Modern contraceptive utilization and its associated factors among married women in Senegal: a multilevel analysis

Background Utilization of modern contraceptives is still low in low-and middle-income countries, although fertility and population growth rates are high. In Senegal, modern contraceptive utilization is low, with few studies focusing on its associated factors. This study examined modern contraceptive use and its associated factors among married women in Senegal. Methods Data from the 2017 Continuous Demographic and Health Survey (C-DHS) on 11,394 married women was analysed. We examined the associations between the demographic and socioeconomic characteristics of women and their partners and modern contraceptive use using multilevel logistic regression models. Adjusted odds ratios with 95% confidence intervals (CI) were estimated. Results The utilization of modern contraceptives among married women was 26.3%. Individual level factors associated with modern contraceptive use were women’s age (45–49 years-aOR = 0.44, 0.30–0.63), women’s educational level (higher-aOR = 1.88, 1.28–2.76) husband’s educational level (higher-aOR = 1.43, 1.10–1.85)), number of living children (5 or more children-aOR = 33.14, 19.20–57.22), ideal number of children (2 children-aOR = 1.95, 1.13–3.35), desire to have more children (wants no more-aOR = 2.46, 2.06–2.94), ethnicity (Diola-aOR = 0.70, 0.50–0.99), media exposure (yes-aOR = 1.44, 1.16–1.79)), wealth index (richer-aOR = 1.31, 1.03–1.67) and decision making power of women (decision making two-aOR = 1.20, 1.02–1.41). Whereas, region (Matam-aOR = 0.35, 0.23–0.53), place of residence (rural-aOR = 0.76, 0.63–0.93), community literacy level (high-aOR = 1.31, 1.01–1.71) and community knowledge level of modern contraceptives (high-aOR = 1.37, 1.13–1.67) were found as significant community level factors. Conclusions The findings indicate that both individual and community level factors are significantly associated with modern contraceptive use among married women in Senegal. Interventions should focus on enhancing literacy levels of women, their husbands and communities. Furthermore, strengthening awareness and attitude towards family planning should be given priority, especially in rural areas and regions with low resources

Barriers and Facilitators to Accessing Health Care Services among Married Women in Ethiopia: a Multi-level Analysis of the Ethiopia Demographic and Health Survey

Background and Objective: Access to health care services is a major challenge to women and children in many developing countries such as Ethiopia. In this study, we investigated the individual- and community-level factors associated with barriers to accessing health care services among married women in Ethiopia. Methods: Data from the 2016 Ethiopia demographic and health survey on 9,824 married women of reproductive age (15-49 years) were analyzed. Multilevel logistic regression models were used to assess individual- and community-level factors associated with barriers to access health care services. Regression analysis results revealed adjusted odds ratios at 95% confidence intervals. Results: Over two-thirds (71.8%) of married women in Ethiopia reported barriers to accessing health care services. Some of the individual-level factors that were associated with lower odds of reporting barriers to access health care services include: having secondary education (aOR=0.49, 95% CI: 0.32-0.77), being in the richest quintile (aOR=0.34, 95% CI: 0.22-0.54), and indicating wife-beating as unjustified (aOR=0.66, 95% CI:0.55-0.81). Among the community-level factors, high community-level literacy (aOR=0.56, 95% CI: 0.34-0.92) and moderate community socioeconomic status (aOR=0.62, 95% CI: 0.45-0.85) were significantly associated with lower odds of reporting barriers to access health care services. Conclusion and Implications for Translation: The findings revealed high barriers to access health care services, and both individual- and community-level factors were significant contributing predictors. Therefore, it is important to consider multidimensional strategies and interventions to facilitate access to health care services in Ethiopia.   Copyright © Zegeye et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License CC BY 4.0.</jats:p

Hemoxygenase-1 in cardiovascular disease

Hemoxygenase (HO)-1 is an inducible isoform of the first and rate-controlling enzyme of the degradation of heme into iron, carbon monoxide, and biliverdin, the latter being subsequently converted into bilirubin. Several positive biological effects exerted by this enzyme have gained attention, as anti-inflammatory, antiapoptotic, angiogenic, and cytoprotective functions are attributable to carbon monoxide and/or bilirubin. Thus, the physiological induction of HO-1 may be an adaptive and beneficial response to several possibly noxious stimuli, including heme itself, suggesting a potentially autoprotective and autodefensive role in several pathophysiological states including acute coronary syndromes and stroke. This review article provides a comprehensive overview of the biochemistry, physiology, and pathophysiology of HO-1 in relation to cardiovascular disease (CVD). Furthermore, we present some of the emerging evidence in support of the view that the induction of the HO-1 gene may be a new opportunity to target the pathophysiology of CVD, with therapeutic implications for management