; 6% (95% CI: 3–11%) among the poorest and 46% (95% CI: 41–51%) among the wealthiest. In West and Central Africa, large gaps were found for almost all countries, especially in Central African Republic, where mDFPS was 11% (95% CI: 7–18%) among the poorest and 47% (95% CI: 41–53%) among the wealthiest. Inequalities by type of method were also observed for urban poor, with an overall pattern of lower use of long-acting and permanent methods. Our ecological analyses showed that the higher the proportion of the population living in informal settlements, the lower the mDFPS and the higher the inequalities.Conclusion: Our results rise the need for more focus on the urban-poorer women by public policies and programs. Future interventions developed by national governments and international organizations should consider the interconnection between urbanization, poverty, and reproductive health.

Characteristics and attitudes of family planners in Khartoum, Sudan

1982 ◽  
Vol 14 (1) ◽  
pp. 7-16 ◽  
Author(s):  
M. A. Khalifa
Keyword(s):  
Family Planning ◽  
Birth Control ◽  
Early Stage ◽  
Significant Proportion ◽  
Large Family ◽  
Capital City ◽  
Age Group ◽  
African Countries ◽  
The Mean ◽  
Almost All

SummaryIn a survey of 1475 urban Moslem wives in the age group 15–49 living in the capital city of the Sudan, knowledge of birth control was reported by almost all respondents while a significant proportion had used contraception at least once. The mean age of the users was 32·8 years, their duration of marriage was 15·1 years and their mean number of surviving children was 4·6. Those who had never used contraception had a higher mean age, a longer duration of marriage and more surviving children. Most of the users had an urban residential background and belonged to the high socioeconomic class. They held favourable attitudes to family planning. Although they thought that having a large family (more than five children) was not desirable, their mean preferred family size was no different from that of the never users.The results indicate that contraception is used for the purpose of spacing births rather than limiting their ultimate number. At this early stage of contraceptive adoption in Sudan, the characteristics of the pioneer acceptors are similar to those observed in other African countries.

scholarly journals Determinants Associated with Discontinuation of Modern Contraceptive in East Kalimantan: a Further Analysis of Indonesia Demographic and Health Survey 2017

2020 ◽  
Vol 8 (2) ◽  
Author(s):  
Ike Anggraeni ◽  
Annisa Nurrachmawati ◽  
Winardi Winardi ◽  
Hasmawati Hasmawati ◽  
Dewi Endah Ramadhani
Keyword(s):  
Family Planning ◽  
Health Survey ◽  
Urban Areas ◽  
Demographic And Health Survey ◽  
Modern Contraceptive ◽  
Entertainment Education ◽  
Childbearing Age ◽  
Cross Sectional ◽  
East Kalimantan ◽  
Modern Contraceptives

