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Achilles SL, Kelly CW, Hoesley CJ, Blithe DL, Brown J, Richardson BA, Devlin B, Hendrix CW, Poloyac SM, Marzinke MA, Gundacker H, Singh D, Piper JM, Johnson S, Steytler J, Chen BA. Phase 1 randomized trials to assess safety, pharmacokinetics, and vaginal bleeding associated with use of extended duration dapivirine and levonorgestrel vaginal rings. PLoS One 2024; 19:e0304552. [PMID: 38838028 PMCID: PMC11152307 DOI: 10.1371/journal.pone.0304552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 05/14/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND Vaginal rings formulated to deliver two drugs simultaneously have potential as user-controlled, long-acting methods for dual prevention of HIV and pregnancy. METHODS Two phase 1 randomized trials (MTN-030/IPM 041 and MTN-044/IPM 053/CCN019) respectively enrolled 24 and 25 healthy, HIV-negative participants to evaluate safety, pharmacokinetics, and vaginal bleeding associated with use of a vaginal ring containing 200mg dapivirine (DPV) and 320mg levonorgestrel (LNG) designed for 90-day use. MTN-030/IPM 041 compared the DPV/LNG ring to a DPV-only ring (200mg) over 14 days of use. MTN-044/IPM 053/CCN019 compared continuous or cyclic use of the DPV/LNG ring over 90 days of use. Safety was assessed by recording adverse events (AEs). DPV and LNG concentrations were quantified in plasma, cervicovaginal fluid, and cervical tissue. Vaginal bleeding was self-reported. RESULTS There were no differences in the proportion of participants with grade ≥2 genitourinary AEs or grade ≥3 AEs with DPV/LNG ring vs. DPV ring use (p = .22), or with DPV/LNG ring continuous vs. cyclic use (p = .67). Higher plasma DPV concentrations were observed in users of DPV/LNG compared to DPV-only rings (Cmax p = 0.049; AUC p = 0.091). Plasma DPV and LNG concentrations were comparable with continuous and cyclic use (Cmax p = 0.74; AUC p = 0.25). With cyclic use, median nadir plasma DPV concentration was approximately 300 pg/mL two days after removal and median t1/2 for cervicovaginal fluid DPV concentration was 5.76 hours (n = 3). Overall bleeding experiences did not differ between continuous and cyclic users (p = 0.12). CONCLUSIONS The extended duration DPV/ LNG rings were well tolerated and the observed DPV concentrations in plasma and cervicovaginal fluid when used continuously exceeded concentrations observed in previous DPV ring efficacy studies. LNG concentrations in plasma were comparable with other efficacious LNG-based contraceptives. Genital DPV concentrations had a short half-life and were thus not well sustained following ring removal.
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Affiliation(s)
- Sharon L. Achilles
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Magee-Womens Research Institute, Pittsburgh, Pennsylvania, United States of America
| | - Clifton W. Kelly
- Statistical Center for HIV/AIDS Research & Prevention, Fred Hutchinson Cancer Center, Seattle, Washington, United States of America
| | - Craig J. Hoesley
- University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama, United States of America
| | - Diana L. Blithe
- National Institute of Child Health and Human Development, Contraceptive Development Program, DIPHR, NIH, Bethesda, Maryland, United States of America
| | - Jill Brown
- National Institute of Child Health and Human Development, Contraceptive Development Program, DIPHR, NIH, Bethesda, Maryland, United States of America
| | - Barbra A. Richardson
- Statistical Center for HIV/AIDS Research & Prevention, Fred Hutchinson Cancer Center, Seattle, Washington, United States of America
- Department of Biostatistics, University of Washington, Seattle, Washington, United States of America
| | - Brid Devlin
- International Partnership for Microbicides, Silver Spring, Maryland, United States of America
| | - Craig W. Hendrix
- Department of Medicine, Division of Clinical Pharmacology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Samuel M. Poloyac
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Mark A. Marzinke
- Department of Medicine, Division of Clinical Pharmacology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Holly Gundacker
- Statistical Center for HIV/AIDS Research & Prevention, Fred Hutchinson Cancer Center, Seattle, Washington, United States of America
| | - Devika Singh
- Magee-Womens Research Institute, Pittsburgh, Pennsylvania, United States of America
| | - Jeanna M. Piper
- National Institutes of Allergy and Infectious Disease, NIH, Bethesda, Maryland
| | - Sherri Johnson
- FHI 360, Durham, North Carolina, United States of America
| | - John Steytler
- International Partnership for Microbicides, Silver Spring, Maryland, United States of America
| | - Beatrice A. Chen
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Magee-Womens Research Institute, Pittsburgh, Pennsylvania, United States of America
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Halkjelsvik T, Skirbekk VF. Concurrent decline in teenage fertility rate and binge drinking? An observational study across 45 nations. Drug Alcohol Rev 2024. [PMID: 38773899 DOI: 10.1111/dar.13867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 04/29/2024] [Accepted: 04/29/2024] [Indexed: 05/24/2024]
Abstract
INTRODUCTION Alcohol consumption is associated with unintended pregnancies among teenagers. Its role as a broader determinant of teenage fertility rates remains unclear. We investigate whether adolescent binge drinking affects the number of teenage births. METHODS Binge drinking data from 137,898 females aged 15-16 were collected in the HBSC study (2002-2018, 43 countries/regions) and 267,359 in the ESPAD study (1995-2019, 41 countries/regions). Age-specific fertility rates were from the Human Fertility Database and the World Health Organization. We examined changes over time in countries' average levels of binge drinking among female pupils aged 15-16 and population-level fertility rates for the same cohorts when aged 16-19 years. RESULTS Controlling for differences between countries and survey waves, we found an association between binge drinking and fertility rate, B = 0.019, 95% confidence interval [0.004, 0.034]. When accounting for the countries' time trends, the association was substantially reduced, B = 0.006, 95% confidence interval [-0.0062, 0.0174]. The relationship was not moderated by abortion rates and controlling for contraceptive use had no impact on the findings. DISCUSSION AND CONCLUSIONS The association between adolescent binge drinking and fertility rates diminishes when accounting for country-specific time trends. Given the lack of clear mechanisms linking binge drinking to trends in fertility rates rather than shorter-term changes, the association likely reflects broader secular trends. Binge drinking may be involved in teen pregnancy and childbirth in individual cases but it does not explain recent developments in teenage fertility rates.
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Affiliation(s)
- Torleif Halkjelsvik
- Department of Tobacco and Drugs, Norwegian Institute of Public Health, Oslo, Norway
- Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, Oslo, Norway
| | - Vegard Fykse Skirbekk
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
- Columbia Aging Center, Columbia University Mailman School of Public Health, New York, USA
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Ghaznavi C, Ueda P, Okuhama A, Sakamoto H. Sexual Behaviors among Individuals Aged 20-49 in Japan: Initial Findings from a Quasi-Representative National Survey, 2022. JOURNAL OF SEX RESEARCH 2024; 61:9-20. [PMID: 36842974 DOI: 10.1080/00224499.2023.2178614] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Nationally representative data on sexual health and behaviors in Japan are scarce. We conducted an online survey, including questions about a range of topics related to sexual behaviors and outcomes. The sample, including 8000 men and women aged 20-49 years in Japan, was stratified by sex and weighted with respect to age, marital status, and region of residence to reflect the population of Japan. Of the women, 82.9% and 10.0% reported that they were heterosexual and asexual, respectively; corresponding proportions for men were 87.4% and 6.9%. 15.3% of women and 19.8% of men reported never having had any partners with whom they engaged in vaginal, anal, or oral sex. 45.3% of women and 44.5% of men reported not having had any sexual partners during the past year; this proportion was highest among women aged 40-49 years (51.7%) and men aged 20-29 years (55.1%). The proportion of those reporting satisfaction with their sex life was 27.8% for women and 23.1% for men; 17.6% of women and 27.1% of men reported dissatisfaction. Pornography use of ≥3 times per week was most common among those aged 20-29 years (6.5% of women; 34.8% of men), and the frequency of pornography use decreased slightly with age. 4.0% of women and 48.3% of men reported ever having used commercial sex worker services in their lifetime. This survey-based study provides data on sexual behaviors and health outcomes in Japan. Compared to other high-income countries, levels of sexual inexperience and inactivity seem to be high in Japan.
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Affiliation(s)
- Cyrus Ghaznavi
- Department of Health Policy and Management, School of Medicine, Keio University
- Medical Education Program, Washington University School of Medicine in St Louis
| | - Peter Ueda
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet
| | - Ayako Okuhama
- Disease Control and Prevention Center, National Center for Global Health and Medicine
| | - Haruka Sakamoto
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo
- Department of Hygiene and Public Health, Tokyo Women's Medical University
- Tokyo Foundation for Policy Research
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Hailegebreal S, Dileba Kale T, Gilano G, Haile Y, Endale Simegn A. Modern contraceptive use and associated factors among reproductive-age women in Ethiopia: multilevel analysis evidence from 2019 Ethiopia mini demographic and health survey. J Matern Fetal Neonatal Med 2023; 36:2234067. [PMID: 37433665 DOI: 10.1080/14767058.2023.2234067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 04/26/2023] [Accepted: 07/03/2023] [Indexed: 07/13/2023]
Abstract
BACKGROUND Despite the high fertility and population growth rates, the use of modern contraceptives remains low in low- and middle-income countries. Different pocket-sized studies on the use of modern contraceptive methods conducted in various parts of Ethiopia have been extremely varied and ambiguous. Therefore, this study aimed to assess modern contraceptive use and its associated factors in women of reproductive age in Ethiopia. METHODS Cross-sectional data from the Ethiopia Interim Demographic Health Survey (EMDHS) 2019 in a stratified, two-stage, and cluster sampling study. Multilevel binary logistic regression analysis was used to fit the associated factors. The interclass correlation (ICC), median odds ratio (MOR), proportional change variance (PVC), and deviance were used for model comparison and fitness. The adjusted odds ratio (AOR) with 95% confidence interval (CI) was used to identify the significant factors of modern contraceptive use. RESULT The multilevel analysis demonstrated that Orthodox religion [AOR = 1.7; 95%CI: 1.4-2.10] protestant religion [AOR = 1.2; 95%CI: 0.93-1.62], married [AOR = 4.2; 95%CI: 1.93-9.07], primary education [AOR = 1.5; 95%CI: 1.26-1.76], secondary education [AOR = 1.36; 95%CI: 1.04-1.77 [AOR = 1.89; 95%CI: 1.37-2.61], middle [AOR = 1.4; 95%CI: 1.14-1.73], rich [AOR = 1.3; 95%CI: 1.06-2.68] were positively associated with modern contraceptive utilization, while the age group of 40-49 [AOR = 0.45, 95% CI: 0.34-0.58], and high community poverty [AOR = 0.62; 95%CI: 0.46-0.83] were negatively associated with modern contraceptive utilization. CONCLUSION The prevalence of modern contraception in Ethiopia remains low. Maternal age, religion, maternal education, marital status, wealth index, region, and community poverty were significant predictors of modern contraceptive utilization in Ethiopia. Governments and non-governmental organizations should expand their public health programs to poorer communities to increase the use of modern contraception in the country.
