Sexuality and reproductive health

This paper attempts to study the prevalence of contraceptive morbidity among the slum dweller married women, using Correspondence Analysis Technique. The study is based on a survey conducted during the year 2006 in the slum pockets of Guwahati City. Out of 1350 women interviewed, 767 are ever users of any contraceptive method, with 550 current users, the drop out cases thus numbering to 217. The most commonly used contraception method is tubectomy (36.2%), followed by pill intake (32.5%). Out of the 767 ever users, 181 reported to have faced some complicacy like weight problem, menstrual problems, RTI, general problems like weakness, tiredness, inability to work, unsteadiness, etc. Morbidity is highest (45%) in case of tubectomy. Among the morbid conditions, complications related to menstruation are found to be the highest. Weight problem is the highest among pill in takers. Correspondence analysis showed that contraceptive methods used and the type of complicacy involved is not independent of each other. In the Correspondence Map, proximity of ‘weight problem’ to the contraceptive method ‘pill’ indicates that weight problem is strongly associated with the use of contraceptive pills. Likewise proximity of ‘Condom’ to ‘RTI’ indicates higher frequency of RTI and related problems among condom users.

Two thirds of the youth become daily smokers before reaching 25 years of age, and few quit smoking in China. Unlike their counterparts in western countries, Chinese youth have limited knowledge about the harm that smoking can cause, which places them at risk of negative outcomes. Based on the data from 1st National Youth Reproductive Health Survey in 2009, using binominal and ordered probit models with a Heckman’s two-stage estimation procedure, this study examines the socio-demographic and life-style related determinants explaining both cigarette smoking and its frequency, respectively. The results indicate that both the occurrence of cigarette smoking and the frequency of cigarette smoking are mainly associated with lifestyle-related variables covering other nonsexual risk behaviors and sexual behavior. The conclusions reflect an urgent need for exploring the relationship between cigarette smoking and other health risk behaviors will be helpful for designing further tobacco control interventions among Chinese youth.

This paper is based on the results of the study “Evaluation the implementation of reproductive health care (RHC) policies for ethnic minorities in Vietnam” that was implemented in 2008 by the Institute for Population and Social Studies – NEU required by UNFPA. This study used a combination of three research methods (desk-study, quantitative survey, and qualitative survey). The report indicated that the strength of RHC policies is to clearly express the orientation of incentive RHC for ethnic minorities by setting up specific objectives and solutions towards better condition of human resources, natural and financial resources in the mountainous areas. However, there are some weaknesses: inconsistence and vagueness in terms for subjects of the policies, loopholes in policies, some infeasible objectives, illogicality, contradiction among policies, general criteria, overlapping, and some problems in policymaking procedure. The gaps of policy implementation related to issuing guidance for policy implementation, the dissemination of RHC policies to people, RHC models, human resources, essential health equipment and medicines, regular income-expense for the commune medical centers, are also found out. This paper gave some recommendations to enhance the quality of RHC services for ethnic minorities.

This paper examines the poor, rich differentials in contraceptive adoption in India. Study takes advantage of calendar data, which is first time available in Indian National Family Health Survey (2005-06), to deal with the differentials between poor and rich women in type and time to initiate contraceptive method. The initiation of postpartum contraceptive use analyzed from calendar data by selecting the first use of contraceptive in subsequent month after having a last birth in 5 years preceding survey. The study employed multinomial logistic regressions to investigate a variable indicating type of contraceptive method and Cox hazard regression model to examine timing of adoption of contraceptive, for those who use, the time from birth in months until contraception is started. Result shows that, there are significant gaps in modern contraceptive prevalence between the poor and rich. About 55 percent poor household women did not adopt contraceptive after having birth, for rich women this percentage was only 30. Nearly 35 percent rich and only 10 percent poor women have adopted spacing method, although the difference in adoption of sterilization is insignificant. Findings show that 71 percent rich women and only half of poor women have adopted spacing method within six months after delivery.

Though the contraceptive use in India has increased over time, the use of modern spacing
method remained low across socio-economic groups. The low use of spacing method may lead to
high infant mortality and increased maternal and child morbidities. This paper studies the factors
associated with contraceptive discontinuation with an emphasis on the socio-economic
differentials.
Utilizing the calendar data of National Family Health Survey (2005-06), a multiple decrement
life table approach revealed that about 40% of all modern spacing method users stop use within
12 months of initiating. The most likely stoppers were pill users (49%) followed by condom
users (44%). IUD users are the least likely to stop with 81% persisted to use the method after one
year. The main reason for discontinuation varied from the reasons like side-effects for pill and
IUD to method failure in case of traditional methods. Three types of discontinuations: failure,
switching and abandoned at the risk of pregnancy were analyzed. The multilevel multivariate
analysis suggests that the contraceptive method used, experience with the immediate previous
method, age, wealth status and parity of women were found to influence the discontinuation behavior.
A large amount of unexplained variation in discontinuation rates remains at the community level.

