Contraception and reproductive medicine最新文献

{"title":"Predictors of time to unplanned implanon discontinuation in the first year of application at public hospitals in North Shoa, Central Ethiopia: using acceleration failure time model.","authors":"Befekadu Tesfaye Oyato, Husen Zakir Abasimel, Derara Girma Tufa, Hana Israel Gesisa, Dursa Hussein, Bacha Merga Chuko","doi":"10.1186/s40834-024-00321-8","DOIUrl":"https://doi.org/10.1186/s40834-024-00321-8","url":null,"abstract":"<p><strong>Introduction: </strong>Contraceptive discontinuation has become a widespread issue on a global basis. Implants, of which Implanon is the most popular, are only the second most widely used form of modern contraceptive in Ethiopia. However, Implanon was discontinued at a rate as high as 23.4% in Ethiopia within the first year of use. Therefore, the purpose of this study was to identify the incidence rate and predictors of unplanned discontinuation of Implanon in the first year of application at public hospitals in the North Shoa zone, Central Ethiopia.</p><p><strong>Methods: </strong>A retrospective follow-up study was conducted at public hospitals in the North Shoa zone among women who use Implanon. A total of 429 women who wanted their Implanon removed after insertion were selected as study participants during the data collection period. Data were gathered from the family planning initiation and removal registration books as well as by contacting users directly. A log-rank test was used to assess the significance of observed differences between categorical variable strata. The acceleration failure time model with log-normal distribution was used to fit the survival data.</p><p><strong>Results: </strong>The unplanned discontinuation rate Implanon in the first year of insertion was 19.1% with an estimated mean survival time of 10.9 months (95% CI: 10.65, 11.14). Women with an interval period of insertion (AAF = 1.53; 95% CI: 1.06, 2.21), women who chose implanon by themselves (AFF = 1.32; 95% CI: 1.02, 1.71), women who were satisfied with the service (AFF = 1.40; 95% CI: 1.06, 1.83), and women who were given instructions on what to do if they experienced side effects (AFF = 1.85; 95% CI: 1.40, 2.44), had a lower likelihood of discontinuing their implanon in the first year of insertion.</p><p><strong>Conclusion: </strong>The risk of unplanned Implanon discontinuation was found to be high in the study area. Health care providers should pay close attention to clients' needs when delivering family planning services, and the client should ultimately decide whether to use the service. Family planning departments must also engage in early-side effects treatment and reassure clients to lessen discontinuation.</p>","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":"9 1","pages":"65"},"PeriodicalIF":2.2,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11610072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modern contraceptive use among currently married non-pregnant women (aged 15-49 years) in West Bengal, India: a reflection from NFHS-5.","authors":"Susanta Sen, Amit Banerjee, Asif Ali, Namita Chakma","doi":"10.1186/s40834-024-00322-7","DOIUrl":"10.1186/s40834-024-00322-7","url":null,"abstract":"<p><strong>Background: </strong>There is a dearth of research on modern family planning practices in high focus states like West Bengal in India with diverse population groups and distinct health needs. Thus, this study aims to investigate the latest picture of modern contraceptive use and its associated socio-demographic factors among currently married non-pregnant of reproductive aged (15-49 years) women in West Bengal.</p><p><strong>Methods: </strong>The study is based on secondary data, collected from the fifth round of the National Family Health Survey (NFHS-5; 2019-20). A total of 15,841 currently married non-pregnant women were included into this study. With the overarching goal of understanding the determinants and patterns of modern contraceptive use, the study employed a combination of bi-variate and multivariate analyses, including logistic regression.</p><p><strong>Results: </strong>The results reveal that female sterilization is the most common modern contraceptive method across the state. Contraceptive use varies by district, from 43% in Puruliya to 77.3% in Birbhum. Women aged 30-34 were significantly more likely to use contraception (OR = 1.47), while those aged 45-49 were less likely to use it (OR = 0.74). Women with mixed gender composition of living children (OR = 1.48) were more likely to use contraception, compared to women with no children (OR = 0.21) or daughters only (OR = 0.80). SC women (OR = 1.63) and Christians (OR = 2.17) showed higher usage. Wealthier women (OR = 1.26) and urban residents also reported higher use. Moreover, son preference continues and women married after 18 are less likely to adopt modern methods. These findings highlight the need to improve reproductive health outcomes and overcome barriers to increasing contraceptive uptake.