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African Journal of Reproductive Health    [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  [230 journals]   [SJR: 0.24]   [H-I: 22]
  • Contraceptive Discontinuation and Switching Among Ghanaian Women: Evidence
           from the Ghana Demographic and Health Survey, 2008.
    • Authors: EJ Modey, R Aryeetey, R Adanu
      Abstract: This study identifies factors associated with contraceptive discontinuation and switching among Ghanaian women of reproductive age, using data from 1,378 female respondents of the 2008 Ghana Demographic and Health Survey. Logistic regression models were used to determine relationships between key socio-demographic factors and user status. Discontinued use occurred among 56% of ever users and switching among 55% of current users. The IUD was most abandoned (70%) and its use was associated with almost twice the odds of discontinuation (OR=1.97; 95% CI (1.04, 3.75)). Having a history of terminated pregnancy significantly predicted both discontinuation (OR=1.36; 95% CI (1.03, 1.79) and switching (OR=1.78; 95% CI (1.16, 2.73)) and intention to limit births significantly predicted lower discontinuation (OR=0.71; 95% CI (0.52, 0.96)). Counseling services emphasizing contraceptive options and reinforcing switching are critically needed to reduce unwanted pregnancies that may result from poor method use and discontinuation especially among post-abortion clients and IUD users. (Afr J Reprod Health 2014; 18[1]: 84-92).Keywords: Contraceptive use, discontinuation, switching, predictors, Ghanaian women
      PubDate: 2014-04-11
      Issue No: Vol. 18 (2014)
       
  • The Prevalence of Polycystic Ovary Morphology Among Women Attending a New
           Teaching Hospital in Southern Nigeria
    • Authors: O Ogueh, M Zini, S Williams, J Ighere
      Abstract: The aim of this study was to determine the prevalence of polycystic ovary morphology (PCO) among Nigerian women attending for pelvic ultrasound. This was a retrospective study of the ultrasound scan findings of all women who attended for pelvic ultrasound scan at a new teaching hospital in southern Nigeria from the commencement of ultrasound services on 1 March to 31 July 2010. The main indication for the scans was infertility (52.7%), and the commonest finding was fibroid (44.6%). Polycystic ovary morphology was present in 12.2% of the women. On average women with PCO were younger (30.3 v 35.0 years) and more likely to present with amenorrhea (33.3 v 7.6%) than women without PCO, but there was no other statistically significant differences between the two groups. This study suggests that Nigerian women have a low incidence of PCO morphology. (Afr J Reprod Health 2014; 18[1]: 161-164)Keywords: Prevalence, Polycystic Ovary Morphology, Nigerian
      PubDate: 2014-04-11
      Issue No: Vol. 18 (2014)
       
  • Group Psychological Therapy in Obstetric Fistula Care: A Complementary
           Recipe for the Accompanying Mental Ill Health Morbidities'
    • Authors: OA Ojengbede, Y Baba, IO Morhason-Bello, M Armah, A Dimiti, D Buwa, M Kariom
      Abstract: The objective of this study is to determine the impact of group psychological therapy (GPT) on the mental health of obstetric fistula patients. It was a comparative pre and post intervention design. All patients had GPT prior to surgery and mental health assessment conducted before and after surgical repair. There was a significant reduction in proportion of those with severe mental health status after surgery. Specifically, the proportion of those with depression score of 4 and above reduced from 71.7% to 43.4%, and those with score of less than 4 increased from 28.3 to 56.6 percent. There was a significant reduction in those with very low self-esteem from 65.0% to 18.3%. Suicidal ideation reduced generally; severe (15.0 to 0%), moderate (16.7 to 5.0%) and mild (25.0 to 21.7%) and those without increased (43.3 to 73.3%). In conclusion, GPT is a useful adjunct to OF care as it improves their overall mental health status. (Afr J Reprod Health 2014; 18[1]: 156-160).Keywords: Obstetric fistula, mental ill health, Group Psychotherapy, South Sudan
      PubDate: 2014-04-11
      Issue No: Vol. 18 (2014)
       