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Affiliation(s)
- Samuel Hailegebreal
- Department of Health Informatics, School of Public Health, College of Medicine and Health Sciences, Wachemo University, Hosaena, Ethiopia
| | - Temesgen Dileba Kale
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Girma Gilano
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Yosef Haile
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
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Kneale D, Kjaersgaard A, de Melo M, Joaquim Picardo J, Griffin S, French RS, Burchett HED. Can cash transfer interventions increase contraceptive use and reduce adolescent birth and pregnancy in low and middle income countries? A systematic review and meta-analysis. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001631. [PMID: 37943721 PMCID: PMC10635429 DOI: 10.1371/journal.pgph.0001631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 08/22/2023] [Indexed: 11/12/2023]
Abstract
Becoming pregnant and giving birth under the age of 20 is associated with a range of adverse social, socioeconomic and health outcomes for adolescent girls and their children in Low and middle income countries. Cash transfers are an example of a structural intervention that can change the local social and economic environment, and have been linked with positive health and social outcomes across several domains. As part of a wider review of structural adolescent contraception interventions, we conducted a systematic review on the impact of cash transfers on adolescent contraception and fertility. Fifteen studies were included in the review with eleven studies providing evidence for meta-analyses on contraception use, pregnancy and childbearing. The evidence suggests that cash transfer interventions are generally ineffective in raising levels of contraceptive use. However, cash transfer interventions did reduce levels of early pregnancy (OR 0.90, 95% CI 0.81 to 1.00). There was suggestive evidence that conditional, but not unconditional, cash transfers reduce levels of early childbearing. Given that much of the evidence is drawn from interventions providing cash transfers conditional on school attendance, supporting school attendance may enable adolescent girls and young women to make life choices that do not involve early pregnancy.
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Affiliation(s)
- Dylan Kneale
- EPPI-Centre, UCL Social Research Institute, University College London, London, United Kingdom
| | - Abel Kjaersgaard
- EPPI-Centre, UCL Social Research Institute, University College London, London, United Kingdom
| | - Malica de Melo
- International Centre for Reproductive Health Mozambique (ICRH-M), Maputo, Mozambique
| | | | - Sally Griffin
- International Centre for Reproductive Health Mozambique (ICRH-M), Maputo, Mozambique
| | - Rebecca S. French
- Department of Public Health, Environments and Society, Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Helen E. D. Burchett
- Department of Public Health, Environments and Society, Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
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Okeke C, Ezenwaka U, Ekenna A, Onyedinma C, Onwujekwe O. Analysing the progress in service delivery towards achieving universal health coverage in Nigeria: a scoping review. BMC Health Serv Res 2023; 23:1094. [PMID: 37828496 PMCID: PMC10571459 DOI: 10.1186/s12913-023-10090-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 09/29/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND Attainment of universal health coverage (UHC) requires optimal utilization of health services. Poor coverage and inequitable access to healthcare could hinder improvement in service delivery towards UHC. The study analyzed the progress in service delivery coverage and equity in access to care within the Nigerian health systems based on the tracer indicators of the WHO framework for monitoring UHC. METHODS We searched the literature in databases: PubMed, Scopus, Directory of Open Access Journals, Google Scholar, Science Direct and websites of relevant health Ministries, Agencies, and Organizations between March to December 2022. Search terms were identified in four broader themes: Service delivery coverage, equity, UHC and Nigeria. Data were collected through a review of 37 published articles (19 peer-reviewed articles and 8 grey documents). We synthesized the findings in thematic areas using the WHO framework for monitoring UHC. RESULTS The findings show a slow improvement in service delivery coverage across the UHC tracer indicators; reproductive, maternal, newborn and child health, infectious diseases, non-communicable diseases and service capacity and access. With regards to equity in access to care across the tracer indicators, there has been a great disparity in the utilization of healthcare services among rural dwellers, lower educational level individuals and those with poor socio-economic status over 20 years. However, there was remarkable progress in the ownership and use of long-lasting insecticide-treated nets among rural and lowest-wealth quantile households than their urban counterpart. CONCLUSION There is poor coverage and persistent inequitable access to care among the tracer indicators for monitoring progress in service delivery. Attaining UHC requires concerted efforts and investment of more resources in service delivery to address inequitable access to care and sustainable service coverage for improved health outcomes.
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Affiliation(s)
- Chinyere Okeke
- Health Policy Research Group, University of Nigeria Enugu Campus, Enugu, Nigeria
- Department of Community Medicine, College of Medicine, University of Nigeria Enugu Campus, Enugu, Nigeria
| | - Uchenna Ezenwaka
- Health Policy Research Group, University of Nigeria Enugu Campus, Enugu, Nigeria.
- Department of Health Administration and Management, Faculty of Health Sciences and Technology, University of Nigeria Enugu Campus, Enugu, Nigeria.
| | - Adanma Ekenna
- Health Policy Research Group, University of Nigeria Enugu Campus, Enugu, Nigeria
- Department of Community Medicine, College of Medicine, University of Nigeria Enugu Campus, Enugu, Nigeria
| | - Chioma Onyedinma
- Health Policy Research Group, University of Nigeria Enugu Campus, Enugu, Nigeria
- Department of Community Medicine, College of Medicine, University of Nigeria Enugu Campus, Enugu, Nigeria
| | - Obinna Onwujekwe
- Health Policy Research Group, University of Nigeria Enugu Campus, Enugu, Nigeria
- Department of Health Administration and Management, Faculty of Health Sciences and Technology, University of Nigeria Enugu Campus, Enugu, Nigeria
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Landripet I, Božičević I, Baćak V, Štulhofer A. Changes in sexually transmitted infections-related sexual risk-taking among young Croatian adults: a 2005-2021 three-wave population-based study. Croat Med J 2023; 64:186-197. [PMID: 37391916 PMCID: PMC10332298 DOI: 10.3325/cmj.2023.64.186] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 06/14/2023] [Indexed: 10/29/2023] Open
Abstract
AIM To assess the prevalence and dynamics of risky sexual behaviors among Croatian emerging adults in the 2005-2021 period. METHODS Three surveys were conducted on large-scale national samples of young adults aged 18-24 in 2005 (N=1092) and 18-25 in 2010 and 2021 (N=1005 and N=1210, respectively). The 2005 and 2010 studies were conducted with face-to-face interviews on stratified probabilistic samples. The 2021 study was conducted by computer-assisted web-interviewing on a quota-based random sample from the largest national online panel. RESULTS Compared with 2005 and 2010, the age at coital debut increased for both genders in 2021 (by a median of one year, to 18 years, and by a mean of half a year, to 17.5 years, in men and to 17.9 in women). In the 2005-2021 period, condom use increased by about 15% both at first intercourse (to 80%) and in consistent use (to 40% in women and 50% in men). When we controlled for basic socio-demographics, Cox and logistic regressions indicated that, for both genders, in 2005 and 2010 compared with 2021, the risks/odds were significantly higher for reporting an earlier sexual debut (adjusted hazard ratio 1.25-1.37), multiple sexual partners (adjusted odds ratio [AOR] 1.62-3.31), and concurrent relationships (AOR 3.36-4.64), while the odds were lower for condom use at first sexual intercourse (AOR 0.24-0.46) and consistently (AOR 0.51-0.64). CONCLUSION Risky sexual behaviors decreased in the 2021 survey compared with the previous two waves, in both genders. Nonetheless, sexual risk-taking is still frequent among young Croatian adults. The introduction of sexuality education and other national-level public health interventions to reduce sexual risk-taking thus remains a public health imperative.
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Affiliation(s)
- Ivan Landripet
- Ivan Landripet, Department of Sociology, Faculty of Humanities and Social Sciences, Ivana Lučića 3, 10000 Zagreb, Croatia,
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Błajda J, Kucab A, Miazga A, Masłowski M, Kopańska M, Nowak A, Barnaś E. Google Trends Analysis Reflecting Internet Users' Interest in Selected Terms of Sexual and Reproductive Health in Ukraine. Healthcare (Basel) 2023; 11:healthcare11111541. [PMID: 37297681 DOI: 10.3390/healthcare11111541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 03/31/2023] [Accepted: 04/14/2023] [Indexed: 06/12/2023] Open
Abstract
INTRODUCTION The war in Ukraine has had adverse impacts on all areas of life, including health-related issues. Limited access to medical care increases the need to look for alternative sources of medical information. AIM To analyze trends of Internet users' interest in sexual and reproductive health in Ukraine based on Google Trends. MATERIALS AND METHODS The retrospective study was based on the analysis of terms related to sexual and reproductive health searched by Ukrainian Internet users. The tool used was Google Trends. The period from 1 January 2021 to 1 January 2023 was analyzed. The time variability in search growths and peaks was assessed from the perspective of two time intervals (before the war and during the war) using the chi-square test. RESULTS Significant changes have been demonstrated in the interests of Internet users from Ukraine regarding selected issues of sexual and reproductive health during the ongoing war. Compared to the pre-war period, a marked increase was observed in active searches for terms such as "condoms" (p = 0.0081), "rape" (p = 0.0008), "syphilis" (p = 0.0136), "ovulation" (p = 0.0002) and "pregnancy test" (p = 0.0008). CONCLUSIONS The conducted analysis clearly indicates an increased need for information regarding sexual and reproductive health among Ukrainian citizens during the ongoing armed conflict. The analysis of trends among Internet users interests can be a valuable source of knowledge for decision makers, including human rights organizations, regarding the scope and coordination of activities aimed at protecting the sexual and reproductive health of the inhabitants of Ukraine.
