Married Women Of Reproductive Age Research Articles

Contraceptive use, unmet need, and demand satisfied for family planning across Cameroon: a subnational study including indirect effects of COVID-19 and armed conflict on projections

BackgroundCameroon is among countries that have made notable investments nationwide in line with the Family Planning 2030 initiative. This study examines the progress made across the 10 regions and 58 divisions of the country, including potential impairments following COVID-19 and armed conflict.MethodsIn this time-series analysis, parameters were sourced from 5 Demographic and Health Surveys and 3 Multiple Indicator Cluster Surveys conducted between 1991 and 2018. The Family Planning Estimation Tool (FPET) was used to estimate key family planning indicators among married women of reproductive age. Data from official country reports and FPET results were incorporated into Bayesian models to assess how projections (from 2020 to 2030) would vary given varying contractions (i.e., 0%, 5%, 10%, and 25% annually) to services coverage.ResultsNationally, modern contraceptive prevalence rate (mCPR) and demand satisfied with modern (contraceptive) methods reached 16.8% (95% credible interval 12.0 to 23.0) and 37.6% (28.7 to 47.0), respectively; and unmet need for modern methods decreased to 27.9% (22.9 to 33.7) in 2022. Notable improvements were observed in the East region and Boumba et Ngoko division, with annual mCPR trends of 2.1 percentage points (%p) (− 0.2 to 4.2) and 7.0%p (4.5 to 9.3) from 2015–2020; and 2030 projections of 58.7% (41.3 to 74.0) and 79.1% (65.0 to 89.0), respectively. The least performing in terms of demand satisfied with modern methods include Adamawa at the regional and Boyo at the divisional level, with 2030 projections of 45.5% (26.5 to 65.1) and 0.4% (0.2 to 0.8), respectively. The northern regions (Adamawa, Far North, and North) recorded the lowest levels of unmet need for modern methods. To achieve ≥ 75% demand satisfied with modern methods in 2030, an additional 1.4 (0.6 to 2.2) million modern contraceptive users are required. Given large reductions (− 25% annually) in services coverage post-COVID-19/armed conflict (2020 to 2030), the South region could experience the most significant contraction in projected mCPR, with a decrease of − 9.2%.ConclusionsFamily planning outcomes vary significantly across subnational territories of Cameroon. While the East region shows notable success, greater attention is needed in the northern regions. Strategies must be adaptive to address unprecedented emergencies that may disrupt access to services.

Factors influencing childbearing intention among married women of reproductive age in Bueng Kan Province

Factors influencing childbearing intention among married women of reproductive age in Bueng Kan Province

The impact of positive psychology counseling on sexual and marital satisfaction and anxiety among reproductive-aged women during the COVID-19 pandemic: a randomized controlled clinical trial

BackgroundSexual and marital satisfaction is considered one of the important factors in happiness and life satisfaction of couples. COVID-19 pandemic results in psychological effects, such as increased anxiety levels which can affect sexual and marital satisfaction. This study aimed to investigate the impact of positive psychology on women’s sexual and marital satisfaction.MethodsA randomized controlled trial was conducted on 72 married women of reproductive age in Tabriz, Iran between February 2021 and May 2022. The participants were randomly divided into the intervention and control groups. There was no significant difference between the control and intervention groups in terms of the socio-demographic characteristics (p < 0.05). The mean age of the participants in the intervention and control groups was 31.8 ± 6.92 and 30.97 ± 5.09 years, respectively. The intervention group attended seven 60–90 min counseling sessions at weekly intervals. The Spielberger anxiety, sexual satisfaction and marital satisfaction questionnaires were completed before and four weeks after the intervention.ResultsThe results of this study indicated that after counseling, the average overall score of marital satisfaction [MD: 15.46, 95% CI: 7.47 to 23.41, p = 0.034] and sexual satisfaction [MD: 7.83, 95% CI: 6.25 to 9.41, p = 0.001] significantly increased in the intervention group compared to the control group. Also, the mean score of state anxiety [MD: -2.50, 95% CI: -4.19 to -0.80, p = 0.001] and trait anxiety [MD: -1.03, 95% CI: -2.46 to -0.09, p = 0.032] significantly decreased after counseling in the intervention group compared to the control group.ConclusionsUsing counseling based on a positive psychology approach can improve anxiety, sexual and marital satisfaction, and anxiety of women of reproductive age during the COVID-19 pandemic. However, further randomized clinical trials are needed before making a definitive conclusion.Trial registrationIranian Registry of Clinical Trials (IRCT): IRCT20171007036615N8. Date of registration: 11/28/21. Date of first registration: 11/28/21. URL: https://www.irct.ir/user/trial/58680/view; Date of recruitment start date: 12/01/21.

