Ever-married Women Research Articles

Socioeconomic Factors and Patterns of Intimate Partner Violence among Ever-Married Women in Uganda: Pathways and Actions for Multicomponent Violence Prevention Strategies.

Intimate partner violence (IPV) is a severe public health problem in sub-Saharan Africa (SSA) with harmful effects on the physical, psychological, and socioeconomic wellbeing of survivors and their families. In SSA, IPV is associated with mental health disorders, high-risk behaviors, and HIV vulnerability, especially among women. In Uganda, poor socioeconomic status increases women's vulnerability to IPV. Yet there is limited evidence on the association between socioeconomic factors and IPV severity in Uganda. Our study used population-based data to (a) establish different patterns describing the severity of IPV experiences, (b) explore associations between socioeconomic factors and severity of IPV experiences among Ugandan ever-married women, and (c) examine direct and indirect pathways from socioeconomic factors to severity of IPV experiences. Data were drawn from the 2016 Uganda Demographic and Health Survey's sample of 7,536 ever-married women aged 15-49 years. A latent class analysis examined distinct patterns of IPV severity among this sample, yielding a four-class solution: low violence (n = 5,059; 67.1%); high physical violence, low sexual violence (n = 1,501; 19.9%); high sexual violence, moderate physical violence (n = 535; 7.1%); and high sexual and severe physical violence (n = 441; 5.9%). Using the low violence group as the reference category, we conducted a multinomial logistic regression that found significant associations between secondary education (aOR 2.35, 95% CI: [1.06, 5.24]), poorest on the wealth index (aOR 2.00, 95% CI: [1.13, 3.54]), and severe IPV experiences. Decision-making (aOR 0.81, 95% CI: [0.68, 0.96]) played a protective role against membership in the high sexual and physical violence class compared to the reference category. Using path analysis, we found that labor force participation partially mediated the path from wealth index and education to IPV severity. Findings indicate the need for interventions that aim to keep girls in school and target schools, communities, and media platforms to address gender norms, economic vulnerability, and comprehensive screening for multiple forms of violence.

Prevalence and determinants of contraception use in Pakistan: trend analysis from the Pakistan Demographic and Health Surveys (PDHS) dataset from 1990 to 2018.

Background: In developing countries, pregnancy and childbirth are the leading causes of death among women. In this context, family planning and access to contraceptives are crucial for reducing pregnancy-related morbidity and mortality. Therefore, we aimed to look into the trends of contraception and determinants of contraceptive use in Pakistan. Methods: This study used data for women of reproductive age from four Pakistan Demographic and Health Surveys datasets. Contraception was the outcome variable, whereas, women's and partner's education, occupation, wealth quintile, region, place of residence, and exposure to family planning messages were the explanatory variables. Pooled prevalence was estimated using SUMARI and regression analysis was undertaken using SPSS to produce an adjusted prevalence ratio with 95% confidence intervals. Results: Data of 40,259 ever-married women of reproductive age (EMWRA) was analysed. Of the total EMWRA, 30% were using contraception. Of these, 26% were using traditional methods and 74% were using modern methods. The most common method of contraception was condoms (30.5%). The pooled prevalence of contraception used was 29.5% (95% CI 29.1 to 30.0). Through multivariate analysis, women's age, place of residence, region, wealth index, women's education, their working status, and exposure to family planning messages were found to be significant determinants of contraception usage. Conclusions: There is a noticeable gap regarding awareness and uptake of contraception leading to low contraceptive use among women in Pakistan. In the light of our results, it is important to highlight the importance of girl's education for building awareness and empowerment.

