Women's television watching and reproductive health behavior in Bangladesh

Do education and living standard matter in breaking barriers to healthcare access among women in Bangladesh?

BACKGROUND

Barriers to healthcare access for women have a substantial influence on maternal and child health. By removing barriers to accessing healthcare, several sustainable development goals can be achieved. The goal of this study, based on the dominance analysis, was to examine how living standards and spousal education play role in removing barriers to healthcare access for women in Bangladesh.

METHODS

The study used the nationally representative Bangladesh Demographic and Health Survey (BDHS), 2017-18 data. A binary logistic regression model was applied for analyzing different types of health access barriers in the study. Additionally, a dominance analysis was conducted to identify the most responsible factors for removing barriers.

RESULTS

In Bangladesh, 66% of women faced at least one barrier in accessing healthcare. The results obtained from logistic regression and dominance analysis revealed that women's standard of living and spousal education explained the highest variation of having at least one barrier in accessing healthcare. Specifically, a high standard of living explained 24% of the total explained variation (OR 0.56, 95% CI 0.52-0.62), while both spousal education accounted for 27% (OR 0.49, 95% CI 0.45-0.54) of the total explained variation. The regression results also showed that women with higher standards of living as well as educated women having educated partners had lower odds of facing barriers in getting permission (OR 0.87, 95% CI 0.76-1.00 and OR 0.66, 95% CI 0.58-0.75) to go for advice/treatment, obtaining money (OR 0.43, 95% CI 0.39-0.47 and OR 0.37, 95% CI 0.34-0.40), distance to a health facility (OR 0.60, 95% CI 0.55-0.66 and OR 0.70, 95% CI 0.65-0.76), and not wanting to go alone (OR 0.72, 95% CI 0.66-0.89 and OR 0.75, 95% CI 0.69-0.81) for getting medical advice/treatment.

CONCLUSION

The findings of the study suggest paying extra attention to the spousal education and living standard of women to strengthen and reform the existing strategies and develop beneficial interventions to enhance unhindered accessibility to healthcare facilities for women.

The use of mass media by mothers and its association with their children's early development: comparison between urban and rural areas

BACKGROUND

Mass media can play critical roles in influencing parents' attitudes and practice toward the healthy upbringing of children.  OBJECTIVE: This study examined the association between the use of five types of mass media among mothers living in rural and urban areas and the early childhood development (ECD) of their children.

METHODS

We analysed nationally representative and internationally standardized Multiple Indicator Cluster Survey data collected in 2013 and 2019 in Bangladesh. The ECD was calculated using four domains of development: physical health, literacy-numeracy, learning and social-emotional. Mothers' use of newspapers/magazines, radio, television, internet and mobile phones was the study factor. We used Poisson regression with robust variance. The dataset included 27,091 children aged three or four years.

RESULTS

Almost 21% of the children were living in urban and 78% in rural areas. Mothers/caretakers of 30% of the children used none, 39% used one, 25% used two, and approximately 6% used three or more of the five types of media. Mobile phones and television were the dominant types of media, both in terms of the number of users and the frequency of use. Overall, 68.87% of the children were on track in terms of their ECD and 31.13% were not. A significantly larger proportion of urban children (74.23%) than rural children (67.47%) were on track in their ECD. The prevalence of children being on track of ECD increases by 4% (aPR 1.04; 95%CI: 1.01-1.06) for each additional media use among women who lived in urban areas and increases by 7% if women live in rural areas. In terms of the individual formats of media, using newspapers, television and internet was found to be significantly associated with the children in rural areas being on track in terms of their ECD. In the urban sample, only radio use was found to be significant.

CONCLUSIONS

Targeted and well-designed child development campaigns that are delivered through popular media types are likely to help mothers to take better care of their children.

