Married Women Of Reproductive Age Research Articles

Psychometric Properties of Dyadic Sexual Communication Scale- Persian Version

Background and Aim: Couples’ sexual communication is one of the contributing factors to the quality of couples’ sexual relationships. The aim of the present study was to psychometrically evaluate the Persian version of the Dyadic Sexual Communication Scale (DSCS) among married women of reproductive age. Methods: In this psychometric study, translation was carried out using the back-translation method. The validity of the final version of the DSCS was performed using confirmatory factor analysis and Rasch analysis. Concurrent validity was examined using the Female Sexual Function Index (FSFI), Female Sexual Distress Scale (FSDS) and Marital Intimacy Scale (MIS). Reliability was assessed by calculating Cronbach’s alpha coefficient. Data analysis was performed using SPSS and Mplus software. Results: The participants comprised 400 married women with a mean age of 35.66 years living in Qazvin, Iran. Construct validity was confirmed based on confirmatory factor analysis (χ2[df]: 113.49 (65), Tucker-Lewis index: 0.980, Composite Reliability: 0.87, SRMSR: 0.065, RMSEA: 0.043, CFI: 0.983. Concurrent validity was analyzed using Pearson correlation coefficients, and the DSCS was positively correlated with scores on the MIS (r=.64) and FSFI (r=.65) and negatively correlated with scores on the FSDS (r=-.61). The internal reliability of the Persian DSCS was very good (Cronbach’s alpha=.88). Conclusion: Based on psychometric testing, the Persian DSCS has good validity and reliability. Therefore, the tool can be used to assess women’s sexual communication in the context of sexual relationships. Future research should include males and compare and contrast results with females.

Family structure factors influencing modern contraceptive use in Cameroon based on analysis of 2018–2019 demographic and health survey data

Maternal mortality remains a significant global concern, particularly in sub-Saharan Africa, underscored by its inclusion in Sustainable Development Goal 3.1. Cameroon faces substantial challenges, with a maternal mortality rate of 438 per 100,000 live births as of 2023. Family planning is a crucial strategy for mitigating maternal and infant mortality. This study explored the association between husbands’ sociodemographic factors, household socioeconomic characteristics, and modern contraceptive use in Cameroon, contributing to a deeper understanding of contraceptive use. This cross-sectional study utilized data from the 2018–2019 Demographic and Health Surveys to examine modern contraceptive use among married or live-in partners women of reproductive age in Cameroon. The study excluded pregnant women, nonunion women, and individuals identified as sisters, granddaughters, mothers of household heads, or visitors. A quantitative analysis employing multiple logistic regression was conducted to assess the likelihood of modern contraceptive use. The study identified an 18.8% prevalence of modern contraceptive use among Cameroonian women of reproductive age. Sociodemographic and socioeconomic factors significantly influenced contraceptive use. A higher likelihood of modern contraceptive use was associated with husbands’ occupation (AOR: 4.53, 95% CI (2.55–8.04)), desire for fewer children (AOR: 1.57, 95% CI (1.28–1.93)), educational level (AOR: 2.36, 95% CI (1.80–3.12); AOR: 2.44, 95% CI (1.84–3.24); AOR: 3.9, 95% CI (2.78–5.47); AOR: 1.06, 95% CI (0.65–1.74)), household size (AOR: 1.25, 95% CI (1.06–1.49)), and wealth index (AOR: 2, 95% CI (1.60–2.50); AOR: 1.83, 95% CI (1.46–2.30); AOR: 2.21 95% CI (1.72–2.85); and AOR: 1.90, 95% CI (1.44–2.51)). Conversely, factors such as husbands living elsewhere (AOR 0.75, 95% CI (0.60–0.95)), women’s unawareness of their husbands’ desired number of children (AOR: 0.76, 95% CI (0.66–0.88)), living in households headed by older individuals (AOR: 0.64, 95% CI (0.50–0.83) and AOR: 0.50, 95% CI (0.36–0.68)), and having more than one ideal number of male children (AOR: 0.83, 95% CI (0.72–0.94) and AOR: 0.55, 95% CI (0.47–0.65)) were associated with a decreased likelihood of modern contraceptive use. These findings emphasize the complexity of family planning decisions and the need to consider diverse sociodemographic and socioeconomic factors in reproductive health initiatives. Key policy recommendations include comprehensive family planning education, gender equity promotion, engagement of elderly household heads, and cultural sensitivity in program implementation.