  • Utilization of HIV Testing and Counseling in Ghana: Implications for
           Universal Coverage
    • Authors: AE Yawson, P Dako-Gyeke, SA Addo, BT Dornoo, NA Addo
      Abstract: HIV testing and counselling (HTC) is a gateway to all systems of AIDS-related care. This study examined national programme data to highlight gaps in HTC service utilization, regional differences and differential use of various HTC programs in Ghana in the period, 2007-2010. Analysis showed HTC increased rapidly across the country, however the increase was not uniform across the 10 regions. Also huge differential use of current HTC programs (Diagnostic Centre(DCs), Know Your Status campaigns(KYS) and PMTCT Centres) emphasized differential preferences of various testing programmes. Testing through KYS was substantially higher than testing done at DCs. However, HIV positive test rates at DCs were comparatively higher across the regions than those of KYS. KYS thus attracts and conducts huge numbers of HIV tests, yet it captures relatively low HIV positives. A well structured and more targeted expansion of facility-based HTC services to capture most vulnerable population groups is needed. (Afr J Reprod Health 2014; 18[1]: 145-155).Keywords: HIV testing and counseling, HIV testing programs, regional differences, National AID/STI Control Program, Ghana
      PubDate: 2014-04-11
      Issue No: Vol. 18 (2014)
       
  • Non-surgical Adult Male Circumcision Using the PrePex Device:
           Task-Shifting from Physicians to Nurses
    • Authors: V Mutabazi, P Bitega, LM Ngeruka, T Hategekimana, SA Kaplan, C Karema, A Binagwaho
      Abstract: The Republic of Rwanda is implementing a program of voluntary male circumcision (MC) to reduce HIV transmission but lacks the infrastructure for conventional surgical MC on a nationwide scale. Nonsurgical MC using the PrePex device was first assessed in 5 subjects on an inpatient basis. Subsequent procedures were on an outpatient basis. Physicians performed 100 outpatient procedures (Phase 1 of this study) and trained nurses in the technique; the nurses then independently performed 47 procedures (Phase 2). All subjects achieved complete circumcision and healing within 6 weeks. There were no cases of infection or bleeding. In Phase 1, one case of transient moderate diffuse edema occurred. In Phase 2, no adverse events were reported. Thus, outcomes of MC performed by nurses using the PrePex device were not inferior to outcomes achieved by physicians, suggesting that task-shifting MC by this method from physicians to nurses is feasible in Rwanda. (Afr J Reprod Health 2014; 18[1]: 61-70).Keywords: Circumcision, device, nurses, Rwanda, safety, task-shifting
      PubDate: 2014-04-11
      Issue No: Vol. 18 (2014)
       
  • Current and Predicted Fertility using Poisson Regression Model: Evidence
           from 2008 Nigerian Demographic Health Survey
    • Authors: AF Fagbamigbe, AS Adebowale
      Abstract: Nigeria with persistent high growth rate is among top ten most populous countries. Monitoring key mechanisms of population dynamics particularly fertility in Nigeria is long overdue. Periodical availability of data on fertility and other demographic indices is scarce, hence this study. Our objective was to build a non-linear model to identify fertility determinants and predict fertility using women’s background characteristics. We used 2008 Nigeria Demography and Health Survey dataset consisting of 33,385 women with 31.4% from urban area. Fertility was measured using children ever born (CEB) and fitted into multi -factors additive Poisson regression models. Respondents mean age was 28.64±9.59years, average CEB of 3.13±3.07 but higher among rural women than urban women (3.42±3.16 vs 2.53±2.79). Women aged 20-24years were about twice as likely to have higher CEB as those aged 15-19years (IRR=2.06, 95% CI: 1.95-2.18). Model with minimum deviance was selected and was used to predict CEB by the woman. (Afr J Reprod Health 2014; 18[1]: 71-83).Keywords: Fertility, Incidence rate ratio, Poisson prediction, children ever born, Nigeria,
      PubDate: 2014-04-11
      Issue No: Vol. 18 (2014)
       