</p><p><strong>Conclusion: </strong>Targeted interventions focusing on education, awareness-building, and improving access to diverse contraceptive options are recommended to empower women in making informed reproductive choices and advancing reproductive rights and health equity. Also, effective modern contraceptive services must overcome legal policy, social, cultural and structural barriers to benefit more women.</p>","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":"9 1","pages":"63"},"PeriodicalIF":2.2,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11606083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142756058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond policy: perspectives of school health practitioners about providing contraception services to school-going adolescents in South Africa.","authors":"Thabile J Ketye, Gbotemi Bukola Babatunde, Olagoke Akintola","doi":"10.1186/s40834-024-00320-9","DOIUrl":"10.1186/s40834-024-00320-9","url":null,"abstract":"<p><strong>Background: </strong>Providing contraception to adolescents is a critical intervention in reducing adolescent and early pregnancy. However, many adolescents, including those attending school, still lack access to contraception. We adapted Baroudi's ecological framework of access to healthcare to explore the perspectives of school health practitioners about providing contraceptive services to school-going adolescents.</p><p><strong>Methods: </strong>This is an exploratory qualitative research study. We employed purposive sampling to recruit school health practitioners directly involved in implementing sexual and reproductive health policies or interventions in public secondary schools. From September to October 2023, we conducted semi-structured interviews with forty-nine participants. We followed Braun and Clarke's approach of thematic analysis and adhered to the Consolidated Criteria for Reporting Qualitative Studies checklist for qualitative research reporting.</p><p><strong>Results: </strong>In our study, participants highlighted the importance of having access to accurate information about contraception and being knowledgeable about school health policies. They also identified socio-cultural norms, denialism and misconceptions as potential barriers to contraception access. Notably, they suggested that strengthened parental involvement and the presence of nurses in schools could significantly improve the provision of contraceptive services to school-going adolescents.</p><p><strong>Conclusions: </strong>Our study offers valuable insights into the perspectives of school health practitioners about providing contraception to adolescents. These findings highlight the implications of implementing the Integrated School Health Policy and the Policy on the prevention and management of learner pregnancy in schools. The results of this study could provide valuable insights to policymakers, decision-makers, nurses, and teachers from the Departments of Education and Health. Those insights could enhance the development of school health policies and the implementation of contraception-related programmes for adolescents in secondary schools. This, in turn, would contribute to reducing adolescent pregnancies in South Africa.</p>","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":"9 1","pages":"62"},"PeriodicalIF":2.2,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11603850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge, attitudes and strategies on contraceptive utilization among adolescents: views from beneficiaries and parents in City of Kigali.","authors":"Jean Baptiste Hategekimana, Adolphe Ndikubwimana, Justin Ndayisenga, Fidele Niyitegeka, Daniel Ukwishatse, Serieux Cyubahiro, Bivegete Kenny Ntwali, Absolomon Gashaija, Alice Nyirazigama, Noel Korukire, Felix K Rubuga, Patrick Karakwende, Celestin Banamwana, Pierre Dukuziyaturemye, Jean Muhire, Marie Josee Mwiseneza, Theoneste Ntakirutimana, Deborah Oluwaseun Shomuyiwa, Don Eliseo Lucero-Prisno Iii","doi":"10.1186/s40834-024-00317-4","DOIUrl":"10.1186/s40834-024-00317-4","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Pregnancy among adolescents is a significant public health concern worldwide, particularly in developing countries, including Rwanda. Although contraception could be an effective tool to prevent unintended pregnancy, its utilization among adolescents is often low.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;This study explored knowledge, attitudes and strategies on contraceptive utilization among adolescents.