Unspoken Pain: Exploring Spousal Violence and Its Associated Risk Factors Among Married Women of Reproductive Age in Rural Chengalpattu District

Unspoken Pain: Exploring Spousal Violence and Its Associated Risk Factors Among Married Women of Reproductive Age in Rural Chengalpattu District

Determinant of Long-Term Contraceptive Method Use Among Married Women of Reproductive Age: Cross-Sectional Study in Urban Area of South Sumatra

The Sustainable Development Goals (SDGs) emphasize the integration of reproductive health into national strategies and programs, including universal access to sexual and reproductive health services such as Family Planning (FP). This study aims to examine the factors influencing the use of long-term contraceptive methods among married women of reproductive age in urban areas of South Sumatra. A quantitative approach with a cross-sectional design was employed, using secondary data from the 2017 Indonesian Demographic and Health Survey (IDHS). The sample consisted of 247 married women. Data were analyzed using logistic regression. In urban areas of South Sumatra, 13.8% of married women of reproductive age used long-term contraceptive methods. The use of these methods was significantly associated with the number of living children and employment status (p < 0.05). Among all variables, education was found to be the most strongly associated factor with the use of long-term contraceptive methods (p = 0.04; PR = 4.238, 95% CI: 1.070–16.779). Education plays a pivotal role in the use of long-term contraceptive methods. Enhancing knowledge and awareness about these methods significantly influences women’s decisions to adopt them.

Impact of Birth Control Measures on the Quality of Life Among Married Women.

Birth control measures are crucial for women's reproductive health and overall well-being. Effective contraception reduces the risk of unintended pregnancies, potentially improving quality of life. However, in India, utilization of birth control remains suboptimal due to various factors, including concerns about side effects and limited access to information. This study investigates the association between birth control measures and quality of life among married women in Punjab, India. The primary aim of the study was to assess the birth control measures and quality of life among married women.Furthermore, to find out the association of birth control measures with selected socio-demographic variables. This cross-sectional study enrolled 100 married women of reproductive age (18-45 years) attending antenatal and pediatric outpatient departments at a tertiary care hospital in Punjab. Data collection included socio-demographic characteristics, a clinical profile with birth control measures usage, and a structured five-point Likert scale to assess the quality of life of married women.The collected data was analyzed using IBM SPSS Statistics for Windows, Version 23 (Released 2015; IBM Corp., Armonk, New York, United States), including both descriptive and inferential statistics. The study of 100 married women revealed a sample predominantly Sikh (59%), with 41% aged 34-40 years and 40% possessing secondary education. Most participants were homemakers (64%), while their spouses were largely employed (92%). A significant majority were mothers (90%), with two children being the most common family size (51.1%). Condoms were the most frequently used contraceptive method (67%), followed by tubectomy (13%), Copper T (Cu T) (12%), and oral contraceptive pills (OCPs) (8%). Overall, 66% reported excellent quality of life. Significant associations were found between contraceptive type and overall (p = 0.03), physical (p < 0.001), social (p < 0.001), and emotional (p < 0.001) well-being, with OCP users reporting higher scores. Furthermore, contraceptive choice was significantly associated with women's education, religion, socio-economic status, number of children, duration of contraceptive use, source of information, and gynecologist consultation (all p < 0.05). However, no significant association was observed between contraceptive method and sexual quality of life (p = 0.92) or satisfaction with the current method (p = 0.44). This study demonstrates a complex interplay between socio-demographic factors, contraceptive choices, and quality of life among married women in Punjab. The findings highlight the importance of accessible and tailored family planning counseling and education to empower women in making informed decisions about contraception and improve their overall well-being. Further research is needed to explore the specific reasons behind contraceptive choices and their long-term impact on quality of life.

