Socioecological analysis of determinants of early adolescent sexuality in Benin: a qualitative study

Introduction: early adolescent sexuality is associated with an increase in risky sexual behaviour, unwanted pregnancies, and the occurrence of sexually transmitted infections. However, despite the efforts of governments and their partners, the implementation and effectiveness of appropriate and adapted services to improve adolescent sexual and reproductive health are lagging. Therefore, this study aimed to document determinants of early adolescent sexuality in the central district of Tchaourou in Benin based on a socio-ecological approach. Methods: an explorative and descriptive qualitative study was conducted using focus groups and individual interviews based on the socio-ecological model. Participants included adolescents, parents, teachers, and community leaders in Tchaourou. Results: the number of participants in each focus group was 8 (32). There were 20 girls and 12 boys aged 10-19 years, of whom 16 were students (7 females and nine males) and 16 were apprentice dressmakers and hairdressers. In addition, five participants attended individual interviews (two community leaders, one religious' leader, one teacher and one parent). Four themes were identified that influence early sexuality among adolescents and grouped into individual determinants related to knowledge about early sexuality; interpersonal determinants related to adolescents' function, including the influence of family and peers; community and organizational determinants related to where harmful sociocultural norms; political determinants comprising the disadvantaged socioeconomic status of the communities where adolescents live. Conclusion: many factors at multiple social levels influence early adolescent sexuality in the commune of Tchaourou in Benin. Therefore, interventions directed at these various levels are needed urgently.

Knowledge and parity: Perspectives of usage of emergency contraceptive pills among women of a rural area of Delhi

Context: Correct use of emergency contraceptive pills (ECPs) may prevent up to 95% of unwanted pregnancies which may significantly decrease unsafe abortions and maternal mortality. Aims: Assessment of knowledge and use of ECPs among women and to explore factors associated with them. Materials and Methods: This was a facility-based cross-sectional study. Data were collected using a prestructured, pretested questionnaire from 381 reproductive age women (15­49 years) selected by systematic random sampling. Statistical Package for the Social Sciences version 16 and Epi info (version 7.0.) were used for all statistical analyses. Descriptive analysis was performed, and results were expressed in terms of frequencies and percentages. The Chi-square and Fisher's exact test were used as tests of significance in univariate analysis. Determinants of use of ECPs were identified using logistic regression. Results: Of 381 women interviewed, awareness level of ECPs (ever heard about ECPs) was found to be 34% (n = 128). Ever use of emergency contraception was reported by 38 (9.7%). Age (odds ratio [OR] = 3.02, 95% confidence interval [CI] [1.88­4.87]), education (OR = 0.086, 95% CI [0.047­0.158]), husband's education (OR = 0.11, 95% CI [0.067­0.187]), socioeconomic status (OR = 6.14, 95% CI [3.28­11.51]), and family status (OR = 2.6, 95% CI [1.59­4.24]) were found to be significantly associated with the use of emergency contraceptives. Conclusions: The study identified that most respondents lack adequate knowledge about ECPs, and ever use of ECPs was very low. Factors that were associated with the use of ECPs were age, literacy, socioeconomic status, and knowledge about the method. Creating a sustainable awareness on ECPs and their use may serve them with power to control their parity

Maternités des adolescentes au Centre Hospitalier Universitaire de Conakry en Guinée. Profil socio-démographique et obstétrical