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Mixed method research (MMR) using a cross-sectional design, Sequential explanatory design was used to explore the views from 394 participants in Gitega Sector. This approach was chosen to first quantify the prevalence and patterns of contraceptive use through the questionnaire-based survey, and then to deepen understanding by exploring attitudes, beliefs, and experiences of adolescents and parents through in-depth interviews and focus group discussions. This sequential approach allowed quantitative findings to guide qualitative inquiry, providing richer context to the statistical data. For the quantitative phase, convenience sampling facilitated by the in charge of Health at the sector level and community health workers at the cell level ensured effective access to the study's target demographic. Qualitative participants were purposively chosen to gain detailed insights from those identified with unique or significant experiences in the initial survey. Data were analyzed using SPSS version 25.0 for quantitative analysis and ATLAS.ti 23 for qualitative analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The study found that both adolescents and parents (59.1%) have a low level of knowledge about contraceptive utilization, with adolescents (75.5%) showing significantly lower knowledge than parents (46.4%). A majority of the participants, 195 (56.7%), had a positive attitude towards contraceptive utilization among adolescents. Bivariate analysis revealed significant associations between knowledge and socio-demographic factors such as education (P = 0.00) and marital status (P = 0.00), indicating higher knowledge levels among those with higher educational attainment and married individuals. Additionally, attitudes towards contraceptive utilization were significantly influenced by occupation (P = 0.005) and religion (P = 0.00). However, challenges such as the lack of parent-child communication and low knowledge contributed to the low contraceptive usage despite the existing initiatives such as the INGOBYI Activity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The findings highlight a need for targeted interventions that address the specific challenges identified, including the lack of knowledge and communication barriers. Improved education and awareness programs for both adolescents and parents, along with supportive community strategies, may enhance contraceptive utilization. A concerted effort involving parents, healthcare providers, and community leaders may foster a supportive environment that encourages respons","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":"9 1","pages":"61"},"PeriodicalIF":2.2,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11600872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social media as health educator: An assessment of the understandability and accuracy of tiktok content about contraception.","authors":"Julianna K Coleman, Maetal E Haas-Kogan, Andrea Pelletier, Rachel E Stoddard, Natasha R Johnson, Julia R Beatini, Nora Y Sun, Alex S Keuroghlian, Deborah Bartz","doi":"10.1186/s40834-024-00324-5","DOIUrl":"10.1186/s40834-024-00324-5","url":null,"abstract":"<p><strong>Background: </strong>Contraception knowledge and attitudes are largely formed from conversations within one's social network. More recently, this network has expanded to include social media. As the fastest growing social media platform, we aimed to assess popular contraception videos on TikTok for content understandability, actionability and accuracy.</p><p><strong>Methods: </strong>This is a secondary analysis of the most viewed, contraception-specific TikTok videos that were previously coded as containing educational messaging in a content-analysis study. We assessed videos for understandability (ability to explain a key message) and actionability (identify what they can do to act on that message) using the Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT-A/V) instrument and for Currency, Relevance, Authority, Accuracy, and Purpose (CRAAP) using a modified instrument within the health information education literature.</p><p><strong>Results: </strong>The 174 videos with educational content scored as understandable but not actionable in PEMAT-A/V assessment, with videos created by healthcare providers (HCPs) performing better than those by non-HCPs in six of eleven domains of understandability. Videos overall scored well in relevance and purpose within the CRAAP assessment. Videos created by HCP's (n = 99) scored higher than those by non-HCPs (n = 75) in relevance (score = 3.9 versus 3.3), authority (score = 4.8 versus 1.7), accuracy (score = 6.0 versus 3.5), and purpose (score = 7.1 versus 5.7) [all p < 0.001]. Regarding video engagement, the median number of views among the videos in the cohort was 604,450. Of all video views, 79.2% were of HCP-created videos and 20.8% were of non-HCP videos.</p><p><strong>Discussion: </strong>Much of the contraceptive educational messaging on TikTok is understandable, relevant, and accurate. HCP-created videos overall scored better as compared to other creators, though even HCP-created videos score fail to provide actionable recommendations. The videos created by HCP also had greater metrics of engagement. Given this, we encourage HCPs to use social media to better inform its users.