The national family planning program in East Kalimantan needs to achieve a larger target on modern contraceptives. Despite the fertility decline, this program still facing increasing discontinuation rates. A better understanding of the factors behind the discontinuation of a modern method would help in improving programs. This study aims to analyze the determinants of discontinuation of modern contraceptive use. This was a cross-sectional study, the dataset came from Indonesia Demographic and Health Survey 2017 of East Kalimantan Province. The sample is all couples of childbearing age between 10–49 years with marital status who have used and are still using contraception (408 samples). Descriptive analyses were used to assess the reasons for discontinuation. Multiple logistic regression was used to estimate the likelihood of discontinuation by demographic characteristics and others. The proportion of respondents who continue using modern contraceptives was 51%, against 49% discontinuation. The reasons for discontinuation were the husband’s disapproval (31%) and health problems related to side effects (26.5%). In the multivariate analysis showed maternal age, women who live in urban areas, and women with birth planning near the future will have an opportunity to discontinue in modern contraceptives. It concluded that there is still high modern contraceptive discontinuation in East Kalimantan, therefore it needed for disseminating information through entertainment-education in social media, health workers better counseling services from also better tools, and include the male participation in family planning counseling. DETERMINAN YANG BERHUBUNGAN DENGAN PUTUS PAKAI KONTRASEPSI MODERN DI KALIMANTAN TIMUR: ANALISIS LANJUT SURVEI DEMOGRAFI DAN KESEHATAN INDONESIA 2017Program keluarga berencana nasional di Kalimantan Timur perlu mencapai target yang lebih baik dalam penggunaan kontrasepsi modern. Meskipun terdapat penurunan fertilitas, namun program keluarga berencana masih menghadapi peningkatan angka putus pakai. Pemahaman yang lebih baik tentang faktor-faktor di balik putus pakai metode kontrasepsi modern akan membantu meningkatkan program. Penelitian ini bertujuan menganalisis faktor-faktor penentu putus pakai penggunaan kontrasepsi modern. Desain penelitian ini adalah cross-sectional, set data berasal dari Survei Demografi Kesehatan Indonesia 2017 untuk Provinsi Kalimantan Timur. Sampel adalah semua pasangan usia subur berusia 10–49 tahun dengan status perkawinan baik bagi yang pernah menggunakan dan masih menggunakan kontrasepsi, yaitu 408 sampel. Analisis deskriptif digunakan untuk menilai alasan putus pakai. Regresi logistik berganda digunakan untuk memperkirakan kemungkinan putus pakai berdasar atas karakteristik demografis dan lainnya. Proporsi responden yang masih terus menggunakan kontrasepsi modern adalah 51% dibanding dengan 49% putus pakai. Alasan penghentian adalah ketidaksetujuan suami (31%) dan masalah kesehatan yang berkaitan dengan efek samping (26,5%). Dalam analisis multivariat menunjukkan usia ibu, wanita yang tinggal di daerah perkotaan, dan wanita dengan perencanaan kelahiran dalam waktu dekat akan memiliki kesempatan untuk berhenti menggunakan kontrasepsi modern. Dapat disimpulkan bahwa kejadian putus pakai kontrasepsi modern masih tinggi di Kalimantan Timur, oleh karena itu diperlukan diseminasi informasi melalui entertainment-education dalam sosial media, layanan konseling dari petugas kesehatan, serta alat bantu konseling yang lebih baik dan juga keikutsertaan pria dalam proses konseling.

scholarly journals Impact of COVID-19 on maternal healthcare in Africa and the way forward

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Edward Kwabena Ameyaw ◽  
Bright Opoku Ahinkorah ◽  
Abdul-Aziz Seidu ◽  
Carolyne Njue
Keyword(s):  
Family Planning ◽  
Reproductive Health ◽  
Sexual And Reproductive Health ◽  
Healthcare Providers ◽  
Healthcare Services ◽  
Expert Advice ◽  
Maternal Healthcare ◽  
African Countries ◽  
Family Planning Services ◽  
The Impact

Abstract Background The impact of COVID-19 is weighing heavily on many African countries. As of November 14th 2021, 6,109,722 cases had been recorded with 151,173 deaths and 2.5% case fatality rate. Studies reveal substantial morbidity and socioeconomic impacts when accessing quality maternal healthcare including fear of infection and the containment measures in place, including social distancing and community containment. The pandemic has put additional strain on healthcare systems that are overburdened and under-resourced even in normal times and has exposed the vulnerabilities of high-risk population groups in addressing critical healthcare concerns. This study presents a mini review of how COVID-19 has disrupted maternal healthcare in Africa, and it further proposes ways to improve the situation. Main body COVID-19 has disrupted antenatal, skilled birth, and postnatal family planning services. Women and girls are vulnerable to the impact of COVID-19 on several fronts and represent a group whose needs including antenatal, skilled birth, and postnatal family planning services have been disrupted, leading to unmet needs for contraception and an increase in unintended pregnancies. Restricted travel due to the fear and anxiety associated with contracting COVID-19 has resulted in delays in accessing prompt skilled care and essential healthcare services such as pregnancy care, immunisation, and nutritional supplementation. Misconceptions relating to COVID-19 have prompted concerns and created distrust in the safety of the healthcare system. Innovative measures are required to address these obstacles and ensure women are not denied access to available, accessible, acceptable, and quality maternal healthcare services in spite of COVID-19. Conclusions In the immediate term while physical distancing measures remain in force, deliberate effort must be made to provide evidence-based guidelines, good practice and expert advice that addresses the unique sexual and reproductive health context of African countries. Efforts to train and motivate healthcare providers to adopt online, remote approaches such as use of telemedicine, and expand the involvement of frontline maternal healthcare providers to deliver information on the availability of services through phone-based referral networks, culturally appropriate social media, community radio and folklore messaging strategies are critical to mobilise and secure community confidence in the safety of sexual and reproductive health and maternal care services.

