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

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

Mapping Evidence of Impacts of COVID-19 Outbreak on Sexual and Reproductive Health: A Scoping Review

Introduction: The emergence of the coronavirus disease 2019 (COVID-19) pandemic has rapidly transformed the pre-existing worldwide sexual and reproductive health environment. The provision and supply of contraceptives, and a wide variety of sexual health, new-born, and maternal health services have been seriously affected. Thus, this scoping review mapped the available evidence on the impacts of the COVID-19 outbreak on sexual and reproductive health. Methods: Arksey and O’Malley’s methodological framework guided this scoping review. A search was conducted from the following databases: Embase, PubMed, CINAHL, Scopus, WOS, and AJOL. The preferred reporting items for systematic reviews and meta-analyses (PRISMA) chart and PRISMA extension for scoping reviews (PRISMA-ScR) checklist were used to document the review process. The McMaster critical review checklist was used to determine the quality of the included studies. Thematic analyses were conducted using NVivo version 12. Results: Three studies showed evidence on the impact of COVID-19 and family planning services, six studies reported on maternal and child services and eleven studies reported on sexual health (sexual behavior). Limited access to family planning use, reduction in multiple sexual partnership, decreased transactional sex, and maternal and child services disruption were some impacts reported in the included studies. Conclusion: This study has demonstrated the impacts of COVID-19 on family planning access, multiple sexual partnership, transactional sex, and disruption of maternal and child health services. Interventions that will consider the immediate availability of and access to all sexual and reproductive health services should be prioritized

Mass Media Exposure and Safer Sex Negotiation among Women in Sexual Unions in Sub-Saharan Africa: Analysis of Demographic and Health Survey Data.

(1) Background: Improving sexual autonomy among women in sexual unions comes with various benefits, including the reduction of sexually transmitted and blood-borne infections. We examined the relationship between mass media exposure and safer sex negotiation among women in sub-Saharan Africa (SSA). (2) Methods: The study involved a cross-sectional analysis of Demographic and Health Survey (DHS) data of 29 sub-Saharan African countries. A total of 224,647 women aged 15–49 were included in our analyses. We examined the association between mass media exposure and safer sex negotiation using binary logistic regression analysis. The results are presented using a crude odds ratio (cOR) and adjusted odds ratio (aOR), with their respective confidence intervals (CIs). Statistical significance was set at p < 0.05. (3) Results: The overall prevalence of safer sex negotiation among women in sexual unions in SSA was 71.6% (71.4–71.8). Women exposed to mass media had higher odds of negotiating for safer sex compared with those who had no exposure (aOR = 1.94; 95% CI = 1.86–2.02), and this persisted after controlling for covariates (maternal age, wealth index, maternal educational level, partner’s age, partner’s educational level, sex of household head, religion, place of residence, and marital status) (aOR = 1.40; 95% CI = 1.35–1.46). The disaggregated results showed higher odds of safer sex negotiation among women exposed to mass media in all the individual countries, except Ghana, Comoros, Rwanda, and Namibia. (4) Conclusions: The findings could inform policies (e.g., transformative mass media educational seminars) and interventions (e.g., face-to-face counselling; small group sensitization sessions) in SSA on the crucial role of mass media in increasing safer sex practice among women in sexual unions. To accelerate progress towards the achievement of the Sustainable Development Goal five’s targets on empowering all women and safeguarding their reproductive rights, the study recommends that countries such as Ghana, Comoros, Rwanda, and Namibia need to intensify their efforts (e.g., regular sensitization campaigns) in increasing safer sex negotiation among women to counter power imbalances in sexual behaviour

Not just numbers: beyond counting caesarean deliveries to understanding their determinants in Ghana using a population based cross-sectional study.

BACKGROUND:The increasing rate of caesarean deliveries (CD) has become a serious concern for public health experts globally. Despite this health concern, research on factors associated CD in many low- and -middle countries like Ghana is sparse. This study, therefore, assessed the prevalence and determinants of CD among child-bearing women aged 15-49  in Ghana. METHODS:The study used data from the 2014 Ghana Demographic and Health Survey. The analysis was limited to mothers (n = 2742) aged 15-49 , who had given birth in health facilities 5 years preceding the survey. Association between CD and its determinants was assessed by calculating adjusted odds ratios (AOR) with their respective 95% confidence intervals using a binary logistic regression. RESULTS:The percentage of mothers who delivered their babies through caesarean section (CS) was 18.5%. Using multivariable logistic regression, the results showed that women aged 45-49 (AOR = 10.5; 95% CI: 3.0-37.4), and women from a household that are headed by a female (AOR = 1.3; 95% CI = 1.1-1.7) had higher odds to deliver through CS. Women from the Upper East (AOR =0.4; 95% CI = 0.2-0.7) and Upper West (AOR = 0.4; 95% CI = 0.2-0.8) regions had lower odds to deliver their children through CS. Women with parity 4 or more (AOR = 0.3; 95% CI = 0.2-0.5) had lower odds of CD compared to those with parity 1. Women with female babies had lower odds (AOR = 0.8; CI = 0.7-0.9) of delivering them through CS compared to those with male children. CONCLUSION:The percentage of women delivering babies through the CS in Ghana is high. The high rates of CD noted do not essentially indicate good quality care or services. Hence, health facilities offering this medical protocol need to adopt comprehensive and strict measures to ensure detailed medical justifications by doctors for performing these caesarean surgeries