</p>","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":"9 1","pages":"60"},"PeriodicalIF":2.2,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11590206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early sexual debut and pregnancy termination: uncovering the link among sexually active young women in 23 sub-Saharan African countries.","authors":"Obasanjo Afolabi Bolarinwa","doi":"10.1186/s40834-024-00323-6","DOIUrl":"10.1186/s40834-024-00323-6","url":null,"abstract":"<p><strong>Background: </strong>Unplanned pregnancy could be a socio-economic burden for many young women in sub-Saharan Africa (SSA) which often leads to pregnancy termination. The role of age at sexual debut in pregnancy termination in countries with lower income remains unknown. Hence, this study examines the association between age at sexual debut and pregnancy termination among sexually active young women between the ages of 15 -24 in 23 SSA countries.</p><p><strong>Methods: </strong>Cross-sectional secondary datasets from the most recent Demographic and Health Survey conducted in 23 countries in SSA conducted between 2010 and 2018 among 34,343 sexually active young women were analysed using bivariate and multivariable logistic regression to examine the association between age at sexual debut and pregnancy termination with statistical significance of p < 0.05.</p><p><strong>Results: </strong>The pooled prevalence of pregnancy termination among sexually active young women in SSA was 11.00%. Higher odds of pregnancy termination were found among those who had early sexual debut (below 16 years) [(aOR = 1.34, 95% CI = (1.22-1.48)] compared to those who had late sexual debut. Furthermore, those who were exposed to mass media [(aOR = 1.29, 95% CI = (1.16-1.43)] were more likely to report pregnancy termination compared to those who were not exposed. On the other hand, those residing in rural areas and those within the richest wealth index were associated with lower odds of pregnancy termination.</p><p><strong>Conclusion: </strong>The study concluded that early sexual debut of sexually active young women in SSA was significantly associated with pregnancy termination. Mass media exposure was found to be a risk factor for pregnancy termination whilst residing in rural areas, and those within the richest wealth index were protective factors. Interventions should be designed to target young women with early sexual debut to provide comprehensive sexual and reproductive health education to enable them to make informed decisions on pregnancy termination.</p>","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":"9 1","pages":"59"},"PeriodicalIF":2.2,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rights-based reproductive services in medical schools in Rajasthan, Gujarat and Chandigarh, India: baseline findings of mixed-methods implementation research.","authors":"Madhu Gupta, Kirti Iyengar, Neena Singla, Kiranjit Kaur, Madhur Verma, Rimpi Singla, Minakshi Rohilla, Vanita Suri, Neelam Aggarwal, Tarundeep Singh, Swarnika Pal, Anchal Dhiman, Poonam Goel, N K Goel, Reena Pant, Kusum Lata Gaur, Hanslata Gehlot, Indra Bhati, Manoj Verma, Sudesh Agarwal, Rekha Acharya, Keerti Singh, Madhubala Chauhan, Radha Rastogi, Renu Bedi, Poornima Pancholi, Bipin Nayak, Bhavesh Modi, Kanaklata Nakum, Atul Trivedi, Shonali Aggarwal, Sangita Patel","doi":"10.1186/s40834-024-00316-5","DOIUrl":"10.1186/s40834-024-00316-5","url":null,"abstract":"<p><strong>Introduction: </strong>There is a need to assess and strengthen reproductive rights-based family planning and abortion services in Indian medical schools that play a key role in medical education and service delivery. This study presents the findings of baseline assessment across nine schools in two states and one union territory with objective to assess, identify the gaps and improve the status of reproductive rights and evidence-based family planning and abortion services in Indian medical schools.</p><p><strong>Methods: </strong>A convergent parallel mixed methods study was conducted in nine medical schools in Rajasthan, Gujarat, and Chandigarh a Union territory in India from October 2018 to June 2019. In-depth interviews with 33 faculty from the Department of Obstetrics and Gynaecology were conducted. The COM-B (Capability, Opportunity, and Motivation) model of behaviours was used to qualitatively identify barriers and facilitators of reproductive rights-based family planning and abortion services. Reproductive health services provided to 104 women for family planning and abortion were observed quantitatively using a pre-tested checklist.</p><p><strong>Findings: </strong>Providers' preference bias in recommending contraceptive methods to specific clients (wherein sterilisation was offered to women with two or more children and IUCD to women with one child) was observed as barrier to reproductive rights. The facilitators of rights based reproductive services included well-informed faculty regarding providing dignified and respectful care. Barriers included infrastructure gaps, high workload, insufficient human resources affecting privacy, and lower awareness and decision-making power of clients. Family planning counselling using the cafeteria approach was offered in 69.4% of cases, 31.6% of women seeking abortion services were offered counselling on both family planning and abortion. Sterilisation or IUD insertion was a pre-condition in 36.8% of women requesting an abortion.