Community views on short birth interval in Northern Uganda: a participatory grounded theory.
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ABSTRACT: Background
Short birth interval is associated with adverse perinatal, maternal, and infant outcomes, although evidence on actionable factors underlying short birth interval remains limited. We explored women and community views on short birth intervals to inform potential solutions to promote a culturally safe child spacing in Northern Uganda.Methods
Gendered fuzzy cognitive mapping sessions (n = 21), focus group discussions (n = 12), and an administered survey questionnaire (n = 255) generated evidence on short birth intervals. Deliberative dialogues with women, their communities, and service providers suggested locally relevant actions promote culturally safe child spacing.Results
Women, men, and youth have clear understandings of the benefits of adequate child spacing. This knowledge is difficult to translate into practice as women are disempowered to exercise child spacing. Women who use contraceptives without their husbands' consent risk losing financial and social assets and are likely to be subject to intra-partner violence. Women were not comfortable with available contraceptive methods and reported experiencing well-recognized side effects. They reported anxiety about the impact of contraception on the health of their future children. This fear was fed by rumors in their communities about the effects of contraceptives on congenital diseases. The women and their communities suggested a home-based sensitization program focused on improving marital relationships (spousal communication, mutual understanding, male support, intra-partner violence) and knowledge and side-effects management of contraceptives.Conclusions
The economic context, gender power dynamics, inequality, gender bias in land tenure and ownership regulations, and the limited contraceptive supply reduce women's capacity to practice child spacing.
SUBMITTER: Belaid L
PROVIDER: S-EPMC8080315 | biostudies-literature |
REPOSITORIES: biostudies-literature
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| S-EPMC6959604 | biostudies-literature
Project description:BackgroundShort birth interval is a universal public health problem resulting in adverse fetal, neonatal, child and maternal outcomes. In Ethiopia, more than 50% of the overall inter birth spacing is short. However, prior scientific evidence on its determinants is limited and even then findings are inconsistent.MethodsA community -based unmatched case-control study was employed on 218 cases and 436 controls. Cases were ever married reproductive age women whose last delivery has been in the past five years with birth interval of less than 3 years between the latest two successive live births whereas those women with birth interval of 3-5 years were taken as controls. A multistage sampling technique was employed on 30% of the kebeles in Dessie city administration. A pre-tested interviewer based questionnaire was used to collect data by 16 trained diploma nurses and 8 health extension workers supervised by 4 BSc nurses. The collected data were cleaned, coded and double entered into Epi-data version 4.2 and exported to SPSS version 22. Binary logistic regression model was considered and those variables with P<0.25 in the bivariable analysis were entered in to final model after which statistical significance was declared at P< 0.05 using adjusted odds ratio at 95% CI.ResultIn this study, contraceptive use (AOR = 11.2, 95% CI: 5.95-21.15), optimal breast feeding for at least 2 years (AOR = 0.098, 95% CI:0.047-0.208), age at first birth <25 years (AOR = 0.36, 95% CI: 0.282-0.761), having male preceding child (AOR = 0.46, 95% CI: 0.166-0.793) and knowing the duration of optimum birth interval correctly (AOR = 0.45, 95% CI: 0.245-0.811) were significant determinants of short birth interval.ConclusionContraceptive use, duration of breast feeding, age at first birth, preceding child sex and correct understanding of the duration of birth interval were significant determinants of short birth interval. Fortunately, all these significant factors are likely modifiable. Thus, the existing efforts of optimizing birth interval should be enhanced through proper designation and implementation of different strategies on safe breastfeeding practice, modern contraceptive use and maternal awareness about the health merits of optimum birth interval.
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Project description:To rationalize the selection of a research methodology, one must understand its philosophical origins and unique characteristics. This process can be challenging in the landscape of evolving qualitative methodologies. Grounded theory is a research methodology with a distinct history that has resulted in numerous approaches. Although the approaches have key similarities, they also have differing philosophical assumptions that influence the ways in which their methods are understood and implemented. The purpose of this discussion paper is to compare and contrast three widely used grounded theory approaches with key distinguishing characteristics, enabling a more thoughtful selection of approach. This work contributes to the existing literature through contrasting classic Glaserian grounded theory, Straussian grounded theory, and constructivist grounded theory in a systematic manner with prominent distinguishing characteristics developed from a review of the literature. These characteristics included historical development, philosophical perspective, role of the researcher, data analysis procedures, perspective of the grounded theory, and strengths/critique. Based on this analysis, three considerations are proposed to direct the methodological choice for a study: purpose, philosophy, and pragmatics. Understanding the similarities and differences in the grounded theory approaches can facilitate methodological transparency and determine the best fit for one's study and worldview as a researcher.
