‘God helps those who help themselves’… religion and Assisted Reproductive Technology usage amongst urban Ghanaians

Assisted Reproductive Technology (ART) is increasingly becoming a viable option for infertile couples in Ghana. There exists significant literature that explores the gender, legal, religious and socio-cultural implications of ART usage. In this paper, we expand the discourse on the nexus between religion and ART usage by looking at how the former is used as a frame of reference in the decision-making process, as well as how it is employed to explain treatment successes and failures. Irrespective of religious orientation, there was a general acceptance of ART by participants in the study-with exceptions only when it came to some aspects of the procedure. Even here, participants’ desperate desire to have children, tended to engender some accommodation of procedures they were uncomfortable with because of their religious beliefs. Thus, in contrast to some studies that suggest religion as interfering with ART use, we posit that religion is not an inhibiting factor to ART usage. On the contrary, it is an enabling factor, engendering the agentic attitude of participants to find a solution to their infertility in ART; as well as providing the strength to endure the physical and emotional discomfort associated with the biomedical process of conception and childbirth. In this context, religion thus provides participants with a frame of reference to navigate the spaces between decision-making, treatment processes and outcomes, and attributions of responsibility for the outcomes whatever they may be.

Inflammatory bowel disease negatively impacts household and family life

BackgroundInflammatory bowel disease (IBD) has a major impact on different aspects of life of patients with IBD, but functioning in the home environment is under-reported in literature. The aim of this study was to assess the impact of IBD on household and/or family life.MethodAdult patients with IBD from the outpatient clinic of the Erasmus MC (Rotterdam, the Netherlands) were invited to participate in this cross-sectional study between September and December 2020. A questionnaire was composed to measure the impact of IBD on functioning in the household and family life. In addition, the IBD Disability Index and Work Productivity and Activity Impairment Questionnaire were used. Data were analysed using descriptive statistics and multiple logistic regression modelling.ResultsOf 308 invited patients, 229 patients were included (response rate 74%). Sixty-eight per cent of patients were diagnosed with Crohn’s disease, 69% were female and median age was 38.0 years. Many patients reported difficulties with domestic activities (55.0%), leisure (53.9%), parenting (50.6%), sexual activities (48.4%) and interpersonal relationships (39.1%). Fatigue was associated with the experience of more severe difficulties in domestic activities (OR 16.160, 95% CI 6.053 to 43.141). Furthermore, 32.7% of patients felt that IBD influenced their desire to have children.ConclusionIBD has a markedly negative impact on household and/or family life in many patients. To optimise patient care, household and family related difficulties need to be considered in a holistic treatment approach.

The Impact of the COVID-19 Pandemic on the Reproductive Attitudes of Russian Women

The article presents the results of a sociological survey aimed at studying the impact of the pandemic of the new coronavirus infection COVID-19 on the reproductive attitudes of Russian women. The results of the survey showed that 19% of respondents postponed the birth of children due to the pandemic. 75% of respondents were not affected by the pandemic, since they did not plan to have a child, about 6% gave birth or will give birth to a child, as they wanted. Also, for 16% of respondents, the number of conflicts in the family has increased significantly, which may indicate the likelihood of a breakdown in relations, which will also negatively affect the demographic situation in the country. At the same time, about 63% of respondents noted that their incomes have become lower, for 31% of respondents, the income level has not changed, and for 6%, income has increased. Low family incomes also have a negative impact on the desire to have children. Since the beginning of a pandemic in Russia was announced in March 2020, due to physiological reasons, changes in the reproductive attitudes of women are likely to be noticeable only in statistics for 2021. since 2020, the number of births has decreased by 1%, the number of marriages has increased by 34%, and the number of divorces has increased by 33%. Thus, at the moment, the operational data of Rosstat do not agree with the results of our sociological survey. The reason could be that the survey was conducted on the Internet, and respondents who were more worried about the pandemic than the average Russian women of reproductive age showed an increased interest in it, so the proportion of women who postpone the birth of children due to the pandemic, according to the survey, may turn out to be higher. than the average in Russia.