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Affiliation(s)
- Joanna Błajda
- Institute of Health Sciences, Medical College, University of Rzeszow, 35-959 Rzeszow, Poland
| | - Anna Kucab
- Institute of Health Sciences, Medical College, University of Rzeszow, 35-959 Rzeszow, Poland
| | - Aldona Miazga
- Institute of Health Sciences, Medical College, University of Rzeszow, 35-959 Rzeszow, Poland
| | - Maciej Masłowski
- Institute of Health Sciences, Medical College, University of Rzeszow, 35-959 Rzeszow, Poland
| | - Marta Kopańska
- Institute of Medical Sciences, Medical College, University of Rzeszow, 35-959 Rzeszow, Poland
| | - Anna Nowak
- Center for Foreign Language Studies, University of Rzeszow, Aleja Rejtana 16c, 35-959 Rzeszow, Poland
| | - Edyta Barnaś
- Institute of Health Sciences, Medical College, University of Rzeszow, 35-959 Rzeszow, Poland
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Muluneh MD, Francis L, Agho K, Stulz V. The association of intimate partner violence and contraceptive use: a multi-country analysis of demographic and health surveys. Int J Equity Health 2023; 22:75. [PMID: 37101283 PMCID: PMC10134549 DOI: 10.1186/s12939-023-01884-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 04/04/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND Intimate partner violence (IPV) affects millions of women each year and has been recognized as a leading cause of poor health, disability, and death among women of reproductive age. However, the existing studies about the association between IPV and contraceptive use have been found to be conflicting and relatively less studied, particularly in low and middle income countries, including Eastern Sub Saharan Africa (SSA). This study examines the relationship between IPV and contraceptive use in Eastern SSA countries. METHODS The Demographic and Health Surveys (DHS) from 2014 to 2017 were a multi-stage cluster sample survey of 30,715 ever married (or cohabitating) women of reproductive age from six countries. The six Eastern SSA datasets were pooled and multivariable logistic regression using a hierarchical approach was performed to examine the association between IPV and contraceptive use after adjusting for women, partners, and household and health facility factors. RESULT Two thirds of women 67% [66.55, 67.88] were not using any modern contraceptive methods and almost half (48%) of the women had experienced at least one form of IPV from their partners. Our analysis showed a strong association with decreased odds of physical violence [adjusted odds ratios (aOR) = 0.72, 95%CI: 0.67, 0 0.78] among women not using any contraceptive methods. Other factors associated with women not using any contraceptive methods were older women (35-49 years), illiterate couples and women from poorest households. Women who had no access to any form of communication [aOR = 1.12, 95%CI: 1.08, 1.36], unemployed partner [aOR = 1.55, 95%CI: 1.23, 1.95] and women who travelled long distances to access health services [aOR = 1.16, 95%CI: 1.06, 1.26] significantly reported increased odds of not using any contraceptive methods. CONCLUSION Our study indicated that physical violence was negatively associated with not using any contraceptive method among married women in Eastern SSA countries. Tailored intervention messages to reduce IPV including physical violence among women not using contraceptive methods in East Africa should target those from low-socioeconomic groups especially, older women with no access to any form of communication, unemployed partners, and illiterate couples.
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Affiliation(s)
- Muluken Dessalegn Muluneh
- Amref Health Africa in Ethiopia, Addis Ababa 17022, Bole Sub, Ethiopia.
- School of Nursing and Midwifery, Western Sydney University, Parramatta South Campus, Penrith, NSW, 2751, Australia.
| | - Lyn Francis
- School of Nursing and Midwifery, Western Sydney University, Parramatta South Campus, Penrith, NSW, 2751, Australia
| | - Kingsley Agho
- School of Health Sciences, Western Sydney University, Locked Bag1797, Penrith, NSW, 2571, Australia
- African Vision Research Institute (AVRI), University of KwaZulu-Natal, Durban, 4041, South Africa
| | - Virginia Stulz
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
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Kenny L, Lokot M, Bhatia A, Hassan R, Pyror S, Dagadu NA, Aden A, Shariff A, Bacchus LJ, Hossain M, Cislaghi B. Gender norms and family planning amongst pastoralists in Kenya: a qualitative study in Wajir and Mandera. Sex Reprod Health Matters 2022; 30:2135736. [DOI: 10.1080/26410397.2022.2135736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Leah Kenny
- Research Officer, London School of Hygiene and Tropical Medicine, London, UK
- London School of Economics and Political Science, London, UK
| | - Michelle Lokot
- Assistant Professor, London School of Hygiene and Tropical Medicine, London, UK
| | - Amiya Bhatia
- Assistant Professor, London School of Hygiene and Tropical Medicine, London, UK
| | - Rahma Hassan
- PhD Fellow, University of Nairobi, Nairobi, Kenya
| | - Shannon Pyror
- Family Planning Technical Lead, Save the Children, Washington DC, USA
| | | | - Abdullahi Aden
- Programme Manager, Wajir Field Office, Save the Children, Nairobi, Kenya
| | - Abdalla Shariff
- Programme Manager, Mandera Field Office Save the Children, Nairobi, Kenya
| | - Loraine J. Bacchus
- Associate Professor, London School of Hygiene and Tropical Medicine, London, UK
| | - Mazeda Hossain
- Associate Professorial Research Fellow, London School of Hygiene and Tropical Medicine, London, UK
- Honorary Associate Professor, London School of Economics and Political Science, London, UK
| | - Beniamino Cislaghi
- Associate Professor, London School of Hygiene and Tropical Medicine, London, UK
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Burchett HED, Griffin S, de Melo M, Picardo JJ, Kneale D, French RS. Structural Interventions to Enable Adolescent Contraceptive Use in LMICs: A Mid-Range Theory to Support Intervention Development and Evaluation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14414. [PMID: 36361287 PMCID: PMC9658296 DOI: 10.3390/ijerph192114414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 09/29/2022] [Accepted: 10/03/2022] [Indexed: 06/16/2023]
Abstract
Enabling contraceptive use is critical for addressing high adolescent pregnancy rates in low- and middle-income countries (LMICs). Broader or 'upstream' determinants, such as poverty, education, and social norms, can affect the knowledge, attitudes, motivation, and ability to access and use contraception. Structural interventions aim to address these broader determinants, e.g., through poverty alleviation from livelihood training or cash transfers, increasing school participation, or changing social norms. We conducted an evidence synthesis using intervention component analysis, a case-based approach, following a systematic mapping of the evidence base. We identified 17 studies with 29 structural intervention arms, which reported adolescent contraceptive use outcomes compared to a control group or baseline. It was not possible to identify with certainty which interventions were 'likely effective' or 'likely ineffective' due to the high heterogeneity of the methods. We built on an existing framework of family planning use to propose three steps to designing interventions: (1) tailor interventions to adolescents' life stages; (2) assess the baseline situation; and (3) select appropriate activities to match the gaps. These steps will aid developers and evaluators of structural adolescent contraceptive interventions to develop an evidence base that is of use across a wide range of settings and use scenarios.
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Affiliation(s)
- Helen Elizabeth Denise Burchett
- Department of Public Health, Environments & Society, Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, London WC1H 9SH, UK
| | - Sally Griffin
- International Center for Reproductive Health, Maputo 1100, Mozambique
| | - Málica de Melo
- International Center for Reproductive Health, Maputo 1100, Mozambique
| | | | - Dylan Kneale
- EPPI-Centre, UCL Social Research Institute, University College London, London WC1H 0NR, UK
| | - Rebecca S. French
- Department of Public Health, Environments & Society, Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, London WC1H 9SH, UK
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12
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Burchett HED, Kneale D, Griffin S, de Melo M, Picardo JJ, French RS. Which Structural Interventions for Adolescent Contraceptive Use Have Been Evaluated in Low- and Middle-Income Countries? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11715. [PMID: 36141987 PMCID: PMC9517431 DOI: 10.3390/ijerph191811715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/08/2022] [Accepted: 09/09/2022] [Indexed: 06/16/2023]
Abstract
Reducing adolescent childbearing is a global priority, and enabling contraceptive use is one means of achieving this. Upstream factors, e.g., gender inequalities, fertility norms, poverty, empowerment and schooling, can be major factors affecting contraceptive use. We conducted a systematic map to understand which structural adolescent contraception interventions targeting these upstream factors have been evaluated in LMICs. We searched eight academic databases plus relevant websites and a 2016 evidence gap map and screened references based on set inclusion criteria. We screened 6993 references and included 40 unique intervention evaluations, reported in 138 papers. Seventeen evaluations were reported only in grey literature. Poverty reduction/economic empowerment interventions were the most common structural intervention, followed by interventions to increase schooling (e.g., through legislation or cash transfers) and those aiming to change social norms. Half of the evaluations were RCTs. There was variation in the timing of endline outcome data collection and the outcome measures used. A range of structural interventions have been evaluated for their effect on adolescent contraceptive use/pregnancy. These interventions, and their evaluations, are heterogenous in numerous ways. Improved understandings of how structural interventions work, as well as addressing evaluation challenges, are needed to facilitate progress in enabling adolescent contraceptive use in LMICs.
