Antenatal women's childbearing practices at the Niger Delta university teaching hospital, Okolobiri Nigeria

Background: Overpopulation in a community or a country reflects high fertility desires of its citizens. A country can only progress meaningfully if its resources and amenities can provide for all its citizens. Objectives: To examine the childbearing practices of antenatal attendees at the Niger Delta University Teaching Hospital, Okolobiri, Nigeria and whether there is any suggestion of fertility decline or transition. Materials and Methods: A cross-sectional study of two hundred and fifty-two women who had antenatal care in the hospital during the study period. Data was collected using a structured self-administered questionnaire with a reliability coefficient of 0.85. Data collected were analysed using IBM SPSS Statistics version 25. Statistical significance was a p-value <0.05. Results: The mean age of the respondents was 30.5 ± 5.9 years. More than half (53.6%) had tertiary education and 39.3% had secondary education. Only 29.4% were housewives/unemployed. The median parity was 2 and 229 women accounted for previous deliveries of 596 babies. The median desired total number of children was 4 (range 1 to 8). More than half (56.3%) did not believe in spacing after the first child. Seventy-six (30.2%) had no knowledge of modern contraceptives. There was a significant relationship (p - 0.018) between child sex preference and number of births. Conclusion: With a current median parity of two children/woman and desired total number of children of a median of four children/woman, the childbearing practices of the population studied may not result in a fertility rate far below the Nigeria national average of 5.3 children per woman. Nevertheless, a study to derive the total fertility rate in the study population is necessary to determine whether or not there is ongoing fertility transition.

Exploring experiences with sensitivity to cultural practices among birth attendants in Kenya: A phenomenological study

Background: Sensitivity to women's cultural needs and expectations by care providers is essential. Skilled birth services for women are as essential as traditional birth services. Therefore, collaborative skilled and cultural care optimises childbearing experiences. Aim: This study explored the experiences of birth attendants (BAs) with sensitivity to cultural practices (CPs) during pregnancy and birth among the Keiyo community in Kenya. Setting: The study was conducted in the purposively selected public health centres and dispensaries offering maternity services and the villages in Keiyo South Sub County in Kenya. Methods: A qualitative interpretive phenomenological study of BAs was conducted. Iterative and inductive interviews using a semistructured guide were conducted with 11 skilled BAs (SBAs) and eight traditional BAs (TBAs). Audio-recorded interviews were transcribed and analysed using ATLAS.ti software version 8.4.4 (1135), following Van Manen's five thematic analysis steps. Results: Three themes emerged: birth attendants' cultural encounters, response to cultural encounters and collaboration. Birth attendants' responses to different cultural encounters revealed their awareness of CPs. The response was experienced as a sensitivity to the need for a triad (woman, TBAs and SBAs) collaborative care, enabling collaborative, woman-centred and culturally safe care. Conclusion: Birth attendants are exposed to cultural encounters, and their responses determine their awareness of enabling sensitive care for optimal childbearing experiences. The study illuminated the need for further collaborative engagements between the BAs and the community to facilitate positive experiences by women through woman-centred, culturally safe care.

Food fortification knowledge in women of child-bearing age at Nkowankowa township in Mopani District, Limpopo Province, South Africa

Background: Globally, there is evidence that three micronutrients deficiencies are of public health concern among children. They are vitamin A; iodine and iron deficiencies. Communities particularly affected are those in situations where poverty, unemployment, civil unrest, war and exploitation remain endemic. Malnutrition is an impediment to productivity; economic growth and poverty eradication. It is estimated that 32% of the global burden would be removed by eliminating malnutrition; including micronutrients deficiencies. Setting: The study was carried out in NkowaNkowa township of Mopani District, Limpopo Province, South Africa.Aim: The main objective was to determine the women's knowledge on food fortification. Methods: The study design was descriptive. The snowballing method was used to identify women of child-bearing age. Data were collected from 120 participants using a questionnaire. The questionnaire consisted of socio-demographic; general questions on women's knowledge on food fortification. The questionnaire was administered by the researcher using the local language Xitsonga. Results: The findings of the study revealed that a majority of 204 (57.0%) of the participants were able to define food fortification correctly while 257 (72.0%) of the participants knew which foods are fortified as well as the benefits of a food fortification programme. The majority (252 [70.0%]) of the participants knew that maize meal is one of the food vehicle used for fortification in South Africa. Conclusion: Most of the questions were answered correctly by more than 50.0% of the participants. The researcher deduced that the study participants are knowledgeable about food fortification based on the response given in relation to the programme