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Project description:A short interpregnancy interval (IPI) is a risk factor for preterm delivery among women of reproductive age. As limited data exist concerning adolescents, we aimed to examine the association between short IPIs and preterm birth among adolescents using a majority of US births. Using 2007-2008 US natality data, we assessed the relationship between IPIs <3, 3-5, 6-11, and 12-17 months and moderately (32-36 weeks) and very (<32 weeks) preterm singleton live births among mothers <20 years, relative to IPIs 18-23 months. Adjusted odds ratios (aORs) and 95 % confidence intervals (95 % CIs) adjusted for maternal race, age, previous preterm deliveries, marital status, smoking and prenatal care were determined from a multivariable multinomial logistic regression model. In 2007-2008, there were 85,077 singleton live births to women aged <20 who had one previous live birth, 69 % of which followed IPIs ≤18 months. Compared with IPIs 18-23 months, short IPIs were associated with moderately preterm birth for IPIs <3 months (aOR 1.89, 95 % CI 1.70-2.10), 3-5 months (aOR 1.33, 95 % CI 1.22-1.47), and 6-12 months (aOR 1.11, 95 % CI 1.02-1.21). IPIs <3 and <6 months were also associated with very preterm birth, with aORs of 2.52 (95 % CI 1.98-3.22) and 1.68 (95 % CI 1.35-2.10) respectively. Many adolescent mothers with repeat births have short IPIs, and shorter IPIs are associated with preterm birth in a dose-dependent fashion. Increasing adolescent mothers' use of effective contraception postpartum can address both unintended adolescent births and preterm birth.
| S-EPMC5547434 | biostudies-other
Project description:BackgroundShort birth interval, defined as a birth-to-birth interval less than 33 months, is associated with adverse maternal and child outcomes. Evidence regarding the association of maternal socioeconomic status and short birth interval is inconclusive. Factors contributing to the socioeconomic inequality of short birth interval have also not been investigated. The current study assessed socioeconomic inequality in short birth interval and its contributing factors in Ethiopia.MethodsData from 8448 women collected in the 2016 Ethiopia Demographic and Health survey were included in the study. Socioeconomic inequality in short birth interval was the outcome variable. Erreygers normalized concentration index (ECI) and concentration curves were used to measure and illustrate socioeconomic-related inequality in short birth interval, respectively. Decomposition analysis was performed to identify factors explaining the socioeconomic-related inequality in short birth interval.ResultsThe Erreygers normalized concentration index for short birth interval was - 0.0478 (SE = 0.0062) and differed significantly from zero (P < 0.0001); indicating that short birth interval was more concentrated among the poor. Decomposition analysis indicated that wealth quintiles (74.2%), administrative regions (26.4%), and not listening to the radio (5.6%) were the major contributors to the pro-poor socioeconomic inequalities in short birth interval.ConclusionThere was a pro-poor inequality of short birth interval in Ethiopia. Strengthening the implementation of poverty alleviation programs may improve the population's socioeconomic status and reduce the associated inequality in short birth interval.
| S-EPMC7542382 | biostudies-literature
Project description:ObjectiveTo determine the prevalence, predictors and case fatality risk of hypothermia among neonates in Lira district, Northern Uganda.SettingThree subcounties of Lira district in Northern Uganda.DesignThis was a community-based cross-sectional study nested in a cluster randomised controlled trial.ParticipantsMother-baby pairs enrolled in a cluster randomised controlled trial. An axillary temperature was taken during a home visit using a lithium battery-operated digital thermometer.Primary and secondary outcomesThe primary outcome measure was the prevalence of hypothermia. Hypothermia was defined as mild if the axillary temperature was 36.0°C to <36.5°C, moderate if the temperature was 32.0°C to <36.0°C and severe hypothermia if the temperature was <32.0°C. The secondary outcome measure was the case fatality risk of neonatal hypothermia. Predictors of moderate to severe hypothermia were determined using a generalised estimating equation model for the Poisson family.ResultsWe recruited 1330 neonates. The prevalence of hypothermia (<36.5°C) was 678/1330 (51.0%, 95%?CI 46.9 to 55.1). Overall, 32% (429/1330), 95%?CI 29.5 to 35.2 had mild hypothermia, whereas 18.7% (249/1330), 95%?CI 15.8 to 22.0 had moderate hypothermia. None had severe hypothermia. At multivariable analysis, predictors of neonatal hypothermia included: home birth (adjusted prevalence ratio, aPR, 1.9, 95%?CI 1.4 to 2.6); low birth weight (aPR 1.7, 95%?CI 1.3 to 2.3) and delayed breastfeeding initiation (aPR 1.2, 95%?CI 1.0 to 1.5). The case fatality risk ratio of hypothermic compared with normothermic neonates was 2.0 (95% CI 0.60 to 6.9).ConclusionThe prevalence of neonatal hypothermia was very high, demonstrating that communities in tropical climates should not ignore neonatal hypothermia. Interventions designed to address neonatal hypothermia should consider ways of reaching neonates born at home and those with low birth weight. The promotion of early breastfeeding initiation and skin-to-skin care could reduce the risk of neonatal hypothermia.Trial registration numberClinicalTrial.gov as NCT02605369.
| S-EPMC7880091 | biostudies-literature