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Journal Cover African Journal of Reproductive Health
  [SJR: 0.325]   [H-I: 25]   [5 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  [263 journals]
  • Is Abortion Incidence Rising In Nigeria'

    • Authors: Friday Okonofua
      Abstract: No Abstract
      PubDate: 2016-02-25
      Issue No: Vol. 19, No. 4 (2016)
  • Quality of Spousal Relationship on Procurement of Abortion in Peri-Urban

    • Authors: Abimbola Phillips, Adesegun O. Fatusi, Akanni I. Akinyemi, Bamidele Bello
      Abstract: The quality of spousal relationship may influence the acceptance of the status of pregnancies and the decision to procure abortion; however, this relationship has largely been unexplored. The objective of this paper is to assess the influence of specific dimensions of relationship quality on abortion procurement. Data from the 2010 Family Health and Wealth Survey site were used to assess the association between relationship quality and induced abortion among 763 ever-pregnant married or cohabiting women in Ipetumodu, South-west Nigeria. Abortion question though not directly related to current time, however, it provides a proxy for the analysis in such context where abortion is highly restrictive with high possibility of underestimation. The association between relationship quality and abortion risk was analyzed using bivariate and multivariate (logistic regression) methods. Only 7.9% of women 15-49 years reported ever having induced abortion. Communication was the only dimension of relationship quality that showed significant association with history of induced abortion (aOR=0.42; 95% C.I. =0.24-0.77). The paper concludes that spousal communication is a significant issue that deserves high consideration in efforts to improve maternal health in Nigeria.Keywords: Induced abortion, Spousal communication, Nigeria, relationship-quality
      PubDate: 2016-02-25
      Issue No: Vol. 19, No. 4 (2016)
  • Challenges Addressing Unmet Need for Contraception: Voices of Family
           Planning Service Providers in Rural Tanzania

    • Authors: Jitihada Baraka, Asinath Rusibamayila, Admirabilis Kalolella, Colin Baynes
      Abstract: Provider perspectives have been overlooked in efforts to address the challenges of unmet need for family planning (FP). This qualitative study was undertaken in Tanzania, using 22 key informant interviews and 4 focus group discussions. The research documents perceptions of healthcare managers and providers in a rural district on the barriers to meeting latent demand for contraception. Social-ecological theory is used to interpret the findings, illustrating how service capability is determined by the social, structural and organizational environment. Providers’ efforts to address unmet need for FP services are constrained by unstable reproductive preferences, low educational attainment, and misconceptions about contraceptive side effects. Societal and organizational factors – such as gender dynamics, economic conditions, religious and cultural norms, and supply chain bottlenecks, respectively – also contribute to an adverse environment for meeting needs for care. Challenges that healthcare providers face interact and produce an effect which hinders efforts to address unmet need. Interventions to address this are not sufficient unless the supply of services is combined with systems strengthening and social engagement strategies in a way that reflects the multi-layered, social institutional problems.Keywords: Contraception, Unmet need for family planning, Provider perspectives, Tanzania, Quality of care
      PubDate: 2016-02-25
      Issue No: Vol. 19, No. 4 (2016)
  • Perceived Risks Associated with Contraceptive Method Use among Men and
           Women in Ibadan and Kaduna, Nigeria

    • Authors: Hilary M. Schwandt, Joanna Skinner, Luciana E. Hebert, Abdulmumin Saad
      Abstract: Research shows that side effects are often the most common reason for contraceptive non-use in Nigeria; however, research to date has not explored the underlying factors that influence risk and benefit perceptions associated with specific contraceptive methods in Nigeria. A qualitative study design using focus group discussions was used to explore social attitudes and beliefs about family planning methods in Ibadan and Kaduna, Nigeria. A total of 26 focus group discussions were held in 2010 with men and women of reproductive age, disaggregated by city, sex, age, marital status, neighborhood socioeconomic status, and—for women only—family planning experience. A discussion guide was used that included specific questions about the perceived risks and benefits associated with the use of six different family planning methods. A thematic content analytic approach guided the analysis. Participants identified a spectrum of risks encompassing perceived threats to health (both real and fictitious) and social concerns, as well as benefits associated with each method. By exploring Nigerian perspectives on the risks and benefits associated with specific family planning methods, programs aiming to increase contraceptive use in Nigeria can be better equipped to highlight recognized benefits, address specific concerns, and work to dispel misperceptions associated with each family planning method.Keywords: contraceptives, family planning, side effects, Nigeria, qualitative
      PubDate: 2016-02-25
      Issue No: Vol. 19, No. 4 (2016)
  • To God Be the Glory: Discussing Sex in Evangelical Communities in Southern

