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Journal Cover   African Journal of Reproductive Health
  [SJR: 0.325]   [H-I: 25]   [4 followers]  Follow
    
  This is an Open Access Journal Open Access journal
   ISSN (Print) 1118-4841 - ISSN (Online) 2141-3606
   Published by African Journals Online Homepage  [273 journals]
  • Prévention et contrôle du cancer du col en Afrique: Appel à
           l'action

    • Authors: F Okonofua
      Abstract: No .
      Issue No: Vol. 19, No. 1
       
  • Human Resource Challenges to Integrating HIV Pre-Exposure Prophylaxis
           (PrEP) into the Public Health System in Kenya: A Qualitative Study

    • Authors: N Mack, C Wong, K McKenna, A Lemons, J Odhiambo, K Agot
      Abstract: Extensive planning will be necessary to integrate HIV pre-exposure prophylaxis (PrEP) into public health systems. In Bondo and Kisumu, Kenya, we conducted interviews with 16 district and provincial public health stakeholders and held consultations with 18 provincial and 23 national public health stakeholders on topics related to PrEP rollout. We coded interview transcripts and created memos summarizing responses. We documented consultation discussions through note taking. Human resource challenges identified included increased workload and insufficient personnel, the need for task shifting/sharing, training needs, infrastructural requirements, discrimination and stigma by staff towards at-risk clients, and providers’ personal priorities about offering PrEP. These challenges paralleled current challenges related to integration of antiretroviral therapy (ART) and could be partially addressed prior to PrEP rollout. The recommendations for training staff are likewise grounded in lessons from ART and have practical application for program planners developing training curricula for PrEP delivery. 
      Keywords: Human resources; pre-exposure prophylaxis; PrEP integration
      Issue No: Vol. 19, No. 1
       
  • Factors Influencing Prevention and Control of Malaria among Pregnant Women
           Resident in Urban Slums, Southern Ghana

    • Authors: M Dako-Gyeke, HM Kofie
      Abstract: Throughout Africa and particularly in Ghana, there are concerns about malaria infection during pregnancy. This study aimed to investigate factors that influence malaria prevention and control practices among pregnant women residing in Chorkor and Korle-Gonno in Accra, Ghana. One hundred and twenty pregnant women between ages 18-49 were randomly recruited during antenatal sessions at a maternity facility in Accra, as participants for the study. An interviewer-administered questionnaire was used to collect data, which were analysed using SPSS version16.0. It was found that in Chorkor and Korle-Gonno, 57.4% and 42.6% participants respectively reported having been infected with malaria during their current pregnancy. There was no significant relationship between religious beliefs of participants and their malaria prevention and control practices (X2 = 0.28, P = .53). However, there was a significant relationship between malaria prevention and control practices of participants and their income earning (X2 = 53.94, P = .00) and employment (X2 = 61.76, P = .00) statuses. With the exception of ethnicity (X2 = 35.62, P =.22), other socio-cultural conditions had a significant relationship with malaria prevention and control practices of the participants. The findings suggest the need to consider and integrate factors, such as poverty and poor living conditions in malaria prevention and control strategies. 
      Keywords: Ghana, Malaria prevention and control practices, pregnant women, slums.
      Issue No: Vol. 19, No. 1
       
  • Social Networks and Decision Making for Clandestine Unsafe Abortions:
           Evidence from Kenya

    • Authors: J Osur, A Orago, I Mwanzo, E Bukusi
      Abstract: Little is known about the role of social networks in promoting clandestine abortions. This study investigated the role social networks play in decision making for and facilitation of clandestine abortions. It was a mixed method study in which 320 women treated for complications of unsafe abortions were interviewed in a cross sectional survey to determine their consultation with social networks and how this ended up in clandestine abortions. Information obtained was supplemented with information from focus group discussions, case studies and key informant interviews. It was found that 95% of women consulted their social networks as part of decision making before aborting clandestinely and unsafely. The man responsible for pregnancy, friend of same sex and woman’s mother were the most consulted at 64%, 32% and 23% respectively. 92% of advice was for the woman to abort. The man responsible for pregnancy and the woman’s mother were the most influential advisors (p˂0.05). Intermediaries linked the woman to clandestine and unsafe abortion and included agents and previous clients of clandestine abortion providers and the woman’s friends and relatives. Decision making and seeking for clandestine abortion were therefore found to be shared responsibilities. It is recommended that programs for reducing unsafe abortions be designed with this fact in mind. 
      Keywords: abortion decisions, social influence, health seeking behavior
      Issue No: Vol. 19, No. 1
       
