Knowledge of cervical cancer among women of reproductive age in Ibadan north lga, Oyo State, Nigeria

Nigeria has one of the highest rates of cervical cancer morbidity and mortality in Sub-Saharan Africa. Both the human papillomavirus vaccine (HPV) and cervical screening are effective prevention strategies against both HPV infection and cervical cancer. Lack of awareness, limited knowledge, limited decision-making agency, lack of spousal support and stigma are barriers to uptake of these preventive measures. Cervical cancer is a deadly disease claiming the lives of many women in developing countries due to late presentation which might be influenced by a lack of knowledge of the disease and its prevention. Method: This descriptive study examined the knowledge assessment of cervical cancer among women of reproductive age (15-49), about cervical cancer, its prevention, and their utilization of Pap smear screening; using a convenience sample of 426 women in Ibadan North Local Government Area of Oyo State, Nigeria. Women voluntarily completed a structured questionnaire. Result: Results showed that women who participated in the study were aware of cervical cancer (77%; n=328) but many (62.9%; n= 268) were unaware of Pap smears as the screening tests for cervical cancer. Although 41.3% (n=176) were knowledgeable about cervical cancer, risk factors and prevention, only 9.4% (n=40) had Pap smear tests done. Conclusion: Health care professionals, need to intensify efforts to increase awareness about cervical cancer screening, and encourage women through the different clinics to use these services. The benefits of screening and early diagnosis of cervical cancer should be emphasized to enhance the utilization of cervical cancer screening services.

Use of contraceptive methods in rural areas in Cote d'Ivoire: a cross-sectional study

Patients and methods: This cross-sectional survey took place in May, 2018 in Kodjokro, a village in the south-east of Côte d'Ivoire. The study population consisted of women of reproductive age, from 15 to 49 years old. A questionnaire was used to collect data on socio-demographic, gyneco-obstetrical characteristics, knowledge and attitudes and he use of contraceptive methods. The chi-square test was used to measure the associations between the use of contraceptive methods and each of the characteristics studied

Sexually transmitted infection (STI): A malady with skewed marital unfaithfulness, the Nigerian experience

Marital unfaithfulness is a major contributor to sexually transmitted infections in both sexes; however, societal view of the menace seems to use various lenses for the different sexes. Globally, evidence suggests that marital infidelity has existed in history. In Africa, as well as in Western society, infidelity is a problem facing many families and accounts for high incidence of divorce. This narrative review described and synthesized literature on marital infidelity and its association with sexually transmitted infections. We conducted informal interviews with married women on their experiences with marital infidelity in Nigeria. Associated physical, social and psychological cultured imposed consequences were experienced by women in Nigeria. The recurrent themes felt helplessness, enduring physical, emotional and psychological torture, accepting fate with reservation and being strangers in marital union. This narrative review could initiate critical thoughts and discussions on the factors in skewed marital unfaithful and the contribution to reproductive health and family life.

Facteurs favorisant la douleur postopératoire aiguë après césarienne au Centre Hospitalier Universitaire Androva, Mahajanga, Madagascar / Risk factors for acute postoperative pain after caesarean section at the Androva University Hospital, Mahajanga, Madagascar

