Using Andersen’s Behavioral Model of Health Care Utilization to Assess Contraceptive Use among Sexually Active Perinatally HIV-Infected Adolescents in UgandaRead the full article
International Journal of Reproductive Medicine publishes original research articles, review articles, and clinical studies in all areas of reproductive medicine.
International Journal of Reproductive Medicine maintains an Editorial Board of practicing researchers from around the world, to ensure manuscripts are handled by editors who are experts in the field of study.
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Determinants of Fertility Desire among Women Living with HIV in the Childbearing Age Attending Antiretroviral Therapy Clinic at Jimma University Medical Center, Southwest Ethiopia: A Facility-Based Case-Control Study
Background. High fertility and aspiration to have more children are a normal phenomenon in many developing countries including Ethiopia. The desire of people living with HIV/AIDS (PLWHA) to have children can have significant public health implications. Despite the growing number of women living with HIV/AIDS, the issues of fertility and childbearing intention have not been widely studied in Ethiopia. Objective. To identify determinants of fertility desire among women living with HIV in the childbearing age attending antiretroviral therapy clinic at Jimma University Medical Center, Southwest Ethiopia. Methods. A facility-based case-control study was conducted in March 2019. Cases were women living with HIV who had fertility desire, and controls were those who had not. Data was collected using a face-to-face interview using a pretested questionnaire. The data was entered into EpiData 3.1 and exported to SPSS Version 24 for analysis. Bivariate and multivariable logistic regression analyses were used to identify candidate and independent determinants of fertility desire, respectively. Independent determinants associated with fertility desire were assessed using AORs with their corresponding 95% CIs at value < 0.05 cutoff point. Results. Three hundred forty-four (115 cases and 229 controls) were included into the study with a 100% response rate. Age categories 15-24 (AOR: 4.1; 95% CI: 2.0, 8.4) and 25-34 (AOR: 2.3; 95% CI: 1.3, 4.2) years, not using family planning (AOR: 2.3; 95% CI: 1.4, 4.0), and having a sexual partner (AOR: 1.9; 95% CI: 1.1, 3.2) were independent predictors of fertility desire. Conclusions. Age of women, family planning, and sexual partner were found to be the independent predictors of fertility desire among women living with HIV/AIDS. Policymakers and health care providers who are working on an ART clinic should try to consider the effects of these factors for women living with HIV while developing HIV/AIDS interventions and discussing on sexual and reproductive health issues with their clients, respectively.
Determinants of Modern Contraceptive Methods Discontinuation among Women within Reproductive Age in Dire Dawa City, Eastern Ethiopia
Background. Modern family planning methods are widely believed to influence fertility reduction worldwide. Family planning had a clear effect on the health of women, children, and families worldwide especially those in developing countries. It has been shown that there are many instances in which women might discontinue contraception methods that put women’s health at risk. Objectives. To assess and identify Determinants of Modern Contraceptive Methods Discontinuation among Women in Reproductive age interval in Dire Dawa City. Method. A cross-sectional study design was employed. A total of 811 respondent women with one-year history of modern contraceptive method usage were considered in the study. A stratified random sampling method was used to select the study participants. Data was collected using a structured questionnaire and analyzed by descriptive statistics and binary logistic regression. Result. The study indicated that 634 (78.20%) of respondent mothers continued using the method that they have used before a year. Whereas 177 (21.80%) of women discontinued using the method within a year. The factors age, number of children, who made the decision on the choice of the method used, the type of contraceptive method used, and taking counseling before using the method were found significant at 5% level of significance. Conclusion. Young women, respondents who have no or a small number of children, and not the decision maker on the choice of the method were more likely to discontinue. Whereas women who did not take counseling are less likely to discontinue. When compared to women who used implant those women who used pills and injectables are more likely to discontinue. Thus, the study identified factors that contribute to the discontinuation of modern contraception methods.
Maternal Satisfaction with Antenatal Care and Associated Factors among Pregnant Women in Hossana Town
Background. A woman’s satisfaction with antenatal care service has immediate and long-term impacts on maternal and her baby’s health. It also ensures further use of service. However, it is not well studied in Ethiopia in general and at the southern region in particular. Objective. The main objective of this study is to assess the level of a maternal satisfaction with antenatal care services and associated factors. Methods. An institution-based cross-sectional study that involves both quantitative and qualitative methods of data collection was employed. A systematic sampling technique was used to obtain study participants, and quantitative data were collected using an interviewer-administered questionnaire. For qualitative data, Focus Group Discussions were done among clients that have a repeated visit by taking educational status as homogeneity criteria. EpiData version 3.1 and SPSS version 21 were used for analysis. Descriptive statistics, bivariate and multivariable logistic regression analyses were employed to describe and identify factors associated with maternal satisfaction on antenatal care. The qualitative data were analyzed thematically and manually. Results. Overall, 74% of mothers were satisfied with antenatal care services rendered in public health institutions of Hossana town. Most of the respondents were satisfied with privacy, cleanness, physical facility, and approaches of care. Age, educational status, privacy, cleanness, distance, and respect were significantly associated with a client’s satisfaction. Conclusion. Three-fourths of the respondents were satisfied with the service. Age, education, living distance, maintenance of privacy, cleanness of the facility, and respect from providers were the significant predictors of the satisfaction level.