Age at First Conception and its Determinants of Ever-Married Women in Bangladesh

Age at first conception is an important part of the reproductive process that identifies the level of fecundability and indicative fertility during the early stages of marriage. This study explores the age at first conception and its determinants of ever-married women in Bangladesh by extracting the recent Bangladesh Demographic and Health Surveys (BDHS 2017) data. Descriptive statistics, ANOVA, chi-square tests, and binary logistic regression analysis were carried out to analyze data. Overall, the mean age at first conception of Bangladeshi women is 17.82 ± 3.29 years with significant variations by different socio-demographic, cultural, and behavioral factors. Bivariate analysis of chi-square tests shows that all the independent variables have a significant effect on age at first conception. The finding of the binary logistic regression analysis revealed that respondents' current age, age at first cohabitation, respondents' education, and partners' education are the most important determinants of age at first conception in Bangladesh. Moreover, secondary (OR= 0.743, 95% CI = 0.622- 0.886, P < 0.01) and higher educated women (OR= 0.838, 95% CI = 0.710- 0.989, P < 0.05) were respectively less likely to having first conception at age above 17.25 years, compared to no educated women. Thus, to increase the age at the first conception and reduce the level of fertility, it is necessary to increase the age at the first marriage of the respondents and the level of education for both partners.

Domestic Coercive Control and Common Mental Disorders Among Women in Informal Settlements in Mumbai, India: A Cross-Sectional Survey.

Coercive control behaviors central to the abuse of power appear more frequent than other types of domestic violence, but little is known about its frequency, features, and consequences for women in India. We aimed to examine the prevalence of domestic coercive control and its association with physical, sexual, and emotional domestic violence in the preceding year and symptoms of depression, anxiety, and suicidal thinking. In a crosssectional survey, we interviewed 4,906 ever-married women aged 18-49 years living in urban informal settlements in Mumbai, India. We developed a 24-item scale of coercive control, assessed physical, sexual, and emotional violence using existing questions, and screened for symptoms of depression with the Patient Health Questionnaire (PHQ9), anxiety with the Generalized Anxiety Disorder (GAD7) questionnaire, and suicidal thinking with questions developed by the World Health Organization. Estimates involved univariable and multivariable logistic regression models and the prediction of marginal effects. The prevalence of domestic coercive control was 71%. In total, 23% of women reported domestic violence in the past 12 months (emotional 19%, physical 13%, sexual 4%). Adjusted models suggested that women exposed to controlling behavior had greater odds of surviving emotional (aOR 2.1; 95% CI 1.7, 2.7), physical (1.4; 1.0, 1.9), and sexual (1.8; 1.1, 3.0) domestic violence in the past 12 months; and higher odds of a positive screen for moderate or severe depression (1.7; 1.3, 2.2), anxiety (2.1; 1.3, 3.1), and suicidal thinking (1.7; 1.2, 2.3), and increased with each additional indicator of coercive control behavior. When women reported 24 indicators of coercive control, the adjusted predicted proportion with moderate or severe depressive symptoms was 60%, anxiety 42%, and suicidal thinking 17%. Inclusion of coercive control in programs to support domestic violence, would broaden our understanding of domestic abuse to resemble most victims experience and improve interventions.

Intimate partner violence among ever-married Afghan women: patterns, associations and attitudinal acceptance

Intimate partner violence (IPV) is one of the most prevalent forms of violence that women suffer globally. Women in Afghanistan have been exposed to high levels of IPV which coincided with high levels of conflict during more than four decades. We cross-sectionally examined the Afghanistan Demographic and Health Survey responses of 21,234 ever-married Afghan women. We first performed the frequency distribution analysis to determine the prevalence of IPV and the basic socio-demographic characteristics of the participants. Subsequently we examined the relationship between the independent and dependent variables followed by the bivariate and survey versions of logistic regression analyses. We report odds ratios in order to depict the strength and direction of the associations between the IPV and selected independent variables. P-values less than 0.05 were considered statistically significant. The analyses showed that 55.54% of Afghan women experienced some form of physical, emotional, or sexual violence by their intimate partners during the recall period partners. The most common form of IPV found was physical violence (50.52%). Factors such as being exposed to inter-parental violence (respondent woman’s father physically abused her mother) (adjusted OR= 3.69, CI= 3.31–4.10) and respondent’s acceptance of IPV (aOR= 1.85, 1.51–2.26) were associated with increased exposure to IPV. Having a spouse with at least a primary education (aOR= 0.76, CI= 0.64–0.91) or a respondent with at least a primary education (aOR= 0.82, CI= 0.68–0.98) was associated with lower exposure to reported IPV. The lifetime experience of IPV occurs to a high extent among Afghan women, and several socio-demographic factors have predisposing attributes. IPV policy formulation and strategizing may benefit from considering these factors.

