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Article ; Online: Socio-demographic determinants of pregnancy termination among adolescent girls and young women in selected high fertility countries in sub-Saharan Africa.

Ahinkorah, Bright Opoku

BMC pregnancy and childbirth

2021 Volume 21, Issue 1, Page(s) 598

Abstract: Background: Most of the unintended pregnancies that occur among adolescent girls and young women (AGYW) in sub-Saharan Africa (SSA) end up in pregnancy termination. In this study, the socio-demographic determinants of pregnancy termination among AGYW ( ... ...

Abstract	Background: Most of the unintended pregnancies that occur among adolescent girls and young women (AGYW) in sub-Saharan Africa (SSA) end up in pregnancy termination. In this study, the socio-demographic determinants of pregnancy termination among AGYW (aged 15-24) in selected countries with high fertility rates in SSA were examined. Methods: This was a cross-sectional analysis of data from the most recent Demographic and Health Surveys of nine countries in SSA. The countries included are Angola, Burkina Faso, Burundi, Chad, Gambia, Mali, Niger, Nigeria, and Uganda. A total of 62,747 AGYW constituted the sample size for the study. Fixed and random effects models were used to examine the determinants of pregnancy termination with statistical significance at p < 0.05. Results: Higher odds of pregnancy termination were found among AGYW aged 20-24, those who were cohabiting and married, those who listened to radio and watched television at least once a week and those who lived in communities with high literacy level. Conversely, the odds of pregnancy termination were lower among AGYW with three or more births and those with secondary/higher education. Conclusion: The socio-demographic determinants of pregnancy termination among AGYW in this study were age, level of education, marital status, exposure to radio and television, parity, and community literacy level. The findings provide the needed information for designing health interventions to reduce unwanted pregnancies and unsafe abortions in countries with high fertility rates in SSA. It is recommended that governments and non-governmental organisations in these countries should enhance sexuality education and regular sensitization of adolescent sexual and reproductive health programmes targeted at AGYW who are at risk of pregnancy termination.
MeSH term(s)	Abortion, Induced/psychology ; Abortion, Induced/statistics & numerical data ; Adolescent ; Adolescent Behavior ; Africa South of the Sahara ; Cross-Sectional Studies ; Female ; Fertility ; Humans ; Pregnancy ; Sociodemographic Factors ; Surveys and Questionnaires ; Young Adult
Language	English
Publishing date	2021-09-04
Publishing country	England
Document type	Journal Article
ISSN	1471-2393
ISSN (online)	1471-2393
DOI	10.1186/s12884-021-04064-1
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Under-5 mortality in sub-Saharan Africa: is maternal age at first childbirth below 20 years a risk factor?

Ahinkorah, Bright Opoku

BMJ open

2021 Volume 11, Issue 9, Page(s) e049337

Abstract: Objectives: This study aimed at examining the association between young maternal age at first childbirth and under-5 mortality in sub-Saharan Africa (SSA).: Design and setting: This cross-sectional study pooled nationally-representative data from the ...

Abstract	Objectives: This study aimed at examining the association between young maternal age at first childbirth and under-5 mortality in sub-Saharan Africa (SSA). Design and setting: This cross-sectional study pooled nationally-representative data from the most recent Demographic and Health Surveys conducted in 30 countries in SSA from 2010 to 2019. Participants: 116 379 mothers of children under 5. Results: The prevalence of adolescent childbirth and death in children under 5 in SSA were 57.36% (95% CI 53.73% to 60.99%) and 4.10% (95% CI 3.65% to 4.54%), respectively. Children born to mothers whose first childbirth occurred at <20 years were 11% more likely to die before the age of 5 compared with those whose mothers' first childbirth occurred at age ≥20 years (adjusted odds ratio (aOR) 1.11; 95% CI 1.05 to 1.18). In terms of the covariates, the likelihood of under-5 mortality was higher among children born to single (aOR 1.54; 95% CI 1.41 to 1.67) and cohabiting mothers (aOR 1.10; 95% CI 1.01 to 1.21) compared with married mothers. Children born to mothers who were obese were more likely to die before the age of 5 compared with those born to mothers with normal body weight (aOR 1.17; 95% CI 1.09 to 1.26). The odds of under-5 mortality were higher among children whose weight at birth was <2500 g compared with those whose weight was ≥2500 g at birth (aOR 1.83; 95% CI 1.64 to 2.03). Conclusions: The findings call for the need to enhance policies aimed at reducing under-5 mortality in SSA by reducing adolescent pregnancy and childbirth through family planning, comprehensive sexuality education, and the elimination of child marriage. Again, Since under-5 mortality among adolescent mothers is linked with their poor socio-economic status, there is the need for government and non-governmental organisations in SSA to introduce poverty alleviation programmes and improve access to both formal and informal education as a way of enhancing the socioeconomic status of adolescent mothers. Public health education, through continuous advocacy programmes should be done to encourage adolescent mothers to access antenatal care and health facility deliveries as a way of enhancing the survival status of their children. These interventions should be implemented, taking into consideration other characteristics of mothers such marital status and BMI and child's characteristics such as child's weight, which were found to be associated with high under-5 mortality.
MeSH term(s)	Adolescent ; Adult ; Africa South of the Sahara/epidemiology ; Child ; Cross-Sectional Studies ; Female ; Health Surveys ; Humans ; Infant, Newborn ; Maternal Age ; Parturition ; Pregnancy ; Risk Factors ; Young Adult
Language	English
Publishing date	2021-09-30
Publishing country	England
Document type	Journal Article
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2021-049337
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Article: Intimate partner violence against adolescent girls and young women and its association with miscarriages, stillbirths and induced abortions in sub-Saharan Africa: Evidence from demographic and health surveys.