Whereas the coverage of prenatal care in much of rural sub-Saharan Africa has greatly increased, institutional deliveries continue to lag behind as a substantial share of rural women give birth outside clinic settings and without professional obstetric care. This study uses unique longitudinal data from rural southern Mozambique to examine both the probability of having an institutional delivery and the choice of clinic for institutional delivery as a function of individual and household characteristics and of location and characteristics of maternal and child health facilities. Spatial and multivariate regression analyses are employed to determine both additive and interactive effects of the two groups of factors in the context of high HIV prevalence and a massive scale-up of HIV testing, prophylaxis, and treatment services.

In Nepal, little information has been collected about sexual practice where HIV/AIDS prevalence is increasing. The main objectives of this paper are to explore the sexual behavior especially focusing on prevalence of risky sexual behavior and investigate the influencing factors of risky sexual behavior among college students. A self-administered questionnaire was completed by 1276 (636 male and 640 female) students. A composite index of risky sexual behavior was constructed. Association between risky sexual behavior and the explanatory variables was assessed in bivariate analysis using Chi-square tests. The associations were further explored using multivariate logistic analysis.

Male students were about 3 times (OR=2.8) more likely to be involved in risky sexual behavior than female students. Unmarried students, who received RH education, were less likely to be engaged in risky sexual behavior than married. On the other hand, students who consumed alcohol frequently, who exposure pornography, and who have unmarried friend with experience of sexual intercourse were more likely to be engaged in risky sexual behavior than their comparison groups. College students are exposed to health hazards through their sexual behavior. This problem should be addressed early by targeting these groups of high risk students.

Measuring progress in meeting the demand for family planning requires not only attention to levels and trends in contraceptive prevalence and unmet need for family planning but also assessment of the diversity of contraceptive methods used. We examine changes in contraceptive method mix from 1990 to 2011 for 188 countries and if trends in contraceptive prevalence are associated with the average effectiveness and concentration of methods used. We use annual Bayesian hierarchical model-based estimates of contraceptive prevalence and unmet need for family planning among married or in-union women aged 15-49 and apply the distribution of contraceptive users by method used from surveys at two time points (around 1990 and 2011). Female sterilization and the IUD were the two most common methods used worldwide and geographical differences in method mix profiles were large. Shifts were gradual over the past 20 years in the distribution of users by method and average effectiveness. The evidence does not suggest an association between increases in contraceptive prevalence and improvements towards a more balanced or effective method mix. We propose a measure of the effectiveness of contraceptive demand—one that incorporates unmet need for family planning—as a useful summary measure to describe improvements in meeting family planning demand.

Malaria continues to represent a major public health problem in areas of endemicity, with an estimated 225 million cases worldwide in 2009. The 2015 goals of the World Health Organization’s (WHO’s) Roll Back Malaria Partnership are to reduce global malaria cases by 75% from 2000 levels and to reduce malaria deaths to near zero through universal coverage by effective prevention and treatment interventions. Maternal health is linked with maternal education that results in greater utilization of modern health services. Educated women are better able to break away from tradition to use moderns’ means of safeguarding their own health and those of their children. Educated women are better able to use what is available in the community to their advantage. Pregnant women are vulnerable and exposed to malaria within the tropical countries. Based on the magnitude and the importance of the problem, the following objectives were assigned to this study:
• Describe the use of insecticide treated nets (ITNs) among pregnant women
• Identify socio-demographic factors which are statistically associated to the use of insecticide treated nets (ITNs) among pregnant women
• Examine the magnitude and sense of the influence of each determinant of the use of insecticide treated nets (ITNs) among pregnant women.

This study is based on 6007 subjects of reproductive age group (3201 males and 2806 females) referred for sero-positivity status at ICTC, IMS, BHU, Varanasi. Overall sero-positivity of HIV was 15.3% (18.1% in males and 12.2% in females) which increased 6-7 folds in the age group 35-49 years as compared to 15-24 years in both the sexes. Sero-positivity rate in male migrants was 43.1%, while in female migrants it was 18.7%. The history of multiple sexual contacts was about 3 times higher in males as compared to females; predominantly very high in male migrants (67.7%) compared to male non-migrants (15.8%). History of multiple sexual contacts was not uncommon in females migrants (25.0%) and 9.7% in non-migrant females. The sero-positivity rate with the history of multiple sexual contacts was 45.4% in males and 60.3% in females, while without history of multiple sexual contacts these were only 2.8% and 5.3% respectively. Sero-positive cases had on an average 3.6±1.7 various morbidity symptoms as compared to 0.7±1.1 in sero-negatives. Sero-positivity rate was more in those females who seemed apparently healthy compared to those presenting with some of the symptoms; males presenting with some symptoms HIV infection was 7 times higher than those without symptoms.