“Hush, Girl! Don’t Share Your Family Troubles with the Outside World”

Domestic abuse is a significant problem in Sri Lanka with government statistics showing that 17% of ever-married women between the ages of 15 to 49 have experienced some form of domestic abuse. However, this number could be higher in reality, given the prevalence of physical and emotional abuse in situations where partners live together without being married, in situations where the woman is under 15 years of age (Sri Lanka has a 2% child marriage rate), and due to low self-reportage. Although Sri Lankans can only be married after they reach 18 years of age, the war and economic conditions have resulted in a high number of child marriages in recent times. In this paper, I look at two main questions: What is the correlation between child marriage and the beginning of abuse? What is the correlation between pregnancy and the beginning of abuse? The paper draws from desk research. The paper looks only at physical abuse: It is acknowledged that the arena of emotional abuse was recognized only in 2005 after the Prevention of Domestic Violence Act was introduced in 2005 and that even now, such abuse is not given the prominence it deserves in conversations on domestic abuse. However, it was not possible in this research to examine emotional abuse due to time and resource constraints and also because even today the aspect of domestic physical abuse is also not accepted as a problem in Sri Lanka. Keywords: Domestic abuse; intimate partner violence; silencing women in intimate partnerships, child marriages, marital rape

The impact of girl child marriage on the completion of the first cycle of secondary education in Zimbabwe: A propensity score analysis.

The association between girl child marriage and education is widely acknowledged; however, there is no large body of demographic studies from Zimbabwe that have addressed this aspect. This study aimed to examine the extent to which child marriage affects one academic milestone, i.e. completion of the Ordinary Level, the first cycle of high school, which is also the most critical indicator of educational achievement in Zimbabwe. We used the 2015 Zimbabwe Demographic and Health Survey and extracted 2380 cases of ever-married women aged between 20-29 years. We applied a propensity score-based method, which allowed us to mimic a hypothetical experiment and estimate outcomes between treated and untreated subjects. Our results suggest that child age at first marriage is concentrated between the ages of 15-22, with the typical age at first marriage being 18 years. Both logistic regression and PSM models revealed that early marriage decreased the chances of completing the first cycle of high school. Regression adjustment produced an estimate of prevalence ratio (PR) of 0.446 (95% CI: 0.374-0.532), while PSM resulted in an estimate (PR = 0.381; 95% CI: 0.298-0.488). These results have implications for Zimbabwe's development policy and suggest that girl-child marriage is a significant barrier to educational attainment. If not addressed, the country will most likely fail to meet sustainable development Goal 4.2 and 5.3. Social change interventions that target adults and counter beliefs about adolescent sexuality and prepubescent marriage should be put in place. Moreover, interventions that keep teenage girls in school beyond the first cycle of high school should be prioritised.

INFLUENCE OF INDIVIDUAL AND COMMUNITY-LEVEL ASSOCIATES OF CONTRACEPTIVE USE IN PAKISTAN: A MULTI-LEVEL MIXED EFFECT ANALYSIS (PDHS 2017-18)

Purpose of the study: This research aims to investigate the impact of mass media exposure and women's autonomy on the use of contraceptives, along with other potential determinants at the individual level and community level among women in Pakistan.
 Methodology: Data was extracted from Pakistan Demographic & Health Surveys 2017-18. The sample size included 10,461 non-pregnant and married women from a total of 15,068 ever-married women. The analysis was done using two-level mixed-effects logistic regression for the binary outcome variable, i.e., current contraceptive use (yes/no).
 Main Findings: Significant factors positively associated with contraceptive use at the individual level were women's education, wealth index, parity, age at first cohabitation, child mortality experience, and mass media exposure. Community attributes like region (Sindh, KPK, Balochistan as compared to Punjab), residence (rural as compared to urban) had an inverse relationship with contraceptive use. At the same time, women's education and an ideal number of children were the significant positive associates. Women's empowerment has though insignificant, but it has a positive impact on the use of contraceptives at both individual and community levels.
 Applications of this study: Family planning programs can be extended by focusing on women residing in rural settings or in high fertility intentions communities, less educated and unprivileged younger women who had reduced the uptake of contraceptives. An increase in women's access to education, media exposure, employment, and women's empowerment can help attain Pakistan's contraceptive prevalence targets.
 Novelty/Originality of this study: The current study's effect of individual and community-level factors was investigated using National-level data, mainly focusing on the role of mass media and women's autonomy.

