Poster session on Sexuality and reproductive health (1)

The objectives of this study are to identify the situation of children infected and affected by HIV/AIDS, the children’s primary caregivers, and the needs and the priority of the needs of the children. This study utilized a combination of three methods to collect data such as synthesizing information from available secondary documents, quantitative study and qualitative study. More than a half of primary caregivers for children infected and affected by HIV are over 60 year-old, bad health, and low income. 94% of households said that their income is not sufficient to spend. 44.4% of households have unstable income. About 24% of children infected and affected by HIV are living in the houses with poor condition. The situation of physical and psychological health of the HIV-infected children is very bad. The biggest difficulty for children affected by HIV/AIDS is access to education because of lack of money to pay tuition fees, and discrimination. The children suffer from the discrimination in both their communities and their families. The first needs of the whole children is educational support, the second is medical examination and treatment support and the third is the support related to nutrition. Key words: HIV-infected children, children affected by HIV, support needs, primary caregivers, maternal or paternal grandparents...

Unmet need is a widely used family planning indicator, and in 2008 it was added to the set of MDG indicators. Yet there is considerable confusion about what “unmet need” represents, reflecting lack of clarity about the underlying concept. Unmet need is commonly interpreted as tantamount to unsatisfied demand for contraception. But the conventional unmet need indicator does not use survey items asking women whether they want to use contraception, nor does it use any measures of access to contraception. Moreover, if reducing unmet need is an explicit policy goal, then program design should be informed by a good understanding of reasons for unmet need. The aims of this paper are: (i) to clarify what the widely used estimates of unmet need actually represent; (ii) to explore reasons for unmet need, with the aim of deepening our understanding of the policy and programmatic challenge. After discussing the concept (and clarifying what it does and does not represent), we conduct an extensive and thorough analysis of DHS data on reasons for non-use in surveys from 1990 to the present, looking for societal variation and variation according to stage of transition. Programmatic implications of the main reasons for unmet need are identified.

The ICPD represented a “quantum leap” for population and development policies as it involved a paradigm shift from the previous emphasis on Demography and Population Control to Sustainable Development and Reproductive Rights. Earlier, TFR and CPR used to be the fixation of most population programme. But a revamp in the Family Welfare Programme, from the earlier approach of provider centric-target oriented approach to client centered-target free approach now all couples to decide freely on number, spacing, and timing of childbearing. This paper examines the change in patter of use of family planning methods and the socio-economic- demographic & program factors that influences couples desire to space between children and hence shift from adopting permanent method to reversible methods by using service statistics and survey data in last three decades. There is a clear trend in shifting from acceptance in limiting methods to spacing over time. The timing of limiting and stopping or spacing behaviour is mainly determined by the couple’s desired family size, number of surviving children, sex composition of surviving children and other motivating factors such as cost, demand, opportunity, and individual costs. India is more informed on spacing and thus the re positioning of family planning helps to ‘India Shining’.

Latino population in the United States has a lower prevalence of vasectomy than the non-Hispanic white population. A body of research has considered that cultural perceptions about masculinity might explain why Latinos are less likely to undergo vasectomy. Latino population has experience a limited access to health care which might explain the lower prevalence of vasectomy among Latino population in the United States. We conducted logistic regression to analyze the relationship between the perception about the decision of men to undergo vasectomy and the frustrated demand for female sterilization. We also observed how other women’s experience might influence attitudes toward partners’ willingness to obtain a vasectomy. Finally, in order to have an insight into attitudes toward vasectomy among Latino men, we analyzed the information from the two focus groups conducted in El Paso, Texas. We find evidence that although some Latino men are willing to undergo vasectomy, they face economic and labor situations that prevent them to obtain the procedure.

Northern Nigeria’s infant and child mortality rates have been stagnant or rising since 2005. In 2009 we became part of a partnership program to improve maternal, newborn, infant and child care in four Northern Nigeria states. Control Local Government Areas received less-intense statewide policy changes, while the intervention zones received these state policies plus integrated interventions at primary health care posts and development of a community-based service delivery (CBSD). We assessed changes in maternal, newborn, and child health (MNCH) care and services among women with births in the previous five years by comparing data from surveys of 6,345 women in 2009 and 3,320 women in 2011. Chi-square and t-tests document significant improvements in several maternal newborn, infant, and childcare practices. We found that pregnant women with antenatal care visit during the most recent pregnancy increased from 25% to 46%, 58% and 62% in the control, low intensity and high intensity areas, respectively. In general, the greatest improvements in MNCH care are seen among women in the communities with more interactions and potentially more intense CBSD activities. Regressions showed the differential impact of these interventions by social and economic vulnerability, with less impact in the most vulnerable communities.

