Is Leave for Fathers Pronatalist? A Mixed-Methods Study of the Impact of Fathers’ Uptake of Parental Leave on Couples’ Childbearing Intentions in South Korea

While many countries with low birth rates have implemented policies incentivizing fathers to take parental leave with the anticipation that it will contribute to raising birth rates, there is scant research empirically testing whether fathers’ uptake of leave is pronatalist. Existing research is limited to a few European (mostly Nordic) countries, and it is unclear whether there exists a positive causal relationship. Using mixed methods, this paper seeks to explore the processes and mechanisms by which fathers’ uptake of parental leave impacts intentions for additional children in South Korea, a country characterized by lowest-low fertility and low but rapidly expanding uptake of leave by fathers. Results based on multinomial logistic regression models suggest that in comparison to fathers who expect to take their first leave shortly, fathers with leave experience are less likely to report couple-level intentions for another child, significantly so at parity two. Interviews of fathers with parental leave experience confirm that fathers attenuate their fertility intentions downwards in light of the difficulties of childcare during their leave. While these intentions may change further down the line and/or couples may decide to continue an unplanned pregnancy, results suggest that fathers’ parental leave has an anti- rather than pronatalist effect in South Korea. This study demonstrates that in countries with poor support for the reconciliation of employment and childcare, equalizing the gendered division of parental leave may not be sufficient to see a reversal in its fertility trends.

Maternal Health Services as Determinant Factors for Low Birth Weight in public hospitals of Addis Ababa, Ethiopia: a Case-control Study.

Background: The birth weight of a newborn has a substantial impact on infant mortality, morbidity, development, and long-term health. It is determined by the mother's overall health status. More than 20 million babies are born with low birth weight across the world. In developing countries, almost 17% of all newborns are born with low birth weights, with no exception in Ethiopia. Alleviating this problem, needs a clear understanding of the determinants. Thus, this study was done in Addis Ababa, the most populous city in the country, where the lifestyles of mothers might be affected by the dynamic city life.Method: An unmatched case-control study was applied to assess the risk factors of low birth weight in three randomly selected public hospitals in Addis Ababa, Ethiopia. Data was collected through interviewer-administered structured questionnaires. Data analysis was done using SPSS version 24. Descriptive statistics using frequencies and percentages were used to describe the socio-demographic characteristics of the study participants. Bi-variable and multi-variable logistic regression analyses were used to assess the possible effect of determinant factors on low birth weight, with their respective odds ratios and 95% confidence intervals. P-values of less than 0.05 were considered statistically significant.Result: We enrolled 168 cases and 336 controls; all completed the study with no refusal. Of all pregnancies, 90 (17.8%) were unplanned and unwanted. And, 153 (30.3%) of mothers have a history of prior abortion. Among the factors we studied, maternal age below 18 years (AOR: 2.69, 95% CI: 1.24, 5.84), unwanted and unplanned pregnancy (AOR: 1.25, 95% CI: 1.09, 2.66), ANC visit in the last pregnancy below three (AOR: 3.23, 95% CI: 1.61, 6.49), female neonate (AOR: 1.09, 95% CI: 2.04, 3.20), not supplemented with iron and folic acid (AOR: 3.11, 95% CI: 1.36, 7.11) and hematocrit level of < 30 (AOR: 2.29, 95% CI: 1.00, 5.22) showed a statistically significant association with low birth weight.Conclusion: This study demonstrates that the age of mothers below 18 years, unwanted and unplanned pregnancy, low ANC visits, lack of iron and folic acid supplements, and low maternal hemoglobin level were the significant determinants of low birth weight among term babies. Thus, women of childbearing age should be screened and educated about the risks of pregnancy and should get the necessary care and support when they get pregnant.