Persistence of Multimorbidity Among Women Aged 15-49Years in India: An Analysis of Prevalence, Patterns and Correlation.

Objectives: The present study has examined the patterns and possible correlates of coexisting morbidities among women aged 15–49 years based on biomarker measurement data at the national level in India. Methods: National Family Health Survey conducted during 2015–16 used in the present study. Simple disease count approach was used to calculate the multimorbidity among women. Multinomial logistic regression was applied to analyze the predictors of multimorbidity among women. Results: Almost 30% of the women had any of the selected morbidity and 9% of them had two or more morbidities. Hypertension and overweight combination (3%) was the most prevalent among women. The risk of having two or more morbidities was predominantly high among women aged above 30 years, low educated women, women from the wealthier group, ever-married women and women who were consuming tobacco as compared to their counterparts. Conclusions: From the policy perspective, the identification of groups of women vulnerable to multimorbidity will help in the selection of programmatic focus and preventive public health intervention in adult phase to reduce the multimorbidity burden among women in old ages.

Prevalence and predictors of teenage pregnancy in Pakistan: a trend analysis from Pakistan Demographic and Health Survey datasets from 1990 to 2018.

BackgroundTeenage pregnancies carry an increased risk of adverse obstetric and health outcomes for mothers and children.MethodsThis study assessed the prevalence and predictors of teenage pregnancies over time in Pakistan using the Pakistan Demographic and Health Survey (PDHS). Data on 400 076 ever-married pregnant women aged 15–49 y from four PDHS datasets were used. Teenage pregnancy was the outcome variable, whereas a woman's and her partner's education, occupation, wealth quintile, region, place of residence and access to knowledge on family planning were the explanatory variables. Pooled prevalence was estimated and regression analysis was undertaken to produce an adjusted prevalence ratio with 95% CIs.ResultsAlthough the prevalence of teenage pregnancy decreased from 54.4% in 1990–1991 to 43.7% in 2017–2018, the pooled prevalence was 42.5% (95% CI 37.9 to 49.6%). The prevalence of teenage pregnancy was significantly associated with place of residence, wealth quintile, education and occupation.ConclusionDespite a growing focus on women's education, access to sexual and reproductive health (SRH) services and contraception in the last decade in Pakistan, the prevalence of teenage pregnancy is still high. There is a pressing need to develop appropriate strategies for increasing access to education, SRH services and use of contraception in Pakistan.

Individual- and community-level factors associated with underweight and overweight among women of reproductive age in Bangladesh: a multilevel analysis.

The co-existence of under- and overweight at population level around the globe is well documented. However, this has yet to be explored using suitable statistical techniques in the context of Bangladesh. This study aimed to examine the prevalence and risk factors for being underweight and overweight or obese compared with normal weight in ever-married non-pregnant women aged 15-49 years in Bangladesh using data from the most recent Bangladesh Demographic and Health Survey conducted in 2014. Multilevel multinomial logistic regression (MLMLR) and quantile regression models were fitted to examine the associations of socioeconomic and individual-, household- and community-level factors on the nutritional status of women as measured by BMI. Overall, the prevalences of underweight, normal weight, overweight and obese women were 19%, 58%, 19% and 4%, respectively, in 2014. The MLMLR analysis revealed that women of young age, widowed/divorced/separated, having a larger family size and children aged ≤5 years in the household, currently amenorrhoeic and members of non-government organizations were at significantly increased risk of being underweight; those of older age, having higher parity, more educated, frequently watched TV and non-poor were more likely to be overweight or obese relative to normal BMI. Women from more affluent communities and urban areas were more likely to be overweight or obese relative to normal BMI than their counterparts from less-affluent and rural communities. Women's nutritional status was found to be heterogeneous across the regions of the country. The findings indicate that, along with individual-level factors, community-level characteristics are also important in explaining women's BMI in Bangladesh. The issue of under- and overweight or obesity among women in Bangladesh requires the immediate adoption of a public health policy for its mitigation. When developing intervention programmes, important determinants and uniform development of regions should be taken into consideration to combat the dual burden of under- and overweight among women in Bangladesh.