Une douleur aiguë postopératoire peut être source de complications à court voire à long terme si elle est sous-évaluée et sous traitée. Plusieurs facteurs interviennent à l'exacerbation de cette douleur. Notre objectif était de déterminer les facteurs cliniques influençant la sévérité de la douleur post opératoire immédiate après une césarienne. Méthodes : Une étude type cas-témoin portant sur les patientes césarisées était réalisée en salle de soins post-interventionnels du Centre Hospitalier Universitaire Professeur Zafisaona Gabriel Mahajanga allant de janvier 2019 au décembre 2019. L'étude statistique a été réalisée avec le logiciel Epi-Info® 3.5.4 de l'Organisation Mondiale de la Santé Genève et CDC Atlanta. Les mesures d'association ont été mesurées par le calcul d'Odds ratio. Le seuil de signification statistique (p) a été fixé à une valeur < 0,05. Résultats : Nous avons retenu 32 cas pour 64 témoins. La population d'étude était jeune et la majorité appartenait dans la tranche d'âge de 16 à 29 ans. Les facteurs qui interviennent sur l'intensité de la douleur postopératoire étaient surtout des facteurs liés à la patiente tels que le jeune âge (OR= 3,46 [1,17 - 10,18]; p=0,009), la gestité en l'occurrence la primigestité et la paucigestité (OR=2,77 [1,33 - 5,79]; p=0,002), la primiparité et la pauciparité (OR=5,67 [2,16 - 14,94]; p=< 0,001), l'anxiété préopératoire (OR=5,04 [1,99 - 12,74]; p=0,0003) et l'appartenance à la classe 2 selon la classification de l'American Society ofAnesthesiologists (OR=4,2 [1,49 - 11,76]; p=0,004). Conclusion : La connaissance de ces fac

Contraceptive acceptability and associated factors among young women (15-24) living with HIV/AIDS: a hospital-based study in Kampala, Uganda

introduction: In Uganda, over 43% of all pregnancies among young women (15-24 years) living with HIV are either unwanted or mistimed. Unintended pregnancies account for 21.3% of neonatal HIV infections. The objective was to determine acceptability of contraceptives and associated factors among young women living with HIV attending HIV clinics in Kampala. Methods: Between February and May 2019, 450 young women attending public HIV clinics (Kisenyi HC IV, Kiswa HC III and Komamboga HC III) in Kampala were systematically enrolled in a cross-sectional study and interviewed using structured questionnaires. We used modified Poisson regression to determine the factors associated with acceptability of contraceptive. Data were analyzed using STATA 13.0. Statistical significance was determined at a P values < 0.05. Results: Contraceptive acceptability was 40.7% (95% CI: 27.6%-53.6%). Older age group (20-24 years) (aPR; 2.42, 95%CI; 1.06-5.52, P = 0.035), age at sex debut ≥ 18 years (aPR;1.25,95%CI; 1.13-1.38, P<0.001), having friend on contraceptives (aPR; 1.90, 95%CI; 1.10 - 3.26; P =0.021) and being married (aPR; 1.20, 95%CI; 1.09 - 1.32, P<0.001) were significantly associated with acceptability of contraceptives. Conclusion: There is a low acceptability for contraceptives. Younger age group who are not yet married need to be targeted

Ability and willingness to pay for family planning services in low resource settings: evidence from an operational research

Objective: This paper establishes levels and patterns of ability and willingness to pay (AWTP) for contraceptives, and associated factors. Study design: A three-stage cluster and stratified sampling was applied in selection of enumeration areas, households and individuals in a baseline survey for a 5-year Family planning programme. Multivariable linear and modified Poisson regressions are used to establish factors associated with AWTP. Results: Ability to pay was higher among men (84%) than women (52%). A high proportion of women (96%) and men (82%) were able to pay at least Ug Shs 1000 ($0.27) for FP services while 93% of women and 83% of men who had never used FP services will in future be able to pay for FP services costed at least Shs 2000 ($0.55). The factors independently associated with AWTP were lower age group (<25 years), residence in urban areas, attainment of higher education level, and higher wealth quintiles. Conclusion: AWTP for FP services varied by different measures. Setting the cost of FP services at Shs 1000 ($0.27) will attract almost all women (96%) and most of men (82%). Key determinants of low AWTP include residence in poor regions, being from rural areas and lack of/low education. Implications statement: Private providers should institute price discrimination for FP services by region, gender and socio-economic levels. More economic empowerment for disadvantaged populations is needed if the country is to realise higher contraceptive uptake. More support for total market approach for FP services needed

Sero-prevalence of Hepatitis B virus surface antigen and associated factors among women of reproductive age in Bench Maji Zone, Southwest Ethiopia: Community based cross-sectional study