Prevalence and factors associated with unplanned pregnancy in The Gambia: findings from 2018 population-based survey

Background Unplanned pregnancy is a public health issue that has detrimental implications for the mother and baby alike. However, few studies have been conducted in The Gambia on this subject. As a result, the prevalence of unplanned pregnancy among women of reproductive age in The Gambia was investigated, as well as the factors associated with it. Methods The Gambia's Multiple Indicators Cluster Survey (MICS) was used to evaluate the 2018 results. Data was obtained from 3790 women aged 15 to 49 who had also given birth. The univariate analysis was conducted using percentage. The adjusted odds ratios (AOR) were determined using a multivariable logistic regression model (with corresponding 95% confidence interval (CI)). The degree of statistical significance was set at 5%. Results Approximately 25.3% (95% CI: 23.1%-27.6%) of the women reported unplanned pregnancy. Women aged 30–34 years had 45% reduction in unplanned pregnancy, when compared with those aged 15–19 years (AOR = 0.55; 95% CI: 0.32–0.94). The Fula and non-Gambian women had 30% and 45% reduction in unplanned pregnancy respectively, when compared with Mandinka women. Those who had no functional difficulties had 47% reduction in unplanned pregnancy, when compared with women who had functional difficulties (AOR = 0.53; 95% CI: 0.30, 0.91). Respondents who had given births to 3–4 and 5 + children were 1.79 and 3.02 times as likely to have unplanned pregnancy, when compared with women who had given birth to 1–2 children. Single/unmarried women were 11.38 times as likely to have unplanned pregnancy, when compared with women currently married/in union (AOR = 11.38; 95% CI: 6.38, 20.29). Local Government Area of residence was significantly associated with unplanned pregnancy. Furthermore, women who were neither happy nor unhappy and 18 + at sexual debut were 1.39 and 1.34 times as likely to have unplanned pregnancy, when compared with the very happy women and those < 18 at sexual debut respectively. Conclusion The rate of unintended pregnancies was large (25.3%). Several causes have been linked to unplanned pregnancies. These results suggest that further efforts are required to enhance women's sex education, expand access to family planning services, and provide affordable health care to high-risk women in order to minimize unintended pregnancies.

Factors for Late Initiation of Antenatal Care in Kahama Municipal, Tanzania

Background: Maternal mortality is a major public health issue in developing countries due to its shocking magnitude and lower declining pattern, 295 000 women died of pregnancy or childbirth related complications in 2017. Late initiation of Antenatal Care (ANC) services in most low-income countries like Tanzania has been reported as a major problem which increase maternal mortality rate (MMR). However, different factors for late initiation of antenatal care are not well identified. Therefore, this study aimed to identify factors for late initiation of antenatal care both individual factors and health policy factors as per pregnant women and health care providers opinions in Kahama Municipal, Tanzania. Broad Objective: The study focused on assessment of factors for late initiation of Antenatal Care (ANC) in Kahama Municipal, Tanzania. Materials and Methods: This study was conducted using a qualitative method with exploratory approach which was carried out to explore factors for late initiation of antenatal care in Kahama Municipal. An in-depth interview (IDI) and Focus Group Discussion (FGD) were methods used to collect data. The study comprised of 14 in-depth interviews (IDIs) with pregnant women with age range of 18 years to 49 years attending antenatal care clinics in two health facilities and 4 in-depth interviews (IDIs) with health care providers attending pregnant women during antenatal care clinic visit. Furthermore, two Focus Group Discussions (FGDs), one from each health facility with pregnant women were conducted. Data Analysis: Thematic analysis was conducted through use of inductive approach. The audio recordings were conducted using the Swahili language then transcribed and translated into the English language where themes were obtained after translation. Results: Findings obtained from this study were factors for late initiation of antenatal care as reported by both pregnant women and health care providers. Factors for late initiation of antenatal care were under guidance of Health Behavioral Modal (HBM): Factors mentioned by pregnant women included pregnant women education level, negligence of pregnant women to attend clinic, unplanned pregnancy among couples, distance from pregnant women settlement to the facility, pregnant women misconceptions related to antenatal care services, use of local herbs, pregnancy complications, , unfriendly services and unequal gender power relation within a family. Factors mentioned by health care providers based on health policy and managerial factors such as Partner accompanying policy, distant allocation of health facility from people’s settlement and unfriendly services provided by health care providers. Conclusion: This study focused on assessing factors for late initiation of antenatal care in Kahama municipal council in Shinyanga, Tanzania. Different factors for late initiation of antenatal care were reported which included pregnant women and health care providers. Pregnant women education level, negligence of pregnant women to attend clinic, unplanned pregnancy among couples, and distance from pregnant women settlement to the facility, pregnant women misconceptions related to antenatal care services, use of local herbs, pregnancy complications. Health policy and managerial related factors were partner accompanying policy, unfriendly services, and allocation of health facility. Recommendation: However different improvement made on maternal health services in Tanzania but still some of pregnant women are not utilizing it efficiently because of different obstacles like distance from people’s settlement to the health facility, Partner accompanying policy and unfriendly services provided by health care providers. Through such obstacles as a policy maker, I would like to advice Government through Ministry of Health to allocate health facility nearby people’s settlement, providing outreach program to educate the community about antenatal care rather than relying on partner accompanying policy and lastly is provision of refresher training related to client’s rights during health care services provision to all staff.

