Measurement and conceptualization of male involvement in family planning: a bibliometric analysis of Africa-based studies.

BACKGROUND: Male involvement in Family Planning (FP) is an exercise of men's sexual and reproductive health rights. However, the measurement of male involvement has been highly inconsistent and too discretional in FP studies. As a result, we used bibliometric tools to analyze the existing measures of male involvement in FP and recommend modifications for standard measures. METHODS: Using developed search terms, we searched for research articles ever published on male involvement in FP from Scopus, Web of Science, and PubMed databases. The search results were filtered for studies that focused on Africa. A total of 152 research articles were selected after the screening, and bibliometric analysis was performed in R. RESULTS: Results showed that 54% of the studies measured male involvement through approval for FP, while 46.7% measured it through the attitude of males to FP. About 31% measured male involvement through input in deciding FP method, while others measured it through inputs in the choice of FP service center (13.6%), attendance at FP clinic/service center (17.8%), and monetary provision for FP services/materials (12.4%). About 82.2% of the studies used primary data, though the majority (61.2%) obtained information on male involvement from women alone. Only about one in five studies (19.1%) got responses from males and females, with fewer focusing on males alone. CONCLUSION: Most studies have measured male involvement in FP through expressed or perceived approval for FP. However, these do not sufficiently capture male involvement and do not reflect women's autonomy. Other more encompassing measures of male involvement, which would reflect the amount of intimacy among heterosexual partners, depict the extent of the exercise of person-centered rights, and encourage the collection of union-specific data, are recommended.

Perceived health facility-related barriers and post-abortion care-seeking intention among women of reproductive age in Osun state, Nigeria.

BACKGROUND: Post-abortion care (PAC) prevents death and complications caused by unsafe abortion which is widespread in Nigeria. Yet, there is sparse community-based evidence on women's intention to seek PAC should they have an abortion. This study examined the influence of perceived health facility-related barriers (HFRB) on post-abortion care-seeking intention (PACSI) among women of reproductive ages in Osun state, Nigeria. METHODS: The study focused on women in a sexual relationship and who were residents of Osun state. A community-based survey was implemented using a multi-stage sampling technique. The calculated sample size (with attrition) was 1200 and data were collected from women aged 15-49 years, using open data kit (ODK). However, 1,065 complete responses were received on the ODK server, indicating an 88.8% response rate. Models were estimated using ordered logistic regression (Ologit) (α0.05) and data analysis was performed using Stata 14.0. RESULTS: Mean age of the women was 29.3±7.6 years and 34.01% had the intention to seek PAC in health facilities. Lack of service confidentiality and unavailability of equipment specific to abortion were the two most reported barriers that would prevent women from seeking PAC. The adjusted Ologit model showed that respondents with perceived low HFRB had higher odds (aOR=1.60; CI=1.12-2.11) of seeking PAC in the health facility. Also, women who were employed and skilled were more likely (aOR=1.51; CI=1.13-2.01) while women who had PAC support from spouses/partners had higher odds of healthy PACSI (aOR=2.03; CI=1.48-2.78). Other identified predictors of PAC seeking intention included level of education, employment status, and spousal/partner support. CONCLUSION: Perceived lack of trust in service provision and necessary equipment specific to abortion care had a negative influence on women's PACSI in Osun state. Reassuring health interventions that focus on improving the public perception of healthcare services and confidence to use the facility will likely improve the patronage of health facility for post-abortion care in Osun sate.

Do Community Characteristics Influence Unintended Pregnancies in Kenya?

Background: Most existing studies on unintended pregnancies tend to examine the influence of individual socio-demographic and health characteristics without sufficient attention to community characteristics. This study examines community characteristics influencing unintended pregnancies in Kenya. Methods: Data were extracted from the 2014 Kenya Demographic and Health Survey (KDHS). The outcome variable was unintended pregnancy. The explanatory variables were selected individual and community level variables. The Multilevel mixed-effects logistic regression was applied. Results: Findings show 41.9% prevalence of unintended pregnancies. Community characteristics such as community education, community timing for initiation of childbearing, community fertility norms, and community media exposure significantly influence the likelihood of unintended pregnancies. The Intra-Cluster Correlation (ICC) provided evidence that community characteristics had effects on unintended pregnancies. Conclusion: There is evidence that community characteristics influence the prevalence of unintended pregnancies in Kenya. Community sensitisation and mobilisation should be central to all efforts aiming to reduce prevalence of unintended pregnancies.