Sexuality and reproductive health

Usually, age at first marriage influences the quality of reproductive health services accessed by the women. Worth noting is that, usually early age at first marriage, goes hand in hand with illiteracy, low wealth quintile, and poor health seeking habits among others, hence leading to poor reproductive health. Using 2006 UDHS, results from the analysis revealed that women with low age at first marriage are less likely to observe reproductive health aspects for example, women less than 20yrs’ attendance of Antenatal care (ANC) was lower compared to their other counterparts (33% compared to 60%), and less likely to observe child birth care compared to their older counterparts (that is 46% versus 53%), though it is quite a slight difference. The results therefore portray that the lower age at first birth, the higher the vulnerability of women and the higher the age at first marriage the lower the vulnerability of women.

This paper tries to assess the causal mechanisms which lead to changing patterns of contraceptive use in a sample of countries in Sub-Saharan Africa, alongside improvements in socio-economic conditions and in particular, progress in educational attainment. Factors associated with socioeconomic status and the respective probability of contraceptive prevalence and desired family size are well established. Nonetheless, in spite of education raising awareness and increasing the chances of using contraception, a considerable share of educated women are classified as having an unmet need in the Demographic and Health Surveys (DHS). Given the recently revised and homogenized methods for analyzing the unmet need for family planning in the DHS, it is now possible to compare changes in contraceptive prevalence and obstacles to family planning over time. The paper presented here will investigate data from 19 countries in Sub-Saharan Africa with at least three rounds of DHS available. By applying age-period-cohort methods, we aim to establish interactions of contraceptive prevalence and obstacles to contraception with improvements in educational attainment, changing norms and values in ideal family size, opposition to family planning, family planning efforts and economic well-being over time.

Sexual risk behaviour among Nigerian adolescents is a major health concern. Efforts have been made to reduce teenage pregnancy and discourage child marriage in Nigeria yet, just 26% girls in northern Nigeria make it beyond primary school due to sexual vulnerability and over 600,000 Nigerians seek abortion each year while the HIV infection rates among young people aged 15-19 was put at 3.3% by UNFPA. This put 31.7% of the nation’s populace at HIV and STIs risk. Random sampling method was adopted in the investigation of 400 college students and rural adolescent girls sexual activities in Nigeria. Questionnaire and structured interviews were used to determine the level of success public enlightenment has achieved in curbing further spread of HIV and STDs. Findings reveal that rural adolescent girls are most vulnerable and there is positive correlation between education, exposure to media and sexual activity. Recommendations are also made based on the findings to strengthen media impacts in bringing about behavioural change on the subject matter with the consciousness of the discovery of this work that the media is one of the factors that put youths at risk of illicit sexual behavior and its despicable aftermaths and levers that can be used in preventive interventions.

Male's involvement has been recognized as a key facilitating factor to the women’s reproductive health. This paper analyzes the individual, familial and contextual factors affecting male involvement in the maternal health of their wives using data from 2005-06 National Family Health Survey-3.The analysis is based on information collected from men age 15-49, having a living child age 0-35 months at the time of survey. The findings reveal that over half of such men accompanied their wife for ANC when they were pregnant with their youngest child. Increasing education (AOR=2.32, p<0.10) and exposure to mass media (AOR= 1.65, p<0.05) are having significantly positive impact on male participation in ANC. However, increasing educational gap between husband and wife adversely affect the male participation in maternal health in India. Men from schedule castes and schedule tribes are the less informed group. Men in the central region are significantly less likely to get information about pregnancy complication from health providers (AOR= 0.67, p<0.10). Thus, there is an urgent need to adopt certain innovative approaches to enhance male participation in maternal health services right from timely ANC to safe deliveries, so that India can achieve the millennium developments goals relating to maternal and child health.

Reproductive and Child Health indicators are very important for the improvement and maintenance of health for women and children in any society. This study examines differentials in institutional delivery, child immunization coverage and contraceptive use by religion and also investigates public and private share in institutional delivery and source of obtaining modern spacing methods by Muslim and non-Muslim in Muslim densely populated states and India using data from India's DLHS-3. This paper adopts bivariate analysis to study the differentials by selected background characteristics. In all the indicators, non-Muslims have shown their glorious pictures as compared to Muslims at the national level as well as in the selected states. Substantial differences have been also noticed in public and private share in institutional delivery and source of obtaining modern spacing methods. West Bengal and Assam show highest level of differences for all of the indicators. In backward states of Uttar Pradesh, Jharkhand and Bihar it has been seen that both Muslim and non-Muslim women are increasingly availing private institution for delivery instead of public institutions. This study may help planners or policy makers to formulate various types of policy which will be helpful to reduce the prevailing differences between them.

