Caesarean delivery in Uganda: Do non-clinical factors explain the trend?

The aim of this paper was to assess the association between non-clinical factors and Caesarean delivery in Uganda. Self-reported data from the individual recode file were extracted from the 2016 Uganda Demographic and Health Survey (UDHS), with a sub sample of 9929 women aged 15-49 with a recent birth in the last 5 years preceding the survey. Chi-square tests and multivariate comlementary log-log regression models were used to examine the relationship between non-clinical factors and Caesarean section delivery. About one in ten (7%) of the women aged 15-49 had Caesarean deliveries. Non-clinical factors which were significantly associated with Caesarean section delivery include advanced maternal age, having the first birth compared to subsequent births, having 1-3 children compared to 4 or more children, higher level of women's education relative to no education, being in the middle, richer, and richest wealth quintile compared to the poorest quintile. In conclusion, evidence suggests that the trend in Caesarean delivery can be attributed partially to non-clinical factors including advanced maternal age, birth order, parity, women's education level, and wealth quintile. Thus, efforts to address the trend in Caesarean section delivery, need to take account of non-clinical factors.

Factors associated with knowledge about family planning and access to sexual and reproductive health services by sexually active immigrant youths in Hillbrow, South Africa: a cross-sectional study.

BACKGROUND: In South Africa, universal access to health care services, including those relating to sexual and reproductive health (SRH) care, is contained in Section 27 of the Constitution and commits the country to supporting the United Nations 2030 Agenda for the Sustainable Development Goals (SDGs). The objective of this study was to examine the factors associated with knowledge about family planning and access to SRH services among sexually active immigrant youths in Hillbrow, South Africa. METHOD: This cross-sectional study was based on data from a household survey conducted in Hillbrow during December 2019. Interviewer-administered questionnaires were used to collect information from immigrant youths (18-34 years old). Data on 437 sexually active respondents was analysed in STATA 14 using univariate, bivariate, logistic, and multinomial regression models. A p-value of < 0.05 was chosen as the level of significance. RESULTS: About half of the respondents had poor knowledge about family planning; about one-third (35%) of the immigrant youths had no access to SRH services, 42% had some access, and 23% had access. The adjusted logistic regression model showed that being a female (AOR = 3.85, CI: 2.34-6.35, belonging to age group 30-34 years (AOR = 3.88, CI: 2.00-7.53); belonging to the rich wealth index (AOR = 2.55 (1.32-4.93); not having received information about family planning (AOR = 0.17, CI = 0.10-0.29) and not using a contraceptive at the time of the survey (AOR = 0.37, CI: 0.19-0.70) were factors associated with having knowledge about family planning. The adjusted multinomial regression shows that the factors associated with not having access to SRH services were secondary or higher level of education (ARRR = 1.89, 95% CI = 1.06-3.36), belonging to the rich wealth quintile (ARRR = 2.25, 95% CI = 1.00-5.07), being undocumented (ARRR = 0.49, 95% CI = 0.27-0.88), having experienced discrimination in Hillbrow (ARRR = 2.06, 95% CI = 1.15-3.67) and having received information about family planning 6 months prior to the survey (ARRR = 0.49, 95% CI = 0.26-0.90, p-value < 0.05). CONCLUSION: To move towards realization of the Constitution of South Africa, achieve the SDGs, and curb associated negative SRH outcomes, there is a need to advocate for the implementation of universal access to SRH services that is inclusive of immigrant youths.

Access to SRH services by adolescents and youths has been a serious public health concern globally. In South Africa, universal access to health care including reproductive health care services is contained in Sect. 27 of the Constitution. The country is committed to the 2030 Agenda of the SDGs with the theme "leaving no one behind". The objective of this study was to examine the factors associated with knowledge about family planning and access to SRH services among sexually active immigrant youths in Hillbrow, South Africa. Interviewer-administered questionnaires were used to collect information on the socio-demographic, migration, and reproductive health characteristics from 439 sexually active immigrant youths in Hillbrow during December 2019. The data were analysed to assess the factors associated with knowledge about family planning and access to SRH services. The findings show that 46% of the immigrant youth had poor knowledge about family planning, while 35% had no access to SRH services, 42% had some access and only 23% had access. The study showed that the factors associated with knowledge about family planning are female respondents, from the rich income group, those in the older age category, those who received information about family planning 6-months prior to the survey and those using a contraceptive at the time of the survey. The factors associated with having no access to SRH services were those respondents having completed secondary education and higher, from the rich income group, undocumented immigrants, those respondents having experienced discrimination in Hillbrow, youths not having received information about family planning prior to the survey, and those not using a contraceptive. It is important to make access to SRH services available to immigrant youths to prevent associated negative SRH outcomes among the youths.

