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.
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.
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.
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.
Health of Afghan Migrants Residing inIstanbul" [1], the first sentence in the Introduction should be corrected as follows."The volatile civil war in Syria and conflict and economic instability in
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.
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.
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.
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.
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.
The role of proximate determinants in influencing fertility has been well documented worldwide. Bongaarts’ aggregate model of the proximate determinants (which focuses on marriage, contraception, abortion, and sterility) has been widely used to analyse the influence of proximate determinants on fertility. In Zambia, however, there is limited understanding of their effects. Therefore, the aim of this study was to examine the effect of proximate determinants of fertility in Zambia using Bongaarts’ model. This was a cross-sectional analysis of women’s data from the 2007 Zambia Demographic and Health Survey (ZDHS). A total of 7,146 women aged 15 to 49 years participated in the ZDHS. Bongaarts’ model was employed in the data analysis. Results showed that, overall, mean age was 27.8 years and rural-urban distribution was 56% and 44%, respectively. Marriage (40%) and postpartum infecundity (22%) accounted for the largest inhibiting effect on natural fertility from its biological maximum of 19.10. Contraception use accounted for only 3%. Therefore, in order to manage fertility in Zambia, policies and programmes should consider the effects of marriage, postpartum infecundity, and contraception on fertility. Without such targeted interventions, managing and maintaining population growth will remain a challenge in Zambia.
Background . The sociopolitical situation in Afghanistan continually pushes Afghans to seek safety and better socioeconomic prospects in neighboring and foreign countries. In this paper we examine the mental health of Afghan migrants residing in Istanbul, Turkey, an understudied population at high risk of psychopathology. Methods . We surveyed 158 Afghan migrants to assess psychological distress using a culturally grounded measure of mental health, the Afghan Symptom Checklist [ASCL], and used hierarchical regression analysis to examine the impact of postmigration living difficulties (PMLDs) on mental health. Results . We found that depressive, somatoform, anxiety-like symptoms occurred often, as did a number of culturally salient idioms of distress. Regression analyses showed that while socioeconomic variables and poor physical health status significantly predicted psychological distress, PMLDs exerted the strongest negative effect. The most pressing PMLDs for Afghans in Turkey are poverty, unemployment, lack of treatment for health problems, fears of being deported and related legal challenges, and family-related stressors. Conclusion . Our results point to the importance of the critical need to create culturally sensitive interventions to remediate high levels of psychological distress by addressing related PMLD stressors in a highly vulnerable Afghan migrant population residing in Turkey.
This paper examines the education-fertility linkage in tribal society through a cross section study on the Misings, the second largest scheduled tribe of the state of Assam, India. Applying multiple regression analysis, the paper finds that while the education of both wife and husband has retarding effect on fertility, the number of live births born is significantly less when wives are more educated than husbands. The education of females has been found to have positive relation with fertility up to 5.3 years of schooling and negative relation thereafter so as to reach the replacement level of fertility at the graduate level of education. Thus, the critical years of education of the wives required to have a depressing impact on fertility is 5.3. The paper recommends policies for expansion of education with primary focus on inclusion and retention of the females in education.
The study was a secondary analysis of existing data from the 2011 Ethiopia Demographic and Health Survey data. Of the 2097 live births recorded in Affar, Somali, Benishangul-Gumuz, and Gambela regions of Ethiopia between 2006 and 2011, 366 deaths before the age of five years were reported. The univariable and multivariable Cox proportional regression models were fitted to select the factors affecting under-five mortality in these regions. The model revealed that under-five mortality significantly associated with preceding birth interval, family size, birth type, breastfeeding status, source of drinking water, and income of mother. Children born after a preceding birth interval of 2-3 years and 3 years and above were significantly less likely to have died before their fifth birthday than those born within two years. Children who were breastfed, for any period, were 25.5% (HR 1.255, 1.005–1.567, p = 0.045) less likely to have died before their fifth birthday than those who were not breastfed. Increased birth interval time corresponds to a low probability of child mortality. Thus, mothers should be encouraged to wait for a sufficient number of months after a birth to conceive another child. Furthermore, breastfeeding was of paramount importance in the fight against child mortality.
Research in assortative mating in developing countries focused mainly on the cultural similarities of individuals till the most recent times. Educational homogamy was not considered a significant factor. This study examined the changes in educational homogamy of 39,257 ever-married couples in India for the three marriage cohorts 1964–1984, 1985–1995, and 1996–2006 by place of residence, religion, and economic background. The study also examined the regional pattern of educational homogamy based on female literacy and the probability of educational homogamy after adjusting for socioeconomic background of the respondent. Data from the National Family Health Survey (NFHS-3) was used for the study. The study observed significant increase in educational homogamy for the successive marriage cohorts. Homogamy is concentrated at the extremes of the educational attainment. In urban areas, homogamy is concentrated among the higher educated individuals whereas, in rural areas, homogamy is high among uneducated individuals. The results also depict regions with higher female literacy having the highest educational homogamy and vice versa . The study also found an increase in the probability of homogamy and a decline in hypogamy for literate women, after accounting for socioeconomic confounders.
