Poster session on Sexuality and reproductive health (1)

Casual heterosexual sex remains a significant contributor to HIV transmissions in Ghana, as well as many other countries in sub-Saharan Africa. With the PRECEDE framework as a conceptual guide, the study used data from the 2008 Ghana Demographic and Health Survey (GDHS) to assess the socio-demographic, economic and spatial factors influencing unprotected casual heterosexual sex among Ghanaian men and women. Results from binary logistic regression models revealed both protective and risk factors associated with unprotected casual heterosexual sex, with variations between men and women. A positive significant association between women aged 35-39 years and unprotected casual heterosexual sex emerged, while an inverse association was found for women living in the Eastern Region and women with exposure to print media. Men of Christian or Traditional religion were positively associated with unprotected casual heterosexual sex, while the reverse was true for men with middle/JSS or secondary/higher education, men living in the Upper East Region, and men with exposure to television. These findings emphasise the undiminished need to tailor interventions to the unique needs and circumstances of specific population subgroups.

Contraceptive use dynamics plays the vital role for the fertility reduction and empowered women in Bangladesh which is indeed one of the most substantial achievements for the Millennium Development Goals (MDGs). It is to identify the factors associated with contraceptive use and it seems imperative to know the issues related to contraceptive use through which fertility can be controlled. However, in Bangladesh though the rate of fertility has been declined for increasing use of contraceptives, but it is still far from replacement level. In this study, an attempt has been made to examine the role of contraceptive use dynamics for the fertility reduction in using nationally representative data from Bangladesh Demographic and Health Survey (BDHS), 2007. The study also emphasis on the issues related to contraceptive use and women autonomy and empowerment, which directly or indirectly have impact on fertility reduction in Bangladesh. The prominent multivariate technique such as logistic regression has been used to identify the important factors affecting contraceptive use, autonomy and empowerment. The result indicates that the contraceptive users are more empowered and autonomous than non-contraceptive users. Bongaarts model has been used to know the impact of contraceptive use on fertility reduction.

This paper examine the trends and differentials in contraceptive use in Egypt using data from the 1988, 1995, 2000 and 2005 Egypt Demographic and Health Surveys. The contraceptive practice rate has increased from 30.3 percent in 1984 to 59.2 percent in 2005. This represents a relative increase of 95.4 percent. In 1984, 19.2 percent of rural women, compared with 45.1 percent of urban women, were using contraception. However, by 2005, the proportion of women using contraception has increased significantly in rural areas, 56.8 percent compared with 62.6 percent in urban areas. From 1984 to 2005, the relative increase of contraceptive use for rural women was 195.8 percent compared with 38.8 percent for urban women. The difference in contraceptive use in rural and urban areas in Egypt was less in 2005 compared with 1984 and 1988. In sum, the overall convergence in contraceptive use is evident among rural and urban women in Egypt. An analytical model composed of socioeconomic development, status of women, and family planning variables is tested using logistic regression. Decomposition analysis suggests that the shift in population structure favored increased contraceptive use in Egypt.

The objective of this paper is to present an update of estimates of induced abortion in Brazil based on the statistics of hospitalization for abortion in national and regional levels, using as a data source the Hospital Information System of the Unified Health System (SIH-SUS) for the years 2000 to 2010. The estimation of the incidence of abortion is carried out by the method known as AICM, proposed by Singh and colleagues, after the necessary adjustments for the Brazilian data. The results indicates that induced abortion rates are declining in Brazil in all regions (except the North), although the incidence of induced abortion is still high for a country where contraceptive use is high, which indicates the existence of significant flaws in the use of contraception and the need to correct them. Other important findings relate to age: as the women's age increases, there is also an exponential increase in the number of hospitalizations for abortion in relation to the number of live births, and a decrease in abortion rates in relation to the female population in childbearing age (15-49).

This paper contributes to understanding the associations between a culturally sensitive family planning program and fertility preferences. Previous research on family planning programs are largely focused on addressing unmet need for contraception. Yet, scholars have asserted that even if the expressed need for contraception is met, fertility will remain above replacement levels. Needed to propel low fertility and accelerate economic developments are programs that influence explicit desires to limit child-bearing at low parities. This paper uses longitudinal data from an economically adverse setting (the Navrongo experiment) in Northern Ghana to examine the impact of culturally sensitive family planning program on fertility preferences. Results show that fertility desires are largely a function of the Navrongo experiment net of individual socio-economic characteristics. Involving traditional social institutions in health planning and services is significantly related to promoting preferences for smaller family sizes among women. Overall, women seem to be shifting towards smaller family sizes although decline in preferences is comparatively modest to precipitate transition to low fertility. We discuss the implications of our findings in the context of policy frameworks to increase access to contraception in developing countries.