  • Evaluating the benefits of incorporating traditional birth attendants in
           HIV Prevention of Mother to Child Transmission service delivery in
           Lilongwe, Malawi
    • Authors: G Hamela, C Kabondo, T Tembo, C Zimba, E Kamanga, I Mofolo, B Bulla, C Sellers, RC Nakanga, C Lee, F Martinson, I Hoffman, C van der Horst, MC Hosseinipour
      Abstract: The objective of our intervention was to examine the benefits of incorporating traditional birth attendants (TBA) in HIV Prevention of Mother to Child Transmission (PMTCT) service delivery. We developed a training curriculum for TBAs related to PMTCT and current TBA roles in Malawi. Fourteen TBAs and seven TBA assistants serving 4 urban health centre catchment areas were assessed, trained and supervised. Focus group discussions with the TBAs were conducted after implementation of the program. From March 2008 to August 2009, a total of 4017 pregnant women visited TBAs, out of which 2133 (53.1%) were directly referred to health facilities and 1,884 (46.9%) women delivered at TBAs and subsequently referred. 168 HIV positive women were identified by TBAs. Of these, 86/168 (51.2%) women received nevirapine and 46/168 (27.4%) HIV exposed infants received nevirapine. The challenges in providing PMTCT services included lack of transportation for referrals and absence of a reporting system to confirm the woman’s arrival at the health center. Non-disclosure of HIV status by patients to the TBAs resulted in inability to assist nevirapine uptake. TBAs, when trained and well-supervised, can supplement efforts to provide PMTCT services in communities. (Afr J Reprod Health 2014; 18[1]: 27-34).Keywords: Traditional Birth Attendants, PMTCT, Malawi
      PubDate: 2014-04-11
      Issue No: Vol. 18 (2014)
       
  • Prevalence and Determinants of Adherence to Highly Active Anti-Retroviral
           Therapy Amongst People Living with HIV/AIDS in a Rural Setting in
           South-South Nigeria
    • Authors: AO Oku, ET Owoaje, OO Oku, E Monjok
      Abstract: Adherence to HAART is necessary to achieve the best virologic response and lower the risk of drug resistance amongst People living with HIV/AIDS (PLHIV). However, there is limited documentation of adherence amongst patients on HAART in the south-south region of Nigeria. This study aimed to determine the prevalence and determinants of adherence to HAART amongst PLHIV in a rural setting in Cross River State. A descriptive cross-sectional study was conducted among 393 patients on HAART attending the Heart to Heart centre Ugep using an interviewer-administered questionnaire. Adherence was measured via self report and patients were termed adherent if they took at least 95% of prescribed doses. The self reported adherence rate based on a one week recall was 50.4%. The main reason for skipping doses were being busy (50.6%), simply forgetting to take medications (43.8%) and religious constraints (16%). Perceived improved health status [OR 2.7; CI: 1.37-5.39], Non use of herbal remedies, [OR 1.8; 95% CI: 1.23- 2.64] and ARV regimens devoid of dietary instructions [OR 1.49; 95% CI: 1.07- 2.06] were significant predictors of adherence. The adherence rate reported in this study was low. Appropriate adherence enhancing intervention strategies targeted at use of simplified ARV regimens and discouraging herbal use is strongly recommended. (Afr J Reprod Health 2014; 18[1]: 133-144).Keywords: Adherence, PLHIV, HAART, rural setting, Nigeria.
      PubDate: 2014-04-11
      Issue No: Vol. 18 (2014)
       