Family Planning Knowledge, Attitudes and Practices Among Rohingya Women Living in Refugee Camps in Bangladesh: A Cross-Sectional Study

Background: Considering more than 720,000 Rohingya into Bangladesh, unplanned pregnancy, and serious complications of pregnancy among refugees, this study aims to explore the knowledge, attitude, and practice (KAP) of family planning (FP) and associated factors among the Rohingya women living in the refugee camps in Cox’s Bazar, Bangladesh. Methods: Four hundred Rohingya women were investigated, and data were collected using a structured questionnaire, which included socio-demographic characteristics, awareness of contraceptive methods, knowledge, attitudes and practices on FP. Linear regression analysis was performed to identify the predictors of outcome variables. Results: Of the Rohingya refugee women, 60% were unaware that there is no physical harm in adopting a permanent method of birth control. Half of them lack proper knowledge of whether a girl was eligible for marriage before the age of 18. More than two-thirds think family planning methods should not be used without the husband’s permission. Besides, 40% were ashamed and afraid to discuss family planning matters with their husbands, considering it as a sin. Of them, 58% had the opinion that a couple should continue bearing children until a son is born. Linear regression analyses demonstrated that Racidong in Myanmar as the region of residence, being professional, number of children, physician/nurse being the source of FP knowledge, having FP interventions in the camp, participating in a FP program, visiting a health facility, and talking with a health care provider on FP were significantly associated with Rohingya women’s better KAP of FP. Conclusions: The study showed that Rohingya refugee women are a marginalized population in family planning and the comprehensive FP-KAP capability was low. Contraceptives among the Rohingyas are unpopular, mainly due to a lack of education and family planning awareness. In addition, family planning initiatives among Rohingya refugees were limited by some traditional cultural and religious beliefs. Therefore, strengthening FP interventions and increasing the accessibility to essential health services and education are indispensable in order to improve maternal health among refugees.

Maternal satisfaction with intrapartum care and associated factors among postpartum women at public hospitals of North Shoa Zone Ethiopia

Background Maternal satisfaction is an essential indicator of the quality and the efficiency of the health care systems. At a time when efforts are being made globally to reduce maternal and neonatal mortality and morbidity, assessing maternal satisfaction is essential. There is a dearth of studies on maternal satisfaction with intrapartum care, particularly in the study area. This study aimed to assess maternal satisfaction with intrapartum care and associated factors among postpartum women at public hospitals of North Shoa Zone Ethiopia. Methods A facility-based cross-sectional study with a systematic random sampling technique was conducted from May1-30/ 2020. Data were entered into EpiData version 4.6 and analyzed using a statistical package for the social sciences version 25. Bivariate and multivariable logistic regression were employed. In multivariable logistic regression analysis, level of statistical significance was declared at variables with p < 0.05 and the strength of the association was measured by an adjusted odds ratio and 95% confidence interval. Result Of the total 394 participants, 111 (28.2%) [95% CI: 23.9, 32.5] of postpartum women were satisfied with the intrapartum care. Place of residence [AOR: 1.934; 95% CI (1.183, 3.162)], planned status of the pregnancy [AOR: 2.245; 95% CI, (1.212, 4.158)], number of antenatal care visit [AOR: 2.389; 95% (1.437, 3.974)] and duration of labour [AOR: 2.463; 95% (1.378, 4.402)] were factors significantly associated with maternal satisfaction with intrapartum care. Conclusion The proportion of maternal satisfaction with intrapartum care was low. Therefore, designing strategies to enhance maternal satisfaction by strengthening adherence to antenatal care visits, provision of family planning to prevent unplanned pregnancy, and strict utilization of partograph to prevent prolonged labour and childbirth-related complications are crucial.