Background: Chitungwiza urban PMTCT programme has shown an increase in the number of known HIV-positive pregnant women enrolling in antenatal care (ANC). In 2009, 116 (8.4%) out of 1,376, booked for ANC with known HIV-positive status and in 2010 they were 79 (11.1%) out of 712. It was not known whether these pregnancies were planned or unplanned.

Methods: A descriptive, cross-sectional study was conducted in Chitungwiza from April-September 2011. Multi-gravida women enrolled in the PMTCT programme with known HIV-positive status (n=170) were interviewed using an interviewer-administered questionnaire and focus group discussions of 10-15 women. Quantitative data was analysed using Epi- Info Version 3.3.

Results: Of the 170 respondents, 137 (80.6%) experienced unplanned repeat pregnancies. Reasons for becoming pregnant varied: 75 (44.1%) reported their pregnancy was due to pressure from their partner, 32 (18.8%) were denied the right to use contraception by partners or health workers and 87 (51.2%) respondents could not afford these methods.

Conclusion: The HIV-positive women in this study faced challenges in controlling their fertility and experienced unplanned pregnancies. Chitungwiza municipality should waive fees for contraceptives and make long-acting and permanent FP methods freely available.

In many developing countries, use of the private sector for healthcare, even among the poor, is high. Yet data on private health providers such as their total number and the types of services they provide is often limited. This paper presents results from a unique data collection effort carried out in Lagos and five other states of Nigeria in which all private health facilities in these states were identified and surveyed. At each facility, data was collected on the physical infrastructure, the types of services offered, and the quality of family planning services delivered at the facility. We first present lessons from the data collection effort itself and provide useful suggestions for others seeking to conduct similar exercises elsewhere. We then analyze the geographic distribution of private providers, the type of services they provide, and the quality of family planning practices delivered by private providers in these states.

Objective: To examine association between social economic attributes (often reported at macro-level) and contraceptive use
Methods: Data were accrued from the Ugandan baseline survey of a multi-country three-year prospective study focusing on the role of family planning on Family Health and Wealth. A total of 500 couples were enrolled in Kyengera-parish, Wakiso district, Uganda.
Inequalities defined as differences in population attributes (wealth, ethnicity, health status-BMI category, parity, education and occupation) were assessed for association with contraceptive use (Yes/No). Analysis used descriptive statistics and at bivariate and multivariate, generalized linear models using binomial family and a log link with robust standard errors to obtain Prevalence Risk Ratios (PRRs) and their 95% CI.
Results: Data of 499 couples are presented. Men were older than women, 34 (7.9) and 27 (6.5) years, respectively. Majority (70%) of women reported being in monogamous unions, of parity 2 or higher (70%), education level of secondary or higher (67%), involved in manual or clerical work (71%) and belonging to Christian-faith (66%). Contraceptive prevalence rate was 52%, and was significantly higher among parity of 2 or higher. Health status, household wealth and education level were not associated with contraceptive use

The Latin American countries have experienced, albeit at different speeds and intensities, a sustained fertility decline. Among the factors responsible for decline, the increase in prevalence of modern contraceptive methods is point out as one of the main proximate determinants of fertility decline. Given this context, this paper aims to analyze contraceptive prevalence and the main types of methods known and used by women, according to the type of union for two representative countries of the low level of fertility in Latin America, Brazil and Mexico. The interest in assessing those dimensions according to the type of union is related to the fact that would be a new profile of women adopting the consensual union in the region. Firstly, we present the proportion of women in each type of union and a short description of these women's profile. After that, we do an descriptive analysis of the prevalence and the contraceptive methods known and used by women, according to the union type. The analysis is performed by education. We expect this work contributes to the identification of different profiles of contraceptive use, providing inputs for policies related to fertility planning for all social groups and ensure universal access to reproductive rights.