  • “Over my Dead Body”: Knowledge and Attitude of Children
           towards HIV and AIDS in the Cape Coast Metropolis of Ghana

    • Authors: SA Owusu
      Abstract: In Ghana, it was estimated in 2013 that some 34,557 children were living with HIV and AIDS. Researches on children’s perception of risk, knowledge and support services for infected persons have been rarely undertaken. This paper is based on responses obtained from 120 in-school children aged 9-13 years drawn from three schools in the Cape Coast Metropolis of Ghana. The respondents provided qualitative data through essays and quantitative data through questionnaires. All the respondents have had some knowledge on HIV and AIDS and knew of where to access HIV and AIDS information. More than seventy per cent of them were not willing to purchase fresh vegetables from AIDS vendors nor were willing to allow AIDS infected female teachers to continue teaching them. It was recommended that children should be targeted with behavioural change communication messages especially by teachers to enable them live harmoniously with people infected and affected with AIDS. 
      Keywords: Children, perception, HIV and AIDS, Cape Coast, Ghana
      Issue No: Vol. 19, No. 1
       
  • Accessing Sexual and Reproductive Health Information and Services: A Mixed
           Methods Study of Young Women’s Needs and Experiences in Soweto,
           South Africa

    • Authors: N Lince-Deroche, A Hargey, K Holt, T Shochet
      Abstract: Young women and girls in South Africa are at high risk of unintended pregnancy and HIV. Previous studies have reported barriers to contraceptive and other sexual and reproductive health (SRH) services among young women in this context. We aimed to assess young women’s SRH knowledge and experiences and to determine how they get SRH information and services in Soweto, South Africa using quantitative and qualitative methods. Young women, aged 18-24, recruited from primary health clinics and a shopping mall, reported that they have access to SRH information and know where to obtain services. However there are challenges to accessing and utilizing information and services including providers’ unsupportive attitudes, uneven power dynamics in relationships and communication issues with parents and community members. There is a need to assist young women in understanding the significance of SRH information. They need access to age-appropriate, youth-friendly services in order to have healthy sexual experiences. 
      Keywords: HIV, gender-based violence, contraception, abortion
      Issue No: Vol. 19, No. 1
       
  • Prevalence and Correlates of Sexual abuse among Female Out-of-School
           Adolescents in Iwaya Community, Lagos State, Nigeria

    • Authors: MON Kunnuji, A Esiet
      Abstract: This study set out to document the prevalence and predictors of sexual intercourse with persons below the age of consent (statutory rape) and outright sex without consent (rape) among out-of-school adolescents in an urban slum in Lagos, Nigeria. Data gathered from a survey of 480 participants were employed. About 14% and 35% of the participants had been victims of rape and statutory rape respectively. Experience of rape was found to be a function of age and basic deprivation (Cox and Snell’s R2 of 0.060 and a Nagelkerke’s R2 of 0.108). Another model (with a Cox and Snell’s R2 of 0.286 and a Nagelkerke’s R2 of 0.394) shows that predictors of the experience of statutory rape include age, basic deprivation, living arrangement and previous attendance of school. In view of the overarching influence of basic deprivation on the experience of sexual abuse, an intervention programme that addresses the material conditions of adolescent girls in Nigeria is recommended. 
      Key words: Rape, statutory rape, basic deprivation, age of consent, adolescent girls, sexual abuse
      Issue No: Vol. 19, No. 1
       
  • Prevalence and Factors Associated with Intimate Partner Violence among
           Married Women in an Urban Community in Lagos State, Nigeria.

    • Authors: MO Onigbogi, KA Odeyemi, OO Onigbogi
      Abstract: Violence against women is a major public health problem globally. A cross-sectional descriptive study was conducted in Ikosi Isheri LCDA of Lagos State among 400 married women. A multistage sampling method was used to select the respondents. The lifetime prevalence for physical violence, sexual violence and psychological violence were 50.5%, 33.8% and 85.0% respectively. Predictive factors for physical IPV include lower educational status of the women (AOR 3.22 95%CI: 1.54-6.77) and partner’s daily alcohol intake (AOR: 1.84 95%CI: 1.05-3.23). The predictors of sexual violence include unemployment status of the partners (OR 5.89:1.39-24.84) and daily/weekly alcohol use (AOR 1.87 95%CI: 1.05-3.33). Predictors of psychological violence include respondents witness of parental violence (AOR 2.80 95%CI: 1.04-7.5) and daily alcohol use by partners (AOR 2.71 95%CI: 1.19-6.18). Preventive interventions such as increasing the educational status of women and reducing the intake of alcohol by men may help break the cycle of abuse. 
      Keywords: Intimate partner violence, women, prevalence, risk factors
      Issue No: Vol. 19, No. 1
       