Background: Hepatitis B virus infection is one of the leading causes of liver diseases which occurs worldwide particularly in developing countries. It is often caused by prenatal transmission from mother to child or household transmission from a close contact during early childhood. It causes different complications like; jaundice, induces premature labor, and prematurity. Objective: The aim of this study was to estimate the Sero-prevalence of hepatitis B virus surface antigen and associated factors among women of reproductive age in Bench Maji Zone, South West Ethiopia. Methods: A community-based cross-sectional study was conducted from December 15th, 2016, to February 15th, 2017. Multistage sampling technique was applied to select study participants. Logistic regression analysis was applied and p-values < 0.05 was used to see the significant association between dependent and independent variables. Results: A total of 330 participants were included in this study yielding 98.8% response rate. The Sero-prevalence of hbsag among women of reproductive age was 28(8.5%). Having multiple sexual partners (AOR = 18.73, 95% CI = [3.65, 96.21) history of unprotected sex (AOR = 9.39, 95% CI = [1.64, 53.77) were found to be significantly associated with Sero-prevalence of HBV. Conclusions: The Sero-prevalence of HBV infection among women of reproductive age was highly endemic. Hence, behavioral education and communication programs focusing on reduction of risky sexual behaviors should be designed to reduce HBV infection

Association between serum lipid profile, body mass index and osteoporosis in postmenopausal Sudanese women

Background: Epidemiological observations suggest links between osteoporosis and the risk of acute cardiovascular events. Whether the two clinical conditions are linked by common pathogenic factors or atherosclerosis per se remains incompletely understood. The reduction of bone density and osteoporosis in postmenopausal women contributes to elevated lipid parameters and body mass index (BMI). Objective: To investigate the relationship between serum lipid profile, BMI and osteoporosis in postmenopausal women. Materials and Methods: A prospective analytical case control-study conducted in Khartoum north hospital at Khartoum city, capital of the Sudan from April 2017 to March 2018 after ethical approval obtained from the local Research Ethics Committee of Faculty of Medical Laboratories, Alzaeim Alazhary University on the committee meeting number (109) on Wednesday 15th February 2017. A written informed consent was obtained from all participants to participate in the study.Two hundred postmenopausal women were enrolled in the study. The age was studied in one hundred osteoporosis postmenopausal women as a case group and one hundred non-osteoporosis postmenopausal women as control group. The serum lipid profiles were estimated using spectrophotometers (Mandry) and BMI calculated using Quetelet index formula. The data were analysed using SPSS version 16. Results: The BMI, serum total cholesterol, triglyceride, HDL and LDL in case group respectively were (24.846±2.1647, 251.190±27.0135 mg/dl, 168.790 ±45.774 mg/dl, 50.620 ± 7.174 mg/dl, 166.868 ±28.978 mg/dl). While the BMI, serum total cholesterol, triglyceride, HDL and LDL in control group respectively were (25.378 ±3.8115, 187.990 ± 26.611 mg/dl, 139.360±20.290 mg/dl, 49.480 ±4.659 mg/dl, 111.667 ±28.0045 mg/dl). All serum lipid profiles significantly increased (p=0.000) in the case group compared to the control group, except serum HDL was insignificant different between the case and control group and also BMI was insignificant different between the case and control group. There was a positive Pearson's correlation between BMD and serum total cholesterol (r= 0.832, P<0.01), serum LDL (r = 0.782, P<0.01) and serum triglyceride (r = 0.72, P<0.01). Conclusions: Osteoporotic postmenopausal women had a significant increase in serum lipid profile and BMI. Moreover, we found a positive link between women with cardiovascular diseases and stroke

Maternal factors and short-term outcome associated with episiotomy during vaginal delivery at the Women and Newborn Hospital, Lusaka, Zambia