Ahinkorah, Bright Opoku

SSM - population health

2021 Volume 13, Page(s) 100730

Abstract: Intimate partner violence has been associated with numerous consequences for women, including pregnancy termination. This study aimed to examine the association between intimate partner violence and pregnancy termination among adolescent girls and young ... ...

Abstract	Intimate partner violence has been associated with numerous consequences for women, including pregnancy termination. This study aimed to examine the association between intimate partner violence and pregnancy termination among adolescent girls and young women in 25 sub-Saharan African countries. Data for this study was obtained from the demographic and health surveys of 25 countries in sub-Saharan Africa, published between 2010 and 2019. A total of 60,563 adolescent girls and young women were included in this study. Binary logistic regression models were used in analyzing the data and the results were presented as crude odds ratios (CORs) and adjusted odds ratios (AORs) at 95% confidence interval (CI). The prevalence of intimate partner violence and pregnancy termination among adolescent girls and young women in the 25 countries in sub-Saharan Africa were 19% and 10.1% respectively. In all these countries, the odds of pregnancy termination was higher among adolescent girls and young women who had ever experienced intimate partner violence, compared to those who had never experienced intimate partner violence [COR = 1.60, 95% CI = 1.51-1.71], and this persisted after controlling for confounders [AOR = 1.58, 95% CI = 1.48-1.68]. However, across countries, intimate partner violence had significant association with pregnancy termination among adolescent girls and young women in Angola, Chad, Congo DR and Gabon (Central Africa); Benin, Burkina Faso, Cote D'lvoire, Gambia and Mali (West Africa); Comoros, Rwanda and Uganda (East Africa); and Malawi and Zambia (Southern Africa). The findings imply that reducing pregnancy termination among adolescent girls and young women in sub-Saharan Africa depends on the elimination of intimate partner violence. Thus, policies and programmes aimed at reducing pregnancy termination among adolescent girls and young women in sub-Saharan Africa, should pay particular attention to those who have history of intimate partner violence.
Language	English
Publishing date	2021-01-12
Publishing country	England
Document type	Journal Article
ISSN	2352-8273
ISSN	2352-8273
DOI	10.1016/j.ssmph.2021.100730
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Article ; Online: Factors associated with female genital mutilation among women of reproductive age and girls aged 0-14 in Chad: a mixed-effects multilevel analysis of the 2014-2015 Chad demographic and health survey data.

Ahinkorah, Bright Opoku

BMC public health

2021 Volume 21, Issue 1, Page(s) 286

Abstract: Background: Chad is one of the African countries with high prevalence of female genital mutilation (FGM). The aim of this study was to examine the factors associated with FGM among women aged 15-49 and girls aged 0-14 in Chad.: Methods: Data for the ... ...