  • Adolescent Sexuality and Life Skills Education in Nigeria: To What Extent
           have Out-of-School Adolescents Been Reached'

    • Authors: UC Isiugo-Abanihe, R Olajide, E Nwokocha, F Fayehun, R Okunola, R Akingbade
      Abstract: The introduction of school-based adolescent sexuality and life skills education in Nigeria’s formal education sector raises the misgiving that out-of-school youths who constitute more than half of the youth population might be neglected. This study investigated the extent to which out-of-school adolescents have been reached with sexuality education in Nigeria. The study took place in the six geopolitical zones and the Federal Capital Territory Abuja, and involved out-of-school adolescents, Non-Governmental Organizations, and community leaders. The qualitative research approaches were employed. Most of the youths had been exposed to sexuality education through seminars, trainings and workshops organized by different organizations. However, states in the south were better served than those in the north. Sexually Transmitted Infections including HIV/AIDS prevention accounted for more than 40% of the content of sexuality and life skills education received by out-of-school adolescents. The programmes have impacted positively on adolescents’ disposition and relationship with the opposite sex, knowledge and skill building.
      Keywords: Adolescents, sexually transmitted infections, non-governmental organizations, community leaders
      Issue No: Vol. 19, No. 1
       
  • Obstetric Fistula “Disease” and Ensuing Care: Patients’
           Views in West-Africa

    • Authors: N Maulet, A Berthe, S Traore, J Macq
      Abstract: We explored obstetric fistula patients’ real-life experience of care in modern Health System. Our aim was to analyze how these women’s views impacted their care uptake and coping. We conducted 67 in-depth interviews with 35 fistula patients or former patients in 5 fistula repair centers within referral hospitals in Mali and Niger. Perceptions of obstetric fistula influenced the care experience and vice versa. Obstetric fistula was viewed as a severe chronic disease due to length of care process, limitation of surgery and persisting physical and moral suffering. We highlight the opportunity to build on patients’ views on obstetric fistula trauma and care in order to implement an effective holistic care process. 
      Keywords: Vesico-vaginal fistula, long-term care, social perception, chronic disease, qualitative research, West Africa.
      Issue No: Vol. 19, No. 1
       
  • Perceived Health System Causes of Obstetric Fistula from Accounts of
           Affected Women in Rural Tanzania: A qualitative study

    • Authors: LT Mselle, TW Kohi
      Abstract: Obstetric fistula is still a major problem in low income countries. While its main cause is untreated obstructed labour, misconceptions about it still persist. This study aimed at exploring and describing perceived health system causes of obstetric fistula from women affected by it in rural Tanzania. This exploratory qualitative study included twenty-eight women affected by obstetric fistula. Semi structured interviews and focus group discussions were held and thematic analysis used to analyse perceived health system causes of obstetric fistula from women’s account. Perceived health system causes of obstetric fistula fundamentally reflected the poor quality of obstetric care women received at health care facilities relating to staff unaccountability, late referral, and torture by nurses. The women's perception emphasizes the importance of improving the quality of obstetric care provided by health care providers in health care facilities. 
      Keywords: Obstetric fistula, perceived causes, health system, birth experiences, Tanzania
      Issue No: Vol. 19, No. 1
       
  • Epidemiology of Cervical Squamous Intraepithelial Lesions in HIV Infected
           Women in Kenya: a cross-Sectional Study

    • Authors: P Memiah, V Makokha, W Mbuthia, GW Kiiru, S Agbor, F Odhiambo, S Ojoo, J Mbizo, S Muhula, G Mahasi, S Biadgilign
      Abstract: Cervical cancer is the second most common cancer among women worldwide. Infection with the human immunodeficiency virus (HIV) and its related immunosuppression are associated with an increased risk of prevalent, incident, and persistent squamous intraepithelial lesions (SILs) of the cervix. The objective of the study was to describe the prevalence and predictors of high-risk HPV and cervical cancer to support the need for strengthening cervical cancer screening programs for HIV infected women in Kenya. A cross sectional study was conducted in a hospital in Central Kenya, Kiambu district. The study population constituted of HIV positive women attending the ART treatment clinic. A total of 715 HIV positive women initiated on Antiretroviral Therapy (ART) were enrolled in this study. About 359 (52.1%) were less than 40 years of age and 644 (90.3%) of the patients were widowed. About 642 (92.6%) of the HIV infected women were in follow-up period of ≥ 1 year. The outcome/prognosis of the patients undergoing ICC was 3 cured, 5 good and 4 poor respectively. In a multivariable ordinal logistic regression analysis showed that for a one-unit decrease of CD4, we expect 1.23 log odds of increasing the severity of cervical cancer (B=1.23, P<0.015), given that all of the other variables in the model are held constant. In conclusion screening of all HIV infected women, who are under HIV care and treatment, enrolling patients on HAART with higher CD4 counts is recommended to see the net effect of HAART response. 
      Keywords: Cancer screening, ART, SILs, Women, CD4
      Issue No: Vol. 19, No. 1
       