  • The Knowledge Base and Acceptability of Prenatal Diagnosis by Pregnant
           Women in Ibadan
    • Authors: AOA Adekanbi, OO Olayemi, AO Fawole
      Abstract: This cross-sectional study evaluated knowledge and acceptability of prenatal diagnosis among 500 pregnant women at the University College Hospital, Ibadan. Most participants were aged 25-34 years , self-employed, Muslim, monogamy, secondary school leavers, on income of < ₦10,000.00 (US$ 67.00)/month. Attitudinal mean score was dependent on age (p = 0.006), educational attainment (p = 0.001), marital status (p = 0.025) and religion (p = 0.012). Knowledge mean score was influenced by marital status (p = 0.028). Overall, acceptance of prenatal diagnosis was high. There was a direct correlation between acceptance and educational attainment: 41.5%, 31.5%, 19%, 19% of women who agreed to have prenatal diagnosis had tertiary, secondary school, primary school and no formal education respectively. Determinants of acceptability were age, educational attainment, marital status and religion. Being married significantly affected knowledge scores, while tertiary education, being divorced, unskilled and self-employed positively influenced attitude towards prenatal diagnosis. (Afr J Reprod Health 2014; 18[1]: 127-132).Keywords: Prenatal Diagnosis Knowledge Acceptance
      PubDate: 2014-04-11
      Issue No: Vol. 18 (2014)
       
  • Estimating the Influence of Maternal Height on Under-Five Mortality in
           Nigeria
    • Authors: NY Enwerem, AC Obirieze, DM Bishai
      Abstract: This study uses a nationally representative data sample to assess the effect of maternal height as an intergenerational influence on under-five mortality. Data from the 2003 and 2008 Nigerian Demographic Health Survey (NDHS) (n=41,005) selecting women aged 15 to 49yrs whose most recent births were within 5 years (n=23,568), were analyzed. The outcome measure was under-five mortality. Independent variables included maternal height categorized as ≥63inch, 61-62.9inch, 59.1-60.9inch, <59.1inch. Confounding factors were controlled for. A multivariable logistic regression was used to obtain odds ratio estimates along with their respective confidence interval. After adjusting for confounding factors, we found that each 1inch increase in maternal height, was associated with a decreased odds of mortality OR 0.98(95%CI 0.97-0.99). The OR of under-five mortality when comparing women ≥63inch versus women <59.1inch was 1.13(95%CI 0.98-1.31). The population attributable fraction of child death due to maternal short stature was 0.36. (Afr J Reprod Health 2014; 18[1]: 54-60).Keywords: Under-Five Mortality, Maternal height, Intergenerational Influences.
      PubDate: 2014-04-11
      Issue No: Vol. 18 (2014)
       
  • Prevalence and Correlates of Maternal Anemia in Rural Sidama, Southern
           Ethiopia
    • Authors: S Gebremedhin, F Enquselassie, M Umeta
      Abstract: In order to assess the prevalence and correlates of prenatal anemia, a survey was conducted among 700 randomly selected pregnant women in rural Sidama, Southern Ethiopia. The prevalences of anemia, Iron Deficiency (ID) and ID anemia were 31.6%, 17.4% and 8.7%, respectively. The burden of anemia was significantly high among illiterates, women devoid of self-income, lowlanders, multiparas and women aged 25-34 years. Women who weren’t on iron-folate supplementation had 1.90 (95% Confidence Interval (CI): 1.14-3.19) times increased odds of anemia. Anemia was associated with ID, zinc deficiency and elevated C-reactive protein with odds ratio of 2.46 (95%CI: 1.63-3.73), 2.29 (95%CI: 1.62-3.23) and 1.98 (95%CI: 1.12-3.47) respectively; however, it was not associated with vitamin A deficiency. Though ID was a significant correlate of anemia, only 11.8% of anemia was attributable to it. Zinc, iron and vitamin A deficiencies did not show synergistic interaction in associating with anemia. (Afr J Reprod Health 2014; 18[1]: 44-53).Keywords: Maternal nutrition, maternal anemia, anemia in pregnancy
      PubDate: 2014-04-11
      Issue No: Vol. 18 (2014)
       