Bridging the Gap: The Sustainable Transformative Power of Financial Literacy to Women’s Economic Empowerment in Punjab, Pakistan

Among other factors, financial literacy plays a key role in empowering women. The present study has been carried out to assess the sustainable impact of financial literacy on women’s economic empowerment in South Punjab, an area characterized by patriarchal norms. The sample of 150 married women of reproductive age (19-49, Mage=34.43, S.D.= 8.43 ) having at least one child was recruited from district Multan, Muzaffargarh and Dera Ghazi Khan, of South Punjab, Pakistan, using mixed sampling technique. The independent variables were listed as area, age, education, job status of women, married life, earning members of family and three dimensions of financial literacy viz., financial attitude, financial knowledge and financial behavior. Women empowerment (the dependent variable) was categorized as highly empowered, moderately empowered and least empowered. Through ordered logit model, the marginal effects of the different independent variables were estimated. The results indicated that with one more unit of financial literacy in terms of two dimension viz., financial knowledge, and financial behavior, women are more likely to be in economically highly empowered category as compared to moderately and least empowered women. Whereas the impact of financial attitude appeared to be non-significant to affect women empowerment. The variables AGE and EDU are indicated to statistically significantly and negatively associated, and variables viz., area, age, marital life, Jobs and earning members are positively and statistically significantly and more likely to impact economic empowerment of highly empowered women as compared to moderately and least empowered women. The recommendations in the light of the results have also been discussed.

Assessing Child Marriage in Indonesia: A Call for Educational Empowerment

Although the age of first marriage is generally increasing, many young women continue to marry as children in Indonesia. This study aims to assess the prevalence and predictors of child marriage in Indonesia. The data were obtained from the 2019 Performance and Accountability Survey of Population, Family Planning, and Family Development with a total sample of 46,220 married reproductive-age women. Multivariate binary logistic regression models were used to identify the significant associated predictors of child marriage. Overall, the prevalence of child marriage was 23.7 percent and ranged from only 0.1 percent in West Papua to 27.7 percent in West Java Province. Child marriage practice was found to be 54.80 (95%, CI: 41.01, 73.24) and 47.42 (95%, CI: 37.18, 60.49) times higher among uneducated women with primary education level compared to educated women with a university level of education. Those who live in Kalimantan islands were 2.13 (95%, CI: 1.73, 2.60) times more likely to experience child marriage compared to women who live in Maluku or Papua Islands. Child marriage was 1.28 (95%, CI: 1.22, 1.35) higher among rural residents compared to urban. The government, the private sector, and the community must continue empowering young girls, particularly regarding education.

The role of social determinants of health in woman’s intention to pregnancy: a model with the mediation of social support

BackgroundChildbearing intention is a complex issue that is influenced by a number of factor. However, childbearing intention does not necessarily lead to actual behavior, and mediating factors are effective in the realization and emergence of reproductive behavior. Since childbearing intention is influenced by several factors, including the social determinants of health, a thorough understanding of the effect of health determinants on this intention will help the reproductive process. Therefore, the present study was conducted using a social support-mediated model to examine the role of social determinants of health in women’s intention to pregnant.MethodsThis cross-sectional study was conducted on 500 married women of reproductive age (age range 15–49 years old) who were referred to health centers affiliated with Shahid Beheshti University of Medical Sciences during 2022–2023. Sampling was performed in a multi-stage (class-cluster) manner. Data collection tools in this study included the Demographic Information Form, the Childbearing Intention Questionnaire, social determinants of health questionnaires such as the Ghodratnama Socio-Economic Status Questionnaire, the Perceived Social Support Questionnaire, and the Depression Anxiety Stress Scales (DASS-21), and the Dyadic Adjustment Scale (Spinner questionnaire). Data analysis was performed using SPSS21 software with descriptive statistical tests and analytical statistics. Laserl 8.8 software was also used to test the model using the path analysis statistical test.ResultsThe mean scores of depression, anxiety and stress were 5.03 ± 4.39, 4.49 ± 3.68 and 7.7 ± 4.67, respectively. The mean score of marital adjustment was 103.26 ± 23.49, indicating that the majority of women (60.4%) had marital adjustment. Based on the results of the path analysis, marital adjustment was the only variable that had a direct positive and significant causal relationship with the childbearing intention from only one path (B = 0.74). Moreover, based on the results of the path analysis, perceived social support had the most direct and indirect positive causal relationship with the childbearing intention to have children (B = 0.74). Among the components of DASS21, depression was the only variable that had both a direct and indirect negative causal relationship with childbearing (B=-0.12). Both stress and anxiety had a direct positive causal relationship with the childbearing intention (B = 0.11 and B = 0.15 respectively).ConclusionFactors such as marital adjustment, perceived social support, depression, stress, and anxiety, as structural social determinants of health, are associated with childbearing intention. Accordingly, changes in social structures depend on population planning and policies.