Economic abuse and its associations with symptoms of common mental disorders among women in a cross-sectional survey in informal settlements in Mumbai, India

BackgroundDomestic violence takes a range of interconnected forms, of which economic abuse is common, but less studied than others. We examine the prevalence of economic abuse, its determinants, and its association with symptoms of depression, anxiety, and suicidal ideation.MethodsOur cross-sectional survey in informal settlement areas in Mumbai, India, asked women aged 18–49 years 15 questions about acquisition, use, and maintenance of economic resources, demographic and socioeconomic factors, and physical, sexual, and emotional violence. We administered the Patient Health Questionnaire 9 (PHQ-9) and Generalised Anxiety Disorder 7 (GAD-7) scales and asked about suicidal thinking. Determinants of economic abuse and its associations with positive screens for depression and anxiety were explored in univariable and multivariable logistic regression models.ResultsOf 4906 ever-married women respondents, 23% reported at least one form of economic abuse by either an intimate partner or another family member. The commonest were denial of property rights (10%), not being trusted with money (8%), and coercive appropriation of belongings (7%). Economic abuse was more commonly reported by widowed, separated, or divorced women than by married women (aOR 12.4; 95% CI 6.4, 24.1), and when their partners used alcohol or drugs (aOR 1.4; 95% CI 1.2–1.7). Women had greater odds of reporting economic abuse if they had suffered emotional (aOR 6.3; 95% CI 5.0–7.9), physical (aOR 1.9; 95% CI 1.4–2.6), or sexual violence (aOR 5.4; 95% CI 3.6–8.1) in the preceding 12 months. Economic abuse was independently associated with positive screens for moderate-severe depression (aOR 2.6; 95% CI 2.0–3.4), anxiety (aOR 2.7; 95% CI 1.9–3.8), and suicidal ideation (aOR 2.2; 95% CI 1.5–3.1). The odds of anxiety and depression increased with each additional form of economic abuse.DiscussionTo our knowledge, this is the first community-based study in India of the prevalence of economic abuse and its associations with symptoms of common mental disorders. It provides empirical support for the idea that economic abuse is at least as harmful to women’s mental health as physical violence. Surveys should include questions on economic abuse and prevention and intervention strategies need to help survivors to understand its forms.

Examining the role of high-risk fertility behaviour in chronic undernutrition among Indian married women age 15-49

IntroductionMaternal undernutrition plays a critical role in influencing maternal, and child health outcomes and magnifies the risk of death of the mother at the time of delivery. High-risk fertility behaviour is an obstacle to tackle maternal and child mortality. ObjectivesThe aim of this study is to understand the level of high-risk fertility behaviour and chronic undernutrition among ever-married women, and also to examine the association between the two. MethodsData for 190,581 ever-married women (15–49) giving at least one birth during five years prior to the National Family and Health Survey (2015-16) was used. Descriptive statistics and modified Poisson regression were applied to examine the association between high-risk fertility behaviour and chronic undernutrition. ResultsResults show that 24% women were undernourished and 32% were subject to have at least one of the high-risk fertility behaviour. Collectively, 26% and 6% of the women were susceptible to single and multiple high-risk behaviour, respectively. After adjusting sociodemographic backgrounds, results showed a significant association between high-risk fertility behaviour and chronic undernutrition. As such, 5% of women were likely to be undernourished due to high-risk fertility behaviour on the whole, and 4% and 6% of the women, respectively, were likely to be undernourished due to single and multiple high-risk fertility behaviour. ConclusionsThis study finds that maternal high-risk fertility behaviour is an important factor in increasing the likelihood of women to be in a state of chronic undernourishment. Therefore, policy and programme should be implemented to reduce high-risk fertility behaviour among Indian women.