Reproductive behaviour among women on antiretroviral therapy in Botswana: mismatched pregnancy plans and contraceptive use

Understanding pregnancy planning and contraceptive use is important in preventing unplanned/unwanted pregnancies among women on antiretroviral therapy (ART). Through a cross-sectional survey of 155 women living with HIV on ART in Botswana (mean age = 36); bivariate/multivariate analyses were used to identify and understand pregnancy planning and contraceptive use. Women who did not plan to have a child (n = 85) were older; less educated; had more children and worried about stigmatisation from family and healthcare workers (HCWs). Multivariate analyses found age (OR:3.41; CI:1.57-7.45; p = 0.002); perceived stigmatisation from family and healthcare workers (OR:3.62; CI:1.47-8.96; p = 0.005); and believing it is irresponsible for women living with HIV to want a child (OR:2.40; CI:1.10-5.24; p = 0.028) to be significantly associated with not planning to have a child. Although reported condom use among 85 women who did not plan to have a child was nearly 90; a total of 26 of these women (34) believed they did not have control over condom use. Lack of contraception was reported by 6 women who did not plan a child; this; coupled with the lack of control over condom use; puts unmet need for contraception at 38 Most women reported feeling comfortable talking with HCWs about contraceptives. However; almost a quarter of the women indicated they were infrequently advised about contraceptives at ART clinics. This study found discordance between pregnancy planning and contraceptive use among women on ART. Lack of control over condom use coupled with low hormonal contraceptive use creates unmet need for contraception and increases the risk of unwanted pregnancies. Regular clinic visits for women on ART present excellent opportunities to address contraceptive needs in a considerate and comprehensive manner

Factors Influencing Women's Intention to Limit Child Bearing in Oromia; Ethiopia

The desire for large family size is one of the factors influencing fertility in Ethiopia. Thus; understanding factors that influence the fertility intentions of women is important for family planning program purposes and population policy. Objective: The objective of this study was to examine factors which influence women's intentions to limit child bearing in Oromia Regional State; Ethiopia. Methods: The 2005 Ethiopian Demographic and Health Survey was the data source. A weighted sub-sample of 3300 married women was drawn from the DHS women's dataset. Results: A greater intention to limit childbearing is associated with older age; larger number of living sons and daughters; being wealthier; no previous child death; knowledge and use of family planning and exposure to media. Conclusion: A high proportion of women desired to limit childbearing; but there was a large unmet need for contraceptives. Thus; improving access to family planning services to women who have achieved their fertility goals would be important

Considering Childbearing in the Age of Highly Active Antiretroviral Therapy (HAART): Views of HIV-Positive Couples