Future emissions of greenhouse gases, particulate matter and volatile organic compounds from municipal solid waste burning in India

Waste generation projections for the 21st century are important for the investigation of long-term global environmental problems, and greenhouse gas emissions associated with waste management. This paper presents future waste generation and open waste burning projections for India, which are consistent with the scenarios in the shared socio-economic pathways (SSPs) database. India's waste generation will increase to 547 Tgy^-1 and 828 Tgy^-1, by 2030 and 2050, respectively, if India's waste generation rates converge to those of developed economies under the fossil fuel based economic growth projections of SSP5. This will increase open waste burning emissions by 140 % and 110 % over 2015 levels by 2030 and 2050, respectively. Business-as-usual projections predict a waste generation of 268 ± 14 Tgy^-1 by 2030 and 356 ± 34 Tgy^-1 by 2050 and elimination of waste burning other than landfill fires by the mid-2040s. Aggressive promotion of source segregation and treatment of biodegradable waste under a sustainable development scenario (SSP1) can advance this transition despite higher income growth and reduce waste burning from 68 (45-105) Tgy^-1 in 2015 to 21-48 Tgy^-1 and 2-22 Tgy^-1 of waste burning by 2030 and 2050, respectively. The failure of programs targeted at this waste component would result in 31-60 Tgy^-1 and 26-108 Tgy^-1 of waste burning by 2030 and 2050, respectively. For the SSP5 income trajectory a failure to successfully source segregate and treat biodegradable waste would almost double open waste burning by 2050.

Do family values and reproductive health knowledge influence reproductive health-promoting behaviors in married women? A cross-sectional survey

PURPOSE

Based on the World Health Organization framework on reproductive health, this descriptive correlational study investigated the factors affecting reproductive health-promoting behaviors ofmarried women, with a focus on family values and reproductive health knowledge.

METHODS

A cross-sectional survey was conducted on 170 married women between the ages of 25and 49 years living in Daegu, Korea. The general and reproductive health characteristics, family values, and reproductive health knowledge of married women were identified, as well as factors affecting reproductive health-promoting behaviors. A questionnaire survey was administered to investigate the impact of various factors on reproductive health-promoting behaviors.

RESULTS

Positive correlations were shown for family values (r=.78, p<.001) and reproductive healthknowledge (r=.55, p<.001). Family values (β=.35, p<.001) and reproductive health knowledge(β=.24, p<.001) were identified as factors influencing reproductive health-promoting behaviors. According to the regression model, the explanatory power of factors affecting reproductive health-promoting behaviors among married women was 51.2%.

CONCLUSION

A history of reproductive diseases, family values, and reproductive health knowledgewere identified as factors influencing reproductive health-promoting behaviors. These results willprovide basic data for the development of a reproductive health-promoting program, including apositive approach to reproductive health among married women, and will serve as a basis for furtherresearch on intervention strategies.

Knowledge of pre-conception health and planned pregnancy among married women in Jinka town, southern Ethiopia and factors influencing knowledge

Background

Optimizing women’s health and knowledge of preconception healthcare before conceiving a pregnancy decreases the risk of adverse pregnancy outcomes. However, preconception health care is one of the missing pillars in the continuum of maternal and child health care in Ethiopia. Therefore, this study aimed to assess knowledge of pre-conception health, its relation to planned pregnancy, parity, family planning use, and education among married women in Southern Ethiopia.

Methods

A community-based cross-sectional study was conducted with 337 married women recruited from March 25 to April 30, 2018 in Jinka town. A simple random sampling technique was employed and the data was collected using a structured questionnaire. Data analysis involved calculating frequencies, percentages, and logistic regression. Associations were assessed using odds ratios and 95% confidence intervals with statistical significance determined at a p-value < 0.05.

Results

The overall women’s preconception health care knowledge score in this study was 55.2%, which is a moderate score. In multivariable analyses, women’s secondary level of education [AOR = 2.3; 95% CI = 1.13–4.87], family planning use [AOR = 2.6, 95% CI = 1.37–4.87], planned pregnancy [AOR = 3.2, 95% CI = 1.35–7.44], Nullyparity [AOR = 21.2; 95% CI = 4.92–91.5], and market trade vendors [AOR = 2.5; 95%CI = 1.06–6.03], were significantly associated with knowledge of preconception health care.

