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Socio-economic and demographic predictors of unmet need for contraception among young women in sub-Saharan Africa: evidence from cross-sectional surveys.

ABSTRACT: INTRODUCTION:Globally, sub-Saharan Africa (SSA) bears the highest proportion of women with unmet need for contraception as nearly 25% of women of reproductive age in the sub-region have unmet need for contraception. Unmet need for contraception is predominant among young women. We examined the association between socio-economic and demographic factors and unmet need for contraception among young women in SSA. METHODS:Data for this study obtained from current Demographic and Health Surveys (DHS) conducted between January 1, 2010 and December 31, 2018 in 30 sub-Saharan African countries. The sample size consisted of young women (aged 15-24), who were either married or cohabiting and had complete cases on all the variables of interest (N?=?59,864). Both bivariate and multivariable binary logistic regression analyses were performed using STATA version 14.0. RESULTS:The overall prevalence of unmet need for contraception among young women was 26.90% [95% CI: 23.82-29.921], ranging from 11.30% [95% CI: 5.1-17.49] in Zimbabwe to 46.7% [95% CI: 36.92-56.48] in Comoros. Results on socio-economic status and unmet need for contraception showed that young women who had primary [aOR?=?1.18; CI?=?1.12-1.25, p?

SUBMITTER: Ahinkorah BO

PROVIDER: S-EPMC7585192 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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Socio-economic and demographic predictors of unmet need for contraception among young women in sub-Saharan Africa: evidence from cross-sectional surveys.

Ahinkorah Bright Opoku BO Ameyaw Edward Kwabena EK Seidu Abdul-Aziz AA

Reproductive health 20201023 1

<h4>Introduction</h4>Globally, sub-Saharan Africa (SSA) bears the highest proportion of women with unmet need for contraception as nearly 25% of women of reproductive age in the sub-region have unmet need for contraception. Unmet need for contraception is predominant among young women. We examined the association between socio-economic and demographic factors and unmet need for contraception among young women in SSA.<h4>Methods</h4>Data for this study obtained from current Demographic and Health ...[more]

PMID: 33097088

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Project description:BACKGROUND:Contraception is a key component of sustainable development, empowering women, reducing the risk of maternal and child mortality and promoting economic growth. It is part of the Sustainable Development Goals agenda, where the aim is to achieve universal access to sexual and reproductive health. Our objective was to evaluate trends and inequalities in modern contraceptive prevalence, and according to the type of modern contraceptive, in 11 low- and middle-income countries that are partners of the Family Planning 2020 initiative. METHODS:Analyses were performed using 62 Performance Monitoring and Accountability 2020 (PMA2020) surveys from 11 countries. Forty surveys were nationally representative, while 22 had regional coverage. Regional surveys were analyzed separately, totalizing 15 geographies from 11 countries. We described trends on modern contraceptive prevalence, and its subtypes (short- and long-acting reversible contraceptives, and permanent methods), by calculating absolute average annual changes. Absolute inequalities on the prevalence of modern contraceptives were assessed for the most recent survey of each geography using the slope index of inequality, and according to wealth, education and age. RESULTS:The overall prevalence of modern contraception increased in most geographies analyzed, reaching a 7.2 percentage points increase per year in Lagos, Nigeria. This increase was mostly influenced by the long-acting reversible contraceptives, which increased in 73% of the geographies. Although the largest share of modern contraception is represented by short-acting reversible contraceptives, these are reducing and giving space for the long-acting methods. The exception was Rajasthan, India, where the permanent methods accounted for 70% of the modern contraception share, and their prevalence was almost 40%. Inequalities were identified in favor of richer, older and better educated women. CONCLUSIONS:Out of the 15 geographies analyzed, 11 demonstrated an increase in overall modern contraceptive use - mainly driven by the uptake of long-acting reversible contraception. However, even in the groups with the highest prevalence, modern contraceptive use was at most 60% in most geographies. So, we are far from reaching the desired universal coverage proposed by the Sustainable Development Goals.

Project description:BackgroundIntimate partner violence (IPV) has been recognized as a defining human rights, development and public health issue of our time. Economic empowerment is one of the most promising interventions to reduce IPV in sub-Saharan Africa, yet the evidence around economic factors that are key to ensure a reduction in IPV are still mixed. Furthermore, there is a lack of clarity on what kinds of economic empowerment works for which population group. This paper seeks a more nuanced understanding, by investigating whether the associations between indicators of economic empowerment and physical and/or sexual IPV are similar between the general population of women and among urban versus rural and young, or middle aged women versus older women.MethodsUsing couples data from 25 DHS surveys across 15 countries (n = 70,993 women and men aged 15 and above at time of survey), we analyse how household wealth, men's and women's education and employment status, decision making on women's income, differences in education and employment of women and their partners and women's cash income are associated with physical and/or sexual IPV. We also provide sub-analyses for both urban and rural areas and for women aged, 15 to 24 25 to 34 and 35 to 49.ResultsAcross all surveys, 20% of women reported physical and/or sexual IPV in the last 12 months. On the one hand, our findings reinforced certain well-established patterns between women's economic empowerment and IPV, with women's and men's higher levels of education and increased household wealth associated with a decrease in IPV, and women's employment, especially if only the woman worked, and women earning more than her partner associated with an increase in IPV. Most patterns did not differ across urban and rural settings and age groups, but notable differences emerged regarding household wealth, women's and men's employment in the last 12 months and relative employment and education.ConclusionsFactors relating to women's economic empowerment are vital in understanding and addressing IPV. Our analysis indicate however that future interventions need to consider the differing needs of urban and rural areas as well as be targeted to different age groups.