Patterns of public and private maternal healthcare use among the urban poor of Bangladesh: cross-sectional survey

Background: Despite some progress, in Bangladesh access to high quality essential maternal healthcare remains inadequate. Women living in urban slums may face additional obstacles to maternal healthcare, but evidence remains limited. The study aims to explore the patterns of maternal healthcare utilisation in urban slums. Methods: This cross-sectional survey was conducted in April 2022 using an established health and demographic surveillance system operating in Dhaka North, Dhaka South and Gazipur city corporations. Six hundred thirty five married women of reproductive age with a baby aged ≤12 months were interviewed. Univariate and multivariate analysis were done to determined the factors affecting utilisation of maternal healthcare services. Results: Overall, 36% of respondents had at least four antenatal care checkups, 56% had facility-based delivery, 58% had delivery with a skilled attendant and received postnatal care within two days of delivery. Use of essential services was low among uneducated women. Geographical differentials were found, raising questions about the low antenatal care and high private facility delivery in Gazipur. Many women opt for private delivery care, and 35% reported having a C-section. Conclusion: Attention is needed across the whole pregnancy journey to improve access to high quality affordable antenatal care, delivery care and postnatal care for urban slum women. A complex of factors appears to be at play, with women’s awareness, household decision-making, and provision of accessible, affordable, high-quality services all requiring action by policy makers.

The Association Between Women's Education and Fertility, Moderating Effect of Unemployment in Context of Polygyny in Pakistan.

Increasing fertility has been the main challenge for Pakistan. It has been characterized as the sixth most populous country in the world, having a total population of 208 million, with a growth rate of 2.4% annually, by census report 2017. This study examines the relationship between women's education, employment status, and fertility outcomes in Pakistan. Utilizing the Demographic and Health Survey of 2017-2018, the study involves 1796 married women of reproductive age (15-49), belonging to polygynous families. Data are analyzed using multiple analytical techniques, including Chi-Square tests, negative binomial regression, and marginal plots. The results reveal that higher educational attainment is significantly associated with reduced fertility, with the decline being most pronounced at secondary and higher education levels. However, the interaction between education and employment status demonstrates that education alone is insufficient to lower fertility unless it translates into paid employment. Unemployed women consistently exhibit higher fertility, even among those with higher education, except at the secondary level.

Casual association between social determinants of health and sexual health literacy in reproductive-aged women: a WHO model analysis

IntroductionSexual health literacy is an important factor affecting sexual health, and social determinants of health significantly increasing health literacy. This study aimed to investigate the relationship between social determinants of health and sexual health literacy.MethodThe present cross-sectional study was conducted on 600 married women of reproductive age referred to health centers in Tehran, Iran (2024). Questionnaires included demographic and obstetric details, Perceived Social Support, Socioeconomic Status, and Intimate Partner Violence. The statistical analysis was performed in SPSS-27, and the relationship model was examined using the path analysis method in LISREL-8.8.ResultsAccording to the path analysis, sexual health literacy was directly affected by domestic violence (B = -0.12) and perceived social support (B = 0.39). It was also indirectly affected by socioeconomic status (B = 0.44) and spouse education (B = 0.48).ConclusionThe results showed that some factors influence sexual health literacy in women both directly and indirectly. Given the factors identified in the suggested model, it is advisable to utilize this model as a suitable framework for research, design, and execution of initiatives concerning sexual health literacy.

Role of Husbands in Antenatal Care, Delivery and Postnatal Care of Their Wives in Panchkhal, Nepal

The present study has assessed the involvement of husbands in antenatal care, delivery, and postnatal care among married women of reproductive age in Panchkhal Municipality, Kavre district, Nepal. Emphasizing the impactful role of a male in the circle of reproductive health, this research tries to address high maternal mortality and morbidity rates in Nepal by showing that a better understanding and support from the husband is highly essential for an improved outcome of maternal health. Data were originally collected through the use of a self-administered structured questionnaire with probability cluster sampling from 96 women who had at least one child aged five years or younger. Results showed that while all respondents received antenatal care, the number of women who received postnatal care was significantly lower, as many reportedly gave birth at home. Educated husbands were more likely to provide nutritional and emotional support during pregnancy. This has also shown that spousal communication about maternal and Child Health issues regarding child spacing, immunization, breastfeeding, and contraceptive use was important. This research found out positive results regarding the role of husbands in maternal care before and after pregnancy. Keywords: Spousal participation, maternal health, family health, role of fathers

Female Sexual Dysfunction in Housewives, Teachers, and Nurses of Productive Age in Indonesia