Demographic and public health studies have indicated urban-rural differences in the utilization of antenatal care services. However, factors accounting for the urban-rural differentials in Antenatal Care use are unknown. The study used the 2008 Nigeria Demographic and Health Survey (NDHS) to examine the factors associated with the urban-rural differences in antenatal care utilization in Nigeria. Rural poor, rural non-poor, urban-poor and urban-non-poor models of antenatal care utilization were used in the study. Findings revealed a strong urban-rural differential in antenatal care utilization. The chi-square analysis showed that more urban-non-poor women received antenatal care (87.97%) than urban-poor (61.01%), rural non poor (75.77%) and rural poor women (34.62%). The logistic regression analysis revealed that women’s education and partner’s educational status are strong determinants of differentials in antenatal utilization across the four models in Nigeria. Other significant determinants are region, age of mothers, distance to health facility and number of living children with varying patterns across the four models.

Early marriage as well as early child bearing is rampant in India. Early child bearing has adverse effect on the mother and the newborn. In spite of global influence on the paradigm shift in reproductive health approach, no population in the world has yet met the goals set at the ICPD, and the predicaments are particularity acute in developing countries. This paper examines the relation between age at initiation of child bearing and utilization of maternal health care services among currently married women in India. The 3rd round of District Level Household and Facility Survey 2007-08 is the data source of the study. The study employed bi-variate and multivariate analysis. Insofar as the ANC, safe delivery and PNC is concerned the pattern of its utilization varies across the different segments of the society. The findings of the study reveals that the women who initiate child bearing before the age of 18 have a very low level of maternal health care services utilization than the women who initiate child bearing after the age 18. This difference is persistent in the subsequent birth order and across the background characteristics.
(Key Words: Child bearing age, maternal health, India)

In the Philippines, less than half of currently married women use a contraceptive method, a level which has remained stagnant in the past ten years. To get a clearer understanding of the contraceptive behavior of Filipino women, the study examines the changes in the patterns of contraceptive discontinuation and switching behavior over time using data from the 1993, 1998, 2003 and 2008 Philippine Demographic Health Surveys. The data show a decline in discontinuation for all methods except for withdrawal. Nearly half of discontinuations of rhythm and withdrawal are due to unintended pregnancy while side effects is the most common reason for discontinuing use of pills, IUD and injectables. Younger women (<30 years old), poor women, and less empowered women exhibited higher discontinuation rates than their counterparts. Results also show an upward pattern in the switching rates to modern methods regardless of the method of origin. Switching rates to modern methods are higher than the switching rates to traditional methods in all subgroups of women regardless of the initial method. The findings suggest the need to encourage women to maintain their contraceptive use particularly of modern methods and to focus efforts on the identified subgroups of women with higher risk of unintended pregnancies.

Access to benefits from inclusive development programmes, maternal-child health (MCH) care and family planning (FP) services can aid development of country’s health. Early efforts to combine these services are still untested and approved. Structural equation models utilize to examine the effect of inclusive development programme at village level on the relationship between MCH and FP service utilization. A cross-sectional District Level Household Survey (2007-08) covered 76,147 currently married women age 15-44 years through multi-stage stratified probability proportion to size sampling. It was found there were no specific pattern of common exogenous predictors except children ever born (p<0.05), mothers education (p<0.05) and wealth index of households (p<0.05) for the service utilization. Finding suggests that FP, MCH care services and inclusive development programs are introduce and available, the likelihood of adoption of services is higher, compared only one service is available in state. The rationale for integration of family planning and MCH care services with inclusive development programme at village level have been based on three grounds: improving the efficiency and effectiveness of programmes and services; meeting clients need from “one-stop” service; and accelerating the pace of health and demographic outcomes.

Background: RTI/STI are major public health concern amongst women especially in SEAR countries . Majority of women think menstrual problem and vaginal discharge as a part of their normal life and thus continue to suffer silently. Hence it is difficult to estimate the burden of RTI from clinic records and therefore data is extracted from ICMR community based study done in rural parts of the country. Multi level cluster sampling techniques was adopted and ever married women aged 15-45 years was taken as sampling unit.
Methods: Information with regards to characteristics of vaginal discharge, education level ,occupation etc was elicited from every sampled women .Also both the diagnosis made by ANM and medical doctor was recorded and compared.
Results : Out of 5567 of the sampled women ,16 per cent of the women were clinically diagnosed of RTIs that too belonging to low risk population and from villages. The results of logistic regression concluded that MTP, use of OC, high risk sexual behavior, and husband infected with urethral discharge may increase the probability of a women for contracting STIs.
Conclusion: The result demonstrating the association should not decrease the acceptance of IUD, OC but should be interpreted carefully.