</p><p><strong>Conclusions: </strong>Right-based reproductive services around family planning counselling and abortion services were delivered partially despite the medical schools' trained faculty, mainly due to provider bias, high workload, and less autonomy and lower awareness of reproductive rights among women.</p>","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":"9 1","pages":"58"},"PeriodicalIF":2.2,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11566405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postpartum modern family planning among women living with HIV attending care at health facilities in Busia County, Kenya.","authors":"Florence Zawedde Tebagalika, Derrick Kimuli, Dennis Walusimbi, Edna Nyang'echi, Louisa Ndunyu","doi":"10.1186/s40834-024-00319-2","DOIUrl":"10.1186/s40834-024-00319-2","url":null,"abstract":"<p><strong>Background: </strong>For women living with the human immunodeficiency virus (WLHIV), preventing untimed pregnancies during the postpartum period reduces vertical transmission and improves other maternal and child health outcomes. In Kenya, Busia County's HIV prevalence and mother-to-child transmission rate are higher than the national average yet uptake of postpartum family planning (PPFP) is generally low. This study examined health system factors influencing the consistent use of PP modern FP methods among WLHIV in Busia County.</p><p><strong>Methods: </strong>A retrospective study involving 314 WLHIV with children aged 12-24 months who were chosen using systematic random sampling was conducted from February to March 2024 from outpatient clinics in Busia County. Additionally, 14 health providers were purposively sampled as key informants. Quantitative data was collected using a pretested questionnaire, while qualitative data was gathered through key informant interview guides. Quantitative data was analyzed using STATA 15 with descriptive statistics, logistic regression, and Chi-square tests, while a deductive thematic analysis was used for qualitative data.</p><p><strong>Results: </strong>The mean age of the participants was 32.06 (± 6.00) with the majority (51.27) aged between 25 and 34 years, married (74.84%) and unemployed (77.39%). Overall, 73.25% had used postpartum (PP) modern family planning (FP) methods, but only 52.55% reported consistent use throughout the first year postpartum. The only factors found to increase the odds of PPFP use were being married (aOR 3.34, 95% CI 1.58-7.07, p = 0.002), being escorted by a preferred person during seeking maternal and child health services (aOR 2.29, 95% CI 1.36-3.83, p = 0.002), and perceiving that they were provided information on all types of FP (aOR 2.33, 95% CI 1.19-4.16, p = 0.012). Persistent stock-outs and inadequate counseling hindered consistent PPFP use.</p><p><strong>Conclusion: </strong>The study identified gaps in the consistent use of PP modern FP methods among WLHIV in Busia County, influenced by the availability of FP information and health system factors. Addressing stock-outs and improving counseling during clinic visits and pregnancy are crucial for improving FP service delivery and reducing maternal and child health risks in high HIV-incidence areas like Busia County.</p>","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":"9 1","pages":"57"},"PeriodicalIF":2.2,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early sexual debut among adolescent girls and young women in Sierra Leone: A multilevel analysis of prevalence and predictors.","authors":"Augustus Osborne, Florence Gyembuzie Wongnaah, Khadijat Adeleye, Camilla Bangura, Richard Gyan Aboagye, Bright Opoku Ahinkorah","doi":"10.1186/s40834-024-00309-4","DOIUrl":"10.1186/s40834-024-00309-4","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Early sexual debut among young women is associated with adverse sexual and reproductive health outcomes, including unintended pregnancies and sexually transmitted infections. Despite its negative impact, there is limited research on this issue in Sierra Leone. This study aims to address this gap by examining the prevalence of early sexual debut and its associated factors among adolescent girls and young women aged 15-24 years in Sierra Leone.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Data from the 2019 Sierra Leone Demographic and Health Survey was used for the study. Provincial variations in the proportion of early sexual debut were visualised using a spatial map. A mixed-effect multilevel binary logistic regression analysis was performed to examine the factors associated with early sexual debut. The results were presented as adjusted odds ratios (aOR) with a 95% confidence interval (CI) and intraclass correlation coefficients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The prevalence of early sexual debut was 26.1% [24.3, 28.0]. Adolescent girls and young women aged 20-24 were less likely to engage in early sexual debut [aOR = 0.52; 95% CI: 0.41, 0.65] than those aged 15-19. The odds of early sexual debut was lower