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Affiliation(s)
- Helen Elizabeth Denise Burchett
- Department of Public Health, Environments & Society, Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
| | - Dylan Kneale
- EPPI-Centre, UCL Social Research Institute, University College London, London WC1H 0NR, UK
| | - Sally Griffin
- International Center for Reproductive Health: Mozambique, Maputo, Mozambique
| | - Málica de Melo
- International Center for Reproductive Health: Mozambique, Maputo, Mozambique
| | | | - Rebecca S. French
- Department of Public Health, Environments & Society, Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
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13
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Parent personality traits and adolescent sexual behaviour: Cross-sectional findings from the Longitudinal Study of Australian Children. PERSONALITY AND INDIVIDUAL DIFFERENCES 2022. [DOI: 10.1016/j.paid.2022.111682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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14
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Haakenstad A, Angelino O, Irvine CMS, Bhutta ZA, Bienhoff K, Bintz C, Causey K, Dirac MA, Fullman N, Gakidou E, Glucksman T, Hay SI, Henry NJ, Martopullo I, Mokdad AH, Mumford JE, Lim SS, Murray CJL, Lozano R. Measuring contraceptive method mix, prevalence, and demand satisfied by age and marital status in 204 countries and territories, 1970-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2022; 400:295-327. [PMID: 35871816 PMCID: PMC9304984 DOI: 10.1016/s0140-6736(22)00936-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 05/13/2022] [Accepted: 05/18/2022] [Indexed: 12/17/2022]
Abstract
BACKGROUND Meeting the contraceptive needs of women of reproductive age is beneficial for the health of women and children, and the economic and social empowerment of women. Higher rates of contraceptive coverage have been linked to the availability of a more diverse range of contraceptive methods. We present estimates of the contraceptive prevalence rate (CPR), modern contraceptive prevalence rate (mCPR), demand satisfied, and the method of contraception used for both partnered and unpartnered women for 5-year age groups in 204 countries and territories between 1970 and 2019. METHODS We used 1162 population-based surveys capturing contraceptive use among women between 1970 and 2019, in which women of reproductive age (15-49 years) self-reported their, or their partner's, current use of contraception for family planning purposes. Spatiotemporal Gaussian process regression was used to generate estimates of the CPR, mCPR, demand satisfied, and method mix by age and marital status. We assessed how age-specific mCPR and demand satisfied changed with the Socio-demographic Index (SDI), a measure of social and economic development, using the meta-regression Bayesian, regularised, trimmed method from the Global Burden of Diseases, Injuries, and Risk Factors Study. FINDINGS In 2019, 162·9 million (95% uncertainty interval [UI] 155·6-170·2) women had unmet need for contraception, of whom 29·3% (27·9-30·6) resided in sub-Saharan Africa and 27·2% (24·4-30·3) resided in south Asia. Women aged 15-19 years (64·8% [62·9-66·7]) and 20-24 years (71·9% [68·9-74·2]) had the lowest rates of demand satisfied, with 43·2 million (95% UI 39·3-48·0) women aged 15-24 years with unmet need in 2019. The mCPR and demand satisfied among women aged 15-19 years were substantially lower than among women aged 20-49 years at SDI values below 60 (on a 0-100 scale), but began to equalise as SDI increased above 60. Between 1970 and 2019, the global mCPR increased by 20·1 percentage points (95% UI 18·7-21·6). During this time, traditional methods declined as a proportion of all contraceptive methods, whereas the use of implants, injections, female sterilisation, and condoms increased. Method mix differs substantially depending on age and geography, with the share of female sterilisation increasing with age and comprising more than 50% of methods in use in south Asia. In 28 countries, one method was used by more than 50% of users in 2019. INTERPRETATION The dominance of one contraceptive method in some locations raises the question of whether family planning policies should aim to expand method mix or invest in making existing methods more accessible. Lower rates of demand satisfied among women aged 15-24 years are also concerning because unintended pregnancies before age 25 years can forestall or eliminate education and employment opportunities that lead to social and economic empowerment. Policy makers should strive to tailor family planning programmes to the preferences of the groups with the most need, while maintaining the programmes used by existing users. FUNDING Bill & Melinda Gates Foundation.
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Affiliation(s)
- Annie Haakenstad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Department of Health Metrics Sciences, University of Washington, Seattle, WA, USA
| | - Olivia Angelino
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Caleb M S Irvine
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Zulfiqar A Bhutta
- Centre for Global Child Health, University of Toronto, Toronto, ON, Canada; Centre of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan
| | - Kelly Bienhoff
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Corinne Bintz
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Kate Causey
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - M Ashworth Dirac
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Department of Health Metrics Sciences, University of Washington, Seattle, WA, USA; Swedish Family Medicine, First Hill, Seattle, WA, USA
| | - Nancy Fullman
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Emmanuela Gakidou
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Department of Health Metrics Sciences, University of Washington, Seattle, WA, USA
| | - Thomas Glucksman
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Department of Health Metrics Sciences, University of Washington, Seattle, WA, USA
| | - Nathaniel J Henry
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Ira Martopullo
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Department of Health Metrics Sciences, University of Washington, Seattle, WA, USA
| | - John Everett Mumford
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Stephen S Lim
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Department of Health Metrics Sciences, University of Washington, Seattle, WA, USA
| | - Christopher J L Murray
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Department of Health Metrics Sciences, University of Washington, Seattle, WA, USA
| | - Rafael Lozano
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Department of Health Metrics Sciences, University of Washington, Seattle, WA, USA.
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15
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Nguyen VK, Eaton JW. Trends and country-level variation in age at first sex in sub-Saharan Africa among birth cohorts entering adulthood between 1985 and 2020. BMC Public Health 2022; 22:1120. [PMID: 35659216 PMCID: PMC9167540 DOI: 10.1186/s12889-022-13451-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 05/17/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Debuting sexual intercourse marks exposure to pregnancy or fatherhood and sexually transmitted infections (STIs), including HIV. In sub-Saharan Africa (SSA), sexual debut varies according to cultural, religious, and economic factors, and encouraging delay has been a longstanding component of behavioural HIV prevention strategies. Age at first sex (AFS) is routinely collected in national household surveys, but data are affected by reporting biases, limiting utility to monitor trends and guide sexual health interventions. METHODS We collated individual-level data from nationally-representative household surveys to analyse timing and national trends in AFS in 42 SSA countries. We used a log-skew-logistic distribution to characterize the time to AFS in a Bayesian spatio-temporal model, providing estimates of the sexual debut rate by sex, age, time, and country. We statistically adjusted for reporting biases by comparing AFS reported by the same birth cohorts in multiple survey rounds, allowing different reporting biases by sex and country. RESULTS Median AFS in 2015 ranged from 15.8 among Angolan women to 25.3 among men in Niger. AFS was younger for women than men in 37/40 countries. The gap was largest for Sahel region countries and minimal in southern African countries. The distribution of female AFS was asymmetric with half debuting sex in an age range of 3.9 years [IQR 3.4-5.0 across countries]. Median AFS increased slightly between 1985 and 2020, ranging 0.84 years [IQR 0.11-1.55] and 0.79 [IQR -0.23-1.98] for females and males, respectively. The gender gap changed little over time in most countries. Female teens often reported higher AFS compared to when asked in their late twenties while male teens reported lower AFS; both sexes recalled a higher AFS in older ages compared to their thirties. CONCLUSIONS AFS increased slightly in most SSA countries, but changes were modest relative to large and persistent variation between countries and sexes, indicating relatively entrenched socio-cultural practices around sexual debut. Sexual health, family planning, and HIV/STI prevention services should adapt to local practices rather than focusing interventions to change AFS. These estimates for rates of sexual debut provide data to guide programmatic prioritization and implementation of sexual health services.
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Affiliation(s)
- Van Kính Nguyen
- grid.7445.20000 0001 2113 8111MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, St. Mary’s Hospital Campus, Norfolk Place, London, W2 1PG UK
| | - Jeffrey W. Eaton
- grid.7445.20000 0001 2113 8111MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, St. Mary’s Hospital Campus, Norfolk Place, London, W2 1PG UK
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16
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Hellwig F, Ewerling F, Coll CVN, Barros AJD. The role of female permanent contraception in meeting the demand for family planning in low- and middle-income countries. Contraception 2022; 114:41-48. [PMID: 35568087 DOI: 10.1016/j.contraception.2022.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 05/02/2022] [Accepted: 05/04/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Our aim was to describe the reliance on female permanent contraception among women with demand for family planning satisfied with modern methods (mDFPS) in low- and middle-income countries (LMICs) and to describe socio-economic and demographic patterns of permanent contraception in countries with high use. METHODS Using data from the latest national health survey carried out in LMICs we estimated mDFPS and the share of each contraceptive method used. Countries with a share of more than 25% of female permanent contraception were further explored for differences by wealth, number of living children, woman's age, and by the intersection of woman's age and number of living children. RESULTS In the 20 countries studied, between 6% and 94% of the contracepting population used modern methods. Female permanent contraception accounted for more than half of women using modern contraceptives in India, Dominican Republic, El Salvador, Mexico, and Colombia. In India and Tonga, more than 20% of women using contraceptives with fewer than two living children were using female permanent contraception. Among women with two living children, countries with the highest reliance on permanent contraception were India (79%), El Salvador (61%), Cuba (55%), Colombia (52%), and Thailand (51%). Dominican Republic, El Salvador, India, and Mexico presented high levels of permanent contraception among younger women, with reliance higher than 30% among women aged 25 to 29 and 50% or more among women aged 30 to 34. CONCLUSIONS Reliance on permanent contraception was high in several countries and among women aged less than 35 years.