  • Cervical Cancer and Human Papilloma Virus Knowledge and Acceptance of
           Vaccination among Medical Students in Southwest Nigeria

    • Authors: FF Adejuyigbe, BR Balogun, AO Sekoni, AA Adegbola
      Abstract: Human papillomavirus (HPV) is the commonest viral sexually transmitted infection in the world and the leading cause of cervical cancer. Medical students as future healthcare providers will play a role in influencing patients’ decision to receive HPV vaccination. This study was aimed at determining the knowledge of cervical cancer and HPV as well as the acceptance of HPV vaccination among medical students of the University of Lagos. A descriptive cross-sectional study was carried out among 280 medical students sampled using stratified sampling technique. Self-administered questionnaires were used to collect relevant data. Most respondents were aware of cervical cancer (95.4%), HPV (85.4%) and HPV vaccination (69.3%) and the most common source of information was school teaching. Good knowledge of cervical cancer, HPV and HPV vaccination was demonstrated by 51.8%, 67.1% and 21.1% respectively; only 39.6% fully accepted HPV vaccination. Inadequate information and high costs were the obstacles identified to receiving vaccine and recommending it to others. Older age and higher levels of study were significantly associated with good knowledge of HPV. Good knowledge of HPV and HPV vaccination respectively were significantly associated with full acceptance of vaccination. There is need for more education on cervical cancer, HPV infection and HPV vaccination for the medical students via school teaching and other media, and inclusion of the HPV vaccine in the National Program on Immunization to improve access. 
      Keywords: Human papillomavirus, medical students, knowledge, Nigeria
      Issue No: Vol. 19, No. 1
       
  • Editorial

    • Authors: F Okonofua
      Abstract: Preventing and Controlling Cervical Cancer in Africa: A Call for Action
      Issue No: Vol. 19, No. 1
       
  • Skilled Birth Attendance in Nigeria: A Function of Frequency and Content
           of Antenatal Care

    • Authors: CC Okigbo, AC Eke
      Abstract: The utilization rate of maternal services remains low in sub-Saharan Africa and may be contributing to the region’s high maternal mortality rate. This study examines the influence of antenatal care (ANC) on skilled birth attendance (SBA) in Nigeria. The data used were collected from a nationally representative sample of women (aged 15-49) in 2011. The sample is restricted to women who were within two years postpartum (weighted n=9879). Multivariate logistic regression was used to assess the association between ANC (number of visits attended and services received during last pregnancy) and SBA. Despite 70% of the women receiving any ANC, only 49% had SBA during their last childbirth. The number of ANC services received, rather than the number of ANC visits attended, was positively associated with having SBA during last childbirth after controlling for relevant covariates (p<0.05). The focus, therefore, should be on increasing the number of services received during ANC. 
      Keywords: Antenatal care, skilled birth attendance, pregnancy, Nigeria
      Issue No: Vol. 19, No. 1
       
  • Community Factors Influencing Birth Spacing among Married Women in Uganda
           and Zimbabwe

    • Authors: C McGuire, R Stephenson
      Abstract: Short birth spacing continues to be a problem in Uganda and Zimbabwe, resulting in negative infant, child, and maternal health outcomes. This study investigates community-level influences on birth spacing outcomes among women aged 15-49 in Uganda and Zimbabwe, using Demographic and Health Surveys conducted in 2011 (Uganda) and 2010-2011 (Zimbabwe). Women living in communities with higher mean maternal age, mean age at marriage, and mean parity were significantly more likely to have longer birth spacing. Women living in communities with higher levels of contraceptive use and low levels of unmet contraceptive need were more likely to have short birth spacing. The significance of community-level demographic and fertility norms, gender norms, economic prosperity, and family planning behaviors demonstrate the broad influence of community variables on birth spacing outcomes. This analysis highlights the importance of moving beyond individual and household-level interventions in order to harness the power of contextual influences on birth spacing.
      Keywords: birth spacing, community, gender, social epidemiology
      Issue No: Vol. 19, No. 1
       
 
 
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