Linking Female Adolescents’ Knowledge, Attitudes and Use of Contraceptives to Adolescent Pregnancy in Ghana: A Baseline Data for Developing Sexuality Education Programmes

(1) Background: Nearly one out of ten Ghanaian female adolescents aged 15–19 has experienced childbearing in urban settlements compared to twice this number in the rural populations due to unintended pregnancies. This study assessed the linkages between knowledge, attitudes, and use of contraceptives and adolescent pregnancy in one of the highly affected Municipalities (i.e., Komenda-Edina-Eguafo Abrem [KEEA]) in Ghana. (2) Methods: Employing a facility-based sampling method, 378 female adolescents aged 15–19 were selected. Unadjusted odds ratio (uOR) and adjusted odds ratio (aOR) at 95% confidence intervals (CI) and p-values were used for significant variables at p < 0.05. (3) Results: Pregnant adolescents were 2 times more likely to indicate that the procedure of procuring contraceptives is quite uncomfortable (aOR = 2.42, 95% CI = [1.29–4.55]; p = 0.006). Also, pregnant adolescents were 5 times more likely to have ever used traditional contraceptive methods than their non-pregnant counterparts (aOR = 5.02, 95% CI = [2.60–9.71]; p < 0.001). On the contrary, pregnant adolescents had lower odds of indicating that contraceptives are for only married people (aOR = 0.38, 95% CI = [0.20–0.70]; p = 0.002) and that it feels bad to receive contraceptive information from parents and relatives than non-pregnant adolescents (aOR = 0.42, 95% CI = [0.24–0.74]; p = 0.003). Pregnant adolescents were less likely to use modern contraceptives than their non-pregnant adolescents (aOR = 0.18, 95% CI = [0.11–0.31]; p < 0.001). (4) Conclusions: The findings indicate that female adolescents’ use of traditional contraceptives is associated with the risk of pregnancy in KEEA Municipality within the Central Region of Ghana. However, adolescents who had the perception that contraceptives are for married people and those who used modern contraceptives were less likely to get pregnant. Government and non-governmental organizations in Ghana should implement educational policies and programmes aimed at educating sexually-active female adolescents on modern contraceptives and the need to use them to prevent pregnancies. The basis for such policies and programmes should be based on evidence that compared to traditional contraceptives, modern contraceptives are more effective. In addition, there is the need to provide accurate information regarding the use of contraceptives to adolescents that will help change their attitudes towards the use of contraceptives

One novel virus, different beliefs as playmakers towards disease spread in Africa: looking at COVID-19 from a religious lens.

Religious and spiritual observances that draw large people together are pervasive in many parts of the world, including Africa. With the recent emergence of COVID-19, these mass religious gatherings may pose significant threats to human health. Given the compromised healthcare systems in many parts of Africa, faith-based institutions have a huge responsibility towards the management of the potential spread of the virus through effective organizational strategies or interventions. This essay sheds light on what the novel virus has to do with religion, the role of religious practices in inhibiting or spreading COVID-19, and what appropriate evidence-based interventions religious or faith-based organizations could adopt to help prevent the spread of the disease in Africa through a unity of thoughts for religious action

Africa's COVID-19 Situation in Focus and Recent Happenings: A Mini Review.

Given that COVID-19 (SARS-CoV-2) has crept into Africa, a major public health crisis or threat continues to linger on the continent. Many local governments and various stakeholders have stepped up efforts for early detection and management of COVID-19. This mini review highlights the current trend in Africa, history and general epidemiological information on the virus. Current ongoing efforts (e.g., improving testing capacity) and some effective ways (e.g., intensified surveillance, quick detection, contact tracing, isolation measures [e.g., quarantine], and social distancing) of preventing and managing COVID-19 in Africa are described. The review concludes by emphasizing the need for public health infrastructure development (e.g., laboratories, infectious disease centers, regional hospitals) and human capacity building for combating COVID-19 and potential future outbreaks. Additionally, regular public health educational campaigns are urgently required. Future epidemiological studies to ascertain case fatality and mortality trends across the continent for policy directions are necessary

Experience of Intimate Partner Violence among Women in Sexual Unions: Is Supportive Attitude of Women towards Intimate Partner Violence a Correlate?