Background: Demographic factors (i.e. employment) can be risk factors for female sexual dysfunction, while impaired sexual function can affect self-esteem and interpersonal relationships, so that sexual function may be influenced by the type of work a woman does. Objective: This study was intended to assess the comparison of sexual dysfunction in married women of reproductive age who have different careers. Materials and Methods: There were 214 respondents who met the inclusion criteria, 75 unemployed housewives, 68 teachers, and 71 nurses. Respondents' sexual function was measured using the FSFI questionnaire developed by Rosen et al., in 2000, which consisted of 19 questions covering six domains of sexual function, namely desire, arousal, lubrication, orgasm, satisfaction, and pain. Results: The mean total FSFI scores of housewives, teachers, and nurses were 25.88, 25.15, and 25.14, respectively. All housewives (100%), 66.2% of teachers, and 81.7% of nurses experienced desire disorders. Arousal disorders were experienced by 81.3% of housewives, 83.1% of teachers, and 66.2% of nurses. Housewives, teachers, and nurses with vaginal lubrication disorders were 61.3%, 86.2%, and 66.2%, respectively. There were 40% of teachers, 53.8% of teachers, and 54.9% of nurses who failed to achieve orgasm. The levels of satisfaction felt by housewives, teachers, and nurses in sexual intercourse were 88.0%, 44.7%, and 57.7%, respectively. Meanwhile, vaginal pain was felt by 48% of housewives, 53.8% of teachers, and 66.2% of nurses. Conclusion: Differences in careers of married women of reproductive age do not significantly differentiate the sexual dysfunction they suffer from.

Determinants of pressure to conceive among reproductive age women in Sub-Saharan Africa: A multilevel analysis of recent Demographic and Health Surveys in five countries.

Globally, 40% of pregnancies are unplanned, with higher rates in Sub-Saharan Africa, often ending in abortion. Women face pressure from spouses/families to conceive, leading to unintended pregnancies and violations of reproductive rights, jeopardizing women's autonomy and well-being. Respecting individual decisions is crucial during this pivotal life stage. The study conducted a secondary data analysis using information from the latest Demographic and Health Surveys, encompassing five Sub-Saharan African nations from 2021 to 2023. The research focused on a weighted sample of 97,350 married women of reproductive age. Data analysis was performed using Stata 14, employing a multilevel mixed-effects logistic regression model to uncover the factors contributing to the pressure exerted by husbands and families on women to conceive. The study highlights that in Sub-Saharan Africa, approximately one in ten women experience pressure to conceive. Factors like age (20-35 years; AOR = 1.6, 95% CI: 1.46, 1.87), socioeconomic status (middle/affluent; AOR = 1.12, 95% CI: 1.04, 1.2 and AOR = 1.12, 95% CI: 1.03, 1.21), parity (childless; AOR = 4.65, 95% CI: 4.1, 5.2), and community literacy (low; AOR = 1.44, 95% CI: 1.25, 1.66) significantly influence this pressure. Notably, women in Tanzania have a 55% lower risk (AOR = 0.45, 95% CI: 0.41, 0.49), while those in Mozambique face a 1.88 times higher risk. The study highlights the substantial pressure faced by reproductive-age women to conceive in Sub-Saharan Africa. Addressing these challenges through targeted policies and interventions is crucial to empower women and promote their reproductive autonomy.

Utilization of Maternal Health Services among Married Women of Reproductive Age (MWARA) at Selected Rural Municipality in Nepal: A Cross-sectional Study

Utilization of Maternal Health Services among Married Women of Reproductive Age (MWARA) at Selected Rural Municipality in Nepal: A Cross-sectional Study

The Effect of Offspring Gender Composition on Modern Contraceptive Uptake Among Married Women of Reproductive Age in Pakistan: A Facility-Based Cross-Sectional Study.

