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      Fertility knowledge, contraceptive use and unintentional pregnancy in 29 African countries: a cross-sectional study

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          Abstract

          Objectives

          We examined the association between incorrect knowledge of ovulation and unintentional pregnancy and child among young women in sub-Saharan Africa countries.

          Methods

          Using Pearson’s Chi-square, t test, multiple logistic regression, and likelihood ratio test, we analyzed Demographic and Health Survey data (2008–2017) of 169,939 young women (15–24 year).

          Results

          The range of prevalence of incorrect knowledge of ovulation was 51% in Comoros and 89.6% in Sao Tome and Principe, while unintentional pregnancy ranged between 9.4% in the Republic of Benin and 59.6% in Namibia. The multivariate result indicates a strong association between incorrect knowledge of ovulation and unintentional pregnancy (OR = 1.17; p < 0.05) and unintentional child (OR = 1.15; p < 0.05).

          Conclusions

          Adolescent women (15–19) generally have poor knowledge of ovulation and are more likely to report an unintentional pregnancy/child than women between ages 20–24. To reduce the burden of unintentional child/pregnancy in Africa, fertility knowledge should not only be improved on but must consider the sociocultural context of women in different countries that might affect the adoption of such intervention programs. Pragmatic efforts, such as building community support for young women to discuss and share their experiences with professionals and educate them on fertility and sexuality, are essential.

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          Most cited references24

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          Adolescent sexual and reproductive health: The global challenges

          Adolescent sexual and reproductive health (ASRH) has been overlooked historically despite the high risks that countries face for its neglect. Some of the challenges faced by adolescents across the world include early pregnancy and parenthood, difficulties accessing contraception and safe abortion, and high rates of HIV and sexually transmitted infections. Various political, economic, and sociocultural factors restrict the delivery of information and services; healthcare workers often act as a barrier to care by failing to provide young people with supportive, nonjudgmental, youth-appropriate services. FIGO has been working with partners and its member associations to break some of these barriers-enabling obstetricians and gynecologists to effect change in their countries and promote the ASRH agenda on a global scale.
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            Persistent high fertility in Uganda: young people recount obstacles and enabling factors to use of contraceptives

            Background High fertility among young people aged 15-24 years is a public health concern in Uganda. Unwanted pregnancy, unsafe induced abortions and associated high morbidity and mortality among young women may be attributed to low contraceptive use. This study aims at exploring reasons for low contraceptive use among young people. Methods In 16 focus group discussions, the views of young people about obstacles and enabling factors to contraceptive use in Mityana and Mubende districts, Uganda were explored. The groups were homogeneously composed by married and unmarried men and women, between the ages of 15-24. The data obtained was analyzed using qualitative content analysis. Results Young men and women described multiple obstacles to contraceptive use. The obstacles were categorized as misconceptions and fears related to contraception, gender power relations, socio-cultural expectations and contradictions, short term planning, and health service barriers. Additionally, young people recounted several enabling factors that included female strategies to overcome obstacles, changing perceptions to contraceptive use, and changing attitude towards a small family size. Conclusions Our findings suggest changing perceptions and behavior shift towards contraceptive use and a small family size although obstacles still exist. Personalized strategies to young women and men are needed to motivate and assist young people plan their future families, adopt and sustain use of contraceptives. Reducing obstacles and reinforcing enabling factors through education, culturally sensitive behavior change strategies have the potential to enhance contraceptives use. Alternative models of contraceptive service delivery to young people are proposed.
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              Early marriage and sexual and reproductive health vulnerabilities of young women: a synthesis of recent evidence from developing countries.

              K Santhya (2011)
              To review current evidence on the links between early marriage and health-related outcomes for young women and their children. Every third young woman in the developing countries excluding China continues to marry as a child, that is before age 18. Recent studies reiterate the adverse health consequences of early marriage among young women and their children even after a host of confounding factors are controlled. The current evidence is conclusive with regard to many indicators: unintended pregnancy, pregnancy-related complications, preterm delivery, delivery of low birth weight babies, fetal mortality and violence within marriage. However, findings present a mixed picture with regard to many other indicators, the risk of HIV and the risk of neonatal, infant and early childhood mortality, for example. The findings call for further examination of the health consequences of early marriage. What are even less clear are the pathways through which the associations between early marriage and adverse outcomes take place. There is a need for research that traces these links. At the same time, findings argue strongly for programmatic measures that delay marriage and recognize the special vulnerabilities of married adolescent girls. (C) 2011 Lippincott Williams & Wilkins, Inc.
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                Author and article information

                Contributors
                aei11@txtstate.edu
                Journal
                Int J Public Health
                Int J Public Health
                International Journal of Public Health
                Springer International Publishing (Cham )
                1661-8556
                1661-8564
                9 April 2020
                9 April 2020
                2020
                : 65
                : 4
                : 445-455
                Affiliations
                [1 ]GRID grid.264772.2, ISNI 0000 0001 0682 245X, Department of Geography, , Texas State University, ; San Marcos, TX USA
                [2 ]GRID grid.264772.2, ISNI 0000 0001 0682 245X, Department of Criminal Justice, , Texas State University, ; San Marcos, TX USA
                [3 ]GRID grid.9582.6, ISNI 0000 0004 1794 5983, Department of Geography, , University of Ibadan, ; Ibadan, Nigeria
                [4 ]Center for Gender and Development, Ado-Ekiti, Ekiti State Nigeria
                [5 ]GRID grid.266869.5, ISNI 0000 0001 1008 957X, Department of Geography and Environment, , University of North Texas, ; Denton, TX USA
                Article
                1356
                10.1007/s00038-020-01356-9
                7275004
                32270234
                ccf2713e-0093-4910-9568-19ffef8fb530
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 27 May 2019
                : 2 March 2020
                : 17 March 2020
                Categories
                Original Article
                Custom metadata
                © Swiss School of Public Health (SSPH+) 2020

                Public health
                adolescence,reproductive health,knowledge of ovulation,fertility awareness,contraception,unintentional pregnancy,medical geography,africa

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