scholarly journals Patterns of access to reproductive health services in Ghana and Nigeria: results of a cluster analysis

2020 ◽  
Author(s):  
Oluwasegun Jko Ogundele ◽  
Milena Pavlova ◽  
Wim Groot
Keyword(s):  
Cluster Analysis ◽  
Family Planning ◽  
Maternal Health ◽  
Reproductive Health ◽  
Health Services ◽  
Multinomial Logistic Regression ◽  
Maternal Health Services ◽  
Household Wealth ◽  
Reproductive Health Services ◽  
Poor Access

Abstract Background To understand differences in access to reproductive healthcare services, the use of family planning and maternal care by women in Ghana and Nigeria is examined.Methods We used population-level data from the Ghana and Nigeria Demographic Health Surveys of 2014 and 2013 in two-step cluster analysis followed by multinomial logistic regression analysis.Results The initial two-step cluster analyses on family planning identify three groups of women in Ghana and Nigeria: women with high, medium and poor access to family planning services. The subsequent two-step cluster analyses identify five distinct groups: higher, high, medium, low and poor access to maternal health services in Ghana and Nigeria. The multinomial logistic regression shows that education and occupation are associated with access to family planning and maternal health services. Women without education often have poor access to reproductive health services in both countries. In Nigeria, household wealth is strongly associated with access to maternal health services but household wealth does not explain access in Ghana. Not having insurance in Ghana is associated with low access to family planning service, while this is not the case in Nigeria.Conclusions These differences confirm the importance of a focused context-specific approach towards reproductive health services, particularly to reduce inequality in access resulting from socioeconomic status.

scholarly journals Assessing the Acceptability of Vasectomy as a Family Planning Option: A Qualitative Study with Men in the Kingdom of Eswatini

2019 ◽  
Vol 16 (24) ◽  
pp. 5158 ◽  
Author(s):  
Philile Shongwe ◽  
Busisiwe Ntuli ◽  
Sphiwe Madiba
Keyword(s):  
Family Planning ◽  
Reproductive Health ◽  
Urban Areas ◽  
Cultural Beliefs ◽  
Sub Saharan Africa ◽  
Group Discussions ◽  
Adult Men ◽  
Societal Norms ◽  
Willingness To Adopt ◽  
Sub Saharan

The uptake of vasectomy in many countries in sub-Saharan Africa is low. In Eswatini, a kingdom with strong patriarchal norms, the use of vasectomy is at 0.3%. This is despite great efforts to introduce vasectomy and involve men in reproductive health. This study explored the views of men about the acceptability of vasectomy and their willingness to adopt vasectomy as a family planning option. Focus group discussions were conducted with adult men recruited from health facilities located in rural, semi urban, and urban areas in two of the regions of Eswatini. A thematic approach was used to analyze the data. The acceptability of and intention to use vasectomy as a family planning option was very low. Cultural beliefs, societal norms, lack of knowledge about the procedure for vasectomy, and misconceptions influenced the acceptability of vasectomy greatly. The participants could not grasp the concept of a family planning method that is as permanent as vasectomy. However, the decisions to accept or reject vasectomy were influenced by their misconceptions and fears about vasectomy and were not based on facts. To address the need to involve men in reproductive health and improve the acceptability and adoption of vasectomy, planning should be conducted with them and informed by their understanding of their needs.