Objective:To explore the maternal factors and short-term outcomes associated with episiotomy during vaginal delivery at Women and Newborn Hospital, Lusaka, Zambia.Materials and Methods:An unmatched case control study was conducted in postnatal wards of Women and New-born hospital in Lusaka, Zambia between November 2019 and April 2020 with convenient sample for the cases and systematic sample for the controls.Asemi-structuredintervieweradministered questionnaire was used and 102 participants (cases) who had episiotomy performed were recruited while 204(controls) werewithoutepisiotomy.Results:Atotal of 306 (102 are cases and 204 are control) were included. Age was found to be a good predictor of episiotomy in that those younger than 18 years were more than seven times likely to have an episiotomy (AOR=7.65; 95%CI 1.36-18.21; p=0.035). It was also found out that primi gravidas were five times likely to have an episiotomy performed compared to parous women (OR=4.96; 95%CI 2.58-9.52; p<0.001). Out of those delivered by a midwife, 73(28.3%) participants had an episiotomy performed compared to 29(60.4%) deliveredbyamedicalofficer.Multivariateregression it was shown that being delivered by a midwife was protective against an episiotomy (OR=0.260; 95%CI 0.14-0.49; p=0.001). Out of the 102 participants who had an episiotomy, only two had third degree tear extension. It was also noted that 99 out of 102 (97%) participants who had an episiotomy experienced post-delivery perineal pain compared to 94 out of 204(46%) of those who had no episiotomies. In univariate analysis, it was found that post-delivery perineal pain was associated with episiotomy (p<0.001). It was further found that those who had an episiotomy performed were about 4 times likely to experience perineal pain post- delivery (OR=3.8; 95%CI 1.2-12.3) Conclusion:Maternal factors associated with episiotomy includedage,parity,method of induction,and the personnel conducting the elivery. Shorttermmaternaloutcomesofepisiotomy were perineal tear extension, and post-delivery perineal pain. It was found that 8.5% of women had undergone an episiotomy done on them. Health professional conducting deliveries should be educated on indications of episiotomy, patient selection during episiotomy and trained on surgical skills to repair episiotomy to reduce morbidity associated the procedure.

Perceptions and Willingness to Undertake Transvaginal Sonography by Women at the Sally Mugabe Central Hospital, Zimbabwe

ntroduction: The acceptability and willingness to undergo Transvaginal Sonography by the patients havegeneratedmixedreactionsindifferenthealthcare settings. There is little that is known aboutZimbabweanwomen'sperceptionsandwillingness to undergo Transvaginal Sonography and there are no specific guidelines to guide its use. Aim:To evaluate the perception and willingness to undergo Transvaginal Sonography among women attending Obstetrics and Gynaecology clinic at SallyMugabeCentralHospitalinHarare, Zimbabwe.Methods:Across-sectionalsurveyusingastructured questionnaire was conducted between 1 and 30 June 2022. Atotal of 170 women attending the obstetrics and gynaecology clinic at Sally MugabeCentralHospitalwereselectedbyconsecutive sampling to participate in the study.Results:The majority of women (81.76%) had no previous TVS experience, with an equally large proportion (60.84%) not having seen a TVS probe before. Most of the women would prefer female sonographers (85.37%) to conduct the examination. In addition, about 58% of the participants concurred that a chaperone should be present. Less than half of the females (47.93%) were eager to have a TVS done on them. Equally, just 45% of the females said they would encourage others to have a TVS scan. The difference in willingness to undergo a TVS study stratified by employment status was statistically significant (chi-square 7.26, p = 0.03). Conclusion: Our study findings revealed that a large proportion of females had no previous TVS experience, with an equally large proportion not having seen a TVS probe before. Only a sizeable proportion of women were willing to accept TVS provided it is conducted by female sonographers and or in the presence of a chaperone. The findings underscoretheimportanceofeducationandawareness of the benefits of TVS in terms of diagnosis on maternal health outcomes, in the Zimbabwean population.