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Affiliation(s)
- Franciele Hellwig
- Federal University of Pelotas; International Center for Equity in Health; Pelotas Brazil; Federal University of Pelotas; Post-graduation Program in Epidemiology; Pelotas Brazil.
| | - Fernanda Ewerling
- Federal University of Pelotas; International Center for Equity in Health; Pelotas Brazil
| | - Carolina V N Coll
- Federal University of Pelotas; International Center for Equity in Health; Pelotas Brazil
| | - Aluísio J D Barros
- Federal University of Pelotas; International Center for Equity in Health; Pelotas Brazil; Federal University of Pelotas; Post-graduation Program in Epidemiology; Pelotas Brazil
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17
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Abubakar I, Dalglish SL, Angell B, Sanuade O, Abimbola S, Adamu AL, Adetifa IMO, Colbourn T, Ogunlesi AO, Onwujekwe O, Owoaje ET, Okeke IN, Adeyemo A, Aliyu G, Aliyu MH, Aliyu SH, Ameh EA, Archibong B, Ezeh A, Gadanya MA, Ihekweazu C, Ihekweazu V, Iliyasu Z, Kwaku Chiroma A, Mabayoje DA, Nasir Sambo M, Obaro S, Yinka-Ogunleye A, Okonofua F, Oni T, Onyimadu O, Pate MA, Salako BL, Shuaib F, Tsiga-Ahmed F, Zanna FH. The Lancet Nigeria Commission: investing in health and the future of the nation. Lancet 2022; 399:1155-1200. [PMID: 35303470 PMCID: PMC8943278 DOI: 10.1016/s0140-6736(21)02488-0] [Citation(s) in RCA: 70] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 11/04/2021] [Accepted: 11/04/2021] [Indexed: 01/19/2023]
Affiliation(s)
| | | | - Blake Angell
- UCL Institute for Global Health, London, UK; The George Institute for Global Health, UNSW Sydney, Sydney, Australia
| | - Olutobi Sanuade
- UCL Institute for Global Health, London, UK; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Seye Abimbola
- School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Aishatu Lawal Adamu
- Department of Community Medicine, Bayero University, Nigeria; Aminu Kano Teaching Hospital Kano, Nigeria; Department of Infectious Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London, UK; Department of Epidemiology and Demography, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Ifedayo M O Adetifa
- Department of Infectious Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London, UK; Department of Epidemiology and Demography, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya; Department of Paediatrics and Child Health, College of Medicine, University of Lagos, Lagos, Nigeria
| | | | | | - Obinna Onwujekwe
- Health Policy Research Group, University of Nigeria Enugu Campus, Enugu, Nigeria
| | - Eme T Owoaje
- Department of Community Medicine, College of Medicine, University of Ibadan, Nigeria
| | - Iruka N Okeke
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, University of Ibadan, Ibadan, Nigeria
| | - Adebowale Adeyemo
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, USA
| | - Gambo Aliyu
- National Agency for the Control of AIDS, Abuja, Nigeria
| | - Muktar H Aliyu
- Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Sani Hussaini Aliyu
- Infectious Disease and Microbiology, Addenbrookes Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Emmanuel A Ameh
- Division of Paediatric Surgery, National Hospital, Abuja, Nigeria
| | - Belinda Archibong
- Department of Economics, Barnard College, Columbia University, New York, NY, USA
| | - Alex Ezeh
- Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Muktar A Gadanya
- Department of Community Medicine, Bayero University, Nigeria; Aminu Kano Teaching Hospital Kano, Nigeria
| | | | | | - Zubairu Iliyasu
- Department of Community Medicine, Bayero University, Nigeria; Aminu Kano Teaching Hospital Kano, Nigeria
| | - Aminatu Kwaku Chiroma
- Department of Community Medicine, Bayero University, Nigeria; Aminu Kano Teaching Hospital Kano, Nigeria
| | - Diana A Mabayoje
- Hospital for Tropical Diseases, University College London Hospitals NHS Foundation Trust, London, UK
| | | | - Stephen Obaro
- Department of Pediatric Infectious Diseases, University of Nebraska Medical Center, Omaha, Nebraska, USA; International Foundation Against Infectious Diseases in Nigeria, Abuja, Nigeria
| | | | - Friday Okonofua
- Centre of Excellence in Reproductive Health Innovation, University of Benin, Benin City, Nigeria; University of Medical Sciences, Ondo City, Nigeria
| | - Tolu Oni
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK; Research Initiative for Cities Health and Equity, School of Public Health and Family Medicine, University of Cape Town, South Africa
| | - Olu Onyimadu
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Muhammad Ali Pate
- Health, Nutrition and Population (HNP) Global Practice and Global Financing Facility for Women, Children and Adolescents, World Bank, Washington DC, WA, USA; Harvard T Chan School of Public Health, Boston, MA, USA
| | | | - Faisal Shuaib
- National Primary Health Care Development Agency, Abuja, Nigeria
| | - Fatimah Tsiga-Ahmed
- Department of Community Medicine, Bayero University, Nigeria; Aminu Kano Teaching Hospital Kano, Nigeria
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Anderson EJ, Hinson L, Berhe H, Berhane K, Warholak T, Equar A, Hailu D, Abraha A. Validation and Assessment of a Tool to Measure Psychosocial Readiness to Use Modern Contraceptives among Women in Tigray, Ethiopia. Stud Fam Plann 2022; 53:209-225. [PMID: 35278249 DOI: 10.1111/sifp.12188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Social norms, beliefs, and attitudes around modern contraception (MC) use can influence the decision to take up a method, but susceptibility to these factors varies between individuals. The effect of psychosocial readiness to use MC at the individual level is not established for women in Ethiopia. Data from 349 women were used for validity and reliability testing of a 12-item MC psychosocial readiness scale. A rating-scale Rasch model tested for unidimensionality, rating scale functioning, and construct and content validity. Multiple linear regression assessed the effect of respondent characteristics on MC psychosocial readiness scores. The psychometric properties of the univariate MC psychosocial readiness scale were satisfactory after the stepwise removal of two items. Prior MC use, socioeconomic status, geographic zone, and education were significantly associated with increased endorsement of MC psychosocial readiness. The 10-item scale measures the extent of endorsement of MC psychosocial readiness for childbearing women in Tigray, Ethiopia. Further research should qualitatively explore the identified influence of education on MC psychosocial readiness.
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Kamuyango A, Yu T, Ao CK, Hu SC, Hou WH, Tseng CC, Li CY. The public-sector family planning program impact scores in association with long acting reversible contraceptive use among young women in 22 Sub-Saharan African countries; A pooled multi-level analysis. Contraception 2022; 108:44-49. [PMID: 35031303 DOI: 10.1016/j.contraception.2021.12.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 12/18/2021] [Accepted: 12/22/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate the role of public-sector family planning program impact scores and other country-level factors on LARC use among young women aged 15-24. STUDY DESIGN We conducted this research using a large population database covering several decades' worth of multi-wave cross-sectional samples of the demographic health survey (DHS) and the World Bank website data. We carried out a multi-level analysis on data from 1990 to 2019 from 22 Sub-Saharan African countries, with 163,242 participants. RESULTS We found LARC use was at 3.1% of all young women under study. Sierra Leone, 2019 survey had the highest LARC use at 21,961 per 100,000. A 10% increase in public-sector family planning program impact scores was positively associated with LARC use with odds ratio of 1.44, 95% CI, 1.43- 1.45). We also noted that a 1% increase in HIV prevalence was associated with a reduced odds ratio of LARC use at 0.75 (95% CI, 0.70-0.81). CONCLUSIONS Findings from this study provide empirical evidence highlighting the importance of country-level factors in influencing LARC use among young women in sub-Saharan Africa IMPLICATIONS: For young women in Africa, policymakers need to increase their effort on national family planning programs especially in the public sector. Broader societal level interventions to improve LARC use are required. Specific interventions must address the complexities of HIV prevention and LARC use to benefit young women living in countries with a high HIV prevalence.
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Affiliation(s)
- Asantesana Kamuyango
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Tsung Yu
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chon-Kit Ao
- Department of Economics, College of Social Sciences, National Cheng Kung University, Tainan, Taiwan
| | - Susan C Hu
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Healthy Cities Research Center, Research and Services Headquarter, National Cheng Kung University, Tainan, Taiwan
| | - Wen-Hsuan Hou
- School of Gerontology Health Management & Master Program in Long-Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Ching-Cheng Tseng
- Department of Obstetrics and Gynecology, Tainan Sinlau Hospital, Tainan, Taiwan
| | - Chung-Yi Li
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan; Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan.
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20
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Mejía-Guevara I, Cislaghi B, Darmstadt GL. Men's Attitude Towards Contraception and Sexuality, Women's Empowerment, and Demand Satisfied for Family Planning in India. FRONTIERS IN SOCIOLOGY 2021; 6:689980. [PMID: 34977228 PMCID: PMC8717326 DOI: 10.3389/fsoc.2021.689980] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 11/15/2021] [Indexed: 05/02/2023]
Abstract
Whilst the prevalence of unmet need and contraceptive use remained unchanged for 10 years (between 2005-2015) in India, gender restrictive norms and power imbalances also have persisted, preventing married women from meeting their family planning desires. Data for this study are from the 2015-6 National Family Household Survey, which contains information on fertility preferences and family planning for women in reproductive age. As a proxy for men's attitudinal norms, we aggregated men's perceptions regarding contraception (contraception is women's business, women who use contraception may become promiscuous) and control over their wife (if his wife refuses to have sex, men have the right to deny financial support, have sex with another woman, or beat wife) at district level. Using a three-level random intercepts model, we assessed individual and contextual-level associations of men's attitudinal norms and met need for contraception among sexually active women (aged 15-49) with any demand for family planning, while adjusting for women's empowerment indicators [education, job status, and adult marriage] and individual demographic factors. Our results indicate that men's attitudinal norms are negatively associated with women's contraceptive use; for instance, a 1 standard deviation increase in the proportion of men who believe that contraception is women's business was associated with a 12% reduced likelihood of contraceptive use (OR = 0.88, 95% CI 0.82-0.95). Similar associations remained or were stronger after considering only modern methods, or when excluding female sterilization. Furthermore, our contextual effects analysis revealed that women's higher education or wealth did not improve contraceptive uptake in communities with strong attitudinal norms, but working women or women married as children were more likely to use contraception in those communities. Our results suggest that men's attitudinal norms may be dominating over women's empowerment regarding family planning choices among reproductive age women. However, employment appeared to play a strong protective role associated with women's contraceptive use. It is important for programs seeking to transform gender equality and empower women in making contraceptive choices to consider women's employment opportunities and to also address male attitudinal norms in the context of the ecosystem in which men and women coexist and interact.