FACTORS AFFECTING DELIVERY CARE OF URBAN MOTHERS: A CROSS-SECTIONAL STUDY OF THE URBAN PRIMARY HEALTH CARE PROJECT IN BANGLADESH

Maternal mortality and its associated complications can be avoided by ensuring safe and supervised delivery. In this paper, the authors examined the factors associated with the utilisation of institutional delivery care at the Urban Primary Health Care Project (UPHCP) clinic in Bangladesh. A two-stage cluster sampling was used in selecting the ever-married women aged 15-49 years in the catchment areas of the UPHCP in Bangladesh. A total of 3,949 women’s data were analysed. The authors collected data through face-to-face interviews using a structured questionnaire. A multinomial logistic regression analysis was done to determine the potential factors associated with the utilisation of delivery care, in which ‘place of delivery care’ was considered as a dependent variable. Data entry and analysis were done in Statistical Package for the Social Sciences version 22.0. This study found that 30% of the women delivered their most recent child at the UPHCP clinic, and 45.9% of the women delivered their most recent child at other institutions. However, one-fifth of the women delivered at home. Doctors attended two-thirds of the deliveries. A small proportion of women were tended to by nurses, paramedics, FWV, and FWA. Traditional birth attendants attended one-fifth (20%) of deliveries. The multinomial logistic regression analysis found that respondents from poor catchment areas were 33.677 times more likely to utilise delivery care at the UPHCP when compared to 12.052 times by the respondents who took previous antenatal care from the non-poor catchment area. This study also found that women who had entitlement cards were 6.840 times more likely to utilise delivery care at the UPHCP in the poor catchment area, which was almost twice the women from the non-poor catchment area. Although the maternal mortality rate in Bangladesh has notably reduced,Bangladesh still needs to address the issue of safe delivery for marginalised women in order to attain the Sustainable Development Goals (SDGs) by 2030. A red card approach might increase access to the UPHCP for marginalised women to have safe deliveries.Keywords: poor, urban, red card, delivery care, Urban Primary Health Care Project, Bangladesh

Determinants of Malnutrition Among Ever-married Women in Bangladesh

Underweight and overweight problems have serious consequences on the health status of women in Bangladesh. The objective of this study is to find the important factors that may influence a woman for being underweight, overweight and obese. Multinomial logistic regression model is fitted for this purpose. The stepwise variable selection procedure is used to select covariates for the model. Information of ever-married 15,323 non-pregnant women is extracted from Bangladesh Demographic and Health Survey, 2014 data. Seven covariates (region, living place, wealth index, respondent‟s marital status, current working status, education, and current age) are selected finally for the model from the initially considered thirteen variables. The results of the study demonstrate that the women living in Sylhet region, rural area, widowed or divorced, having less education and younger age are more likely to become underweight. Conversely, the women are living in Khulna region, urban area, married, not working, having more than 10 years of schooling and age 35-49 are at higher risk of experiencing overweight or obesity. Thus, the Government of Bangladesh should take proper initiatives to improve underweight and overweight problem of women considering the findings of this study.
 Dhaka Univ. J. Sci. 69(1): 7-13, 2021 (January)

Inequality, chronic undernutrition, maternity, and diabetes mellitus as the determinant of anemia among ever-married women in Bangladesh