Impact of COVID-19 public health responses on income, food security and health services among key and vulnerable women in South Africa

Globally, COVID-19 has impacted lives and livelihoods. Women living with HIV and/or at high risk of acquiring HIV are socially and economically vulnerable. Less is known of the impact of COVID-19 public health responses on women from key and vulnerable populations. The purpose of this cross-sectional survey conducted in four South African provinces with a high burden of HIV and COVID-19 from September to November 2021 was to advance understanding of the socio-economic and health care access impact of COVID-19 on women living with HIV or at high risk of acquiring HIV. A total of 2 812 women >15 years old completed the survey. Approximately 31% reported a decrease in income since the start of the pandemic, and 43% an increase in food insecurity. Among those accessing health services, 37% and 36% reported that COVID-19 had impacted their access to HIV and family planning services respectively. Economic and service disruptions were enhanced by living in informal housing, urbanisation and being in the Western Cape. Food insecurity was increased by being a migrant, having fewer people contributing to the household, having children and experience of gender-based violence. Family planning service disruptions were greater for sex workers and having fewer people contributing to the household. These differentiated impacts on income, food security, access to HIV and family planning services were mediated by age, housing, social cohesion, employment and household income, highlighting the need for improved structural and systemic interventions to reduce the vulnerability of women living with HIV or at high risk of acquiring HIV.

A qualitative synthesis of the impact of infertility on the mental health of African women

Infertility is a reproductive problem that affects all gender, race, or social class. In many African countries, the burden of infertility is usually associated with economic, psychological, and socio-cultural factors. This review aimed to explore the factors that impact the mental health of African women with primary infertility. A qualitative evidence synthesis was used to summarise and analyse primary qualitative studies focused on the impact of primary infertility on African women. Seventeen studies met the eligibility criteria and were included in the review. The review found that social pressure, stigma from family and community members, and financial constraints led to psychological distress. In addition, social stigma also led to marital problems which led to significant psychological distress and low self-worth, especially on the wife. Recommendations to reduce stigma among African infertile women were as follows: advocacy and community mobilisation, education by health professionals, and holistic person-centred care. An intersectional approach to inform public health and social policy was also suggested.

The reliability of smartphone goniometry technology in measuring postural changes in South African female youths carrying head loads

Background: Four empirical studies have measured the impact of head-loading on female African porters posture using expensive radiography and manual kin anthropometry and goniometry. The reliability of cheaper, pragmatic smartphone goniometric technology as an alternate clinical tool to assess posture is needed. Objectives: This study was designed to test the inter-rater reliability of smartphone goniometry technology against manual goniometry in measuring selected sagittal postural angles in South African female youth who habitually head-load. Methods: Female South African youth who habitually headload voluntarily participated in the study (N = 100) and were randomly allocated into experimental (n = 50) and control (n = 50) groups. An observational randomized control design involving a pre-test post-test crossover was used, after which the control group crossed over into the experimental group and vice versa. The control group stood in the unloaded phase without a head load, while the experimental group carried the head load. The daily head loads and body mass were measured on an electronic scale. Demographic characteristics (age, body mass, and stature) were recorded and selected biomechanical angles were measured on the right side. Results: The mean age of the study participants was 12.3 ± 2.5 years; average body mass was 44.5 ± 13.7 kg. The average head load habitually carried was 8.0 ± 2.5 kg. The inter-rater reliability between the smartphone goniometry technology and manual goniometry was 0.9. Conclusion: The findings support the use of smartphone goniometry as a pragmatic method for assessing sagittal plane postural changes among rural South African youth who habitually head-load. Further studies are needed to validate these findings.