But : Etudier le profil sociodémographique et le pronostic obstétrical des adolescentes de 18 ans et moins à la maternité Donka du Centre Universitaire de Conakry.Méthodes : Etude rétrospective descriptive, d'une durée d'un an (1er janvier au 31 décembre 2014). La population d'étude était constituée par les adolescentes de 18 ans et moins ayant accouché à 28 semaines d'aménorrhée (SA) et plus. L'adolescente était définie par un âge maternel inférieur ou égal à 18 ans révolu. Les caractéristiques sociodémographiques, obstétricales et néonatales ont été étudiées. Résultats : Sur 6.782 accouchements réalisés à la maternité Donka, 186 (2,74%) étaient des adolescentes. Le profil était celui d'une adolescente mariée (74,2%), non-scolarisée (54,8%), sans emploi (51,7%). La majorité (67,2%) avait un mauvais suivi prénatal. L'accouchement par voie basse était réalisé dans la majorité des cas (71%) et la césarienne dans 29% des cas. Parmi les nouveau-nés, 16,4% avaient un petit poids pour l'âge gestationnel dont 10% de prématurés. Le taux de mort in-utero et intra-partum était de 10%. Conclusion : Notre étude suggère la mise en place de mesures permettant aux adolescentes de bénéficier d'une plus longue scolarisation, d'un accès à l'information et aux services de santé de la reproduction, ce qui leur permettraient de mieux protéger leur santé et d'éviter les complications liées aux grossesses non-désirées

Connaissances et pratiques contraceptives chez les jeunes burkinabè de 15 à 24 ans

Selon l'OMS, l'utilisation de la contraception a nettement plus d'avantages pour la santé que de risques. Néanmoins, l'accès à la contraception des jeunes reste un problème de santé publique. Cette étude visait à évaluer les connaissances et les pratiques contraceptives des jeunes de Bobo-Dioulasso, et à identifier les obstacles d'utilisation.Il s'agit d'une étude quantitative et transversale. Les données d'enquête ont été recueillies en décembre 2014 à Bobo-Dioulasso, auprès de 573 jeunes de 15 à 24 ans. Ces enquêtés ont été sélectionnés par un sondage en grappes à deux degrés. Pour tous les tests statistiques, le seuil de signification était fixé à p<0,05. La quasi-totalité (99,3%) des jeunes connaissaient au moins une méthode contraceptive moderne. Bien que près de 84,0% d'entre eux soient en situation de cohabitation, les parents étaient les sources d'information les moins citées. Seulement 28,6% des enquêtés sexuellement actifs (ou leurs partenaires) avaient utilisé la contraception lors du premier rapport sexuel. Nous avons aussi constaté que la contraception est devenue la « norme », par l'utilisation du préservatif au début de la relation, puis par la contraception orale lorsque la relation est définie comme stable. Plus les enquêtés étaient âgés, plus ils avaient utilisé un moyen contraceptif (p<0,05).Il est urgent de porter les efforts d'éducation non seulement sur les connaissances, mais aussi sur les pratiques quotidiennes dans la vie sexuelle et les éléments qui les entravent. Il va falloir aussi assurer aux jeunes, la confidentialité et la gratuité de la contraception

Dating violence and self-efficacy for delayed sex among adolescents in Cape Town, South Africa

In South Africa, dating violence is known to be widespread among adolescents, and is therefore a major public health issue because of its association with sexual risk behaviours. The objective of the study was to examine the relationship between dating violence and self-efficacy for delayed sex among school-going adolescents in Cape Town, South Africa. The study is based on analyses of data from a school-based health education programme targeting sexual and reproductive health issues.The study involved 3,655 school-going adolescents aged between 12 and 17 in Cape Town, South Africa. The data was collected by means of a self-administered questionnaire composed of 153 items on sexual and reproductive health, dating violence as well as socio demographic characteristics. The results indicated that males showed a higher percentage of both dating violence victimization and perpetration, as compared to females. It was also found that adolescents from lower socio-economic backgrounds were more likely to be the victims of dating violence as compared to those from a higher socio-economic background. Female learners showed higher levels of self-efficacy for delayed sex than their male counterparts. Although the result revealed that there was a significant association between self-efficacy for delayed sex and socio-economic status, this link decreased with age. It is concluded that educational programmes aimed solely at improving self-efficacy for delayed sex is insufficient. Such programmes must also aim at preventing dating violence and equipping adolescents with the skills to negotiate their way out of dating violence. Afr J Reprod Health 2014; 18[2]: 46-57)

Factors associated with unmet need for modern contraception in post-conflict Liberia