Project description:BackgroundMore than 75% of neonatal deaths occurred in the first weeks of life as a result of adverse birth outcomes. Low birth weight, preterm births are associated with a variety of acute and long-term complications. In Sub-Saharan Africa, there is insufficient evidence of adverse birth outcomes. Hence, this study aimed to determine the pooled prevalence and determinants of adverse birth outcomes in Sub-Saharan Africa.MethodData of this study were obtained from a cross-sectional survey of the most recent Demographic and Health Surveys (DHS) of ten Sub-African (SSA) countries. A total of 76,853 children born five years preceding the survey were included in the final analysis. A Generalized Linear Mixed Models (GLMM) were fitted and an adjusted odds ratio (AOR) with a 95% Confidence Interval (CI) was computed to declare statistically significant determinants of adverse birth outcomes.ResultThe pooled prevalence of adverse birth outcomes were 29.7% (95% CI: 29.4 to 30.03). Female child (AOR = 0.94, 95%CI: 0.91 0.97), women attended secondary level of education (AOR = 0.87, 95%CI: 0.82 0.92), middle (AOR = 0.94,95%CI: 0.90 0.98) and rich socioeconomic status (AOR = 0.94, 95%CI: 0.90 0.99), intimate-partner physical violence (beating) (AOR = 1.18, 95%CI: 1.14 1.22), big problems of long-distance travel (AOR = 1.08, 95%CI: 1.04 1.11), antenatal care follow-ups (AOR = 0.86, 95%CI: 0.83 0.86), multiparty (AOR = 0.88, 95%CI: 0.84 0.91), twin births (AOR = 2.89, 95%CI: 2.67 3.14), and lack of women involvement in healthcare decision-making process (AOR = 1.10, 95%CI: 1.06 1.13) were determinants of adverse birth outcomes.ConclusionThis study showed that the magnitude of adverse birth outcomes was high, abnormal baby size and preterm births were the most common adverse birth outcomes. This finding suggests that encouraging antenatal care follow-ups and socio-economic conditions of women are essential. Moreover, special attention should be given to multiple pregnancies, improving healthcare accessibilities to rural areas, and women's involvement in healthcare decision-making.

Project description:BackgroundHaving HIV/AIDS has been associated with a higher prevalence of smoking. Moreover, evidence suggests that people with HIV/AIDS who smoke have poorer treatment and survival outcomes. The HIV-smoking relationship is understudied in sub-Saharan Africa, where tobacco use patterns and HIV prevalence differ greatly from other world regions.MethodsCross-sectional data from the Demographic Health Surveys and AIDS Indicator Surveys, representing 25 sub-Saharan African countries, were pooled for analysis (n = 286850). The association between cigarette smoking and HIV status was analyzed through hierarchical logistic regression models. This study also examined the relationship between smokeless tobacco (SLT) use and HIV status.ResultsSmoking prevalence was significantly higher among men who had HIV/AIDS than among men who did not (25.90% vs 16.09%; p < .0001), as was smoking prevalence among women who had HIV/AIDS compared with women who did not (1.15% vs 0.73%; p < .001). Multivariate logistic regression revealed that the odds of smoking among people who had HIV/AIDS was 1.12 times greater than among people who did not when adjusting for socioeconomic, demographic, and sexual risk factors (adjusted OR = 1.12, 95% CI = 1.04% to 1.21%; p < .001). Similarly, multivariate logistic regression revealed that HIV-positive individuals were 34% more likely to use SLT than HIV-negative individuals (adjusted OR = 1.34, 95% CI = 1.17% to 1.53%).ConclusionHaving HIV was associated with a greater likelihood of smoking cigarettes as well as with using SLT in sub-Saharan Africa. These tobacco use modalities were also associated with male sex and lower socioeconomic status.ImplicationsThis study shows that in sub-Saharan Africa, as in more studied world regions, having HIV/AIDS is associated with a higher likelihood of smoking cigarettes when adjusting for demographic, socioeconomic, and sexual risk factors. This study also supports the literature stating that cigarette smoking is inversely associated with socioeconomic status, as evidenced by higher smoking prevalence among poorer individuals, less educated individuals, and manual and agricultural laborers.

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Socio-economic and demographic predictors of unmet need for contraception among young women in sub-Saharan Africa: evidence from cross-sectional surveys.

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Socio-economic and demographic predictors of unmet need for contraception among young women in sub-Saharan Africa: evidence from cross-sectional surveys.

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