Attachment Style and Working Models of Parenting in Individuals without Children

<p>This study investigated the extent to which insecure attachment predicted negative attitudes and expectations of parenting among people yet to have children. In total, 572 participants aged between 18 to 40 years completed an online survey that rated attachment styles, working models of parenting, and the desire to have children. As predicted, more avoidant people held more negative attitudes. In addition, a lower desire to have children mediated the link between attachment and negative working models of parenting. In contrast and as expected, more anxious people held less negative expectations of childrearing, were more interested in having children, and expected to be satisfied by the future role of parent. There were two novel features of the current study. First, it replicated and extended findings to an older, community based population. Second, analyses across two different samples (those in current relationships and single people) showed they were generally similar, although insecurity of attachment had stronger links with negative attitudes for those in current relationships.</p>

Attachment Style and Working Models of Parenting in Individuals without Children

<p>This study investigated the extent to which insecure attachment predicted negative attitudes and expectations of parenting among people yet to have children. In total, 572 participants aged between 18 to 40 years completed an online survey that rated attachment styles, working models of parenting, and the desire to have children. As predicted, more avoidant people held more negative attitudes. In addition, a lower desire to have children mediated the link between attachment and negative working models of parenting. In contrast and as expected, more anxious people held less negative expectations of childrearing, were more interested in having children, and expected to be satisfied by the future role of parent. There were two novel features of the current study. First, it replicated and extended findings to an older, community based population. Second, analyses across two different samples (those in current relationships and single people) showed they were generally similar, although insecurity of attachment had stronger links with negative attitudes for those in current relationships.</p>

CONTRACEPTIVE CHOICE AMONG COUPLES OF CHILDBEARING AGE (PUS) IN BENGKULU PROVINCE

Contraceptives are very useful in achieving the family planning (keluarga berencana) program; however, not all contraceptives are suitable for everyone. The choice of contraception depends on how each person must be able to choose a contraceptive that is suitable for him or her. In general, there are two methods of contraception, namely modern and traditional. The government recommends couples of childbearing age or pasangan usia subur (PUS) to use the modern method, as it is more effective in preventing pregnancy. This study was conducted to determine factors (predisposing, enabling, and reinforcing) that influenced the use of contraceptives in Bengkulu Province. The research design was cross-sectional and used secondary data from the Performance Survey and Accountability Program/Survei Kinerja dan Akuntabilitas Program (SKAP) in 2019. The sample of this study was couples of childbearing age ranged 15-49 years old in Bengkulu. The results showed that 232 couples (59.9%) used modern contraception, while 155 people did not use modern contraception (40.1%). The results of the bivariate analysis of predisposing factors show that there is a relationship between work, education, and attitudes towards using family planning in the future, while age and knowledge are not related. It was also found that there are relationships between enabling factors such as place of residence, level of welfare, number of children, desire to have children, and informed choice. Meanwhile, there is no relationship between insurance membership and mass and room information media. It is known that there is no relationship between reinforcing factors in information sources for health workers, non-health workers, information sources for formal institutions, and information sources for non-formal institutions with the selection of contraceptive methods. The factor that most influenced the choice of family planning methods among the respondents aged 15-49 years in Bengkulu was informed choice with OR of 20.11 (95% CI = (11.24-35.98).

Fertility Desires and Family Size Preferences of HIV Positive Women Accessing Care in the University of Port Harcourt Teaching Hospital

Introduction: Women living with HIV may or may not intend to bear children. They may also have different preferences in terms of family sizes. The desire of HIV positive women to bear children and their family size preferences has significant implication for horizontal and vertical transmission of this incurable disease. This study, therefore, aims to determine fertility preferences and their predictors among HIV positive women accessing care at UPTH, Port Harcourt, Rivers State. Methods: The study was a descriptive cross-sectional study among 402 women within the reproductive age (15-49 years) who were on Antiretroviral Therapy (ART). Participants were recruited using systematic sampling method and were interviewed with an interviewer-administered questionnaire. A semi-structured, self-administered questionnaire was used to obtain participant’s socio-demographic characteristics, desire for children, use, demand and choice of contraception and reproductive characteristics. With SPSS version 20, data was summarised as descriptive statistics and Chi-square test was used to test for association. Results: The study showed that 81.8% of respondents desire to have children out of which 96 (29.3%) desired one to two children, 169 (51.5%) desired three to four children, and 18 (5.5%) wanted five or more children. Factors such as age, marital status, and disclosure of Sero-status to partner were found to be associated with family size preferences (p<0.05). Conclusion: HIV positive women in Port Harcourt have high fertility desires and moderate family sizes preferences; thus, indicating the need for more support and involvement of the government and relevant stake holders in ensuring better access to ART services in the country. More resources should be channelled towards provision of effective preventive medications and services, people who live with HIV (PLHIVs) should be continuously and adequately sensitised with the necessary knowledge on how to make healthy reproductive decisions, as well as on available practicable reproductive options for HIV-infected women should be made efficient, and easily accessible.