scholarly journals Geographic distribution and socio-economic determinants of women's nutritional status in Mali households

2012 ◽  
Vol 16 (9) ◽  
pp. 1575-1585 ◽  
Author(s):  
Constance A Gewa ◽  
Timothy F Leslie ◽  
Lisa R Pawloski
Keyword(s):  
Urban Areas ◽  
System Analysis ◽  
Wealth Index ◽  
Household Wealth ◽  
Iodized Salt ◽  
Reproductive Age ◽  
Cluster Sampling ◽  
Modern Contraceptive ◽  
Geographic Variations ◽  
North East

AbstractObjectiveMali is one of the poorest countries in Africa, with 72 % of its population surviving on less than $US 1·00 per day. Health and demographic indicators are bleak. With few exceptions, studies related to the health of women in Mali have largely been under-represented. In addition, in recent years a new type of malnutrition stemming from weight gain and obesity has been observed throughout Africa. The present study aimed to (i) describe geographic and health variations of women of reproductive age, (ii) describe geographic variations of household salt iodine levels and (iii) investigate potential factors associated with women's anthropometric status and use of adequately iodized salt among households in Mali.DesignDemographic and Health Survey data, multistage-stratified cluster sampling methodology.SettingRural and urban areas of Mali.SubjectsNon-pregnant women (n 6015) between the ages of 19 and 44 years.ResultsNineteen per cent of the women were overweight or obese while 11 % were underweight. Seventy-eight per cent of the households utilized adequately iodized salt. Underweight women were more prevalent in southern Mali, while obesity was more frequent in the north-east and within the major urban areas. Households located within the southern parts of Mali were more likely to utilize adequately iodized salt. Education, age, modern contraceptive use, breast-feeding status at time of the survey and household wealth index were significantly associated with the women's BMI or households’ use of adequately iodized salt.ConclusionsThe combined use of statistical and geographic system analysis contributes to improve targeting of interventions among vulnerable populations.

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 Rural-Urban Disparities in the Acceptance and Adoption of Family Planning among Couples in Oyo State, Nigeria

2021 ◽  
Vol 8 (3) ◽  
pp. 31-47
Author(s):  
Stella Akinso
Keyword(s):  
Family Planning ◽  
Health Care Providers ◽  
Urban Areas ◽  
Contraceptive Use ◽  
Reproductive Age ◽  
Family Type ◽  
Living Standard ◽  
Modern Contraceptive ◽  
Care Providers ◽  
Rural And Urban

Modern contraceptive use can enhance the living standard and reduce mortality among people living in rural and urban areas. However, contraceptive use tends to be low in the rural than the urban populace. A descriptive, cross-sectional study of systematic sampling technique was used to select 570 persons of reproductive age in the rural and urban communities of Oyo State. A semi-structured questionnaire on socio-demographic characteristics, knowledge, attitude and factors influencing uptake of modern contraceptives was administered to respondents. of the 570 respondents, the mean age was 34.3 ±8.4 years. The majority (63.3%) were female compared to 36.7% male respondents. Most (97.0%) of respondents had heard of family planning in the past. The result shows significant differences in location, gender, marital status, occupation, ethnicity, and a number of children (P<0.001). The majority (33.3%) of the respondents sourced family planning information from health care providers, while 31.3% sourced theirs from mass media – Radio, TV, or newspapers. Respondents in urban areas were currently using family planning methods than respondents in rural areas (61.8% vs. 38.2%). People in the urban area are 2.344 times the odds of utilizing any family planning compared to people in rural area (95% CI 1.495, 3.676). Urban and rural disposition to modern contraception services is influenced by economic, socio-cultural, environmental factors, location, age, educational, traditional beliefs, religion, family type, and level of knowledge. Although some signs of progress have been made in family planning at the communities, more work needs to be done. Men need to be actively involved, and other fears about family planning addressed. Keywords: Acceptance, Disparity, Family Planning, Rural, Urban.

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 &lt; 0.01) and by 0.75 among the severely deprived women (ß = −0.75, SE = 0.05, p &lt; 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.

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