    • Authors: Lindsay M. Briggs, Kathleen R. Gilbert, Michael D. Reece, Brian M. Dodge, Samuel G. Obeng
      Abstract: Many people hold stereotypes and assumptions about religious communities in regards to their feelings and beliefs about sex and the impact it has on the lived experiences of religious people. However, stereotypes and assumptions are not often grounded in reality, and many people are hesitant to address the issue head on. This qualitative ethnographically informed preliminary grounded theory study aimed to engage an Evangelical Pentecostal community in Southern Nigeria with the ultimate goal of understanding how communities conceptualize and discuss sexuality topics, the factors influencing sexual decision making amongst youth and young adults, and to identify research needs that will better inform innovative and efficacious research utilizing religious communities in sexuality research. Results showed that this population was highly interested in discussing sexuality in their community including major threats to their ideal sexual behavior path, reasons why people stray from this ideal and how to keep people on this ideal path. This research demonstrates that religious communities are interested in conducting sexuality research so long as the research takes their values and beliefs into account and respects their limitations when it comes to research intent and methods.Keywords: Sexuality, faith-based, Nigeria, community based research, qualitative
      PubDate: 2016-02-25
      Issue No: Vol. 19, No. 4 (2016)
  • Reasons for Intrauterine Device Use, Discontinuation and Non-Use in
           Malawi: A Qualitative Study of Women and their Partners

    • Authors: Amy G. Bryant, Gloria Hamela, Ann Gottert, Gretchen S. Stuart, Gift Kamanga
      Abstract: The copper intrauterine device (IUD) is a safe, long-acting, and effective method of contraception that is under-utilized in many countries, including Malawi. A unique cohort of women who had enrolled in a trial of postpartum IUD use one year earlier gave insights into reasons for using, discontinuing, or not using the IUD. We conducted in-depth interviews with 18 women one year after they participated in a pilot study of a randomized controlled trial of postpartum IUD insertion, and 10 of their male partners. Women and their partners expressed a strong desire for family planning, and perceived numerous benefits of the IUD. However, fear of the IUD was common among successful users and non-users alike. This fear arose from rumours from friends and neighbors who were non-users. How women and their partners responded to this fear affected IUD adoption and continuation. Key themes included (1) Trust in information received from health care providers versus rumours from community members; (2) Partner involvement in IUD decision-making; and (3) Experience with side effects from short-term hormonal contraceptive methods. Broad community education about the IUD’s benefits and safety, and proactive counseling to address couples’ specific fears, may be needed to increase uptake of the method.Keywords: Intrauterine Device, IUD, Africa, Malawi, Sub-Saharan Africa, Qualitative Research
      PubDate: 2016-02-25
      Issue No: Vol. 19, No. 4 (2016)
  • Increasing Access to Prevention of Postpartum Hemorrhage Interventions for
           Births in Health Facilities and at Home in Four Districts of Rwanda

    • Authors: Blami Dao, Fidele Ngabo, Jeremie Zoungrana, Barbara Rawlins, Beata Mukarugwiro, Pascal Musoni, Rachel Favero, Juliet MacDowell, Kanyamanza Eugene
      Abstract: To assess coverage, acceptability, and feasibility of a program to prevent postpartum hemorrhage (PPH) at community and facility levels, a study was conducted in 60 health facilities and their catchment areas in four districts in Rwanda. A total of 220 skilled birth attendants at these facilities were trained to provide active management of the third stage of labor and 1994 community health workers (ASMs) were trained to distribute misoprostol at home births. A total of 4,074 pregnant women were enrolled in the program (20.5 % of estimated deliveries). Overall uterotonic coverage was 82.5%: 85% of women who delivered at a facility received a uterotonic to prevent PPH; 76% of women reached at home at the time of birth by an ASM ingested misoprostol—a 44.3% coverage rate. Administration of misoprostol at the time of birth for home births achieved moderate uterotonic coverage. Advancing the distribution of misoprostol through antenatal care services could further increase coverage.Keywords: postpartum hemorrhage; active management of the third stage of labor; misoprostol; community health worker; coverage; home birth
      PubDate: 2016-02-25
      Issue No: Vol. 19, No. 4 (2016)
  • A National Study: the Effect of Egyptian Married Women’s
           Decision-Making Autonomy on the use of Modern Family Planning Methods