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Affiliation(s)
- Iván Mejía-Guevara
- Stanford Aging and Ethnogeriatrics (SAGE) Research Center, Stanford University School of Medicine, Palo Alto, CA, United States
- Center for Population Health Sciences, Stanford University School of Medicine, Palo Alto, CA, United States
| | - Beniamino Cislaghi
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Department of Global Health, Makerere University, Kampala, Uganda
| | - Gary L. Darmstadt
- Global Center for Gender Equality, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, United States
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21
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Parsekar SS, Hoogar P, Dhyani VS, Yadav UN. The voice of Indian women on family planning: A qualitative systematic review. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2021. [DOI: 10.1016/j.cegh.2021.100906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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22
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Krovi SA, Johnson LM, Luecke E, Achilles SL, van der Straten A. Advances in long-acting injectables, implants, and vaginal rings for contraception and HIV prevention. Adv Drug Deliv Rev 2021; 176:113849. [PMID: 34186143 DOI: 10.1016/j.addr.2021.113849] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 06/15/2021] [Accepted: 06/22/2021] [Indexed: 12/22/2022]
Abstract
Worldwide, women face compounding reproductive health risks, including human immunodeficiency virus (HIV), sexually-transmitted infections (STIs), and unintended pregnancy. Multipurpose prevention technologies (MPTs) offer combined protection against these overlapping risks in singular prevention products that offer potential for simplified use, lower burden, higher acceptability, and increased public health benefits. Over the past decade, substantial progress has been made in development of extended-release MPTs, which have further potential to grant sexual and reproductive health autonomy to women globally and to offer choice for women to accommodate varying needs during their reproductive lives. Here, we highlight the advances made in injectable, implant, and ring delivery forms, and the importance of incorporating end-user preferences early in the research and development of these products.
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Affiliation(s)
| | | | - Ellen Luecke
- Women's Global Health Imperative, RTI International, Berkeley, CA, USA
| | - Sharon L Achilles
- University of Pittsburgh, School of Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, Pittsburgh, PA, USA; Magee-Womens Research Institute, Pittsburgh, PA, USA
| | - Ariane van der Straten
- Center for AIDS Prevention Studies, Dept of Medicine, University of California San Francisco, San Francisco, CA, USA; ASTRA Consulting, Kensington, CA, USA
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23
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Toffolutti V, Ma H, Menichelli G, Berlot E, Mencarini L, Aassve A. How the internet increases modern contraception uptake: evidence from eight sub-Saharan African countries. BMJ Glob Health 2021; 5:bmjgh-2020-002616. [PMID: 33257416 PMCID: PMC7705545 DOI: 10.1136/bmjgh-2020-002616] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 10/12/2020] [Accepted: 11/02/2020] [Indexed: 11/24/2022] Open
Abstract
Background Sub-Saharan African (SSA) countries have the highest worldwide levels of unmet need for modern contraception. This has led to persistently high fertility rates in the region, rates which have had major adverse repercussions on the development potential there. Family planning programmes play a key role in improving the uptake of modern contraception, both by fostering women’s health and by lowering their fertility. Increasing awareness of contraception benefits is a major component of such programmes. Here, we ask whether internet access can bridge the gap between women’s need for modern contraception and women’s uptake of the same. Methods We use a compendium of data for 125 242 women, aged 15–49, from the Demographic Health Survey, Akamai and International Communication Union data, covering eight SSA countries, for the period 2014–2019. We apply a Two-Stage Least Square model, using as instruments for individual internet exposure the distance to the main server in the country and whether the backbone network in the country has been connected to at least one submarine cable. Results Internet exposure, measured as women access the internet at least monthly (almost daily), is associated with a positive, 11.4% (95% CI 10.6% to 12.2%) (53.8% (95% CI 13.4% to 94.1%)), increase in modern contraception uptake. Education is an important moderator. Poorly educated women benefit the most from internet exposure. Discussion Internet exposure appears to have significantly increased the uptake of modern contraception among sub-Saharan women. The poorly educated appear particularly to benefit. There are two mechanisms at play: the internet increases women’s knowledge of contraception; and, in parallel, fosters their empowerment.
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Affiliation(s)
| | - Hai Ma
- Bocconi University, Milan, Italy
| | | | | | - Letizia Mencarini
- Carlo F Dondena Research Centre, Milan, Italy.,Department of Management and Technology, Bocconi University, Milan, Italy
| | - Arnstein Aassve
- Carlo F Dondena Research Centre, Milan, Italy.,Department of Social and Political Sciences, Bocconi University, Milan, Italy
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24
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Valverius A, Arnell L, Strandh M. Egalitarian Values and Sexual Behavior-The Role of Country Level Values in Shaping Individual Level Behaviors in Africa, South America and Asia. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2021; 33:396-409. [PMID: 38595749 PMCID: PMC10929577 DOI: 10.1080/19317611.2021.1919952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 04/15/2021] [Accepted: 04/16/2021] [Indexed: 04/11/2024]
Abstract
Objective The aim of this study is to investigate the relationship between country level egalitarian values (broadly speaking emancipatory values/structural gender equality) and sexual behavior among youth. Methods: Comparative individual level data on sexual activity and condom use were collected from the Global School-based Student Health Survey, resulting in a final sample of 23 countries, analyzed utilizing multilevel logistic regression analysis. Results: Egalitarian values were significantly associated with sexual activity and condom use. Conclusions: Egalitarian values have a relationship with adolescents' sexual activity and condom use, and thus contribute to sexual health and well-being in Africa, South America and Asia.
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Affiliation(s)
- Anna Valverius
- Department of Social Work, Umeå University, Umeå, Sweden
| | - Linda Arnell
- School of Law, Psychology and Social work, Örebro Univeristy, Örebro, Sweden
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25
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Kpokiri EE, Wu D, Srinivas ML, Anderson J, Say L, Kontula O, Ahmad NA, Morroni C, Izugbara C, de Visser R, Oduro GY, Gitau E, Welbourn A, Andrasik M, Norman WV, Clifton S, Gabster A, Gesselman A, Smith C, Prause N, Olumide A, Erausquin JT, Muriuki P, van der Straten A, Nicholson M, O'Connell KA, Mwoka M, Bajos N, Mercer CH, Gonsalves LM, Tucker JD. Development of an international sexual and reproductive health survey instrument: results from a pilot WHO/HRP consultative Delphi process. Sex Transm Infect 2021; 98:38-43. [PMID: 33846277 PMCID: PMC8785043 DOI: 10.1136/sextrans-2020-054822] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 01/16/2021] [Accepted: 01/22/2021] [Indexed: 01/24/2023] Open
Abstract
Population health surveys are rarely comprehensive in addressing sexual health, and population-representative surveys often lack standardised measures for collecting comparable data across countries. We present a sexual health survey instrument and implementation considerations for population-level sexual health research. The brief, comprehensive sexual health survey and consensus statement was developed via a multi-step process (an open call, a hackathon, and a modified Delphi process). The survey items, domains, entire instruments, and implementation considerations to develop a sexual health survey were solicited via a global crowdsourcing open call. The open call received 175 contributions from 49 countries. Following review of submissions from the open call, 18 finalists and eight facilitators with expertise in sexual health research, especially in low- and middle-income countries (LMICs), were invited to a 3-day hackathon to harmonise a survey instrument. Consensus was achieved through an iterative, modified Delphi process that included three rounds of online surveys. The entire process resulted in a 19-item consensus statement and a brief sexual health survey instrument. This is the first global consensus on a sexual and reproductive health survey instrument that can be used to generate cross-national comparative data in both high-income and LMICs. The inclusive process identified priority domains for improvement and can inform the design of sexual and reproductive health programs and contextually relevant data for comparable research across countries.