Barriers and facilitators to self-care practices for sexual and reproductive health among women of reproductive age.

Sexual and Reproductive Health and Rights (SRHR) have been promoted globally, yet sexual and reproductive health (SRH) interventions are seldom evaluated from the perspective of service users and service providers. Very little is known about whether and why various target groups including general women are (or are not) practicing SRH -related self-care practices. This study explored SRH self-care practices and facilitators and barriers to the adoption of SRH self-care among reproductive-age women of Nepal. In this descriptive qualitative study, we conducted in-depth interviews in June 2022 with ten married women of reproductive age (service users) and four SRHR service providers (program managers and health service providers) in Nepal. Thematic analysis was conducted for data analysis. We found that commonly practiced self-care practices were self-administration of contraceptives, self-management of pain, self-monitoring of pregnancy, self-awareness and seeking medical abortions (tele-abortion), self-medication for pre-exposure prophylaxis for HIV, and self-testing for HIV and pregnancy. The multi-level barriers to SRH self-care were poor knowledge and perceived lack of need for SRH self-care, limited access, and negative behaviors from the service providers. The program-related barriers included lack of evidence, limited financial resources, lack of accountability, and limited knowledge and skills among service providers on SRH self-care measures. Peer support, an increasing number of service sites, and access to and use of digital (health) tools emerged as the facilitators of SRH self-care. The findings of this study suggest that addressing barriers such as poor knowledge, limited access, and negative attitudes while leveraging facilitators such as peer support and digital tools is essential for promoting and enabling effective SRH self-care among women. Population-wide awareness programs supplemented by increasing service sites are essential for increasing SRH self-care practices.

Effect of Media Exposure and Related Factors on Antenatal Care Visits Among Pregnant Women in Bangladesh: A Study Based on BDHS 2017-18 Data

Providing antenatal care (ANC) to expectant mothers is the primary method of reducing maternal morbidity and death. The objectives of ANC are to monitor and preserve the health and safety of both the mother and the fetus, identify any pregnancy issues and take appropriate action, address the concerns of the mother, get her ready for delivery, and encourage mothers to adopt healthy habits. The goal of this research is to investigate the determinants associated with Bangladeshi women&amp;apos;s ANC. Data were obtained from the BDHS for the 2017–18 year, and 4,920 married women of reproductive age (15–49 years) were selected as participants from 18,895 married women. The data was analyzed using multinomial logistic regression as well as descriptive and inferential statistical methods. The main outcome of this study found that 48.4% of respondents received 4 or more ANC visits. The ANC contacts were correlated with factors such as media exposure, division, maternal age, women&amp;apos;s education, husband&amp;apos;s education, and wealth index. The primary educated women were 0.312 times (p&amp;lt;0.002) less likely to receive 4 or more ANC, compared to higher educated women, and women who don’t access to media, 0.464 times (p&amp;lt;0.000) less likely to engage in 4 or more ANC visits compared to media access. The results of this investigation demonstrate a substantial correlation between media exposure and ANC visits, as well as a noteworthy rise in appropriate ANC visits among expectant mothers with increased media exposure.