This study examined the effects of declining fertility on household socioeconomic and health conditions in Tanzania, using a comparative survey of urban versus rural areas of Kwimba District in Mwanza region. Cross-sectional cum causal-comparative research design was adopted for the study. The target population is comprised of all females of the childbearing age residing in Kwimba District. The study utilized a stratified random sampling technique to pick two areas in the district while disproportionate random sampling technique was used to select 196 respondents. A questionnaire was used to elicit information from the respondents. Multivariate analyses were adopted to answer the three research questions of the study. The findings of this study revealed that women of the childbearing age from the two study sites in the district exhibited a small difference regarding fertility inequalities and socioeconomic and health conditions. This study also discovered a significant relationship between critical socioeconomic variables and women’s improved socioeconomic status in the communities. These findings, therefore, provide an explanation for the onset of fertility decline which has consequently led to some demonstrated demographic dividend at a household level. The paper recommends enhancement of social transformation and women empowerment in both rural and urban environments for sustained improved living conditions.
Interventions aimed at prevention of mother-to-child transmission (PMTCT) of HIV are extremely effective but remain underutilized in many countries. Common economic barriers to PMTCT experienced by pregnant women with HIV are well documented. Addressing these economic barriers has a potential to improve PMTCT utilization and further reduce mother-to-child HIV transmission. This review examines the evidence of the effects economic strengthening (ES) interventions have on use of and adherence to PMTCT and other health services relevant to PMTCT cascade. While very few studies on ES interventions were conducted in PMTCT settings, the results of a recent randomised trial demonstrate that conditional cash transfers offered to women in PMTCT programme can significantly improve retention in care and adherence to treatment. This review also considers evidence on ES interventions conducted within other health care settings relevant to PMTCT cascade. While the evidence from other settings is promising, it may not be fully applicable to PMTCT and more quality research on ES interventions among population of pregnant women with HIV is needed. Answering some of the research questions formulated by this review can provide more evidence for programme implementers and guide decisions about how to increase women’s use of and adherence to PMTCT services.
Fertility rates significantly fell over the last decades in Latin America. In order to assess the extent to which these changes contributed to the observed reduction in income poverty and inequality, we apply microeconometric decomposition to microdata from national household surveys from seven Latin American countries. We find that changes in fertility rates were associated with a nonnegligible reduction in inequality and poverty in the region. The main channel was straightforward: lower fertility implied smaller families and hence larger per capita incomes. Lower fertility also fostered labor force participation, especially among women, which contributed to the reduction of poverty and inequality in most countries, although the size of this effect was smaller.
This paper analyses the risk factors for being overweight or obese among the children of Mexican migrants in the United States. It draws on a qualitative study consisting of in-depth interviews and participant observation with 30 parents in New York State. Findings indicate risks related to nutritional deficiencies and food insecurity before migration, adaptation to US lifestyles, and the cultural tendency to value being overweight as a sign of greater health and higher socioeconomic status. Findings also show that mothers use various strategies to resist the excessive consumption of fast food, yet they simultaneously experience dilemmas around the family’s consumption due to the gender norm that women are responsible for children’s diet.
Poor adherence is one of the main causes of unintended pregnancies among women of reproductive age. The purpose of this study was to establish the predictors of contraceptive adherence. A total of 211 women were enrolled and interviewed while seeking family planning services at reproductive health Uganda facility. Binary logistic regression was used to analyze the association between adherence and the independent variables. Most of the respondents (83.4%) were currently using a hormonal contraceptive. Of the participants who were using contraceptives, 43% had discontinued use at some time for reasons other than pregnancy, 53.1% reported having short birth interval less than 2 years, and 7% reported having more children than desired. The predictors of poor contraceptive adherence included lower education level (OR 2.484, 95% CI 1.403–4.397) and lower self-efficacy (OR 1.698, 95% CI 1.959–3.004). Lack of male partner support (OR 2.014, 95% CI 1.140–3.557) and low education level (OR 2.103, 95% CI 1.196–3.699) were predictive of reporting short birth interval less than 2 years. The findings point to a number of predictors of contraceptive adherence that may have implications for designing and evaluating family planning programs. In the Ugandan context, studies to evaluate effective adherence improvement strategies are needed.
