Health Care Factors Influencing Teen Mothers’ Use Of Contraceptives in Malawi

Objective: The study seeks to examine factors associated with teen mothers’ use of modern contraceptives after giving birth.Methods: The 2010 Malawi Demographic and Health Survey data was used to test the study objective. A sample of 12, 911 teen mothers aged between 10 and 18 years were extracted from 23, 020 women and were asked of contraceptive usage after first birth experiences, in which, a logistic regression model was employed to estimate correlates of contraceptive usage.Results: The study found that 54.8% of the teen mothers are still at a risk of having a repeat teenage pregnancy due to their non-use of contraceptives. This implies that less than 50% of teen mothers use contraceptives after experiencing teen birth. It is noted that health care factors such as use of antenatal care, awareness of pregnancy complications, attainment of primary education and exposure to media predict teen mothers’ use of moderncontraceptives.Conclusion: Despite endeavours made by government to improve access to family planning, health care challenges still exist affecting women’s use of contraceptives in Malawi. Ameliorating these health encounters call for widerange approaches aimed at addressing teen birth comprehensively in order to prevent early motherhood and subsequently high fertility.Funding: None declaredKeywords: teen births, teen mothers, antenatal care, education, Malaw

Assessment of Agricultural Information Needs in African, Caribbean and Pacific (ACP) States: Eastern Africa: Country study Kenya

The study aimed to provide insight on status of infrastructure, information services and ICM capacity of institutions involved in agriculture and rural development, Information and capacity building needs in the area of ICM identified for key institutions and potential CTA partners involved in ARD and potential strategic partners for CTA activities and services identified and baseline data on the status of ICM and ICT in ARD compiled for monitoring purposes and improved outreach..

Factors influencing women\u2019s utilization of public health care services during childbirth in Malawi Public health facility utilization.

Background: Maternal mortality remains a public health challenge claiming many lives at the time of giving birth lives. However, there have been scanty studies investigating factors influencing women\u2019s use of public health facilities during childbirth. Objective: The aim of the study was to explore the factors associated with women choice of public health facility during childbirth. Methods: The study used 2010 Malawi Demographic Health Survey dataset and a binary logistics regression analysis to estimate the determinants influencing women\u2019s use of public health facilities at the time they give birth. Results: Of 23020 women respondents, 8454(36.7%) chose to give birth in public health facilities. Multivariate analysis reported that frequency of antenatal care (ANC), birth order, women\u2019s education, wealth status and quality of care were the major predictors increasing women\u2019s choice to use public health facilities at childbirth. Conclusion: There is need to use multimedia approach to engage women on significance of utilizing public health facilities during childbirth and promote quality of care in facilities if their health outcome is to improve in Malawi

Histomorphological features of atherosclerosis in the left anterior descending coronary arteries among black Kenyans

The pattern of coronary artery atherosclerosis is valuable in informing mitigation strategies for coronary heart disease. Histomorphological data on this disease among Africans living in Sub Saharan Africa are, however, scarce. The left anterior descending is one of the most commonly afflicted arteries. This study, therefore, examined the left anterior descending artery of 213 black Kenyans [Mean age 36.8 years, range 5 – 82 years] who had died of non cardiovascular causes for features of atherosclerosis. The individuals were divided into male and female, then into 10-yr age groups. Specimens were obtained from the proximal segment of the artery during autopsy at the Department of Human Anatomy University of Nairobi, Kenya. They were processed routinely for paraffin embedding andsectioning. Five micron sections were stained with Haematoxylin/Eosin and Mason’s trichrome and examined with light microscope. Micrographs of representative features were taken using a high resolution digital camera. At least one feature of atherosclerosis was present in 54 (25.4%) of the individuals. The features observed included severe intimal hyperplasia (34; 63%), disintegration of the internal elastic lamina [30; 55.6%]; atherosclerotic plaque (20; 37%), adventitial thicknening (14; 26%) and mural neovascularization (10; 18.5%). The mean age of those with features of atherosclerosis was 38.4 years, range 6 – 62 years with 25 (46.3%) being aged 40 years and below. Of these, the male: female ratio was 1.7:1. In conclusion, features of atherosclerosis are present in over 25% of the population studied. The disease affects young people, including women. Proactive preventive measures including follow – up should commence early, and involve both men and womenKeywords: Atherosclerosis, coronary, young, men, women, Keny

The familiarity of parents-teenagers and depressed high school adolescents in the city of Yogyakarta