Application of the integrated gateway model on child nutrition behaviors in Niger: An exploratory analysis.

To identify potential gateway factors and behaviors that are associated with infant and young child feeding (IYCF) practices in the Maradi and Zinder regions of Niger through application of the Integrated Gateway Model. We analyzed data from 2,727 married women of reproductive age including details on child feeding practices for their 2,551 children between the ages of 0 to 23 months. We assessed the association of three gateway behaviors (i.e., any antenatal care, facility delivery, and communication on nutrition practices) and gateway factors (i.e., behavioral determinants, exposure to information, decision-making agency, and woman's group participation) on four IYCF practices (i.e., early initiation of breastfeeding, exclusive breastfeeding, minimum meal frequency, and minimum dietary diversity) while controlling for age, parity, educational attainment, and household wealth. We found antenatal care was associated with exclusive breastfeeding of children 0-5 months [adjusted odds ratio (aOR): 1.17 (95% confidence interval (CI): 1.03-1.33)], and minimum meal frequency of children 6-23 months [aOR: 1.10 (95% CI: 1.03-1.17)], and facility delivery was associated with early initiation of breastfeeding among children 0-5 months [aOR: 2.08 (95% CI: 1.39-3.12)]. We found negative associations with exclusive breastfeeding and communication on nutrition practices with husbands, family/friends, and health workers. Exposure to nutrition messages through radio, women's groups participation, and with health workers was positively associated with minimum dietary diversity. Self-efficacy was positively associated with both early initiation of breastfeeding, exclusive breastfeeding among children 0-5 months and minimum dietary diversity among children 6-23 months. Women's agency was positively associated with early initiation of breastfeeding. The association of antenatal care and facility delivery with child nutrition outcomes suggest intervening before a woman becomes pregnant or early in her pregnancy could improve nutrition outcomes. Programs strengthening the continuum of care should identify gateway behaviors to maximize adoption of priority health behaviors.

An empirical analysis of the demand for family planning satisfied by modern methods among married or in-union women in Nigeria: Application of multilevel binomial logistic modelling technique.

Given the health and economic benefits of family planning (FP), Nigeria's very low demand for FP satisfied by modern methods (mDFPS) of less than 50% is therefore a major public health concern, especially considering the global target aimed at achieving an mDFPS of at least 75% by year 2030 for all countries. In view of this, together with recognising the possible contextual nature of health outcomes, this study aimed to empirically analyse the mDFPS among married or in-union women of reproductive age (WRA) in Nigeria. A multilevel binomial logistic model with two levels of analysis was used: individual and community levels. Secondary cross-sectional data were obtained from the 2018 Nigeria Demographic and Health Survey, and analyses were performed using Stata 15.0. The analytical sample size was 9,122 WRA nested in a total of 1,072 communities. The mDFPS was approximately 31.0%. The median odds ratio (MOR) estimated from the final multilevel model was 2.245, which was greater than the adjusted odds ratio (aOR) for most of the individual-level variables, suggesting that the unexplained/residual between-community variation in terms of the odds of women having their mDFPS was more relevant than the regression effect of most of the individual-level variables. This was with the exception of the regression effects of the following individual-level variables: women's husbands that had higher education level in comparison to their counterparts who had husbands with no formal education (aOR = 2.539; 95% CI = 1.896 to 3.399; p<0.001); and women from the Yoruba ethnic group in comparison to their counterparts from the Hausa/Fulani/Kanuri ethnic group (aOR = 2.484; 95% CI = 1.654 to 3.731; p value<0.001). However, other individual-level variables with positive statistically significant regression effects on mDFPS were: women who mentioned that money for accessing health care was not a problem; women's empowerment in relation to the visitation of family and relatives; and women being exposed to FP messages through various media sources, all in comparison to their respective counterparts. On the other hand, at the community level, women in communities where a high percentage of them had at least a secondary education had statistically significant greater odds of having mDFPS than women in communities with lower education levels (aOR = 1.584; 95% CI = 1.259 to 1.991; p<0.001). We found similar findings regarding women residing in communities with exposure to FP messages through various media sources. However, using the 80% interval ORs (80% IORs) as a supplemental statistical measure for further understanding the regression effects of community-level variables showed that all of the 80% IORs had a value of '1', signifying considerable uncertainty in the regression effects of all community-level variables due to the substantial residual variation existing between communities. Our study showed that to achieve the dire increase in mDFPS in Nigeria, policy interventions aimed at improving the education level of both females and males, especially beyond the secondary school level, should be implemented. Additionally, all of the various media sources should be extensively utilised, both at the individual and the community level, by the Nigerian government to spread information on the importance of women having their mDFPS.