Autodétermination des femmes dans la santé sexuelle et reproductive à Lubumbashi, République Démocratique du Congo / NA

ntroduction.La santé reproductive est caractérisée par une vie sexuelle satisfaisante, sûre et la capacité de se reproduire et de prendre des décisions. La vie de beaucoup de femmes estmarquée par les capacités d'action réduites quant aux décisions portant sur leur propre vie. L'objectif était d'évaluer l'autodétermination des femmes en matière de la santésexuelle et reproductive.Matérieletméthodes.Il s'agit d'une étude descriptive transversale effectuée dans 5 maternités de la ville de Lubumbashi au mois de juillet 2021 au près des 46 accouchées ayant accepté librement de participer à cette étude basée sur le questionnaire préétabli. Résultats.L'analyse des données montre que la moyenne d'âge était de 27,8 ± 3,6 ans avec les extrêmes entre 17 et 41 ans, dont 58,7% d'entre elles avaient le niveau de secondaire et paucipares dans 52,17%. La décision des rapports sexuels revenait au couple dans 58,70%. La décision d'avoir les enfantsrevenait au couple alors que celle de nommer les enfants revenait au mari dans 45,65% et 45,65%. Le nombre d'enfants était déterminé par le couple dans 45,65%. L'espacement des naissances était déterminé par la femme dans 45,65%. Le début de la CPN était décidé par la femme dans 86,6% et le choix du lieu des consultation prénatales(CPN) étaient décidés par la femme dans 89,13%. Le moment de se rendre à la maternité était décidé par la femme dans 73,91%. Le retour à domicile était décidé par le couple dans 39,13% et la décision des rapports sexuels après l'accouchement revenait à l'homme dans 52,17%.Conclusion.La femme congolaise n'a pas toujours une autodétermination maximale dans la santé reproductive. Ainsi des efforts supplémentaires sont nécessairespour laisser la liberté aux femmes de prendre des décisions qui conviennent mieux pour leur santé

Zoom sur le cancer du col utérin chez les adolescentes à Kananga au Kasaï-Central, en République Démocratique du Congo / NA

Introduction. Le cancer du col de l'utérus (CCU) demeure un problème majeur de santé publique et il est le quatrième cancer le plus répandu chez les femmes à l'échelle mondiale. L'objectif est de contribuer à l'améliorationde niveau de connaissance des adolescentes sur le cancer du col utérin dans la ville de Kananga.Matériel et méthodes.Il s'agit d'une étude transversaledescriptive sur le cancer du col utérin, réalisée dans la ville de Kananga et dont l'étude était basée sur l'interview de 436 Adolescentes selon un échantillonnage à plusieurs degrés, dans les Aires de Santé de la Zone de Santé Urbaine de Kananga.Résultats. La moyenne d'âge des répondantes était de 17,7 ± 1,2 ans. Le niveau de connaissances sur le cancer du col utérin s'est révélé inadéquat chez presque toutes les participantes (90%). Les signes couramment connus étaient le saignement vaginal (80,3%), dyspareunie (4,8%) et règles prolongés (2,3%). Le sexe était pratiqué dans55,5% des adolescents alors que 70,9% savaient l'existence du lien entre le cancer du col utérin et les infections sexuellement transmissible (IST). Les connaissances sur lesfacteurs de risque de survenu du cancer du col étaient: la consummation de tabacdans 31,9% et le rapport sexuel précoce dans 25,5%; la pratique du dépistage était observée dans 0,2% des cas et 37,2% d'adolescentes connaissaient que toutes les femmes étaient prédisposées de développer la pathologie.Conclusion.Le niveau de connaissances de cancer du col utérin s'est révélé inadéquat chez les adolescents et nécessité des campagnes destinées à sensibiliser d'avantage toutes les femmes en particulier et le public de la ville de Kananga en général au sujet de ce cancer du col utérin