Alcohol use before sex may serve as a conduit for engaging in unsafe sexual practices such as unprotected sex, with attendant implications for HIV transmissions. Using data from the 2008 Ghana Demographic and Health Survey (GDHS), this study assessed the socio-demographic, economic and spatial predictors of alcohol use before casual sex among men in Ghana. With the PRECEDE framework as a conceptual guide, binary logistic regression models were run to assess the phenomenon. The results indicate that men older than 40 years were significantly more likely to use alcohol before casual sex. It also became evident that never married men, widowers or divorced men, as well as men in union but no living with their partners were significantly more likely to use alcohol before casual sex. Further, a significant inverse association was observed between men with exposure to television and alcohol use before sex. The study demonstrates the alcohol-casual sex linkage, thereby underscoring the need to incorporate alcohol related sexual risk-taking in HIV prevention programmes and efforts.

The objective of this work is to study the political discussion on the issue of abortion in Uruguay, with the guiding idea that the democratization of the country played a fundamental role to make the discussion about abortion more visible, to expand the debate and to prepare new public policies. Regarding the methodological procedure, the historical perspective - including the description of the demographic scenario – uses as sources of information official documents, of the civil society and of media and literature, in two periods: from the beginning of the military dictatorial period to the beginning of the democratic transition, 1973 to 1985, and from the beginning of the democratic transition to the present democracy, 1985 to 2012. The latter, in turn, is divided in two: from the beginning of democracy to the rise to power of socialist governments, 1985 to 2004, and from the beginning of socialist governments until the present day, 2005 to 2012. The discussion of the subject, on the political agenda since the 1980s, was emphasized in the first decade of this century, culminating in 2012 with the approval by the Parliament of the Law of Voluntary Interruption of Pregnancy, which won on October the presidential approval.

Globally more than 350,000 women annually die from complications of pregnancy or child birth. The problem of unsafe abortion is complicated by limited availability of services and restrictive laws. It is estimated that over 97% of all unsafe abortions occur in sub-Saharan Africa due unsafe facilities, untrained providers or both. Understanding the burden and potential areas for intervention is complicated by the lack of data. Data used here came from 292 public and private facilities and 2,680 women seeking post abortion care over a one month period.

Results show that abortion complications are a major cause of morbidity with 37% of all women seeking post abortion care suffering a severe complication. Interference with pregnancy was associated with 2.9 times higher odds of having a severe complication as compared to those who reported no interference with the pregnancy. Second trimester abortions had about 50% higher odds of a severe complication than first trimester abortions. Delay in reaching facility from onset of symptoms was associated with higher odds of a severe complication. Higher proportion of second trimester abortions and those with severe complications had longer hospitalization. About 65% of all abortion clients are managed using vacuum aspiration, 76% were given oxytocics and 55% received contraception.

The research focused on establishing the causes of low contraceptive use in the West Nile. Uganda. The study aimed at providing a clear basis for policy measures so as to reduce or curb down the high and rapidly growing population growth rate levels. The study used secondary data from the 2006 Uganda Demographic Health Surveys (UDHS). In this study, the sample size of 8369 women aged 15-49years from the districts, Adjumani, Arua, Koboko, Nyadri, Nebbi, and Yumbe was used. The researcher used both univariate and bivariate analysis. In bivariate analysis Correlations and Chi square test was also used to measure the degree of association between the dependant variable and the independent variables.
Results indicate a significant relationship was established between mother’s age at first birth, birth interval and infants dead for those which were demographic in nature, as well as education level, religion, marital status and wealth index for socio-economic variables of which all factors were statistically significant with infant mortality. The researcher recommended increasing the number of health facilities so as to supplement the few existing government and private facilities. This would increase the level of accessibility to contraceptives and family planning facilities especially to the rural majority.Our findings also sug

This study aims at estimating the incidence of induced abortion in Yogyakarta province, a province located in Central part of Java Island in Indonesia. Yogyakarta province is among the provinces with high coverage of maternal health care indicators, but is also known for high reliance to traditional method of contraception.

Two method estimation are be applied, the Abortion Incidence Complication method (AICM) and the Residual method. Data on abortion hospitalization were obtained from all hospitals in the five districts of the province, through direct data collection to the hospitals as well as from the provincial health office. Adjustment for under-reporting and misreporting were made by comparing the two sources of data.

The preliminary fndings reported 3071 cases of abortion hospitalization in 2009 in Yogyakarta province, or a rate of 3.3 per 1000 women age 15 to 49 years. Access to skilled care for miscarriage and abortion is measured with recent survey data and found to be significantly lower compared to access for other pregnancy related complications. Adjustment factor using the facility data is being explored for adjusting under-report in the survey data. The final step of the AICM process is determining the multiplier for which educated guess and existing literature will be used.