Coping styles for sexual dysfunction and stress among married women of reproductive age: a cross-sectional study from Turkiye.

To identify sexual dysfunction in married women of reproductive age, and to examine its relationship with stress coping styles. The cross-sectional, descriptive study was conducted between February and June 2019 at the obstetrics and gynaecology outpatient clinic of Gulhane Training and Research Hospital in Ankara, Turkiye. The sample comprised married women aged 18-49 years who had an active sexual life over the preceding month, and were neither pregnant nor in the postpartum phase. Data was collected using the Female Sexual Function Index, and the Stress Coping Styles Scale. Data was analysed using SPSS 22. There were 216 women with mean age 33.58±6.77 years. The mean Female Sexual Function Index score was 22.29±6.08. The mean Stress Coping Styles Scale subscale scores were: self-confident 20.71±3.53, helpless 18.07±4.27, submissive 12.13±3.00, optimistic 13.70±2.35, and seeking social support 11.89±2.01. The total Female Sexual Function Index score had a positive, significant correlation with self-confidence (r=0.15; p=0.03) and seeking social support subscales (r=0.18; p=0.01) and a negative, significant correlation with submissive subscale (r=-0.17; p=0.02) of the Stress Coping Styles Scale. Establishing awareness among women about sexual dysfunction and improving effective coping styles may contribute to improved sexual health among women.

Social Demographic Dimensions of Contraceptive Use in the Land of Papua: A Cross-Sectional Approach

Background: The use of contraception is one of the efforts to prevent unwanted or mistimed pregnancies. Therefore, it has become a family planning program for motivating families to have ideal plans for pregnancies in time and with a desired number. However, although nationally, 58.7% of married women aged 15-49 years old used contraception in 2019, the percentage of contraceptive users remained the lowest in Papua, with only 13.7% of married women of the same age group using contraceptives in addition to 20% of the women having the unmet need for contraception. This study aims to analyze the determinants of the use of contraception in women of childbearing age in Papua Province.Method: This study employed data from the 2020 National Socioeconomic Survey (Susenas) with a cross-sectional approach. Respondents were 666,866 married women aged 10-54 years. Descriptive statistics and logistic regression analysis were performed using SPSS with a 95% confidence interval (p &lt; 0.05) to express statistical significance.Results: Residence, educational status, pregnancy, employment, age at first marriage, number of children, cell phone ownership, and health insurance were significantly correlated with contraceptive use (p &lt; 0.001). Residence in an urban area, junior high school education, pregnancy, marriage at less than 20 years of age, having more than two children alive, and ownership of a cell phone and health insurance were associated with an increased chance of using contraceptive methods among married women of reproductive age in Papua. The chance to use contraception was the highest for married pregnant women of reproductive age, and the women, in this case, were 35 times more likely to use contraceptives compared to unpregnant ones.