The prevalence of unintended pregnancy and its association with HIV status among pregnant women in South Africa, a national antenatal survey, 2019

To describe the prevalence of unintended pregnancy and its association with HIV status among pregnant women in South Africa. A cross-sectional survey was conducted between October and mid-November 2019 among pregnant women aged 15–49 years in 1589 selected public antenatal care facilities. Pregnancy intention was assessed using two questions from the London Measure of Unplanned Pregnancy. Survey logistic regression examined factors associated with unintended pregnancy. Among 34,946 participants, 51.6% had an unintended pregnancy. On multivariable analysis, the odds of unintended pregnancy was higher among women who knew their HIV-positive status before pregnancy but initiated treatment after the first antenatal visit (adjusted odds ratio [aOR], 1.5 [95% confidence interval (CI):1.2–1.8]), women who initiated treatment before pregnancy (aOR, 1.3 [95% CI:1.2–1.3]), and women with a new HIV diagnosis during pregnancy (aOR, 1.2 [95% CI:1.1–1.3]) compared to HIV-negative women. Women who were single, in a non-cohabiting or a cohabiting relationship, and young women (15–24 years) had significantly higher risk of unintended pregnancy compared to married women and women aged 30–49 years, respectively. A comprehensive approach, including regular assessment of HIV clients’ pregnancy intention, and adolescent and youth-friendly reproductive health services could help prevent unintended pregnancy.

Trends in maternal body mass index in Northern Ireland: a cross-sectional and longitudinal study

ObjectivesExplore (1) associations between maternal body mass index (BMI), demographic and clinical characteristics, (2) longitudinal trends in BMI, (3) geographical distributions in prevalence of maternal overweight and obesity.DesignRetrospective population-based study.SettingLinked, anonymised, routinely collected healthcare data and official statistics from Northern Ireland.ParticipantsAll pregnancies in Northern Ireland (2011–2017) with BMI measured at ≤16 weeks gestation.MethodsAnalysis of variance and χ2 tests were used to explore associations. Multiple linear regression was used to explore longitudinal trends and spatial visualisation illustrated geographical distribution. Main outcomes are prevalence of overweight (BMI ≥25 kg/m2) and obesity (BMI ≥30 kg/m2).Results152 961 singleton and 2362 multiple pregnancies were included. A high prevalence of maternal overweight and obesity in Northern Ireland is apparent (singleton: 52.4%; multiple: 48.3%) and is increasing. Obesity was positively associated with older age, larger numbers of previous pregnancies and unplanned pregnancy (p<0.001). BMI category was also positively associated with unemployment (35% in obese class III vs 22% in normal BMI category) (p<0.001). Higher BMI categories were associated with increased rate of comorbidities, including hypertension (normal BMI: 1.8% vs obese III: 12.4%), diabetes mellitus (normal BMI: 0.04% vs obese III: 1.29%) and mental ill-health (normal BMI: 5.0% vs obese III: 11.8%) (p<0.001). Prevalence of maternal obesity varied with deprivation (most deprived: 22.8% vs least deprived: 15.7%) (p<0.001). Low BMI was associated with age <20 years, nulliparity, unemployment and mental ill-health (p<0.001).ConclusionsThe prevalence of maternal BMI >25 kg/m2 is increasing over time in Northern Ireland. Women are entering pregnancy with additional comorbidities likely to impact their life course beyond pregnancy. This highlights the need for prioritisation of preconception and inter-pregnancy support for management of weight and chronic conditions.

EVALUATION OF THE PRACTICAL IMPACT OF SEX EDUATION AMONG GIRL ADOLESCENT STUDENTS- AN EXPERIMENTAL STUDY

Sex education and reproductive health has always been demurred subject in India due to culture and religious inhibitions. Lack of knowledge on reproductive health during adolescent leads to sexually transmitted infections, violence, bullying and unplanned pregnancy ( RM Anderson, 2013).The hormonal changes during the adolescent age, stigma on sex related subject matters and gender inequalities in India are the greater challenges for reproductive health education (WHO,2010).Thus, endowing the scientific knowledge on sex will navigate to a quality life. Considering the above aspects, the study was rolled on to study intends to emphasize the need, knowledge and attitude towards sex education among girl adolescent and also to investigate the positive and negative effect of sex education on students. The study intended to understand the practical possibilities in implementing sex education in India