Introduction: Pakistan is confronted with the formidable challenge of high population growth, which is compounded by cultural norms that prioritize male offspring, leading to adverse implications for family planning efforts and demographic trends. Despite efforts to promote contraception, including a national family planning program, Pakistan continues to struggle with low and stagnant contraceptive prevalence rates among married women. The influence of gender composition on modern contraceptive uptake remains underexplored, necessitating research to elucidate its impact on reproductive behavior. Materials and methods: This study used the dataset of a facility-based cross-sectional survey conducted in six districts of the Sindh and Punjab provinces in Pakistan. A subset of 495 married women of reproductive age seeking health services from March to June 2019 was used for this study. Logistic regression analysis was employed to examine the association between the gender composition of children and modern contraceptive uptake, adjusting for covariates such as province, the age of the women, and the type of health facility. Results: The analysis revealed a significant association between the gender composition of children and modern contraceptive uptake among married women. As the number of daughters increased without sons, the likelihood of contraceptive uptake remained low (adjusted odds ratio [AOR]: 0.12; 95% CI: 0.04-0.34; p < 0.000), while having at least one son substantially increased the odds of contraceptive use (AOR: 19.91; 95% CI: 8.00-49.50; p < 0.000). Notably, the gender composition of having one daughter with two sons had the highest level of contraceptive uptake, potentially because of family composition preferences. Discussion: The findings highlight the pervasive influence of gender composition on reproductive decision-making in Pakistan, with a clear preference for sons driving modern contraceptive behavior. These results underscore the need for targeted interventions to address gender norms and biases while promoting equitable access to family planning services. Engaging men in family planning initiatives is crucial for challenging traditional gender norms and fostering informed decision-making regarding contraception. Conclusions: Gender preference influences modern contraceptive uptake among women in Pakistan, with the strong preference for sons driving reproductive behavior. Addressing gender norms and biases while promoting informed, self-determined choice is essential for enhancing modern contraceptive uptake and achieving sustainable population growth. Targeted interventions, including male engagement strategies, are needed to challenge societal gender norms and empower individuals to make autonomous decisions regarding family planning.

Effectiveness of a technical support program with women's self-help groups in catalyzing health and nutrition behaviors in Bihar-a multicomponent analysis.

Bihar Rural Livelihoods Promotion Society launched the JEEViKA program in 2007 to improve livelihoods through the Self-Help Group (SHG) platform. Women's SHGs have shown members' health improvements by promoting awareness, practices and access to services. This study investigates whether Health & Nutrition (HN) interventions delivered by JEEViKA Technical Support Program (JTSP) via SHG platforms could improve maternal and newborn health and nutritional behaviors in rural Bihar. Annual Household Survey and Married Women of Reproductive Age (MWRA) studies of Bihar Technical Support Unit were used to analyze the effectiveness of JTSP on HN behaviors for mother and their infants in Bihar during 2016-21. Descriptive analysis followed by multivariable (binary and multinomial) logistic regressions were conducted to determine the distribution of and associations between various individual/community and programmatic exposures and outcomes of interest. During 2016-2021, in Bihar, statewide increase (32 to 47%) in SHG membership across all population strata and expansion of HN layering of JTSP from 101 to 349 blocks corroborated with improvements in Maternal-Newborn-Child Health & Nutrition (MNCHN) indicators in JTSP blocks and SHG members. Substantial increase was observed in ≥3ANC visit (9% points), institutional delivery (10%), skin-to-skin-care (17%), dry cord-care (23%), early initiation of breastfeeding (19%) & complementary feeding (9%). Adjusting for socio-demographic factors and Front-Line Workers' (FLWs') advice/counseling, multivariable logistic regression revealed that SHG member in JTSP blocks delivering post-intervention (2021) were more likely (vs 2016) to practice: ≥3ANC visits (Adjusted Odds Ratio: aOR = 1.48, p < 0.0001), institutional delivery (aOR = 1.71, p < 0.0001), skin-to-skin care (aOR = 3.16, p < 0.0001) and dry cord-care (aOR = 2.64, p < 0.0001), early initiation of breastfeeding (aOR = 1.61, p < 0.0001), complementary feeding (aOR6-8 months = 1.48, p < 0.0001) and minimum dietary diversity (aOR6-8 months = 1.24). Better mobility, decision making, economic independence and overall empowerment were also evident among SHG member MWRA as opposed to non-members after both phases. The results highlight successful HN integration in JEEViKA by JTSP, demonstrating its effectiveness in integrating with State Rural Livelihoods Mission community platforms. JTSP showcases collaboration within a government system and emphasizes systematic introduction and strengthening at multiple levels. This integration has enabled JEEViKA systems to self-sustain its own HN implementation processes, paving the way for cross-sectoral comprehensive delivery mechanisms for social development.

Reproductive health care seeking behavior in Bangladesh: Asystematic literature review.

Reproductive health care seeking behavior in Bangladesh: Asystematic literature review.