Familiarity of teens-parents and high school teenagers with incidence of depression in Yogyakarta CityPurposeThis study aimed to determine the differences in the incidence of depression in high school teenagers who are familiar and not familiar with their parents in Yogyakarta City.MethodsThis research was a cross-sectional study, involving 200 high school teenagers in Yogyakarta city and conducted in five high schools in Yogyakarta city. The independent variable was familiarity of parent-teens, the dependent variable was teenager depression and external variables were gender, parental employment status, and socioeconomic status. Data analysis included univariable, and bivariable analysis with Chi-square tests, to determine the strength of the relationship between independent and dependent variable and multivariable analysis with logistic regression tests.ResultsBivariable analysis showed a significant correlation between familiarity of parent-teens with teenagers’ depression. Teenagers who were not familiar with their parents were potentially 3.7 times more likely to get depressed than teenagers who were familiar with their parents. Multivariable analysis showed that there was a significant relationship between parental familiarity with teenagers’ depression when controlled for the variable of gender. Teenagers who are not familiar with their parents and female gender have 7.6 times greater potential to become depressed than teenagers who are familiar with their parents and male gender.ConclusionThe incidence of depression in high school teenagers who are not familiar with their parents was higher than teenagers who are familiar with their parents.Purpose :Method : Metode penelitian cross sectional. Sampel penelitian remaja SMA di Kota Yogyakarta sebanyak 200 orang. Penelitian dilakukan di 5 SMA di Kota Yogyakarta. Variabel bebas keakraban orang tua-remaja, variabel terikat depresi  remaja dan variabel luar jenis kelamin, status pekerjaan orang tua dan status sosial ekonomi. Analisis data meliputi univariabel, bivariabel menggunakan uji Chi-square, untuk mengetahui kekuatan hubungan antara variabel bebas dan variabel terikat menggunakan Rasio Pravelensi (RP) dengan Confidence Interval (CI) 95%, dan multivariabel dengan uji regresi regresi logistik.Findings : Analisis bivariabel menunjukkan ada hubungan bermakna antara keakraban orang tua-remaja dengan depresi remaja. Remaja yang tidak akrab dengan orang tua memiliki peluang 3,7 kali lebih besar mengalami depresi daripada remaja yang akrab dengan orang tua (p:0,001, RP=3.71 CI 95% 2.10-6.53). Analisis Multivariabel menunjukkan bahwa ada hubungan yang bermakna antara keakraban orang tua dengan depresi remaja mengontrol variabel jenis kelamin (p:0,002, OR=7.66 CI 95% 3.63-16.15). Remaja yang tidak akrab dengan orang tua dan berjenis kelamin perempuan berpeluang 7.6 kali lebih besar mengalami depresi dibandingkan dengan remaja yang akrab dengan orang tua dan berjenis kelamin laki-laki. Kejadian depresi pada remaja SMA yang tidak akrab dengan orang tua lebih tinggi daripada remaja yang akrab dengan orang tua. Research Limitations :Practical Implications :Originality

Knowledge and risk factors for foot-and-mouth disease among small-scale dairy farmers in an endemic setting

Foot-and-mouth disease (FMD) is a highly contagious viral infection of cloven-hoofed animals. In Kenya, the disease is endemic with outbreaks typically occurring throughout the year. A cross-sectional study was undertaken in Nakuru County to investigate farmer knowledge and risk factors for clinical disease. Semi-structured interviews were conducted on 220 smallholder farmers, selected using random spatial sampling. The majority of respondents (207/220 [94.1%]) knew of FMD and 166/207 (80.2%) of them could correctly identify the disease based on their knowledge of the clinical signs. Forty-five out of 220 farmers (20.4%) vaccinated their livestock against FMD in the previous 6 months, although of those who knew of FMD only 96/207 (46.4%) perceived it as a preventive measure undertaken to reduce the risk of disease in their farm. FMD had occurred in 5.9% of the surveyed farms within the previous 6 months (from May to November 2016). Using multivariate analysis, the use of a shared bull (OR = 9.7; p = 0.014) and the number of sheep owned (for each additional sheep owned OR = 1.1; p = 0.066) were associated with an increased likelihood of a farm experiencing a case of FMD in the previous 6 months, although the evidence for the latter was weak. This study reports risk factors associated with clinical FMD at the farm level in a densely populated smallholder farming area of Kenya. These results can be used to inform the development of risk-based strategic plans for FMD control and as a baseline for evaluating interventions and control strategies

Uptake of and adherence to oral pre-exposure prophylaxis among adolescent girls and young women at high risk of HIV-infection in Kampala, Uganda: A qualitative study of experiences, facilitators and barriers