  • Barriers to Skilled Birth Attendance: A Survey among Mothers in Rural
           Gambia
    • Authors: PM Lerberg, J Sundby, A Jammeh, A Fretheim
      Abstract: The objectives of this cross-sectional survey were to identify the most important barriers for use of skilled attendance during childbirth by women in rural Gambia. We also assessed information received during antenatal care, preparations made prior to childbirth, and experiences and perceptions that may influence the use of skilled birth attendance in rural Gambia. The most frequently stated barriers for giving birth in a health facility were not having enough time to go (75%), and lack of transport (29%). The majority of the women (83%) stated that they preferred having a health worker attending their childbirth. More than seventy percent of the participants gave birth attended by a traditional birth attendant, but only 27% had intended to give birth at home. Sixty-four percent had made advance arrangements for the childbirth. Only 22% were informed about expected time of birth during antenatal care. Our findings suggest that the participants hold the knowledge and motivation that is necessary if practices are to be changed. Interventions aiming at ensuring timely transport of women to health facilities seem key to increased use of skilled birth attendants. (Afr J Reprod Health 2014; 18[1]: 35-43).Keywords: Childbirth, maternal health services, access, barriers, birth preparedness, complication readiness
      PubDate: 2014-04-11
      Issue No: Vol. 18 (2014)
       
  • Mother-Child Communication about Sexual Health, HPV and Cervical Cancer
           among Antenatal Clinic Attendees in Johannesburg, South Africa
    • Authors: KA Leser, SA Francis
      Abstract: Parent-child communication about sexual health is considered an effective strategy for encouraging safe sexual practices among youth. This study used a brief survey to examine mother-child communication among 86 antenatal clinic attendees in Johannesburg, South Africa. Eighty-five percent of mothers reported having enough information to discuss HIV/AIDS prevention with their children, while only 36% reported having enough information to discuss HPV/cervical cancer prevention. Thirty-seven percent of mothers who reported being comfortable discussing HIV/sexual health with their child actually discussed these topics with their child; while 58% of mothers who reported being comfortable did not discuss HIV/sexual health with their child. Future research and program planning efforts should focus on identifying the best strategies to educate South African mothers on HPV and cervical cancer, so that mothers can effectively communicate their knowledge about these topics to their children. (Afr J Reprod Health 2014; 18[1]: 123-126).Keywords: Sexual health, communication, HPV, cervical cancer
      PubDate: 2014-04-11
      Issue No: Vol. 18 (2014)
       
  • Predictors of Contraceptive use Among Female Adolescents in Ghana
    • Authors: G Marrone, L Abdul-Rahman, Z De Coninck, A Johansson
      Abstract: Adolescent girls in Ghana still face a number of challenges accessing reproductive/sexual health services despite efforts to improve their accessibility. This paper explores the key socio-demographic factors associated with contraceptive use amongst adolescent girls in Ghana using the 2008 Ghana Demographic and Health Survey (GDHS). Data from the 2008 GDHS was analyzed. Socio-demographic variables were selected to assess their interaction with contraceptive use. Multivariable regression analyses were performed. Odds ratios and confidence intervals were computed. Place of residence and marital status were the most important predictors of contraceptive use among sexually active adolescents. Rural residents were less likely to use contraceptives compared to urban residents (OR 0.32, CI 0.12–0.84, p=0.021) as well as married respondents compared to their unmarried peers (OR 0.27, 95% CI 0.11-0.67, p=0.005). The accessibility of reproductive/sexual health services needs to be improved and promoted in rural areas and among married adolescent women. (Afr J Reprod Health 2014; 18[1]: 102-109).Keywords: Adolescents, Contraception, Determinants, Ghana, GDHS
      PubDate: 2014-04-11
      Issue No: Vol. 18 (2014)
       
  • Gender Based Violence and its Effects on Women’s Reproductive
           Health: The Case of Hatcliffe, Harare, Zimbabwe
    • Authors: F Mukanangana, S Moyo, A Zvoushe, O Rusinga
      Abstract: Gender based violence (GBV) negatively impacts on women’s reproductive health (R.H) and is contrary to human rights and RH statutory instruments. The study triangulates quantitative and qualitative research methods with women in the reproductive age group being the target group. The study noted that 95% of the respondents experienced physical violence, 31% rape by a stranger, 92% spousal rape and 65% forced marriages. Socio-cultural, religious, economic and policy implementation factors underlie a culture of silence that prevails among the victims of GBV. The study recommends economic empowerment of women and information, education, counselling pertaining to the negative effects of GBV to both males and females. There is need for education about grievance procedures and scaling up of policy enforcement in order to curb the gruesome effects of GBV. (Afr J Reprod Health 2014; 18[1]: 110-122).Keywords: physical abuse, sexual violence, forced marriages, Hatcliffe, Zimbabwe
      PubDate: 2014-04-11
      Issue No: Vol. 18 (2014)
       