    • Authors: Hana H. AL Sumri
      Abstract: Contraceptive use is vital in protecting the health of women and the survival of their children. This study aims to test whether women’s autonomy influences their use of modern contraception methods and to determine the mediating effect of education and employment. A cross sectional study using Egypt’s 2008 demographic and health survey was carried out including a sample of 13,734 married women aged 15-49 years. Women’s decision-making autonomy score was obtained from 5 questions on who has the final say on various household decisions. Household decision-making autonomy was significantly associated with current modern contraceptive use. Women with intermediate and high autonomy were 1.19 (95%CI 1.04-1.35) and 1.32 (95% CI 1.18-1.49) more likely to use modern contraception methods compared to women with low autonomy. Women’s education and employment did not mediate this relation. This study supports the evidence of the positive role of women’s autonomy on their uptake of contraceptive methods and this is an independent role and not explained by their educational or employment status.Keywords: Egypt, women, autonomy, contraceptive use
      PubDate: 2016-02-25
      Issue No: Vol. 19, No. 4 (2016)
  • Prospective Audit of Avoidable Factors in Institutional Stillbirths and
           Early Neonatal Deaths at Tikur Anbessa Hospital in Addis Ababa, Ethiopia

    • Authors: Asrat Demise, Yirgu Gebrehiwot, Bogale Worku, Jonathan M. Spector
      Abstract: Mortality audits are being used with increasing frequency to improve health outcomes by pinpointing precisely where deficiencies in clinical care exist. We conducted a prospective audit of stillbirths and early neonatal deaths at Tikur Anbessa Hospital in Addis Ababa, Ethiopia, as part of a broader initiative to reduce perinatal mortality in the labor room and neonatal intensive care unit. Out of 1,225 deliveries that took place during the six-month study period, there were 30 stillbirths and 31 early neonatal deaths (PMR 50/1,000). A multi-disciplinary Audit Team was established and convened monthly to review standardized data collection forms that were completed for each death. It was determined that avoidable factors were present in 70% of perinatal deaths. Health worker-related factors were the most common avoidable factors identified (accounting for 84% of avoidable factors identified), followed by patient-related factors (11%) and administrative-related factors (5%). Based on the study findings, quality improvement programs that target gaps in care are being implemented on the hospital’s labor room and in the neonatal intensive care unit.Keywords: Perinatal mortality, Clinical audit, Ethiopia, Developing Countries, Stillbirth
      PubDate: 2016-02-25
      Issue No: Vol. 19, No. 4 (2016)
  • Acute Pelvic Inflammatory Disease in Cameroon: A Cross Sectional
           Descriptive Study

    • Authors: Elie Nkwabong, Madye A.N. Dingom
      Abstract: This cross-sectional descriptive study, aimed at identifying the sociodemographic characteristics of women diagnosed with acute pelvic inflammatory disease (PID), as well as the microorganisms isolated, was carried out between October 1st, 2013 and March 31st, 2014 in two major hospitals in Yaoundé, Cameroon. Seventy women diagnosed with acute PID were recruited. The main variables recorded were maternal age, occupation, marital status, number of current sexual partners, the clinical presentation at admission and the microorganisms identified. Data were analyzed using SPSS 20.0. Mean maternal age was 29.0 ± 7.7 years. Students were more represented (37.1%), 58.6 % were single, 64.3% had ≥2 sexual partners. The most frequent signs and symptoms were abnormal vaginal discharge (100%), adnexal tenderness (97.1%), cervical motion tenderness (94.3%) and fever ≥38.3°C (82.9%). No microorganism was isolated in 20% of cases, especially among women who underwent intra-uterine procedures. The most frequent microorganisms were genital tract mycoplasmas (54.3%). Acute PID is common among young, single women with multiple sexual partners. The micro-organisms frequently responsible for acute PID were genital tract mycoplasmas, whose identification should be included among routine tests for women with suspected acute PID in the hospitals.Keywords: Acute pelvic inflammatory disease- Patients' sociodemographic profile- Clinical presentation- Microorganisms isolated
      PubDate: 2016-02-25
      Issue No: Vol. 19, No. 4 (2016)
  • Ovarian Cancer in Ghana, a 10 Year Histopathological Review of Cases at
           Korle Bu Teaching Hospital