BackgroundAnemia is a public health concern at a global level. This study aims to delineate the association between household economic inequalities, and anemia among reproductive age group women in Bangladesh, along with other confounders.MethodsA cross-sectional population sample from Bangladesh Demographic and health survey data comprising of 5920 reproductive age group women aged between 15 and 49 years was used in this study. The analyses were performed through the application of proportional odds into four models (viz., Model:1 socio-economic, Model:2 socio-demographic factors, Model 3: diabetics and maternity statis, Model 4: nutritional status.)ResultsThe respondents from low and medium socioeconomic status (SES) households vs. richest households were 1.90 (95% CI, 1.65,2.17; p < .01) and 1.41 (95% CI, 1.12,1.78; p < .01) times more likely to suffer from anemia (Model 1). From the model 2 it appears that he likelihood of being anemic reduces for the low and medium SES groups vs. high SES group when sociodemographic variables are added (OR, 1.69, 95% CI, 1.43,1.99 and OR, 1.35, 95% CI, .07,1.70; p < 0.01, respectively). Model 3 evident that after adding the variables of diabetes and maternity status, the association between having anemia belonging to low and medium SES vs. high SES becomes weaker (OR1.36, 95% CI,0.85,2.15 and OR, 1.15, 95% CI, 0.6,2.19; p > .05, respectively). Moreover, the strength of the association between anemia and the subjects with pregnant vs. the subjects without these (OR: 1.7 (1.12, 4.02; p < 0.05) 1.47(0.11,3.399; p < 0.05) conditions was reduced after factoring body mass index (BMI, model 4). Besides, thin women (MBI < 18.50 Kg/m2) shows significantly become more likely to be anemic in comparison to women of normal BMI (OR:1.34, .92,1.96; p < 0.05) (model 4).ConclusionsBMI, pregnancy, and diabetes mellitus were observed to be significantly associated with anemia, and the strength of the association was low with anemia and socioeconomic inequality.

The feasibility of new HPV/DNA test as a primary cervical cancer screening method among 35- years- old ever-married women in Kalutara district; a cross-sectional study

BackgroundCervical cancer is the second commonest female cancer in Sri Lanka. Two major drawbacks of the present cervical cancer screening programme are the suboptimal sensitivity of the pap smear and the low coverage. The objective of the study is to determine the feasibility of a new HPV/DNA test among 35 -years -old ever-married women in a district of Sri Lanka.MethodA community based descriptive cross-sectional study was conducted from 1stof July 2018 to 30th November 2018 in the public health divisions called Medical Officer of Health (MOH) areas of Kalutara district. The study population is comprised of ever-married women 35 years of age. Three women from each cluster (n = 413) were selected by consecutive sampling. A total of 918 women were recruited. HPV/DNA cervical specimen collection (n = 822) was carried out. Cervical specimens were tested by two cytoscreeners with the cobas 4800 PCR based screening machine. Clients’ perceptions and prevalence were assessed. The follow-up of women with positive HPV/DNA screening results was carried out. The operational and technical feasibility of the screening test were assessed. Data entry was done by using the statistical package IBM SPSS version 20.ResultsOverall response rate was 91.1% (n = 836). Clients’ perception was highly positive for HPV/DNA screening test procedure (99.9%, n = 821) and 99.6% (n = 819) of clients had mentioned that the HPV/DNA screening test is worthwhile to be incorporated into the National Cervical Cancer Screening program. The prevalence of HPV was 6.2% (95%CI: 6.18–6.22%). The coverage of the HPV/DNA screening was 89.5%(n = 822). Invalid results reported were 0.12% (n = 1). The percentage of HPV/DNA test positive women who underwent pap test within 3 months of the initial screening was 100% (n = 51), while the percentage of women who attempted to get a colposcopy within the 1 month of referral was 86.7% (n = 13).ConclusionsHPV/DNA test implementation as a primary cervical cancer screening method is feasible among the 35- year age cohort of ever- married women in Kalutara district. It is necessary to further attempt alternative methods of cobas 4800 HPV/DNA test, which would be much suitable for resource-limited settings.

Empowerment and IPV in Married Women of Reproductive Age: Evidence from Pakistan Demographic Health Survey 2017-2018.