Is cohabitation as a form of union formation a licence to intimate partner physical violence in Uganda?

The study examined the argument that cohabitation as a form of union increases physical violence victimization among women. The study's aim was to assess the association between physical violence and other socio-demographic factors that influence physical violence among women. Self-reported data were extracted from the 2016 Uganda Demographic and Health Survey (UDHS), with a sample of 2479 couples, from the couple file. Chi-squared tests and multivariate Firth-logit regression models were used to examine the relationship between intimate partner violence (IPV) victimization and marital status controlling for other social-demographic factors. There was no significant evidence that women in cohabiting union have a higher risk of exposure to physical violence in the Ugandan context. The risk of experiencing physical violence perpetration varied by birth cohort, with the most recent cohorts exhibiting a slightly higher risk of experiencing partner violence than previous cohorts. Significant factors found to be associated with an increased risk of experiencing IPV included being in the poorer, middle and richer compared with the poorest wealth tertile of income, residing in Eastern or Northern regions compared with the Central region, being affiliated to the Catholic faith compared with Anglican and having five or more children compared with 4 or fewer children. In conclusion, there is no evidence that physical violence is more pronounced among women in cohabiting unions compared with married women in Uganda.

Knowledge about male circumcision and perception of risk for HIV among youth in Harare, Zimbabwe.

BACKGROUND: Male circumcision will require high uptake among previously non-circumcising countries to realise the impact of circumcising in preventing HIV. Little is known about whether youths are knowledgeable about male circumcision and its relationship with HIV prevention and their perception of risk of HIV infection. OBJECTIVE: This article aimed to ascertain youth's knowledge about male circumcision and perception of risk of HIV infection. METHODS: A quantitative study on 784 youth (men aged 15-35 years) was conducted in Harare, Zimbabwe, after obtaining their consent. Multivariate analysis examined the associations between background characteristics and knowledge about male circumcision and the perception of risk of HIV infection. RESULTS: The results revealed that age was a significant predictor of knowledge about male circumcision among youth in Harare, as was educational attainment and ever having tested for HIV. In addition, youth who had heard of voluntary medical male circumcision were more likely to have high knowledge of male circumcision compared to those who had never heard of it. The results also showed that male circumcision status was associated with higher knowledge about male circumcision compared to those who were not circumcised. The study also found that educational attainment, belonging to the Shona ethnic group, never having tested for HIV and disapproval of voluntary counselling and testing prior to male circumcision were associated with the perception of risk of HIV infection. CONCLUSION: The study provides two recommendations: the need to strengthen perceived susceptibility to HIV among the youth and the need for advocacy on the health benefits of male circumcision.

COHABITATION AND UNION DISSOLUTION IN CENTRAL UGANDA: DIFFERENCES BETWEEN COHABITORS AND NON-COHABITORS.

The aim of this paper was to establish whether the differences in the risks of union dissolution between cohabitors and non-cohabitors in Uganda have converged over time using event history data. Data were collected in 2013 from 1200 women in central Uganda using retrospective methods. Of these, 839 provided information on three types of first union: women who married directly (without first cohabiting), those who married following cohabitation and those who were still cohabiting. The data were analysed using decrement lifetable analysis. Though the analysis indicated a small difference in the timing of first union dissolution for women who married directly, no evidence was found that the difference in the risk of union dissolution between cohabitors and non-cohabitors had converged over the 9-year period following first union. Women's union/marriage status, number of living children in a union, parental union status and birth cohort were found to significantly influence the timing of union dissolution. Overall, the rate of union dissolution was fairly high, regardless of type of union.

BIOSOCIAL CORRELATES OF AGE AT FIRST SEXUAL INTERCOURSE: THE CASE OF GRADE 9 AND GRADE 11 PUPILS IN THE NORTH WEST PROVINCE OF SOUTH AFRICA.

Survival analysis - specifically the actuarial life-table method and the Cox Proportional Hazards model - was used to assess Bronfenbrenner's bio-ecological model with regards to the onset of sexual intercourse in a random sample of 1697 grade 9 and grade 11 pupils in the North West Province of South Africa. Data were collected in July and August 2007. Of the contextual factors examined, only academic performance and community disorganization were found to be statistically significantly associated with age at first sexual intercourse amongst girls. High academic performance by girls is positively associated with age at first sexual intercourse, while girls who live in disorganized communities initiate sexual intercourse earlier than their counterparts in other communities. Age is negatively associated with the timing of first sexual debut among both girls and boys. Males initiate sexual intercourse earlier than females, while youths with at least one sexual partner are much more likely to initiate sexual intercourse earlier than those without sexual partners.