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Affiliation(s)
- Eneyi E Kpokiri
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Dan Wu
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Megan L Srinivas
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Fort Dodge Community Health Center, Fort Dodge, Iowa, USA
| | - Juliana Anderson
- Infectious Diseases Division, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Lale Say
- UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction, WHO, Geneva, Switzerland
| | - Osmo Kontula
- Population Research Institute, Family Federation of Finland, Helsinki, Finland
| | - Noor A Ahmad
- Institute for Public Health, Ministry of Health Malaysia, Putrajaya, Wilayah Persekutuan, Malaysia
| | - Chelsea Morroni
- IPH, Liverpool School of Tropical Medicine, Liverpool, UK.,Botswana Sexual and Reproductive Health Research Initiative, Botswana-Harvard AIDS Institute Partnership, Gaborone, Botswana
| | | | - Richard de Visser
- School of Psychology, University of Sussex, Brighton & Hove, East Sussex, UK
| | - Georgina Y Oduro
- Department of Sociology and Anthropology, University of Cape Coast, Cape Coast, Central, Ghana
| | - Evelyn Gitau
- African Population and Health Research Center, Nairobi, Kenya
| | | | - Michele Andrasik
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Wendy V Norman
- Department of Family Practice, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Soazig Clifton
- Centre for Population Research in Sexual Health and HIV, Institute for Global Health, University College London, London, UK
| | - Amanda Gabster
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK.,Genómica y Proteómica, Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama City, Panama
| | - Amanda Gesselman
- The Kinsey Institute, Indiana University System, Bloomington, Indiana, USA
| | - Chantal Smith
- Adolescent and Child Health Institute, Durban, South Africa
| | | | - Adesola Olumide
- Institute of Child Health, College of Medicine, University College Hospital, Ibadan, Nigeria
| | - Jennifer T Erausquin
- Department of Public Health Education, University of North Carolina, Greensboro, North Carolina, USA
| | - Peter Muriuki
- African Population and Health Research Center, Nairobi, Kenya
| | - Ariane van der Straten
- Women's Global Health Imperative, RTI International, Berkeley, California, USA.,Center for AIDS Prevention Studies, Department of Medicine, University of California, San Francisco, California, USA
| | | | - Kathryn A O'Connell
- EngenderHealth, Program Impact, Research and Evaluation, Washington, Washington DC, USA
| | - Meggie Mwoka
- African Population and Health Research Center, Nairobi, Kenya
| | - Nathalie Bajos
- INSERM (Institut National de la Santé et de la Recherche Medicale), IRIS-EHESS, Paris, France
| | - Catherine H Mercer
- Centre for Population Research in Sexual Health and HIV, Institute for Global Health, University College London, London, UK
| | - Lianne Marie Gonsalves
- UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction, WHO, Geneva, Switzerland
| | - Joseph D Tucker
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK .,School of Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
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26
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Gujo AB, Kare AP. Utilization of Long-Acting Reversible Contraceptives and Associated Factors Among Reproductive Age Women Attending Governmental Health Institutions for Family Planning Services in Wondo Genet District, Sidama, National Regional State, Southern Ethiopia. Health Serv Res Manag Epidemiol 2021; 8:23333928211002401. [PMID: 33796626 PMCID: PMC7975444 DOI: 10.1177/23333928211002401] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 02/18/2021] [Accepted: 02/18/2021] [Indexed: 11/17/2022] Open
Abstract
Background: Utilization of family planning services improves women’s reproductive health
outcomes. Long-acting reversible contraceptive (LARCs) methods, in
particular, prevent unwanted pregnancy and significantly reduce maternal
mortality and morbidity. In Ethiopia utilization of LARCs was very low.
Therefore, this study was aimed at assessing the utilization of LARCs and
associated factors among reproductive-age women in Wondo Genet District,
Southern Ethiopia. Method: Institution based cross-sectional study was conducted from 15 May to 15
August 2020 among reproductive-age women. A systematic sampling method was
applied to recruit 376 women and the sample size was allocated to health
centers proportionally. Data collection was conducted by trained collectors
using pretested and structured questionnaires. Data coded and entered into
EPI Info 7 and the analysis was done using SPSS version 25. Binary and
multiple logistic regression analyses were done. Statistical significance
was declared with P < 0.05. Result: The utilization of LARCs was 37.8% (95% CI: 32.9-42.7). The multivariable
analysis showed that odds of the utilization of LARCs were increased among
reproductive-aged ≥25 years (Adjusted odds ratio (AOR) = 2.21, 95% CI: 1.04,
4.41), gave birth to ≥3 live births (AOR = 2.2, 95% CI: 1.2, 4.04), employed
(AOR = 1.92, 95% CI: 1.17, 3.14), earned high monthly income (AOR = 2.02,
95% CI: 1.25, 3.26) and discussed contraceptive methods with their husbands
(AOR = 2.87, CI: 1.68, 4.89]. Conclusions: Utilization of LARCs was low. The odds of the utilization of LARCs were
increased in women aged ≥25 years, gave birth to 3 or more children, earned
high monthly income, and discussed with their husbands about contraception
methods.
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Affiliation(s)
- Amelo Bolka Gujo
- Department of Social and Population Health, Yirgalem Hospital Medical College, Yirgalem, Sidama Region, Southern Ethiopia
| | - Assefa Philipos Kare
- Department of Social and Population Health, Yirgalem Hospital Medical College, Yirgalem, Sidama Region, Southern Ethiopia
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27
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Brotherton JML, Wheeler C, Clifford GM, Elfström M, Saville M, Kaldor J, Machalek DA. Surveillance systems for monitoring cervical cancer elimination efforts: Focus on HPV infection, cervical dysplasia, cervical screening and treatment. Prev Med 2021; 144:106293. [PMID: 33075352 PMCID: PMC8403014 DOI: 10.1016/j.ypmed.2020.106293] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 10/12/2020] [Accepted: 10/13/2020] [Indexed: 01/08/2023]
Abstract
In order to achieve the global elimination of cervical cancer as a public health problem, close surveillance of progress in public health and clinical activities and outcomes across the three pillars of vaccination, screening and treatment will be required. Surveillance should ideally occur within an integrated system that is planned, funded, and regularly evaluated to ensure it is providing timely, accurate and relevant feedback for action. In this paper, we conceptualise the main public health surveillance objectives as process and outcome measures in each of the three pillars. Process measures include coverage/participation measures for vaccination, screening and treatment alongside the ongoing assessment of the quality and reach of these programs and activities. Outcome measures related to the natural history of human papillomavirus (HPV) infection include HPV infection prevalence, precursor cervical lesions and cervical cancers (including stage at diagnosis, cancer incidence and mortality). These outcome measures can be used for monitoring the effectiveness of the three core activities in the short, medium and long term to assess whether these interventions are effectively reducing their occurrence. We discuss possible methods for the surveillance of these measures in the context of country capacity, drawing from examples in Australia, the USA and in low and middle income countries.
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Affiliation(s)
- Julia M L Brotherton
- VCS Population Health, VCS Foundation, Level 6, 176 Wellington Parade, East Melbourne, Victoria 3002, Australia; Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Carlton 3053, Victoria, Australia.
| | - Cosette Wheeler
- Department of Pathology and Obstetrics & Gynecology, University of New Mexico Health Sciences Center, Albuquerque, NM 87131, USA
| | - Gary M Clifford
- International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372 Lyon, Cedex 08, France
| | - Miriam Elfström
- Department of Laboratory Medicine, Karolinska Institutet, Alfred Nobels Allé 8, 8th floor, 141 52 Huddinge, Stockholm, Sweden
| | - Marion Saville
- VCS Population Health, VCS Foundation, Level 6, 176 Wellington Parade, East Melbourne, Victoria 3002, Australia; University Department of Obstetrics and Gynaecology, University of Melbourne, The Royal Women's Hospital, Grattan St & Flemington Rd, Parkville, VIC, 3052, Australia
| | - John Kaldor
- Kirby Institute, Level 6, Wallace Wurth Building, University of New South Wales, High Street, Kensington, NSW 2052, Australia
| | - Dorothy A Machalek
- Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Carlton 3053, Victoria, Australia; Kirby Institute, Level 6, Wallace Wurth Building, University of New South Wales, High Street, Kensington, NSW 2052, Australia; Centre for Women's Infectious Diseases, The Royal Women's Hospital, Grattan St & Flemington Rd, Parkville, VIC 3052, Australia
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28
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Jabeen S, Rathor A, Riaz M, Zakar R, Fischer F. Demand- and supply-side factors associated with the use of contraceptive methods in Pakistan: a comparative study of demographic and health surveys, 1990-2018. BMC WOMENS HEALTH 2020; 20:265. [PMID: 33256703 PMCID: PMC7708094 DOI: 10.1186/s12905-020-01112-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 10/27/2020] [Indexed: 12/01/2022]
Abstract
Background A remarkable decline in fertility rates has been observed in many countries, with a primary determinant being an increase in the use of contraceptives. However, the birth rate in Pakistan is still higher compared to the other countries of the region. Therefore, this study aims to assess the effect of demand- and supply-side factors associated with the use of contraceptive measures in Pakistan. Methods Secondary data analysis of four data series of the Pakistan Demographic and Health Surveys (PDHS 1990–1991, 2006–2007, 2012–2013 and 2017–2018) were used. The data includes ever-married women aged 15–49 years who had given birth in the previous five years and participated in the family planning module of the PDHS. A total of 25,318 women were included in the analysis. Data were analysed by investigating the associations between independent variables (demand- and supply-side factors) and the use of contraceptive measures through unadjusted odds ratios (OR) and adjusted OR (AOR). Results The results among demand-side factors indicated that in 2012–2013, women without media exposure were less likely to use contraceptives and the trend remains almost constant for 2017–2018 (AOR = 0.664, 95% CI 0.562–0.784) in 2012–2013 and (AOR = 0.654, 95% CI 0.483–0.885) in 2017–2018. However, they still show a lower likelihood of using contraceptives without media exposure. The results among supply-side factors indicated that absence of transport (2012–2013) and limited visits by family planning workers over the previous 12 months (2006–2007, 2012–2013 and 2017–2018) remained significant factors for not using contraceptive methods. Conclusions The results of the study indicate that certain demand- and supply-side factors are associated with the use of contraceptive measures in Pakistan. It highlights the need for the provision of family planning resources and further structural factors, particularly in remote areas.
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Affiliation(s)
| | - Adnan Rathor
- Institute of Social and Cultural Studies, University of the Punjab, Lahore, Pakistan
| | - Maria Riaz
- Institute of Social and Cultural Studies, University of the Punjab, Lahore, Pakistan
| | - Rubeena Zakar
- Department of Public Health, University of the Punjab, Lahore, Pakistan
| | - Florian Fischer
- Institute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany. .,Institute of Gerontological Health Services and Nursing Research, Ravensburg-Weingarten University of Applied Sciences, Weingarten, Germany.