Background: There is limited information on factors that influence oral pre-exposure prophylaxis (PrEP) uptake and adherence among adolescent girls and young women (AGYW). We conducted a qualitative methods study to explore experiences, facilitators and barriers of PrEP uptake and adherence to PrEP among AGYW at risk of Human Immunodeficiency Virus (HIV) infection in Kampala, Uganda. Methods: This study was nested in a prospective cohort study that offered daily oral PrEP to AGYW. Between April 2019 and October 2020 we conducted in-depth interviews with 26 AGYW aged 14–24 years who had been offered or had been using PrEP for at least 6 months, including PrEP adherers (8), non-adherers (8) and those who had declined PrEP (10). After 12 months, follow-up interviews were conducted with 12 AGYW who had adhered to PrEP and those who had dropped it. Thematic analysis was conducted and data were further examined and categorized into the 5 constructs of the Socio-Ecological Model (SEM). Results: PrEP uptake and adherence were facilitated by factors including: perceptions that one’s own or partner’s sexual behaviour was high risk, a negative attitude towards condoms, social support and wanting to maintain a negative HIV status after receiving a negative HIV test result. Good adherence to PrEP was enabled by effective counselling, support tools such as alarms and phone reminders and incentives like free treatment for STIs and other illnesses during study visits. Barriers to uptake included: anxiety about the pill burden, perceptions of being too young for PrEP and fear of being labelled `prostitute’ or `HIV positive’. Poor adherence was attributed to doubt over the efficacy of PrEP as a result of beliefs that because HIV was incurable, no medicine could prevent it. Alcohol use, side effects experienced, and mobility all had a negative impact on adherence. The majority of PrEP users reported feeling safe as a result of using PrEP which had both good and negative implications on their sexual behaviour, specifically the number of sexual partners and condom use. Conclusion: Addressing community misconceptions to maximize uptake of PrEP among AGYW is important. Targeted education messages, and counselling to address misconceptions in ways that capture the attention of AGYW in communities are required

Understanding the contexts in which female sex workers sell sex in Kampala, Uganda: a qualitative study.

BACKGROUND: Structural, interpersonal and individual level factors can present barriers for HIV prevention behaviour among people at high risk of HIV acquisition, including women who sell sex. In this paper we document the contexts in which women selling sex in Kampala meet and provide services to their clients. METHODS: We collected qualitative data using semi-structured interviews. Women were eligible to participate if they were 18 years or older, self-identified as sex workers or offered sex for money and spoke Luganda or English. Ten women who met clients in venues and outdoor locations were selected randomly from a clinic for women at high risk of HIV acquisition. Ten other women who met clients online were recruited using snowball sampling. Interviews included demographic data, and themes included reasons for joining and leaving sex work, work locations, nature of relationships with clients and peers, interaction with authorities, regulations on sex work, and reported stigma. We conducted interviews over three months. Data were analysed thematically using a framework analysis approach. The coding framework was based on structural factors identified from literature, but also modified inductively with themes arising from the interviews. RESULTS: Women met clients in physical and virtual spaces. Physical spaces included venues and outdoor locations, and virtual spaces were online platforms like social media applications and websites. Of the 20 women included, 12 used online platforms to meet clients. Generally, women from the clinic sample were less educated and predominantly unmarried, while those from the snowball sample had more education, had professional jobs, or were university students. Women from both samples reported experiences of stigma, violence from clients and authorities, and challenges accessing health care services due to the illegality of sex work. Even though all participants worked in settings where sex work was illegal and consequently endured harsh treatment, those from the snowball sample faced additional threats of cybersecurity attacks, extortion from clients, and high levels of violence from clients. CONCLUSIONS: To reduce risk of HIV acquisition among women who sell sex, researchers and implementers should consider these differences in contexts, challenges, and risks to design innovative interventions and programs that reach and include all women

Community perceptions of malaria and vaccines in the South Coast and Busia regions of Kenya

<p>Abstract</p> <p>Background</p> <p>Malaria is a leading cause of morbidity and mortality in children younger than 5 years in Kenya. Within the context of planning for a vaccine to be used alongside existing malaria control methods, this study explores sociocultural and health communications issues among individuals who are responsible for or influence decisions on childhood vaccination at the community level.</p> <p>Methods</p> <p>This qualitative study was conducted in two malaria-endemic regions of Kenya--South Coast and Busia. Participant selection was purposive and criterion based. A total of 20 focus group discussions, 22 in-depth interviews, and 18 exit interviews were conducted.</p> <p>Results</p> <p>Participants understand that malaria is a serious problem that no single tool can defeat. Communities would welcome a malaria vaccine, although they would have questions and concerns about the intervention. While support for local child immunization programs exists, limited understanding about vaccines and what they do is evident among younger and older people, particularly men. Even as health care providers are frustrated when parents do not have their children vaccinated, some parents have concerns about access to and the quality of vaccination services. Some women, including older mothers and those less economically privileged, see themselves as the focus of health workers' negative comments associated with either their parenting choices or their children's appearance. In general, parents and caregivers weigh several factors--such as personal opportunity costs, resource constraints, and perceived benefits--when deciding whether or not to have their children vaccinated, and the decision often is influenced by a network of people, including community leaders and health workers.</p> <p>Conclusions</p> <p>The study raises issues that should inform a communications strategy and guide policy decisions within Kenya on eventual malaria vaccine introduction. Unlike the current practice, where health education on child welfare and immunization focuses on women, the communications strategy should equally target men and women in ways that are appropriate for each gender. It should involve influential community members and provide needed information and reassurances about immunization. Efforts also should be made to address concerns about the quality of immunization services--including health workers' interpersonal communication skills.</p