Physical Activity and Associated Socioeconomic Determinants in Rural and Urban Tanzania: Results from the 2012 WHO-STEPS Survey

Background. Physical inactivity contributes to the rising prevalence of noncommunicable diseases (NCDs). Given the rapidly increasing prevalence of NCDs in Low-Income Countries (LICs), comprehensive evaluation and documentation of physical activity (PA) status in this setting are crucial. Methods. We examined the demographic and social-economic antecedents of PA among adults (5398) from the 2012 Tanzania STEPS survey data. Statistical significance at the level of 0.05 was used to measure the strength of associations. Results. Majority of study participants attained the WHO-recommended levels of physical activity (96.7%). Levels were higher among those living in rural than in urban settings (98% versus 92%, p<0.0001) and generally, urban residency, female gender, higher education achievement, and employment were significantly associated with low levels of PA. Participation in the different domains of PA (work, transport, and recreational) varied with living setting, levels of education, and employment status. Conclusion. These results describe PA status and associated social-economic determinants among adults in rural and urban Tanzania. The findings contribute to the growing evidence that implicates urbanization as a key driver for the growing prevalence of physical inactivity in LICs and underscore the need for tailored PA interventions based on demography and social-economic factors.

Factors Influencing Contraceptives Use among Women in the Juba City of South Sudan

Understanding birth control and child spacing methods used by inhabitants of conflict afflicted settings is important in designing interventions to improve uptake of family planning services. In addressing the dearth of knowledge on family planning use in these settings, this study aimed at identifying the influencing factors of contraceptives use among women in the Juba city of South Sudan. Using a population based cross-sectional study, 380 women aged 15–49 years filled a guided questionnaire between April and May in 2015. We collected contraceptive use data and factors influencing family planning uptake. Data analysis was performed using descriptive statistics and binary logistic regression. Lifetime reported contraceptive use stood at 42% whereas contraceptive use in the last three months was 36%. Logistic regression revealed attitudes (AOR = 1.375, 95 CI 1.246–1.518) and parity (AOR = 1.242, 95% CI 1.000–1.544) as significant determinants of lifetime contraceptive use whereas only attitude (AOR = 1.348, p<0.001) determined contraceptive use in last three months. The findings indicate optimal uptake of family planning and point to the influence of attitudes and parity on contraceptive use. Changing attitudes and embedded sociocultural and political structures influencing attitudes is important to promote contraceptive uptake in these settings.

Prevalence of and Factors Associated with Emergency Contraceptive Use among Female Undergraduates in Arba Minch University, Southern Ethiopia, 2015: A Cross-Sectional Study

Emergency contraceptives (ECs) need to be available and used appropriately as a backup in case regular contraception is not taken by people like university students. This study was conducted to assess emergency contraception use and its associated factors among female undergraduates of Arba Minch University. A cross-sectional study was conducted among 515 undergraduates using a structured questionnaire. Respondents were selected by the stratified random sampling technique and data were analyzed using SPSS version 20. Bivariate and multivariate logistic regression models were fitted to identify associated factors. The adjusted odds ratio with a 95% confidence interval was used to present the identified risk factors. The prevalence of emergency contraception use among Arba Minch University students was 78.0% (95% CI: 71.5%, 84.5%). Better information about emergency contraceptives (AOR = 6.3; 95% CI: 2.4, 9.7), good approach of EC service providers (AOR = 9.3; 95% CI: 2.4, 11.6), and positive attitude about ECs (AOR = 2.4; 95% CI: 1.5, 7.2) were factors significantly associated with EC use. The prevalence of emergency contraceptive use noted in this study was comparatively higher than the results found by previous studies conducted in Africa and Ethiopian universities. Continuing support for and wider dissemination of the class are recommended. The fact that the students/participants readily accepted the preceding provisions made such positive findings possible and sustainable.

Harnessing Social Capital for Resilience to Livelihood Shocks: Ethnographic Evidence of Indigenous Mutual Support Practices among Rural Households in Eastern Ethiopia

In the absence of adequate support from formal social safety nets, rural households in Ethiopia have developed collective risk-sharing strategies to buffer them against adverse livelihood shocks, thus building their resilience capacities. Social capital and network based indigenous mutual support arrangements are the most important strategies that are institutionalized and widely practiced among rural households for centuries in Ethiopia to support households to cope with shocks. Nonetheless, resilience research and rural poverty alleviation policies have yet to fully recognize and embrace social capital as a tool to tackle poverty and vulnerability. Robust policy and academic studies on the role of indigenous welfare system with implications for social development policy making in Ethiopia are lacking. Using ethnographic techniques and simple descriptive statistics, we studied indigenous mutual support systems and how they shape the resilience trajectories of rural households against livelihood shocks within two selected PAs of Babille district of Oromia region. We found that mutual support practices are very effective in building coping resilience of households by smoothing consumption shocks. However, the traditional coping mechanisms often fail when the shock is systemic or covariate, when shocks last longer, and when a household has low level of human or finical capital.

Knowledge and Attitude about Reproductive Health and Family Planning among Young Adults in Yemen

Background. The Yemeni government is focusing more attention on the needs of youth to ensure a healthy transition to adulthood. This is critical because adolescent population (ages 15–24) of 3.35 million will double in just 20 years. Young adults often lack basic knowledge about reproductive health and family planning. Objectives. To determine reproductive health and family planning knowledge and attitude among young adults aged 15 to 25+ years. Method. Sample study was taken from Marie Stopes International in Yemen which was conducted from March to July 2013 on the reproductive health age 15–49 years. Descriptive, bivariate, and multivariate analyses were employed. Results. Majority had heard about reproductive health and family planning and encouraged its methods. Television, relatives, and radio were major sources of information. Adults with higher education tend to have more awareness about health services. Knowledge about health services and family planning methods among older adults was significant, and adults in Belqees Club were more likely to have high empowerment scores for family planning methods. Conclusion. The level of knowledge about health services for reproductive health and family planning and its methods was low to moderate. The introduction of contraceptives remains a challenge in Yemen because the educational reproductive health is weak in Yemeni schools or health institutes or universities. Information about reproductive health and family planning should be provided to adolescents through medical schools curricula.