Conclusion

The findings show that women’s knowledge of preconception health care is moderate. Women’s knowledge of preconception health care can be linked to their level of education, use of family planning methods, pregnancy planning, and Nullyparity. Therefore, the government and other key stakeholders need to develop a specific education package that improves women’s knowledge of preconception care and pregnancy planning, taking into account factors such as levels of education and literacy when designing implementation strategies.

Health facility delivery among women of reproductive age in Nigeria: Does age at first birth matter?

BACKGROUND

High maternal mortality ratio in sub-Saharan Africa (SSA) has been linked to inadequate medical care for pregnant women due to limited health facility delivery utilization. Thus, this study, examined the association between age at first childbirth and health facility delivery among women of reproductive age in Nigeria.

METHODS

The study used the most recent secondary dataset from Nigeria's Demographic and Health Survey (NDHS) conducted in 2018. Only women aged15-49 were considered for the study (N = 34,193). Bi-variate and multivariable logistic regression models were used to examine the association between age at first birth and place of delivery. The results were presented as crude odds ratios and adjusted odds ratios (aOR) with corresponding 95% confidence intervals (CIs). Statistical significance was set at p<0.05.

RESULTS

The results showed that the prevalence of health facility deliveries was 41% in Nigeria. Women who had their first birth below age 20 [aOR = 0.82; 95%(CI = 0.74-0.90)] were less likely to give birth at health facilities compared to those who had their first birth at age 20 and above.

CONCLUSION

Our findings suggest the need to design interventions that will encourage women of reproductive age in Nigeria who are younger than 20 years to give birth in health facilities to avoid the risks of maternal complications associated with home delivery. Such interventions should include male involvement in antenatal care visits and the education of both partners and young women on the importance of health facility delivery.

Which factors predict fertility intentions of married men and women? Results from the 2012 Niger Demographic and Health Survey

INTRODUCTION

Niger is the country with the highest total fertility rate in the world. In the present study, we investigated factors associated with the desire for more children among married men and women in Niger.

MATERIALS AND METHODS

We utilised data from the 2012 Niger Demographic and Health Survey. The outcome variable for the study was fertility intentions. The data were analysed with Stata version 14.0. Both descriptive (frequencies and percentages) and inferential (binary logistic regression) analyses were carried out.

RESULTS

Desire for more children was 97.2% and 87.2% among men and women respectively. Women aged 45-49 were less likely to desire more children, compared to those aged 25-39 [aOR = 0.13, CI = 0.11-0.16]. The odds of desire for more children were high in rural areas, compared to urban areas [aOR = 1.61, CI = 1.20-2.17]. Childbearing women with seven or more births were less likely to desire more children, compared to those with 1-3 births [aOR = 0.09, CI = 0.06-0.14]. Men aged 50-59 were less likely to desire more children, compared to those aged 25-39 [aOR = 0.13, CI = 0.05-0.35]. Men with secondary/higher level of education were less likely to desire more children, compared to those with no formal education [aOR = 0.24, CI = 0.11-0.52]. Childbearing men with seven or more births were less likely to desire more children, compared to those with 1-3 births [aOR = 0.06, CI = 0.01-0.30].

CONCLUSION

This study shows high fertility desire among men and women in Niger. However, the prevalence of fertility desire among men is higher than that of women. A number of socio-economic and demographic factors were found to be associated with desire for more children among men and women in Niger. This calls for a collective effort to educate women and men in Niger on the negative consequences of rapid population growth and large family sizes.

Factors associated with the utilisation of skilled delivery services in Papua New Guinea: evidence from the 2016-2018 Demographic and Health Survey

BACKGROUND

We sought to determine the prevalence and factors associated with the use of skilled assistance during delivery in Papua New Guinea.

METHODS

We analysed nationally representative data from 5210 women in Papua New Guinea using the 2016-2018 Demographic and Health survey. Both bivariate and multivariable analyses were performed. Statistical significance was set at p<0.05.