Intimate partner violence (IPV) is predominant in sub-Saharan Africa (SSA), with nearly 40 percent of women reporting IPV at some point in time. In this study, we investigated whether a supportive attitude towards IPV is associated with past-year experience of IPV among women in sexual unions in SSA. This study involved a cross-sectional analysis of data from the Demographic and Health Survey (DHS) of 23 countries in SSA. Bivariate and multivariable binary logistic regression analyses were performed to determine the association between attitude towards IPV and past-year experience of IPV. The regression results were presented in a tabular form using crude odds ratio (cOR) and adjusted odds ratio (aOR) at 95% confidence intervals (CIs). In the pooled countries, we found that women who had supportive attitude towards IPV were more likely to experience IPV compared to those who rejected IPV (cOR = 1.72, 95% CI = 1.64, 1.79), and this persisted after controlling for maternal age, marital status, wealth, maternal education level, place of residence, and mass-media exposure (aOR = 1.72, 95% CI = 1.64, 1.79). The same trend and direction of association between attitude towards IPV and experience of IPV was also found in all the 23 studied countries. This study has demonstrated that women who accept IPV are more likely to experience IPV. Hence, we recommend that efforts to end IPV must focus primarily on changing the attitudes of women. This goal can be achieved by augmenting women’s empowerment, education, and employment interventions, as well as sensitizing women in relation to the deleterious ramifications of accepting IPV. Furthermore, reducing IPV is critical towards the achievement of Sustainable Development Goal

Bayesian Analysis of Predictors of Incomplete Vaccination against Polio among Children Aged 12-23 Months in Ethiopia.

BackgroundThe re-introduction of polio among children aged 12-23 months is likely to occur in Ethiopia due to the low vaccination rates against poliovirus. The study sought to examine the predictors of incomplete vaccination against polio among children aged 12-23 months in Ethiopia.MethodsThe data used were obtained from the 2016 Ethiopia Demographic and Health Survey. Binary and Bayesian logistic regressions were used for the data analysis, with parameters estimated using classical maximum likelihood and the Bayesian estimation method.ResultsThe results revealed that 43.7% of the children were not fully vaccinated against polio in Ethiopia. Maternal age, educational level, household wealth index, exposure to mass media, place of residence, presence of nearby healthy facility, counseling on vaccination, and place of delivery were significant determinants of incomplete polio vaccination among children aged between 12 and 23 months in Ethiopia.ConclusionConsiderable numbers of children are not fully vaccinated against polio in Ethiopia. Individual and contextual factors significantly contributed to incomplete polio vaccination among children in the country. Therefore, the government and other stakeholders should pay particular attention to maternal education to increase mothers' educational level in all regions and give training and counseling in all urban and rural parts of the country on child vaccination to overcome the problem of children's incomplete polio vaccination and/or vaccination dropout

COVID-19 Pandemic Worsening Gender Inequalities for Women and Girls in Sub-Saharan Africa

Pandemics such as COVID-19 have often resulted in international, national and sub-regional crises, with considerable inequities across many societies. With the already existing structural and socio-economic inequalities in sub-Saharan Africa, the stay-at-home orders, lockdowns, and shutdowns across the sub-regional states could worsen and have a tremendous impact on vulnerable groups. Numerous studies across a variety of contexts have well-documented gender, and cultures on varied health outcomes. However, these have not been contextualized in sub-Saharan Africa in the light of the COVID-19 pandemic. This mini review discusses the ways by which COVID-19 has impacted the lives of girls and women across sub-Saharan Africa and the strategies that can help mitigate these challenges. The mini review specifically shares light on a wide array of dimensions where the inequities exist. These include the disproportionate areas affected by COVID-19; household inequities; educational inequalities; work/employment inequalities; disparities related to healthcare, sexual and reproductive health as well as housing inequities. Conclusively, the review accentuates the need for sub-Saharan African countries to adopt low-cost preventive measures such as discouraging mass gatherings (e.g., local community gatherings), and face masking with non-medical cloth like masks for the local populace as these are crucial in managing the spread of the virus among disproportionate women population. For localities with limited access to handwashing facilities, alternative strategies like alcohol-based hand rub solutions could be deployed. The complex interrelated disparities require a broad set of policy actions to lessen the current burden faced by many women in sub-Saharan Africa

Understanding the linkages between male circumcision and multiple sexual partnership among married Ghanaian men: Analysis of data from the 2014 Ghana demographic and health survey.