A subnational socioeconomic assessment of family planning levels, projections, and disparities among married women of reproductive age in Cameroon.

Local-level socioeconomic gradients significantly influence access to reproductive health services in developing countries. This study examines disparities in family planning use among married women of reproductive age across Cameroon's subnational territories, highlighting inequities often overlooked in national analyses. Furthermore, it incorporates HIV status (a key yet frequently omitted covariate) into the assessment of family planning determinants. A Bayesian hierarchical model incorporated with Cameroon Demographic and Health Survey cross-sectional data (between 1991 and 2018) was employed to generate estimates of family planning indicators per residence, wealth, and education categories within each region. Slope index of inequality was used to quantify disparities. The determinants analysis involved Bayesian logistic regression. Estimates for 2023 revealed that the Centre region's urban and rural areas had the highest modern contraceptive prevalence rate overall, with 49.0% (24.9-73.8) and 28.2% (12.4-52.3), respectively. The rural Far North had the least estimate [3.9% (1.5-10.5)]. Demand satisfied with modern methods was highest among Adamawa region's richest quintile [82.9% (58.1 to 94.4)] and higher educated [85.9% (69.5 to 94.2)], and lowest among the East region's poorest [5.3% (1.5 to 16.5)] and Far North's none-educated [8.6% (3.3 to 20.4)]. Unmet need for modern methods was lowest among the West region's richest [5.1% (1.8 to 13.5)] and highest among the Littoral's poorest [23.1% (9.4 to 47.4)]. 2030 projections show the widest wealth- and education-based gaps for demand satisfied with modern methods in the Adamawa [27.0 percentage points (%p) (2.3 to 51.6) and 79.3%p (73.9 to 84.7), respectively]. Age ≥ 20 years, higher education level, practising Catholic/Christian religion, having ≥ one living child(ren), and higher household wealth quintile, were associated with increased odds of modern contraceptive use. Increased focus is essential on rural, poorer, and less educated populations, particularly in the Northern regions, to effectively address family planning inequities across Cameroon.

How investment in children shape fertility choices of families: Evidence from Pakistan.

Fertility patterns are transitioning globally in that couples are choosing to have fewer children as they become more affluent, and parents are investing more time and resources in the lives of their children than they can receive back. This change is more established in developed countries and is now being recognized in developing countries. We explored this phenomenon and its implications for family planning in Pakistan, hypothesizing a quantity-quality transition underway. We examine the correlation between increased investment in children's education and the use of family planning services among Pakistani families. We conducted a secondary analysis of publicly available data from the Pakistan Social and Living Standards Measurement (PSLM) survey and its complementary Household Integrated Economic surveys (HIES) for 2018-19 accessed through the Pakistan Bureau of Statistics (PBS) website. The study included married women of reproductive age (MWRA) aged between 15 to 49 years of age. The current use of different contraceptive methods by MWRA was the outcome variable, whereas the education expenditure per child, and mother-level, child-level, and household-level factors, as control variables. The study employed multinomial logistic regression to assess the correlation between contraceptive use and education expenditure per child while controlling for other variables using STATA (version 17.0, STATA Corporation, College Station, Texas, USA). Data from 24,024 MWRA and 56,128 children were analyzed. 7,584 (30%) households have no children while 1,658 (10%) don't send any child to school. All households that send children to school incur at least some education related expense. The rise in education spending outpaces rates of rise in household incomes, suggesting that education is procured as a luxury good. However, the rate of spending on education falls off from the third child onwards. After controlling for confounders, the odds of using contraceptives increases as education expenditure rise, from 1.172 [CI, 1.029,1.336] when they spend under PKR 2000 (USD 13) to 1.495 [CI, 1.327,1.683] if they spend more than PKR 13,000 (USD 84) annually on the education of a child, compared to no education expenditure at all. There is one exception in the case of households in the wealthiest quintiles located in rural areas, where FP use reduces. Our findings support the hypothesis of a quantity-quality transition in Pakistan, where increased wealth and educational investment in children are linked to reduced fertility and higher contraceptive use households. The use of FP increases from the poor to the richest wealth quintiles nationally and correlates with spending on the education of an older child. However, an important exception was observed among the wealthiest rural households, where family planning use decreases despite higher income levels. This suggests that affluent women, particularly in rural areas, may opt for larger families due to limited labor market opportunities or cultural preferences. We describe a major social change that reflects evolving values in families.