RESULTS

The prevalence of skilled assistance during delivery was 57.6%. The richest women (adjusted OR [AOR]=3.503, 95% CI 2.477 to 4.954), working women (AOR=1.221, 95% CI 1.037 to 1.439), women with primary (AOR=1.342, 95% CI 1.099 to 1.639), secondary or higher education (AOR=2.030, 95% CI 1.529 to 2.695), women whose partners had a secondary or higher level of education (AOR=1.712, 95% CI 1.343 to 2.181], women who indicated distance was not a big problem in terms of healthcare (AOR=1.424, 95% CI 1.181 to 1.718), women who had ≥4 antenatal care (ANC) visits (AOR=10.63, 95% CI 8.608 to 13.140), women from the Islands region (AOR=1.305, 95% CI 1.045 to 1.628), those who read newspapers or magazines (AOR=1.310, 95% CI 1.027 to 1.669) and women who watched television (AOR=1.477, 95% CI 1.054 to 2.069) less than once a week had higher odds of utilising skilled attendants during delivery. On the contrary, women in the Momase region (AOR=0.543, 95% CI 0.438 to 0.672), women in rural areas (AOR=0.409, 95% CI 0.306 to 0.546), as well as women with a parity of 3 (AOR=0.666, 95% CI 0.505 to 0.878) or ≥4 (AOR=0.645, 95% CI 0.490 to 0.850) had lower odds of utilising skilled attendance during delivery.

CONCLUSION

There is relatively low use of skilled delivery services in Papua New Guinea. Wealth, employment status, educational level, parity and number of ANC visits, as well as access to healthcare and place of residence, influence the utilisation of skilled delivery services.

Postnatal care utilisation among women in rural Ghana: analysis of 2014 Ghana demographic and health survey

Background

Maternal mortality is high in Ghana, averaging 310 maternal deaths per 100,000 live births in 2017. This is partly due to inadequate postnatal care especially among rural communities. Ghana can avert the high maternal deaths if women meet the World Health Organisation’s recommended early postnatal care check-up. Despite the association between geographical location and postnatal care utilisation, no study has been done on determinants of postnatal care among rural residents in Ghana. Therefore, this study determined the prevalence and correlates of postnatal care utilization among women in rural Ghana.

Methods

The study utilised women’s file of the 2014 Ghana Demographic and Health Survey (GDHS). Following descriptive computation of the prevalence, binary logistic regression was fitted to assess correlates of postnatal care at 95% confidence interval. The results were presented in adjusted odds ratio (AOR). Any AOR less than 1 was interpreted as reduced likelihood of PNC attendance whilst AOR above 1 depicted otherwise. All analyses were done using Stata version 14.0.

Results

The study revealed that 74% of the rural women had postnatal care. At the inferential level, women residing in Savanna zone had higher odds of postnatal care compared to those in the Coastal zone [AOR = 1.80, CI = 1.023–3.159], just as among the Guan women as compared to the Akan [AOR = 7.15, CI = 1.602–31.935]. Women who were working were more probable to utilise postnatal care compared to those not working [AOR = 1.45, CI = 1.015–2.060]. Those who considered distance as unproblematic were more likely to utilise postnatal care compared to those who considered distance as problematic [AOR = 1.63, CI = 1.239–2.145].

Conclusions

The study showed that ethnicity, ecological zone, occupation and distance to health facility predict postnatal care utilisation among rural residents of Ghana. The study points to the need for government to increase maternal healthcare facilities in rural settings in order to reduce the distance covered by women in seeking postnatal care.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12884-020-03497-4.

Drivers of desire for more children among childbearing women in sub-Saharan Africa: implications for fertility control

BACKGROUND

Despite the extensive research on fertility desires among women the world over, there is a relative dearth of literature on the desire for more children in sub-Saharan Africa (SSA). This study, therefore, examined the desire for more children and its predictors among childbearing women in SSA.

METHODS

We pooled data from 32 sub-Saharan African countries' Demographic and Health Surveys. A total of 232,784 married and cohabiting women with birth history, who had complete information on desire for more children made up the sample for the study. The outcome variable for the study was desire for more children. Multilevel logistic regression analysis was conducted. Results were presented using adjusted odds ratios (aOR), with their corresponding 95% confidence intervals (CI).