Sexual Experiences of Infertile Women: A Qualitative Study

It is suggested that stress related to infertility causes marriage conflicts and decreases in the frequency of sexual intercourse. Aim: This study aimed to explore the experiences of the sexuality of infertile women. Patients and Methods: A phenomenological design was used in this study. We conducted face-to-face, semistructured, in-depth interviews with 11 infertile women. The interviews were audio-recorded, and a thematic approach was used to assess the data. Results: The average age of the women was 33.05 ± 3.40 years, and their age of first sexual intercourse was 23.0 ± 2.8 years and all of them are legally married. The durations of experiencing the problem of infertility were as follows; 3-5 years in 33%, 6-10 years in 27%, and 11 years and above in 38%. According to interpretative phenomenological analysis, two main themes emerge. Two main themes were determined: Perception of Sexuality and Sexual Problems. The results show that infertile women have a higher risk for sexual dysfunction than fertile women. Conclusion: These findings suggest that the diagnosis of infertility is an important factor in assessing the differences in the sexual satisfaction of women. In infertility counseling, health professionals must explain the gender differences. Also, infertile couples must encourage to share each other's feelings and this may help couples to cope with the communication problems they may experience.

Determinants of the use of family planning methods among rural women in Plateau state, Nigeria

This study aimed at determining the factors that influence family planning practice among rural women of Pankshin district inPlateau state, Nigeria. A cross-sectional study using a simple random sampling method was conducted from October to December 2019. A self-administered questionnaire was used for data collection among 302 respondents. Among respondents, 48.3% had practised family planning and the most popular family planning method ever practised was injectables (57.5%). The determinants of family planning practice were age group 29-39 and 40-49 years old (AOR=4.373, p<0.001; AOR=5.862, p<0.001), discussion with partner (AOR=9.192, p<0.001) and partner's approval (AOR=2.791, p=0.007). Findings showed an encouraging family planning prevalence with the main determinants involving male partners. Further efforts need to be made to promote family planning practice among male partners and to empower women of all reproductive age groups by providing them with relevant information that is needed for them to make informed decisions. (Afr J Reprod Health 2022; 26[4]: 32-41).

Women autonomy and demand for maternal health services in Nigeria: Evidence from the Nigeria Demographic and Health Survey

mproving women autonomy can be vital in determining the uptake of healthcare services, especially in a patriarchal society with gender rights concerns. Using the 2013 Nigeria Demographic and Health Survey and employing Zero Inflated Negative Binomial regression, the effect of household decision-making power with considerations to women autonomy on the demand for maternal health services in Nigeria was examined. The result of the analysis suggests that women autonomy in deciding expenditures on household healthcare services, and autonomy in deciding their income expenditures significantly increases the likelihood of demand for maternal healthcare services. On the other hand, when the husband/partner makes sole decision, as well as joint decision making concerning expenditure on household healthcare services and expenditure of woman's income reduces the likelihood of demand for maternal healthcare services in the country. This reduction was however much more when husband alone takes the decision than when decisions were taken jointly. Other socioeconomic variables like higher maternal education, and household wealth, also increased the demand for maternal healthcare services. We recommend that government should put in place policies that will help increase women's participation in household decision-making through the sensitization and capacity building initiatives such as improved educational quality for women. (Afr J Reprod Health 2022; 26[4]: 65-74).

"When America Sneezes, the World Catches a Cold" What does overturning Roe v. Wade mean for women's reproductive health in Africa?

Communities and countries and ultimately the world are only as strong as the health of their women." - Michelle Obama, 2016 On 24 June 2022, the Supreme Court of the United States (SCOTUS) decided on Dobbs v Jackson Women's Health Center, overturning the historic Roe v. Wade decision that has, since 1973, confirmed and enshrined the constitutional right of a woman to seek an abortion1 . Restrictions to legal, safe abortions are known to have serious repercussions for maternal and infant health. Evidence shows that restricting access to abortion does not reduce the number of abortions; it only makes abortion less safe and more likely to lead to preventable complications, including maternal death. Conversely, expanding access to safe, legal abortion­a common medical procedure that carries very little risk when performed by a trained provider in an appropriate environment­is associated with improved maternal health outcomes. Further, illegal abortion results in negative societal outcomes, including chronic morbidity for the individual woman; economic burdens to women and their communities when they cannot work or finish school; and added stress to families, communities, and already over-stretched public health systems.