The Impacts of Household Financial Stress, Resilience, Social Support, and Other Adversities on the Psychological Distress of Western Sydney Parents

This study investigated the prevalence of psychological distress among parents in Western Sydney households and examined its relationship with household financial, family and life stressors, and potential resilience factors. As part of a longer-term study, parents from Western Sydney, New South Wales (NSW), completed computer-assisted telephone interviews (CATI) in May 2011 (N=439). Respondents were primary caregivers of at least one child (aged 4–16). Responses were weighted to reflect the Western Sydney population. Multivariate analyses were conducted to examine the relationship between parent experiences of stressor and resilience factors and reported psychological distress. Overall, 10.7% (95% CI: 7.8, 14.5) reported experiencing high/very high levels of psychological distress. Multivariate analysis indicated that financial hardship factors formed the strongest associations with psychological distress particularly housing and job security factors and, specifically, inability to meet mortgage/rent payments (OR=5.15, 95% CI: 1.74–15.25, p=0.003), poor self-rated health (OR=4.48, 95% CI: 1.88–10.64, p=0.001), adult job loss (OR=3.77, 95% CI: 1.33–10.66, p=0.013), and other family/life events (OR=2.30, 95% CI: 1.05–5.03, p=0.037). High personal resilience was common within this parent population and was a significant protective factor for high psychological distress (OR=0.14, 95% CI: 0.06–0.34, p<0.001). The findings support the development of targeted interventions to promote parent coping strategies in the context of household financial hardship.

Determinants of Rural Out-Migration in Habru District of Northeast Ethiopia

Migration has become a cause of concern at the global, regional, and national levels. Like the case of many developing countries, Ethiopia has been facing increasing challenges related to rural out-migration. This study aimed to analyze factors that determine rural communities’ decision to migrate to internal and international destinations in Habru district of Northeast Ethiopia. Stratified sampling technique has been employed to select a total of 200 household heads in three agroecologies of the study area. Structured questionnaires have been used as a principal primary data collection method and logistic regression has been employed for analysis. The results of the study showed that intravillage conflict, absence of relief assistant, livestock ownership, farm land size, access to information, and household and individual characteristics including family size, sex, and age of the migrants are the dominant determinant factors for rural out-migration. Migration can have a positive outcome in improving livelihoods if comprehensive and holistic policies and strategies are in place. There is also a need to strengthen the link between rural development policy and the disadvantaged groups by designing and implementing different livelihood alternatives including reducing pressure on scarce resources particularly land, integrating health and education services, and creating nonfarm employment opportunities.

Ensuring the First Breath: A Growing Accountability of Midwifery in Bangladesh

Successful women empowerment relies on providing quality infrastructure facilities to avail maternal healthcare on the national level. In this regard, ensuring women’s access to quality midwifery services is an important consideration. The major intervention for safe maternity is to be enhanced to enable the presence of the skilled midwifery to ensure the quality emergency obstetric care. Therefore, the scope of practice of a midwife is very critical in the supervision of the orderly physiological processes of pregnancy, labor, birth, and the postpartum phase. The midwife as an autonomous practitioner is expected to be competent and accountable for her practice. In Bangladesh, the number of women having the baby at home by unskilled personnel is quite high. Therefore, the government strives to educate midwives and commits to reducing maternal and newborn mortality and morbidity. This study explores the contemporary situation of maternity health to provide a critical understanding of the growing importance of the role of midwifery in Bangladesh. With this, the paper examines the way maternity services in Bangladesh transformed from a social to a medical model over the twentieth century and infers how the social agenda was part of this process.

Predictors of Time-to-Contraceptive Use from Resumption of Sexual Intercourse after Birth among Women in Uganda

Globally, there is extant literature on patterns and dynamics of postpartum contraceptive use with hardly any evidence examining time-to-contraceptive use from resumption of sexual intercourse after birth among women in Uganda. Methods. The analysis was based on data from 2011 Uganda Demographic and Health Survey on a sample of 2983 married women with a birth in the past three years preceding the survey and had resumed sexual intercourse. A time-to-contraceptive use was adopted in the analysis using life tables based on the Kaplan-Meier estimates, while the Log-Rank Chi-square tests assessed the variables to be included in regression analysis. Cox-Proportional Hazard regression was run to identify the predictors of time-to-contraceptive use among postpartum women in Uganda. Sampling weights were applied in the analysis to ensure representativeness. Results. The median time-to-contraceptive use was 19 months (range 0–24). Time to adoption of modern contraceptive use was significantly longer among women with no formal education, residing in northern region, who (HR=0.56, CI: 0.40–0.78) had delivered at home/traditional birth attendant (HR=0.75, CI: 0.60–0.93), had 1–3 antenatal care visits (HR=0.83, CI: 0.70–0.98), and were in poorest wealth quintile. Conclusions. Measures for enhancing modern contraceptive use during and after the postpartum period should focus on (i) addressing hindrances in accessing family planning, particularly among poor and noneducated women; (ii) integration of family planning service delivery into routine ANC through counseling; and (iii) promoting deliveries in health facilities.