"I don't want my marriage to end": a qualitative investigation of the sociocultural factors influencing contraceptive use among married Rohingya women residing in refugee camps in Bangladesh

BackgroundThe timely provision of comprehensive contraceptive services to Rohingya women is impeded due to a lack of clarity and understanding of their traditional beliefs and cultural frameworks. Recognizing this challenge, our paper aims to explore the socio-cultural factors influencing the utilization of contraceptives among married Rohingya women living in the refugee camps of Cox's Bazar, Bangladesh.MethodA qualitative study was conducted in two unregistered Rohingya camps (Camp 7&14) located in Ukhiya Upazila, Cox's Bazar from January 10th to 20th, 2022. A total of 14 In-Depth Interviews (IDIs) were conducted among married Rohingya women of reproductive age (15–49 years), along with 16 Key Informant Interviews (KIIs) involving stakeholders engaged in reproductive healthcare provision. Participants were selected using purposive sampling. All interviews were conducted in the local language, recorded, transcribed verbatim, and subsequently translated into English. The data were analyzed using NVivo (Version 11), and the analysis process followed Neuman’s three-phase coding system.ResultsFive broad themes were identified: Sociocultural expectations and values attached to births, power imbalances within marital relationships, the role of religious beliefs, fear of side effects, and misperceptions about contraception. Having a larger number of children is viewed positively as it is believed that children play a crucial role in preserving the lineage and contributing to the growth of the Islamic population. Despite expressing an inclination towards contraception, the disapproval of husbands becomes a significant barrier for women. Defying their husbands' wishes can result in instances of Intimate Partner Violence (IPV) and even marriage dissolution within the camps. Moreover, the fear of side effects, such as a particular method would cause infertility, discourages women from using contraception. Many of these fears stem from myths, misconceptions, and mistrust in the existing medical system.ConclusionAddressing the socio-cultural barriers that prevent women from using modern contraception will have important public health implications. These findings can support in crafting culturally sensitive programs and educational interventions. These initiatives can assist Rohingya refugee women in planning their pregnancies and reducing high-risk pregnancies, ultimately leading to a decrease in maternal mortality rates within the community.

Knowledge of emergency contraception and acceptability of unplanned pregnancy among married women in reproductive age in Beni-Suef

Knowledge of emergency contraception and acceptability of unplanned pregnancy among married women in reproductive age in Beni-Suef

A population based study on human papillomavirus infection and associated risk factors among women of the remote South Andaman Island, India

BackgroundHuman papillomavirus (HPV) is associated with cervical cancer and cervical dysplasia worldwide. Data on HPV prevalence in a region is important because it serves as a predictor of the likelihood of the population in that particular region acquiring cervical cancer. Moreover, with the availability of effective vaccines, the public health system must be aware of the preponderance of HPV to implement the vaccine. The present study was designed to understand the prevalence of HPV and associated factors among the women of South Andaman Island.MethodsA cross-sectional study was conducted among married women of reproductive age (18–59 years) from South Andaman District from 2018 to 2022. Cervical scrapes were collected from participants after obtaining informed written consent for HPV molecular testing (HPV DNA) such as PCR assay. Demographic data was collected using a standard questionnaire and statistical analyses were performed to determine the associated factors.ResultsThe study showed prevalence of HPV as 5.9%(95% CI: 3.9–7.9) and prevalence of HR-HPV16 was 4.1% (95% CI 2.6 – 5.5) and HR-HPV18 prevalence was 1.8(95% CI: 0.6–3). The independent factors associated the HPV positivity were age above 55 years, menopause, post-menopausal bleeding, blood-stained vaginal discharge and loss of weight. Age was associated with all HPV infections among the South Andaman women.ConclusionsHPV 16 was reported as the predominant high risk HPV type circulating among women of South Andaman. Cervical cancer and precancerous lesions were significantly associated with HPV positivity and High risk HPV 16. Based on the knowledge of the risk factors associated with HPV, implementation of stronger public health awareness and prophylactic HPV vaccination is crucial among the women of this remote island.

Turkish adaptation of the reproductive autonomy scale: Validity and reliability study.