Disclosure of Intimate Partner Violence and Associated Factors among Victimized Women, Ethiopia, 2018: A Community-Based Study
Background. Disclosure is a vital step in the process of finding a lasting solution and breaking the abuse chain in a victim woman by the intimate partner. Objectives. This study is aimed at assessing the disclosure of intimate partner violence and associated factors among victim women in Dilla town, Gedeo Zone, South Ethiopia, 2018. Methods. A community-based cross-sectional study design triangulated with the qualitative method was employed. Data were collected from 280 women victims of intimate partner violence using pretested, structured, and interviewer-administered questionnaires. SPSS version 20.0 software was used for analysis. Binary logistic regression and a multivariate logistic regression model were fitted to assess the association between the independent and dependent variables. Qualitative data were collected through in-depth interviews and categorized into themes and triangulated with the quantitative result. Results. Half of the respondents (51%) disclosed intimate partner violence. Partner alcohol use (; 95% CI:1.18, 3.34), women experiencing a single type of intimate partner violence (, 95% CI: 0.17, 0.79), women having strong social support (; 95% CI:1.44, 4.41), and women whose partners’ having primary (; 95% CI:1.07, 3.9) and secondary education (; 95% CI: 1.07, 4.33) were significantly associated with the disclosure of intimate partner violence as the qualitative result shows most of the women prefer their family to disclose and those who kept silent were due to economic dependency, societal norms towards wife beating, arranged marriage, and not getting the chance especially those who went to the hospital. Conclusion. Nearly 50% of victims of intimate partner violence women disclose intimate partner violence to others. Thus, it is needed for stakeholders to use their efforts to further increase the disclosure of violence and respect women’s rights and equality.
Factors Associated with Utilization of Complete Postnatal Care Service in Baglung Municipality, Nepal
Background. Postnatal period is six weeks after birth. It is critical but is the most neglected period. A large proportion of maternal and neonatal deaths occur during 48 hours following childbirth. The utilization of the recommended three postnatal checkups within seven days after delivery, which plays a vital role in preventing maternal and neonatal deaths, is low in Nepal. Objective. This study is aimed at identifying the factors associated with the utilization of complete postnatal care (PNC) among mothers. Method. A cross-sectional study was carried out among 318 mothers in wards 1, 2, 3, and 4 of Baglung municipality, Nepal. Data was collected by semi-structured interviews. Descriptive analysis and comparison of characteristics of women/families with complete vs. partial postnatal checkups using multivariable logistic regression were done. Results. Among 314 respondents receiving at least one PNC, 78% had partial and 22% had complete PNC. Relatively advantaged caste/ethnicity- Brahman/Chhetri (, 95% CI: 1.24-8.12) and Janajati (, 95% CI: 1.09-7.53) - compared to Dalits, husbands working as a job holder in Nepal (, 95% CI: 1.50-8.13), and delivery in a private hospital (, 95% CI: 5.40-24.2) were associated with having complete PNC. Conclusion. Although PNC attendance at least once was high, utilization of complete PNC was low. More focus to mothers from disadvantaged caste/ethnicity, those whose husbands are in foreign employment, and improvement in quality of care in government health facilities may increase the use of complete PNC.
Antenatal Care Attendance and Factors Influenced Birth Weight of Babies Born between June 2017 and May 2018 in the Wa East District, Ghana
Background. In sub-Saharan Africa, there is high coverage of the recommended four or more times antenatal care (ANC) visits during pregnancy without complications; notwithstanding this achievement, the negative birth outcomes related to childbirth such as low birth weights and stillbirths are still high despite the increased access to antenatal services. Hence, the study assessed the association between antenatal attendance and birth weight in the Wa East District. Method. The cross-sectional study design was used with a semistructured questionnaire to collect data from mothers who delivered within a one-year period through a review of antenatal and birth records from health facilities where the women delivered and interviewed. The chi-squared test and univariate and multivariate logistic regression were performed to establish the association between normal birth weight and ANC services the woman received and other predictor variables, and value < 0.05 was considered a significant association between dependent and independent variables. Result. The study involved 233 women. About 62.2% attended ANC clinics 4+ times before giving birth, 70.0% did not received the minimum ANC services required for every pregnant woman, 0.9% of pregnancies resulted in stillbirth, and 24.5% of babies born had a birth . Women marital status (legally married) [AOR: 2.05, 95% CI: 1.33-6.89, ], religion (Islam) [AOR: 0.33, 95% CI: 0.08-0.39, ], and educational level (SHS/tertiary) [AOR: 4.27, 95% CI: 0.08-0.88, ] were the background characteristics associated with normal birth weight (2.5-40 kg). Also, women who had their urine tested at the ANC clinics [AOR: 6.59, 95% CI: 8.48–15.07, ] and women who received a long-lasting insecticide-treated net [AOR: 2.17, 95% CI: 0.03-0.92, ] from the ANC clinic were associated with normal birth weight. Conclusion. Notwithstanding the benefits of antenatal care services, only 62.2% of pregnant women attended 4 or more ANC visits before giving birth, while 70% did not received the services they need. These might have influence the 24.5% of babies born with a low birth weight. Therefore, there is a need for special attention from all stakeholders to reverse the trend.