RESULTS

The overall prevalence of the desire for more children was 64.95%, ranging from 34.9% in South Africa to 89.43% in Niger. Results of the individual level predictors showed that women aged 45-49 [AOR = 0.04, CI = 0.03-0.05], those with higher education [AOR = 0.80, CI = 0.74-0.87], those whose partners had higher education [AOR = 0.88; CI = 0.83-0.94], women with four or more births [AOR = 0.10, CI = 0.09-0.11], those who were using contraceptives [AOR = 0.68, CI = 0.66-0.70] and those who had four or more living children [AOR = 0.09 CI = 0.07-0.12] were less likely to desire for more children. On the other hand, the odds of desire for more children was high among women who considered six or more children as the ideal number of children [AOR = 16.74, CI = 16.06-17.45] and women who did not take decisions alone [AOR = 1.58, CI = 1.51-1.65]. With the contextual factors, the odds of desire for more children was high among women who lived in rural areas compared to urban areas [AOR = 1.07, CI = 1.04-1.13].

CONCLUSIONS

This study found relatively high prevalence of women desiring more children. The factors associated with desire for more children are age, educational level, partners' education, parity, current contraceptive use, ideal number of children, decision-making capacity, number of living children and place of residence. Specific public health interventions on fertility control and those aiming to design and/or strengthen existing fertility programs in SSA ought to critically consider these factors.

Mass media exposure and maternal healthcare utilization in South Asia

Maternal mortality remains a major population health problem in the developing world due in part to inadequate healthcare before, during, and after childbirth. Mass media has the potential to disseminate information about maternal healthcare that can improve well-being for mothers and infants, particularly among women with limited educational attainment. This study examines the impact of mass media exposure (e.g., television, radio, and newspaper) and sociodemographic factors on maternal healthcare utilization in four South Asian countries: India, Bangladesh, Nepal, and Pakistan. Analyses use 2014–2017 Demographic and Health Surveys, which are nationally representative of women aged 15–49 years. Results show that maternal healthcare utilization is significantly higher among women exposed to mass media across countries, even after controlling for mother's, husband's, and household sociodemographic factors. Women exposed to mass media are 46–86% more likely to receive antenatal care, 24–53% more likely to deliver their babies by skilled birth attendants, and 36–94% more likely to receive postpartum check-ups across countries. Mother's educational attainment moderates the association between mass media exposure and some maternal healthcare services in three of the four countries. Governments and public health organizations can consider mass media as a key intervention in promoting maternal health in developing contexts.

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Maternal mortality is high in South Asia due in part to inadequate maternal healthcare.

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Mass media exposure is positively associated with maternal healthcare utilization.

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Mother's education moderates mass media-healthcare association in three of four South Asian countries.

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NGOs should consider using mass media to disseminate information on maternal health.

The effects of household's climate-related displacement on delivery and postnatal care service utilization in rural Bangladesh

Exposure to extreme climate events causes population displacement and adversely affects the health of mothers and children in multiple ways. This paper investigates the effects of displacement on whether a child is delivered at a health center, as opposed to at home, and on postnatal care service utilization in Bangladesh. Using cross-sectional survey data from 599 mothers who gave birth in the three years prior to the date of interview, including 278 from households which had previously been displaced and 231 from households which had not been displaced, we use multivariate logistic regression to identify the factors associated with maternal healthcare service utilization. The results show that displaced households' mothers are only about a quarter as likely to deliver at a health center as mothers from non-displaced households. The use of health center-based delivery decreases as the numbers of past displacements increases. Higher number of previous children, lower use of antenatal care during pregnancy, lower household income, and lack of access to radio/television also significantly reduce a mother's likelihood of delivery at a health center. Displaced mothers are also substantially less likely to use postnatal care services for their neonates, especially those supplied by trained providers. Use of health facilities for delivery, use of antenatal care services, and previous number of children are other important predictors of postnatal care service utilization for neonates. In light of these findings, relocation of local health facilities with basic and emergency care provisions to areas in which the displaced have resettled, reinforcement of Family Planning services, and extension of coverage of the Maternity Allowance benefits in the displacement-prone mainland riverine areas are recommended policy responses.