This study aimed to determine the validity and reliability of the reproductive autonomy scale by adapting it to Turkish society. Designed with a methodological method, the study was conducted with an online form created by using Google Forms with 308 married women of reproductive age between the ages of 15 and 49 who use WhatsApp or Instagram. The cultural adaptation process of the scale was carried out in three stages: language validity, content validity, and pilot application. Exploratory and confirmatory factor analysis was used to test the scale's construct validity. The scale's reliability was evaluated using Cronbach's α internal consistency coefficient and test-retest analyses. As a result of the exploratory factor analysis conducted in the study, it was determined that reproductive autonomy scale (RAS) consists of 14 items and 3 subscales. Good fit index values were obtained in confirmatory factor analysis. Cronbach's α internal consistency coefficients for the RAS total and subscale were found to be 0.66, 0.64, 0.89, and 0.92, respectively. Additionally, test-retest analysis of the scale was determined to have a high correlation. The reproductive autonomy scale is a valid and reliable measurement tool for measuring the reproductive autonomy of Turkish society.

The Relationship Between Childhood Abuse and Unintended Pregnancy Among Married Women of Reproductive Age in Bangladesh

ABSTRACT Childhood abuse has been associated with adverse medical, psychological, behavioral, and socioeconomic outcomes in adulthood. Despite this, limited research explores the connection between childhood abuse and unintended pregnancy during adulthood. Notably, existing studies have predominantly focused on high-income countries, leaving a significant gap regarding low- and middle-income nations. This study aims to investigate the impact of childhood physical, sexual, and psychological abuse on the prevalence of unintended pregnancies and explore the interaction effects of childhood abuse on unintended pregnancy occurrences. The cross-sectional survey study was conducted between October 2015 and January 2016 in the Chandpur District of Bangladesh. Data were collected from 426 married women aged 15–49 years who had at least one child of six months or younger. The assessment of child abuse pertains to the mother’s own experiences of childhood abuse and not abuse inflicted on her child. The prevalence of childhood physical, psychological, and sexual abuse was 37%, 26%, and 15%, respectively. About 25.1% of their most recent pregnancies were unintended. Notably, women with a history of childhood sexual abuse were twice as likely to experience unintended pregnancy compared to those without such a history. Furthermore, a dose-response connection was observed between the combined exposure of all categories of childhood abuse and a higher risk of unintended pregnancy. These findings highlight the need for targeted interventions, such as comprehensive sex education, accessible mental health support, and improved child protection frameworks, to address the potential repercussions of maternal childhood abuse and reduce the incidence of unintended pregnancies.

Determinants of unmet need for family planning among currently married reproductive age women at Dewa Chefa District of Oromia special zone, Amhara region, Ethiopia, 2021; a case-control study

BackgroundUnmet need for family planning is a proportion of women among reproductive age group who want to stop or delay childbearing but are not using any method of contraception. One in ten married women face unmet need for family planning world-wide whereas, one in five women in Africa. Thus, by understanding factors associated with unmet need specific to the study area; the study contributes to planning and intervention of programs, gives additional finding for controversies in earlier studies, and also helps as a baseline for other researchers conducting studies on similar topics.MethodsA community-based unmatched case-control study was conducted from March 29-April 25, 2021 G.C on 462 currently married reproductive age women (154 cases and 308 controls) in Dewa Chefa District. Currently married reproductive-age women who were fecund, and wanted to limit or delay childbearing but were not using any contraceptive methods were taken as cases and currently married reproductive-age women who were using family planning or did not want to use were taken as controls. A structured and pre-tested questionnaire was used to collect data. Collected data were entered into Epi-data 3.1 and exported to SPSS 23 for analysis. Binary Logistic regression was conducted and variables with p-value < 0.05 were taken as statistically significant.ResultsA total of 462 women participated in this study, with 100% response rate. The mean age of the respondents was 27.92 years (with SD of ± 6.3) Age of woman 35–49 [AOR = 6.6 (1.1–39)], having poor knowledge on family planning [AOR = 1.9 (1.1–3.1)], using family planning decided by husband [AOR = 3.8 (2.1–6.9)], using family planning decided together [AOR = 2.3 (1.07–5.1)] and have no support and disapproval of husband for family planning use [AOR = 2.1 (1.08-4)] were factors significantly associated with unmet need.Conclusion and recommendationsAge of the woman, main decider of family planning use, knowledge about family planning and support and approval of spouse for family planning use were found to have significant association with unmet need for family planning. Thus, family planning providers, District health office, and other concerned bodies should strengthen female empowerment and male involvement in the program with strong couple counseling to reduce unmet need.