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29
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Rizvi F, Williams J, Bowe S, Hoban E. Factors influencing unmet need for contraception amongst adolescent girls and women in Cambodia. PeerJ 2020; 8:e10065. [PMID: 33083131 PMCID: PMC7547592 DOI: 10.7717/peerj.10065] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 09/08/2020] [Indexed: 11/29/2022] Open
Abstract
Background Unmet need is the gap between women’s need and their practice of using contraception. Unmet need for contraception in female adolescents and women in Cambodia is a public health concern which may lead to unintended pregnancies or abortions that can contribute to maternal morbidity and mortality. Methods Bronfenbrenner’s Social Ecological Model was used as a theoretical framework to analyze data from the 2014 Cambodian Demographic and Health Survey to ascertain demographic and social factors potentially associated with unmet need for contraception. Bivariate and weighted multiple logistic regression analyses with adjusted odds ratios (AOR) were conducted for 4,823 Cambodian, sexually active females aged 15–29 years. Results The percentage of unmet need for contraception was 11.7%. At the individual level of the Social Ecological Model, there was an increased likelihood of unmet need in adolescent girls 15–19 years and women 20–24 years. Unmet need was decreased in currently employed women. At the microenvironment level, there was an increased likelihood of unmet need with the husband’s desire for more children and when the decision for a woman’s access to healthcare was made by someone else in the household. At the macroenvironment level, unmet need was decreased in women who could access a health facility near their residence to obtain medical care. There were no urban rural differences found in the Cambodian sample population. Conclusion Unmet need for contraception in Cambodian females adolescents and women is associated with younger age, unemployment and low personal autonomy for accessing healthcare but not with education or wealth status. There is a need to implement culturally appropriate reproductive and sexual health literacy programs to increase access to modern contraception and to raise women’s autonomy.
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Affiliation(s)
- Farwa Rizvi
- Faculty of Health, School of Health and Social Development, Deakin University, Burwood, Victoria, Australia
| | - Joanne Williams
- Department of Health Sciences and Biostatistics, Faculty of Health, Arts & Design, Swinburne University of Technology, Hawthorne, Victoria, Australia
| | - Steven Bowe
- Deakin Biostatistics unit, Faculty of Health, School of Health and Social Development, Deakin University, Burwood, Victoria, Australia
| | - Elizabeth Hoban
- Consultant at Faculty of Health, School of Health and Social Development, Deakin University, Burwood, Victoria, Australia
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30
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Laksono AD, Wulandari RD, Matahari R. The association between recent sexual activity and the use of modern contraceptive methods among married/cohabiting women in Indonesia. J Public Health Res 2020; 9:1885. [PMID: 33282793 PMCID: PMC7706358 DOI: 10.4081/jphr.2020.1885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 11/05/2020] [Indexed: 11/23/2022] Open
Abstract
Background: Modern contraceptive methods are considered more reliable for preventing and spacing pregnancy than traditional methods in sexual activity. The study aimed to analyze the association between recent sexual activity and the use of modern contraceptive methods among married/cohabiting women in Indonesia. Design: The samples used were married/cohabiting women aged 15-49 years old. The sample size was 34,467 women. The variables analyzed included modern contraceptive use, recent sexual activity, age groups, marital status, education level, and wealth status. Analysis using multinomial logistic regression. Results: It was found that women who were sexually not active last 4 weeks had the likely to use modern contraceptive non-LARC (long-acting reversible contraceptives) 0.416 times compared to women who were sexually active last 4 weeks. Women who were sexually active last 4 weeks were more likely to use modern contraceptive LARC 0.535 times than women who were sexually active last 4 weeks. The results of this analysis inform that women who are sexually active last 4 weeks have a higher possibility to use modern contraceptives, both non-LARC and LARC types. Conclusions: Based on the results of the research analysis it could be concluded that recent sexual activity was associated with modern contraceptive use among married/cohabiting women in Indonesia. Significance for public health We demonstrated the potential for the effects of sexual activity on the use of modern contraceptive methods among childbearing age women in Indonesia. We assume that sexual activity is one of the strong predictors of the use of modern contraceptive methods. In this article we analyze sexual activity variables multivariately together with several other variables that have the potential to influence the use of modern contraceptive methods.
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Affiliation(s)
- Agung Dwi Laksono
- National Institute of Health Research and Development, the Indonesian Ministry of Health, Jakarta
| | | | - Ratu Matahari
- Faculty of Public Health, Universitas Ahmad Dahlan, Yogyakarta, Indonesia
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31
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Apanga PA, Kumbeni MT, Ayamga EA, Ulanja MB, Akparibo R. Prevalence and factors associated with modern contraceptive use among women of reproductive age in 20 African countries: a large population-based study. BMJ Open 2020; 10:e041103. [PMID: 32978208 PMCID: PMC7520862 DOI: 10.1136/bmjopen-2020-041103] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To assess the prevalence and factors associated with modern contraceptive (CP) use among women of the reproductive age. DESIGN Cross-sectional study. SETTING We used data from the Multiple Indicator Cluster Surveys (MICSs) from 20 African countries collected between 2013 and 2018. PARTICIPANTS Data on 1 177 459 women aged 15-49 years old. METHODS Multivariable logistic regression was used to identify factors associated with modern CP use, while controlling simultaneously for independent variables, and accounting for clustering, stratification and sample weights from the complex sampling design. We used random effects meta-analysis to pool adjusted estimates across the 20 countries. RESULTS The overall prevalence of modern CP use was 26% and ranged from 6% in Guinea to 62% in Zimbabwe. Overall, injectable (32%) was the most preferred method of CP, followed by oral pill (27%) and implants (16%). Women were more likely to use a modern CP if they: had a primary (adjusted prevalence odds ratios (aPORs): 1.68, 95% CI: 1.47 to 1.91)) or secondary/higher education (aPOR: 2.16, 95% CI: 1.80 to 2.59) compared with women with no formal education; had no delivery in the last 2 years (aPOR: 3.89, 95% CI: 2.76 to 5.47) compared with women who delivered in the last 2 years; were aged 25-34 years (aPOR: 1.33, 95% CI: 1.20 to 1.47) compared with women aged 15-24 years; were of middle-income status (aPOR: 1.25, 95% CI: 1.11 to 1.39) or rich (aPOR: 1.53, 95% CI: 1.27 to 1.84) compared with poor women and had two or more antenatal care visits compared with women without a visit. Perceived domestic violence was not associated with modern CP use (aPOR: 0.98, 95% CI: 0.92 to 1.05). CONCLUSION Our findings are relevant in a global context, particularly in the African region, and improve our understanding on relevant factors essential to increasing modern CP use.
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Affiliation(s)
| | - Maxwell Tii Kumbeni
- Nabdam District Health Directorate, Ghana Health Service, Nangodi, Upper East Region, Ghana
| | - Emmanuel Awine Ayamga
- Nabdam District Health Directorate, Ghana Health Service, Nangodi, Upper East Region, Ghana
| | - Mark B Ulanja
- School of Medicine, University of Nevada, Reno, Nevada, USA
| | - Robert Akparibo
- School of Health and Related Research, The University of Sheffield, Sheffield, UK
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Yang F, Dong L, Zhang X, Li J, Tan K, Li Y, Yu X. Vasectomy and male sexual dysfunction risk: A systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e22149. [PMID: 32925772 PMCID: PMC7489671 DOI: 10.1097/md.0000000000022149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Unintended pregnancy is popular all over the world, accounting for 40% to 50% of all pregnancies. The condition not only exerts pressure on the relationship of couples and severely impacts the quality of life, but also imposes a heavy burden on the health of women and child. Recently, more than 220 million couples have chosen to be sterilized to obtain contraception, 47.3% of married couples select sterilization, of which vasectomy accounts for 17.1%. Vasectomy is currently the most convenient and effective method of male contraception. We will perform the systematic review and meta-analysis to assess the correlation between vasectomy and male sex dysfunction and provide evidence-based evidence for the couple METHODS:: The electronic databases of MEDLINE, PubMed, Web of Science, EMBASE, Clinicaltrials.org., China National Knowledge Infrastructure Database (CNKI), Wan fang Database, China Biology Medicine Database (CBM), VIP Science Technology Periodical Database, Chinese Clinical Trial Registry, and Cochrane Library will be retrieved before November 20, 2021. We will search English literature and Chinese literature with proper Medical Subject Heading or text key words. RevMan 5.3 and Stata 14.0 will be used for Systematic review and Meta-analysis. This protocol reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement, and we will report the systematic review by following the PRISMA statement. CONCLUSION AND DISSEMINATION The aim of this study was to evaluate the effect of vasectomy on the sexual function of patients after operation. The results will be published in a public issue journal to provide evidence-based medical evidence for urologists and andrologists to make clinical decisions. REGISTRATION INFORMATION INPLASY202080014.
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Affiliation(s)
- Fang Yang
- Department of Andrology, The Reproductive & Women-Children Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, P. R. China
| | - Liang Dong
- Department of Andrology, The Reproductive & Women-Children Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, P. R. China
| | - Xiaojin Zhang
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, P. R. China
| | - Junjun Li
- Department of Andrology, The Reproductive & Women-Children Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, P. R. China
| | - Kun Tan
- Department of Andrology, The Reproductive & Women-Children Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, P. R. China
| | - Yulin Li
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, P. R. China
| | - Xujun Yu
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, P. R. China
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The Global Gag Rule: The death trap for comprehensive sexual and reproductive healthcare and way to overcome the US gag rule. JOURNAL OF POPULATION THERAPEUTICS AND CLINICAL PHARMACOLOGY 2020; 27:e87-e99. [PMID: 32621461 DOI: 10.15586/jptcp.v27i2.677] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 05/05/2020] [Indexed: 11/18/2022]
Abstract
The United States of America (USA) is one of the largest bilateral donors in the field of global health assistance. There are beneficiaries in 70 countries around the world. In 2015, the USA released US$638 million for the improvement of global health status by promoting family planning services. Unfortunately, in 2017, Trump administration reinstated Mexico City Policy/Global Gag Rule (GGR). This policy prevents non-US nongovernmental organizations (NGOs) from receiving US health financial assistance if they have any relationship with abortion-related services. This restriction pushed millions of lives into great danger due to the lack of comprehensive family planning services, especially lack of abortion-related services. This article has attempted to let the readers know about the impacts of GGR around the world and how global leaders are trying to overcome the harmful effects of this rule. Finally, it proposes some solutions to the impacts of the extension of Mexico City Policy.
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Shaw D. Patchy progress on the ICPD: are we asking the right questions? THE LANCET GLOBAL HEALTH 2020; 8:e466-e467. [DOI: 10.1016/s2214-109x(20)30080-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 02/24/2020] [Indexed: 10/24/2022] Open
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