IntroductionThis current study sought to investigate the association between male circumcision status and engaging in multiple sexual partnership among men in Ghana.MethodsData from this study come from the men's file of the 2014 Ghana demographic and health survey. Both descriptive and inferential statistics were conducted among 1, 948 men and the level of statistical significance was pegged at p ResultsResults revealed that men who have been circumcised were more likely to engage in multiple sexual partnership (AOR = 3.36; CI:1.14-9.89), compared to those who have not been circumcised. With the covariates, men with primary level of education were more likely to have multiple sexual partners (AOR = 2.01; CI:1.10-3.69), compared to those with no education. With wealth status, men with richest (AOR = 2.27; CI:1.04-4.97), richer (AOR = 2.05; CI: 1.03-4.08), and middle wealth status (AOR = 1.83; CI:1.01-3.34) had the highest likelihood of having multiple sexual partners, compared to those with poorest wealth status. Conversely, men who professed the Islamic faith were less likely to engage in multiple sexual partnership (AOR = 0.58; CI: 0.36-0.94), compared to Christians. Similarly, men who resided in the Brong Ahafo (AOR = 0.51; CI: 0.26-0.99), Upper East (AOR = 0.41; CI:0.19-0.89), and Ashanti regions (AOR = 0.39; CI: 0.20-0.78) were less likely to engage in multiple sexual partnership.ConclusionBased on the current findings, educational campaigns by stakeholder groups (e.g., Ministry of Health in collaboration with the National Commission on Civic Education, civil society, educational institutions) should sensitize the sexually active population at the community level to consistently use condoms, especially when they have multiple sexual partners, even when a man is circumcised. Campaign messages must clearly emphasize that male circumcision should not substitute precautionary measures such as delay in the onset of sexual relationships, averting penetrative sex, reducing the number of sexual partners as well as correct and consistent use of male or female condoms regardless one's social standing

Mother and newborn skin-to-skin contact and timely initiation of breastfeeding in sub-Saharan Africa.

BACKGROUND: Mother and newborn skin-to-skin contact (SSC) plays a key role in breastfeeding practices of mothers. In this study, we examined the association between mother and newborn SSC and timely initiation of breastfeeding in sub-Saharan Africa (SSA). METHODS: This cross-sectional study utilized nationally representative data from the Demographic and Health Surveys of 17 countries in SSA from 2015 to 2020. Multilevel binary logistic regression analysis was performed to examine the association between mother and newborn SSC and timely initiation of breastfeeding. The results are presented using adjusted odds ratios (aOR), with 95% confidence interval (CI). RESULTS: The pooled prevalences of mother and newborn SSC and timely initiation of breastfeeding were 45.68% (95% CI = 34.12-57.23) and 62.89% (95% CI = 55.67-70.11), respectively. Mothers who practiced newborn SSC were more likely to practice timely initiation of breastfeeding compared to those who did not practice SSC [aOR = 1.68, 95% CI = 1.58, 1.78] and this persisted after controlling for all the covariates [aOR = 1.38, 95% CI = 1.29, 1.47]. At the country level, mother and newborn SSC increased the odds of timely initiation of breastfeeding in Angola [aOR = 1.99, 95% CI = 1.44, 2.76], Cameroon [aOR = 1.43, 95% CI = 1.02, 1.99], Ethiopia [aOR = 1.62, 95% CI = 1.16, 2.28], Guinea [aOR = 1.69, 95% CI = 1.10, 2.60], Liberia [aOR = 2.03, 95% CI = 1.33, 3.12], Malawi [aOR = 1.47, 95% CI = 1.02, 2.12], Mali [aOR = 1.42, 95% CI = 1.10, 1.84], Sierra Leone [aOR = 1.87, 95% CI = 1.23, 2.83], South Africa [aOR = 2.59, 95% CI = 1.41, 4.76], Tanzania [aOR = 1.60, 95% CI = 1.27, 2.01], Uganda [aOR = 1.43, 95% CI = 1.02, 1.99], Zambia [aOR = 1.86, 95% CI = 1.50, 2.30], and Zimbabwe [aOR = 1.65, 95% CI = 1.24, 2.21]. CONCLUSION: The prevalence of SCC was relatively low but timely initiation of breastfeeding was high. Mother and newborn SSC is a strong predictor of timely initiation of breastfeeding in SSA. To enhance timely initiation of breastfeeding after birth, this study recommends that more child and maternal healthcare interventions focused on improving mother and newborn SSC should be implemented