We examined the association between intimate partner violence and unmet need for modern contraception in post-conflict Liberia. This is a secondary analysis of data collected using the Priorities for Local AIDS Control Efforts (PLACE) method. Data from 499 sexually experienced young women (aged 14-25) in Montserrado County, Liberia were examined. Intimate partner violence (55.7%), unintended pregnancy (83.2%), and abortion (45.3%) were pervasive in the study population. An estimated 35.9% of respondents had an unmet need for modern contraception. However, multivariate logistic regression results did not reveal an association between intimate partner violence and unmet need (OR 1.11; 95% CI 0.70-1.75). Among covariates examined, only contraceptive use at sexual debut (26.1%) was significantly associated with unmet need (OR 0.27; 95% CI 0.14-0.52). Liberian youth need information about and access to modern contraceptive methods besides condoms. Interventions to identify and treat victims of violence are also needed. Afr J Reprod Health 2014; 18[2]: 58-67)

Emergency contraception amongst female college students ­ knowledge, attitude and practice

Background: Unwanted teenage pregnancies have a notable detrimental impact on the learners' trajectory and have been associated with jeopardising the students' educational progress and future career prospects. These pregnancies are mostly unplanned and unintended and many are terminated; either legally or illegally. Aim: The aim of this study was to explore the contributory role played by the knowledge; attitude and practices of female college students with respect to the utilisation of emergency contraceptives. Setting: Three tertiary institutions in Dessie; Ethiopia. Methods: Quantitative self-administered questionnaires were used to collect descriptive data from 352 female college students. Results: The study revealed that there was a high percentage (78.3) of unwanted pregnancies amongst those engaging in sex. Significantly; nearly half (43.3) of these unwanted pregnancies resulted in abortion. Only 10 of the students sampled admitted to ever having used emergency contraception. Even though more than half (69.9) of the students knew about emergency contraception; only 27 of them felt confident that they understood when it was most effective. Conclusion: These and other observed findings confirm the need for improvement of female college students' knowledge and timely utilisation of emergency contraception

Knowledge, attitude and practice (KAP) of sandwich under graduate students of Delta State University, Abraka, Nigeria on condom use in the prevention of sexually transmitted infections (STLS) and unwanted pregnancy

The study investigated the knowledge, attitude and practice (KAP) of sandwich under graduate students of Delta State University, Abraka, on condom use for the prevention of sexually transmitted infections (STls) and unwanted pregnancy. This is with a view of assessing the relevance of knowledge to attitude and practice. Three hypotheses were generated to guide the study. A self designed (KAP) questionnaire with 18 questions items were used to generate information. The sample was 610 students. Percentages and chi- square statistics were used to analyze the data. It was found that students had good knowledge of condom use towards the prevention of STls and unwanted pregnancy. There was also a relationship between knowledge and attitude. Males and females do not differ in their knowledge, attitude and practice of condom use. It was recommended that family and sexuality education be a part of the school curriculum, while the media should continuously be used to campaign for the use of condom in the prevention of STls and unwanted pregnancy

Abortion and unwanted pregnancy in Adigrat Zonal Hospital, Tigray, North Ethiopia

Unwanted pregnancy is associated with increased risk of maternal mortality and morbidity. This study was done to determine the causes of unwanted pregnancy and its impact on maternal health. A cross sectional study (February 1, 2002-January 31, 2004) was conducted on 907 patients with diagnosis of abortion and admitted to the gynecological ward of Adigrat zonal hospital, Tigray Region, Ethiopia. This accounts to 12.6% of all hospital and 60.6% of gynecolo-gical admissions. The majority of these women (69.8%) had unwanted pregnancy. Modern contraception methods were not in use in 76.2% of unwanted and 57.7% of wanted pregnancies (P = 0.008). Interference was reported in 81.4% of unwanted pregnancy. High incidence of complication was reported in patients with unwanted pregnancy. In this study it is found that unwanted pregnancy is associated with increased risk of maternal morbidity and mortality. The development and prompt implementation of a strategy that enables women to safely manage unwanted pregnancy is recommended (Afr. J. Reprod. Health 2010; 14[3]: 183-188)