Effectiveness of task-sharing in providing comprehensive long-acting reversible contraceptives through Level IV health extension workers in rural Ethiopia

Background: Modern family planning uptake in Ethiopia, primarily short-acting injectables, has increased after the engagement of community health extension workers (HEWs). The aim of this study was to investigate the effectiveness of using Level IV health extension workers to deliver long-acting reversible contraceptives (LARCs) at the community level. Methods: A retrospective cohort study design was used to recruit 710 women who received LARC insertion services at pilot health posts within eight months before survey time. The interviewer administered a data collection tool to collect the required data through a house-to-house survey. The questionnaire had sections covering demographic and socioeconomic characteristics, reproductive history, use of family planning methods, knowledge about LARC methods (i.e., IUCD and Implanon), and service satisfaction. Descriptive statistics were used to analyze data. Chi-square test was used to identify the determinants of LARC use. Results: Out of 702 LARC users included in the study, 92.7% received services from Level IV HEWs. The median age of clients was 30 years (IQR: 25–35), 92.7% were married, and 22.6% were new family planning users (75% Implanon users and 19.4% Jaddelle users). Of the aggregated variables, 67.38% had good knowledge of LARC, 92.28% had positive attitudes in availing services at health posts, and 92.76% was the satisfaction score of clients. New users tended to be young, Muslim, less likely to want more children, and more likely to decide on contraception on their own. At eight months post insertion, LARC use was effective in preventing pregnancy (99.7%) with low removal (n = 36, 5.1%) and expulsion rates (n = 1, 0.1%). No infection was reported. The major reasons for removal were side effects and the desire to have children. Client knowledge, attitude, and satisfaction were found to be high. In conclusion, trained Level IV HEWs provided LARCs safely and effectively at the health post level as an alternative service delivery outlet.

O-188 Participation in a video-based fertility awareness program advances the desire to have children sooner

Study question Participating in a fertility awareness program accelerates the intention to have children 6 to 12 months after video- fertility awareness? Summary answer In combination with positive childbearing motivation, those in the video condition anticipated their intentions to have children at 6-12 months follow-up What is known already Fertility awareness education and initiatives have been focused on increasing fertility awareness and knowledge. However, the role of fertility awareness on reproductive decisions is less explored in literature. There are few studies showing that participating in fertility awareness education is related to higher intentions to have children or decreased time until trying to conceive regarding beforehand planned. Since intentions seem to be a good predictor of behaviour, we were interested in exploring the variables which might predict higher intentions to have children after participating in a fertility awareness education study based on a video intervention Study design, size, duration This study is part of a randomised controlled trial initiated in October 2016. Participants were randomly allocated into the intervention (IG) and control group (CG) at baseline (TO). The follow-up was evaluated 6 to 12 months later. IG participants were exposed to a 5-min video delivering information on age-related fertility decline, infertility risk factors, and pregnancy chances after having filled-in the T0 questionnaire: Participants in CG received no stimulus. Participants/materials, setting, methods Three hundred sixty-five individuals (65% women) were recruited through social media, gynaecology clinics, and religious pre-marital courses. From those, 128 responded to follow-up (between 6 and 12 months). Childbearing Motivation Scale (positive and negative) and a question about childbearing timing intentions were used. Regression analysis was conducted to explore the role of video intervention and childbearing motivation on childbearing timing intention. Main results and the role of chance Participants were, on average, 29.5 years old (SD = 5.13). From baseline to 6-12 months later, participants significantly anticipated their desire to have children (p&lt;.005). Correlations showed that childbearing timing intention was positively and significantly associated with the following subscales of the positive motivations: personal fulfilment, continuity, and couple relationship; negative motivations were not associated with the childbearing timing intention. The regression analysis revealed that only the childbearing motivation regarding couple relationship (having a child would strengthening partnership ties, fulfilling partner’s project, growing as a couple, fulfilling a shared project) and the visualization of the educational video significantly contributed to predicting at follow-up the increased desire to have children sooner at follow-up. Limitations, reasons for caution Other factors, not considered, might contribute to the prediction of childbearing motivation timing. Although we had randomly allocated people to CG and IG, the high attrition rate may limit the generalization of our results. Wider implications of the findings This study seems to indicate that watching an educational video about fertility awareness might contribute to a significant change in childbearing timing. In addition, the importance of the couple relationship is highlighted. These findings reinforce the importance to assist people with informed reproductive decisions in social and healthcare settings. Trial registration number NCT02813993