The missing link between legal age of sexual consent and age of marriage in sub-Saharan Africa: implications for sexual and reproductive health and rights

Child marriage is a fundamental violation of human rights and a threat to access to education, sexual and reproductive health care, and employment. It also threatens freedom from violence, reproductive rights, movement, and the right to consensual marriage. In most countries in sub-Saharan Africa, the legal age of marriage is 18 years. Hence, girls who marry before 18 years are considered as victims of child marriage. Closely knitted to legal age for marriage is the issue of age for sexual consent, which refers to the minimum age at which a person is considered to have the legal capacity to consent to sexual intercourse. While there seem to be a standard legal age for marriage, the legal age for sexual consent varies in most countries in sub-Saharan Africa and is often lower than the legal age of marriage. In this commentary, we argue that the gap between the legal age of sexual consent and marriage partly accounts for some of the sexual and reproductive health challenges such as intimate partner violence, sexually transmitted infections, adolescent pregnancy, early childbirth, including unsafe abortions among adolescent girls in sub-Saharan Africa and infringements on their sexual and reproductive health rights. This commentary highlights strategic potential interventions that could help address the identified gaps. We argue that aligning the age for sexual consent and marriage is not the solution to the problem. However, what is critical is the education of young people about sexual and reproductive health issues and comprehensive sexuality education through advocacy networks at the national and local levels. Thus, the key is to provide accurate, timely, and non-judgmental sexual and reproductive health and rights information to young people irrespective of the prevailing age of consent. This provision will empower them to make informed decisions about their sexual and reproductive health

Physical violence during pregnancy in sub-Saharan Africa: why it matters and who are most susceptible?

OBJECTIVE The study assessed the prevalence of physical violence against pregnant women and its associated factors in sub Saharan Africa SSA DESIGN We analysed cross sectional data of 108971 women in sexual unions from the most recent Demographic and Health Surveys of 26 countries in SSA The predictors of physical violence were examined using a multilevel binary logistic regression All the results were presented as adjusted odds ratios aORs with their corresponding 95 confidence intervals CIs SETTING Twenty six countries in SSA PARTICIPANTS 108 971 women who had ever been pregnant OUTCOME MEASURE Physical violence during pregnancy RESULTS Physical violence was identified in 6 0 of pregnant women in SSA The highest prevalence 14 0 was reported in South Africa while Burkina Faso recorded the lowest 2 1 Women who had primary aOR 1 26 95 CI 1 15 1 38 and secondary education aOR 1 15 95 CI 1 01 1 32 those who were cohabiting aOR 1 21 95 CI 1 11 1 32 those who were working aOR 1 17 95 CI 1 08 1 28 and those whose partners had primary aOR 1 15 95 CI 1 04 1 28 and secondary education aOR 1 14 95 CI 1 01 1 28 were more likely to experience physical violence during pregnancy compared with those who had no formal education those who were married those who were not working and those whose partners had no formal education respectively Moreover women whose partners consumed alcohol aOR 2 37 95 CI 2 20 2 56 those who had parity of four or more aOR 2 06 95 CI 1 57 2 72 and those who perceived intimate partner violence IPV as a culturally accepted norm aOR 1 55 95 CI 1 44 1 67 had higher odds of experiencing physical violence during pregnancy compared to those whose partners did not consume alcohol those with parity zero and those who did not perceive IPV as culturally accepted respectively On the contrary women who were aged 35 39 those who were of the richest wealth index and those in rural areas had reduced odds of experiencing physical violence during pregnancy CONCLUSION Base