Socioecological Approach to Understanding Overnutrition Among Married and Cohabiting Women in Nigeria

Overweight and obesity are currently an epidemic affecting both developed and developing countries. Sub-Saharan Africa has a double burden of being underweight and obese and has recently been battling an alarming increase in the prevalence of overweight. This study investigates the predictors of overnutrition among married women of reproductive age in Nigeria using the socioecological model (SEM) as a framework. The study hypothesizes that the Southern region will have a higher burden of overnutrition than the Northern region. The 2018 Nigeria Demographic and Health Survey (NDHS) was analyzed. A total of 8,531 non-pregnant married women met the inclusion criteria. Hierarchical multilevel logistic regression models were fitted, informed by the SEM framework. The occurrence of overnutrition was found to be 31.4%, with regional variations showing 31.7% in the South and 31.3% in the North. When all covariates were fitted in a model, being older, being a Christian, having tertiary education, having an older partner with tertiary education, being wealthy, and living in the urban area were predictors of overnutrition in multivariate analysis. Overnutrition among Nigerian married women was high, especially in the Southern region. Predictors of overweight are at all the SEM levels; therefore, it is better to consider all the levels when planning public health interventions.

Modern contraceptive utilization and its associated factors in East Africa: Findings from multi-country demographic and health surveys.

The use of modern contraceptives has been low in most Sub-Saharan African countries despite high population growth and a sluggish economy. This study aimed to identify the prevalence and determinants of modern contraceptive use among married reproductive-age women in East Africa. For this study, the Demographic and health survey (DHS) data from nine countries in East Africa were analyzed, yielding a weighted sample of 32,925 married women. A multilevel mixed-effect logistic regression model was used to identify characteristics associated with the utilization of modern contraceptives at a p-value less than 0.05. For model comparison, we used the Akaike and Bayesian Information Criteria (AIC and BIC). For assessing variation (random effects), we used community-level variance with standard deviation and intra-cluster correlation coefficient (ICC). The overall prevalence of modern contraceptive use was 45.68%, 95% CI (45.15, 46.21). Women's age, maternal education level, husband education level, media exposure, wealth status, occupation, religion, the total number of children ever born, distance to health facilities, history of termination of pregnancy, couple's desire for children, women's participation in decision making, living country and place of residence were significantly associated with modern contraceptive use in Eastern Africa. Conferring to this study, utilization of modern contraceptives is low in East Africa. Interventions to improve the use of modern contraceptives should encompass disseminating awareness through mass media, enrolment of males in family planning, giving maternal education, building health facilities in remote areas, and encouraging family planning programs in rural areas.