  • The Effect of Educational Intervention on Family Planning Knowledge,
           Attitudes, and Practices Among Married Women in a Military Barrack in
           Northern Nigeria
    • Authors: AG Abdulrazaq, S Kabir, NS Mohammad, IH Suleiman
      Abstract: Army barracks in Nigeria have low contraceptive prevalence rates (CPRs) and many children per family. The aim of this interventional study, involving 963 married women, is to determine the impact of health education on family planning knowledge, attitudes, and practices among married barrack women. The intervention group attended a 50-minute health talk and demonstrations on family planning methods. In the intervention group, the mean knowledge score rose significantly, from 5.5 points to 7.8 points post-intervention (t = -16.7281, p = 0.0000, df = 460). In addition, the CPR increased significantly, from 11.8% at baseline to 22.4% post-intervention (McNemar’s χ2 = 125.41, p = 0.0000). Such significant changes were not noted in the control group. We conclude that health education is an effective intervention for improving knowledge about and attitudes towards contraceptives and their use among married women in military barracks in Nigeria. Intense and sustained health education is therefore recommended in addressing the low CPR in Nigeria. (Afr J Reprod Health 2014; 18[1]: 93-101).Keywords: Impact, educational, intervention, family, planning, women.
      PubDate: 2014-04-11
      Issue No: Vol. 18 (2014)
       
  • Components of Maternal Healthcare Delivery System Contributing to Maternal
           Deaths in Malawi: A Descriptive Cross-Sectional Study
    • Authors: VC Thorsen, T Meguid, J Sundby, A Malata
      Abstract: In Malawi, it has been observed that some women are dying even when they reach a comprehensive emergency obstetric care facility where the quality is expected to be high and the maternal mortality low. The objective of this study was to describe shortcomings within the maternal healthcare delivery system that might have contributed to maternal deaths in the district of Lilongwe. Retrospectively, 14 maternal deaths that occurred between January 1, 2011 and June 30, 2011 were reviewed. Interviews were conducted with healthcare workers who provided care to the deceased women. Triangulated data from the respective medical charts and interview transcripts were analyzed using a directed approach to content analysis. Excerpts were categorized according to three main components of the maternal healthcare delivery system: skill birth attendant (SBA), enabling environment (EE) and referral system (RS). Most of the shortcomings identified were grouped under SBA. They included inadequate clinical workups and monitoring, missed and incorrect diagnoses, delayed or incorrect treatment, delayed referrals and transfers, patients not being stabilized before being referred and outright negligence. The SBA component should be investigated further. Interventions based on evidence from these investigations may have a positive impact on maternal mortality. (Afr J Reprod Health 2014; 18[1]: 15-25).Keywords: maternal mortality; maternal death review; healthcare delivery system; skilled birth attendant; Malawi
      PubDate: 2014-04-11
      Issue No: Vol. 18 (2014)
       
  • Editorial: Traditional Versus Birth Attendants in Provision of Maternity
           Care: Call for Paradigm Shift
    • Authors: F Okonofua, R Ogu
      Abstract: No Abstract
      PubDate: 2014-04-11
      Issue No: Vol. 18 (2014)
       
  • Editorial: Le Traditionnel contre ls accoucheuses dans la dispensation de
           soins de maternité: Appel à un changement de paradigme
    • Authors: F Okonofua, R Ogu
      Abstract: No Abstract
      PubDate: 2014-04-11
      Issue No: Vol. 18 (2014)
       
 
 
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