Objectives: Based on a qualitative study conducted in Bulawayo; Zimbabwe; this article examines how the availability of HAART since April 2004 may impact the views and choices of HIV-positive couples on childbearing. Methods: In-depth interviews were conducted with 15 couples where at least one partner was HIV positive. All respondents were of reproductive age and had or were confronting reproductive and sexual decision-making. Results: HAART seems to have had a profound impact on the subject of childbearing among those who still desire to have children. Where hitherto individuals had only a desire for a child many are now; as a result of the availability of HAART; actively planning to have one. HAART has not only transformed their physical state but it has also transformed mostly what had been desire into intention. The impact; however; has not been uniform. Some respondents still desired to have a child but were not yet convinced about the efficacy of HAART in preventing vertical transmission. Some respondents felt that HAART may have a negative impact on the foetus and as such were against childbearing by HIV-positive people. No respondent indicated that their desire or intention to have a child had been extinguished by the advent of HAART. Conclusion: Based on the findings of the study; HAART seems to have had a differential but nonetheless significant role in the reproductive plans of HIV-positive couples. The study also notes that there is a need to make available complete and unbiased information on HAART; mother-to-child transmission risk (MTCT) and pregnancy to HIV-positive couples so as to enable them to make informed decisions

"""Better a Dead Child than a Dry Womb!"" Reproduction and HIV/AIDS in Sub-Saharan Africa"

Childbearing is important to individuals and society in sub-Saharan Africa. Proven fertility and many children are powerful symbols of continuity and cohesion. Thus the reported high fertility rates; specifically in rural areas where modern family planning methods are unpopular and uncommon. Sub-Saharan Africa also bears the greatest burden of the HIV/AIDS epidemic. Heterosexual contact with an infected person is the commonest route of transmission in the region. Vertical transmission from mother to child is another apparent transmission mode. Antiretroviral therapy is exclusively unaffordable for many infected Africans. Counsellors discourage infected persons from future childbearing; even though they may still be in the prime of their reproductive years. Positive-living stresses 'a responsible sexual lifestyle for longer life'. The socio-cultural script for the need for children is in dis-equilibrium with the 'safe reproductive health' messages. This paper discusses the interplay between these two contemporary scripts; particularly examining spaces of negotiation. How does HIV/AIDS colour African reproduction?Current statistics about the HIV/AIDS epidemic in Nigeria do not reveal the broader social and economic impacts of the disease on the family.The study therefore primarily aimed to address the socio-economic effects of HIV infection on individuals and their families.The study was carried out in Lagos State. In-depth interviews were employed to collect information from 188 people living with HIV/AIDS through support groups in the state; while four focus group discussions were conducted to elicit information from people affected by AIDS about the socio-economic impacts of HIV/AIDS on families in Nigeria. From the survey; among people living with HIV/AIDS; 66of females and males were in the age group 21-40 years; while 10were older people above 60 years of age. Findings revealed that as HIV/AIDS strikes at parents; grand parents are assuming responsibility for bringing up the children of the infected persons and the orphans of those killed by the virus. It was striking that some of the older caregivers could not meet the requirement of these children.They are often forced to work more than they would have; or borrow in order to cope with the needs of these extra mouths. Some of the infected people have sold their properties to enable them to cope with the economic effects of the virus; while their children have had to drop out of school; since they could not afford the school fees and other related expenses. It was suggested that PLWHA should be economically empowered with adequate medical treatment; in order to reduce the impact of the disease on the family

An assessment of the awareness of sexual and reproductive rights among adolescents in South Western Nigeria

This study; conducted in Ikeja and Ikorodu Local Government Areas of Lagos State; examined the awareness of sexual and reproductive rights among adolescents in south-western Nigeria. A total of 600 in-school and out-of-school adolescents were interviewed using quantitative and qualitative methods. The study revealed that majority of the adolescents were aware of sexual and reproductive health rights (60.3 in Ikeja LGA and 62.3 in Ikorodu LGA) but lacked knowledge of contents of the rights. Majority of them in various categories (by school condition and type of settlement) were not aware of sexual and reproductive health programmes being implemented for adolescents. In addition; those who were aware of such intervention programmes could not access or use the services due to certain sociocultural barriers. The study recommends formulation of appropriate intervention strategies and programmes for adolescents so that they may be aware and knowledgeable of their sexual and reproductive rights

Qualitative Evidence on Adolescents' Views of Sexual and Reproductive Health in Sub-Saharan Africa

N/A