The study was an attempt to identify demographic, household, and women empowerment factors that predicted emotional, physical, and sexual violence in ever-married women of reproductive age (15-49 years, n = 3,965) in Pakistan by performing secondary analysis on Pakistan Demographic and Health Survey, 2017-2018. The analysis was done using SPSS (v.22) and binary and multivariate logistic regression techniques were performed for analyses. The analysis found that 30.2% of women experienced emotional, 24.1% reported less severe physical, 6.5% experienced severe physical, and 4.3% experienced sexual violence, respectively. The multivariate analysis found that husband's age, education, wealth, and alcohol consumption were significant predictors of intimate partner violence (IPV). Additionally, womens' age, education, and number of children also significantly predicted IPV. With respect to empowerment variables, ownership of house was a significant predictor of less severe physical violence, ownership of property significantly predicted emotional violence, and autonomy in household purchase decisions was significantly related to severe physical violence. The control on husband's income as a measure of empowerment significantly predicted all four types of IPV. Belief in patriarchy also turned out to be an important factor in determining emotional and less severe physical violence. The study concludes that women empowerment in household context can prevent less serious forms of violence but to hinder serious forms of violence, interventions at family and community level will be required.

Predictors of institutional delivery service utilization among women of reproductive age in Senegal: a population-based study

BackgroundIn Senegal, sub-Saharan Africa, many women continue to die from pregnancy and childbirth complications. Even though health facility delivery is a key intervention to reducing maternal death, utilization is low. There is a dearth of evidence on determinants of health facility delivery in Senegal. Therefore, this study investigated the predictors of health facility-based delivery utilization in Senegal.MethodsData from the 2017 Senegal Continuous Survey were extracted for this study, and approximately 11,487 ever-married women aged 15–49 years participated. Chi-square test was used to select significant variables and multivariable logistic regression analysis was performed to identify statistically significant predictors at a 95% confidence interval with a 0.05 p-value using Stata version 14 software.ResultsFacility-based delivery utilization was 77.7% and the main predictors were maternal educational status (primary school Adjusted Odds Ratio [aOR] = 1.44, 95% CI; 1.14–1.83; secondary school aOR = 1.62, 95% CI; 1.17–2.25), husband’s educational status (primary school aOR = 1.65, 95% CI; 1.24–2.20, secondary school aOR = 2.17, 95% CI; 1.52–3.10), maternal occupation (agricultural-self-employed aOR = 0.77, 95% CI; 0.62–0.96), ethnicity (Poular aOR = 0.74, 95% CI; 0.56–0.97), place of residence (rural aOR = 0.57, 95% CI; 0.43, 0.74), media exposure (yes aOR = 1.26, 95% CI; 1.02–1.57), economic status (richest aOR = 5.27, 95% CI; 2.85–9.73), parity (seven and above aOR =0.46, 95% CI; 0.34–0.62), wife beating attitude (refuse aOR =1.23, 95% CI; 1.05–1.44) and skilled antenatal care (ANC) (yes aOR = 4.34, 95% CI; 3.10–6.08).ConclusionUptake of health facility delivery services was seen among women who were educated, exposed to media, wealthy, against wife-beating, attended ANC by skilled attendants and had educated husbands. On the other hand, women from ethnic groups like Poular, those working in agricultural activities, living in rural setting, and those who had more delivery history were less likely to deliver at a health facility. Therefore, there is the need to empower women by encouraging them to use skilled ANC services in order for them to gain the requisite knowledge they need to enhance their utilization of health facility delivery, whiles at the same time, removing socio-economic barriers to access to health facility delivery that occur from low education, poverty and rural dwelling.

Linkages between consanguineous marriages and childhood stunting: Evidence from a cross-sectional study in India

The present research aims to decode the ties between marriages within blood relation (consanguineous marriages) and childhood stunting in India using the latest round of National Family Health Survey, conducted during 2015–16. The present study utilizes data on 192,357 ever-married women age 15–49 years and 14,707 children under age five years from National Family Health Survey, India, 2015–16. To draw inferences from the data, bivariate and multivariable logistic regression has been utilized. A Propensity Score Matching technique has been used to understand the causal linkages between consanguineous marriages and childhood stunting. The prevalence of childhood stunting was higher among male child (40%) compared to the female child (38%) among women who have married their blood relatives. The findings hint’s a significant association between consanguineous marriages and childhood stunting. Multivariable regression and propensity score matching results also show that childhood stunting was significantly higher in consanguineous marriages compared to non-consanguineous marriages in the country. Thus, to reduce childhood stunting among children born to women married to their blood relatives, measures like premarital and pre-conception counselling need to be taken for the individuals opting for consanguineous marriages.