among adolescent girls and young women with secondary/higher education [aOR = 0.62; 95% CI: 0.45, 0.85] compared to those with no education. Adolescent girls and young women who used the internet in the last 12 months [aOR = 0.50; 95% CI: 0.34, 0.73] and those who belonged to the Fullah ethnic group [aOR = 0.25; 95% CI: 0.07, 0.85] were less likely to engage in early sexual debut relative to those who did not use the internet and those belonging to the Creole ethnic group respectively. Adolescent girls and young women who intend to use contraceptives [aOR = 0.60; 95% CI: 0.46, 0.77] and those who do not intend to use contraceptives [aOR = 0.65; 95% CI: 0.49, 0.88] were less likely to engage in early sexual debut than those who were using contraceptives. Conversely, adolescent girls and young women who were working [aOR = 1.41; 95% CI: 1.12, 1.77] had higher odds for early sexual debut than those not working. The odds of early sexual debut were higher among adolescent girls and young women who were married/cohabiting [aOR = 1.72; 95% CI: 1.32, 2.22] and previously married [aOR = 3.26; 95% CI: 1.61, 6.56] than those who were never married. Adolescent girls and young women living in the North Western area [aOR = 1.81; 95% CI: 1.05, 3.13] had higher odds for early sexual debut than those living in the Eastern province.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Early sexual debut is prevalent among adolescent girls and young women in Sierra Leone. Age, education, internet use, ethnicity, contraceptive use intention, marital status, employment status, and province of residence were the factors associated with early sexual debut. The study underscores the need for policymakers, government, and non-governmental organisations to design an","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":"9 1","pages":"56"},"PeriodicalIF":2.2,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of intention to use contraceptives among married and cohabiting women in Ghana: A cross-sectional study.","authors":"Augustus Osborne, Richard Gyan Aboagye, Camilla Bangura, Bright Opoku Ahinkorah","doi":"10.1186/s40834-024-00312-9","DOIUrl":"10.1186/s40834-024-00312-9","url":null,"abstract":"<p><strong>Background: </strong>Contraceptive use is a cost-effective intervention for reducing unintended pregnancies and sexually transmitted infections and their negative consequences. It is vital to increase contraceptive use among women to improve their reproductive health outcomes. This study examines the factors associated with contraceptive use intention among married and cohabiting women in Ghana.</p><p><strong>Methods: </strong>We analysed data from the 2022 Ghana Demographic and Health Survey. A total of 5,846 married and cohabiting women were included in the study. A multivariable binary logistic regression analysis was used to examine the factors associated with the intention to use contraceptives. The regression results were presented using an adjusted odds ratio (aOR) with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>The proportion of intention to use contraceptives among married and cohabiting women was 33.0% [31.1, 35.0]. Compared to women living in the Greater Accra, those living in Central (aOR = 1.69; 95% CI = 1.06, 2.69), Bono East (aOR = 1.63; 95% CI = 1.02, 2.61), Oti (aOR = 2.68; 95% CI = 1.63, 4.40), and Upper West Regions (aOR = 4.48; 95% CI = 2.68, 7.48) were more likely to have contraceptive use intention. The odds of intention to use contraceptives increased with increasing parity, with the highest odds among women with four or more births (aOR = 2.41; 95% CI: 1.66, 3.51). The intention to use contraceptives decreased with increasing age, with the lowest odds among those aged 45-49 (aOR = 0.04, 95% CI = 0.25, 0.07). Women with no education (aOR = 0.42, 95% CI = 0.28, 0.63), primary education (aOR = 0.56, 95% CI = 0.37, 0.86), and secondary education (aOR = 0.65, 95% CI = 0.45, 0.92) had lower odds of intention to use contraceptives compared to those with higher education. Married women (aOR = 0.61, 95% CI = 0.49, 0.76) had lower odds of contraceptive use intention relative to cohabiting women.</p><p><strong>Conclusion: </strong>Our study revealed a low contraceptive use intention among women, signalling a barrier in access to family planning services in the country. Various factors, including age, region, marital status, parity, and educational level play a role in determining the intention to use contraceptives. These findings underscore the importance of implementing policy changes and enhancing existing programmes to improve the availability of information, contraceptive education, and family planning services, especially for younger women, those living in rural areas, and those with lower levels of education. Additionally, it is vital to address socio-cultural barriers and empower women to address the factors associated with intention to use contraceptives.</p>","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":"9 1","pages":"55"},"PeriodicalIF":2.2,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}