Improving health indicators of mothers and newborns by empowering communities in urban slums of Mumbai, Maharashtra, India

Abstract Background: Newborns represent the most vulnerable segment of our society, constituting nearly 30% of all under-5 mortality cases. Despite well-established healthcare systems in metropolitan areas, urban slum dwellers, comprising approximately 50%–60% of the population, often lack access to these services. The Society for Nutrition, Education, and Health Action (SNEHA) operates within urban slums, aiming to enhance health outcomes for mothers and children. At SNEHA, we firmly believe that a healthy society starts with the well-being of mothers and infants. Our organization is dedicated to empowering communities to improve the health status of newborns in urban slums. Material and Methods: As part of the intervention, 7819 households with a population of 35,000 were targeted. SNEHA’s field workers conducted regular visits to these households, providing counseling on breastfeeding immunization and identifying potential health risks. Married women of reproductive age were specifically identified and consistently educated about the significance of early pregnancy registration. Pregnant women received support for registering their pregnancies, attending regular antenatal care (ANC) check-ups, adhering to ANC visit schedules, and maintaining adequate iron, calcium, and nutrition intake. Additionally, they were informed about the advantages of institutional delivery and encouraged to prepare for childbirth. Mothers of children under 2 years were urged to bring them to primary health centers for routine immunizations. Furthermore, they were advised on contraception methods to ensure proper spacing between children. Results: Our endeavors have resulted in a 34% rise in early pregnancy registration, a 22% increase in the number of women attending four antenatal check-ups, an 11% uptick in institutional deliveries, a 24% improvement in exclusive breastfeeding rates, and a notable 67% surge in the prevalence of contraception. Conclusion: Our intervention has proven that it is possible to improve the health indicators of women and children through behavior change communication, regular home visits, and community awareness.

Married Women Decision-Making Autonomy on Contraceptive Use in East Africa: A Multilevel Analysis of Recent Demographic and Health Survey

The utilization of contraceptives depends on women’s autonomy in making decisions. Limited and inconclusive information is available on women’s decision-making autonomy to use contraceptives in East Africa. Therefore, the main objective of this study was to assess married women’s decision-making autonomy on contraceptive use and associated factors in East African countries. The most recent Demographic and Health Surveys were used for this study. The study included a total weighted sample of 41,893 married reproductive-age women. A multilevel mixed-effect binary logistic regression model was fitted. The prevalence of married women’s decision-making autonomy on contraceptive use was 18.91% (95% CI: 18.54, 19.29). Respondents who are employed (AOR = 1.24; 95% CI: 1.03, 1.44), having more than two alive children (AOR = 1.38; 95% CI: 1.13, 1.67), and visited a health facility in the last 12 months (AOR = 1.22; 95% CI: 1.05, 1.45), urban residency (AOR = 1.39; 95% CI: 1.27, 1.50), lower middle-income level 1.37 (AOR = 1.37; 95% CI: 1.17, 1.60), and community media exposure to family planning message (AOR = 1.25; 95% CI: 1.04, 1.45) were significantly associated with women’s decision making autonomy on contraceptive use. Despite the fact that every woman has the right to participate in her own healthcare decisions, less than one-fifth of married women in East Africa have contraceptive decision-making autonomy. Hence, Women’s decision-making autonomy on contraceptives should be promoted through mass media as an essential part of sexual and reproductive rights, with particular attention paid to rural women, women with no children, and women living in low-income households.

Associations between sexual violence and women's sexual self-consciousness.

Sexual violence is a global public health problem that has serious and multiple consequences for the victims' health. This study was conducted to determine associations between sexual violence and women's sexual self-consciousness. In the analytical cross-sectional study, 340 eligible married women of reproductive age who have been referred to comprehensive health centers of Rasht, participated. Simple random sampling followed by cluster sampling was used to reach eligible study participants. The data collection tool was a three-part questionnaire including a demographic information form, sexual violence questionnaire, and sexual self-consciousness scale. More than 66% of the participants in this study were exposed to sexual violence by their current spouses/partners. The highest prevalence of sexual violence was in the dimension of unwillingness to have sex (49%), and the lowest in the verbal dimension was 2.1%. Participants were 4.11 ± 5.18. There was a significant positive correlation between the total score of sexual violence and the total score of sexual self-consciousness of participants (P <0.001, r = 469). According to the findings, there is a significant positive correlation between SSC and sexual violence, so prevention policies for sexual violence should be focused on skill-based programs and empowering women.