    • Authors: Patrick K. Akakpo, Leonard Derkyi-Kwarteng, Richard K. Gyasi, Solomon E. Quayson, Jehoram T. Anim
      Abstract: To determine the histopathological types, age distribution, presenting signs and symptoms of ovarian cancers diagnosed at the Korle-Bu Teaching Hospital, Ghana. All histopathology slides and request cards of ovarian cancers diagnosed over a ten-year period (2001 to 2010) were reviewed and the cancers classified according to the World Health Organization 1999 classification. Biographical and clinical data of the patients were collected and results entered into Epi-info to determine the frequency, age distribution and clinical presentation of the various types of ovarian cancer. There were 192(27.2%) ovarian cancers out of 706 ovarian tumours. Epithelial cancers were the most common: 100 (52.1%), followed by sex cord stromal cancers 66 (34.4%). Majority of epithelial cancers were serous adenocarcinomas (71/100) while most sex cord stromal cancers were adult granulosa cell tumours 46 (69.7%). The mean age of patients with adenocarcinoma was 49 years while that of the 46 adult granulosa cell tumours was 46.5years. Patients present with varying combinations of symptoms and signs and ovarian cancers present at an earlier age compared to other populations, with the age of presentation being slightly lower for sex cord stromal cancers compared to adenocarcinomas. There are no specific symptoms or signs associated with ovarian cancer at presentation, to assist with diagnosis.Keywords: Ovary, Cancer, Histopathology, Demographics, Clinical features, Ghana
      PubDate: 2016-02-25
      Issue No: Vol. 19, No. 4 (2016)
  • Clinical Investigations and Management of Refractive Changes in Pregnancy:
           A Case Report

    • Authors: Bernadine N. Ekpenyong, Nwakuso A. Aruotu, Ebele B. Uzodike, Chimela G. Njoku
      Abstract: Pregnancy also presents with ocular changes, just as it affects other non - reproductive systems of the female. It has been reported to be associated with development of new health conditions or can exacerbate pre- existing health conditions. This paper reviews the management of Mrs AA, a 41 year old pregnant woman (primigravida) with refractive changes from myopia in the first trimester, to hyperopia in the second and third trimesters of her pregnancy. A comprehensive ocular examination was performed including fundus photograph and Optical Coherent Tomography. The results revealed signs of Central Serous Chorioretinopathy in both eyes which may have been due to various hormonal changes in pregnancy with resultant changes in refractive error. These ocular changes associated with pregnancy are, most often transient in nature, though occasionally permanent. This condition therefore requires clinical observation and monitoring until the resolution of the serous detachment is complete, and vision returned back to normal. Other ocular changes that are pregnancy related were reviewed.Keywords: Primigravida, central serous chorioretinopathy, ocular changes, transient, optical coherent tomography
      PubDate: 2016-02-25
      Issue No: Vol. 19, No. 4 (2016)
  • Tear Film Functions and Intraocular Pressure Changes in Pregnancy

    • Authors: Waheed A. Ibraheem, Anifat B. Ibraheem, Aramide M. Tijani, Samuel Oladejo, Susan Adepoju, Bukola Folohunso
      Abstract: Pregnancy related ocular changes are diverse with varied clinical outcome. In a cross-sectional, descriptive case control study, we evaluated tear film functions and intraocular pressure during pregnancy and compared the results with non-pregnant women. A total of 270 participants including 165 healthy pregnant women and 105 non-pregnant who were free from systemic and pre-pregnancy eye diseases were investigated. Snellen’s chart, fluorescein dye, No 41 Whatman filter paper, Perkin’s tonometer were employed to assess visual acuity, tear break up time (TBUT), Schirmer’s test (ST), intraocular pressure (IOP) on all subjects. The mean values for IOP (mmHg), TBUT (seconds) and Schirmer’s reading (mm) were: 13.24±2.18, 25.05±9.30, 37.03±17.06 and 14.24±2.66, 22.10±10.81, 50.13±19.10 for cases and controls respectively. Schirmer’s reading (SR) was significantly lower among pregnant women. Only age had a statistically significant association with the measured parameters. Our study revealed reduced SR during pregnancy. We suggest routine ocular assessment for pregnant women to forestall deleterious sequelae of dry eye.Keywords: Tear break-up time, Schirmer’s test, intraocular pressure, pregnancy
      PubDate: 2016-02-25
      Issue No: Vol. 19, No. 4 (2016)
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