Abstract	Background: Chad is one of the African countries with high prevalence of female genital mutilation (FGM). The aim of this study was to examine the factors associated with FGM among women aged 15-49 and girls aged 0-14 in Chad. Methods: Data for the study were obtained from the 2014-2015 Chad Demographic and Health Survey. FGM among women aged 15-49 and girls aged 0-14 were the outcome variables. The prevalence of FGM among women and girls were presented using percentages while a mixed-effects multilevel multivariable logistic regression analysis was carried out to assess the factors associated with FGM. The results were presented using adjusted odds ratio with associated 95% confidence intervals. Results: The results indicate that more than half (50.2%) of the women and 12.9% of girls in Chad had been circumcised. Among women aged 15-49, level of education, employment status, ethnicity, religion, wealth quintile and community literacy level were significant predictors of FGM. Age, partner's level of education, marital status, employment status, ethnicity, religion and mother's FGM status were associated with FGM among girls aged 0-14. Conclusion: This study has identified several individual and contextual factors as predictors of FGM among women and girls in Chad. The findings imply the need to adopt strategies aimed at addressing these factors in order to help eliminate the practice of FGM. Government and non-governmental organisations in Chad need to implement policies that enhance media advocacy and community dialogue to help deal with FGM in the country.
MeSH term(s)	Adolescent ; Adult ; Africa ; Chad/epidemiology ; Child ; Child, Preschool ; Circumcision, Female ; Educational Status ; Female ; Humans ; Infant ; Infant, Newborn ; Middle Aged ; Multilevel Analysis ; Young Adult
Language	English
Publishing date	2021-02-04
Publishing country	England
Document type	Journal Article
ISSN	1471-2458
ISSN (online)	1471-2458
DOI	10.1186/s12889-021-10293-y
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Article: Maternal age at first childbirth and under-five morbidity in sub-Saharan Africa: analysis of cross-sectional data of 32 countries.

Ahinkorah, Bright Opoku

Archives of public health = Archives belges de sante publique

2021 Volume 79, Issue 1, Page(s) 151

Abstract: Background: The prevalence of childhood morbidity remains high in low-and middle-income countries, including sub-Saharan Africa (SSA). In this study, the association between maternal age at first childbirth and under-five morbidity in SSA was examined.!# ...

Abstract	Background: The prevalence of childhood morbidity remains high in low-and middle-income countries, including sub-Saharan Africa (SSA). In this study, the association between maternal age at first childbirth and under-five morbidity in SSA was examined. Methods: This was a cross-sectional study involving nationally-representative data from the most recent Demographic and Health Surveys conducted in 32 countries in SSA from 2010 to 2019. A sample size of 311,603 mothers of children under-five was considered. The outcome variable for this study was under-five morbidity. This variable was derived from the experience of fever, cough, and diarrhoea among children under-five. Both multilevel and binary logistic regression models were used to test the hypothesis that adolescent childbirth is associated with under-five morbidity. The results were presented as crude odds ratios (cORs) and adjusted odds ratios (aORs), with 95 % confidence intervals (CIs). Results: Children born to mothers whose first childbirth occurred at < 20 years were 16 % times more likely to suffer from under-five morbidity, compared to those whose mothers' first childbirth occurred at age ≥ 20 years [cOR = 1.16; CI = 1.13-1.19], and this persisted but with reduced odds after controlling for covariates [aOR = 1.10; CI = 1.07-1.12]. At the country level, children born to mothers whose first childbirth occurred at < 20 years were more likely to suffer from under-five morbidity, compared to those whose mothers' first childbirth occurred at age ≥ 20 years in Angola, Burundi, Congo DR, Guinea, Kenya, and Uganda. Conclusions: In this study, an association between adolescent childbirth and morbidity in children under five in SSA has been established. The study concludes that under-five morbidity is higher among children born to mothers whose first childbirth occurred before 20 years compared to those whose mothers' first childbirth occurred at 20 years and above. The findings indicate that in order to reduce under-five morbidity, there is the need to deal with adolescent childbearing through cultural and social change, coupled with engagement of adolescents and stakeholders in adolescent sexual and reproductive health programmes.
Language	English
Publishing date	2021-08-24
Publishing country	England
Document type	Journal Article
ZDB-ID	1117688-x
ISSN	2049-3258 ; 0778-7367 ; 0003-9578
ISSN (online)	2049-3258
ISSN	0778-7367 ; 0003-9578
DOI	10.1186/s13690-021-00674-5
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Article: Polygyny and intimate partner violence in sub-Saharan Africa: Evidence from 16 cross-sectional demographic and health surveys.

Ahinkorah, Bright Opoku

SSM - population health

2021 Volume 13, Page(s) 100729

Abstract: In sub-Saharan Africa, where intimate partner violence has been found to be predominant, several scholars have made efforts to understand its predictors. Socio-culturally, polygyny has been considered as a key determinant of intimate partner violence. ... ...

Abstract	In sub-Saharan Africa, where intimate partner violence has been found to be predominant, several scholars have made efforts to understand its predictors. Socio-culturally, polygyny has been considered as a key determinant of intimate partner violence. This study aimed to examine the association between polygyny and intimate partner violence in 16 sub-Saharan African countries. Binary logistic regression models were used in testing the association and the results were presented as crude and adjusted odds ratios at 95% confidence interval. The proportion of women in polygamous marriages in the 16 countries was 20.2%, ranging from as high as 40% in Chad to as low as 1.6% in South Africa. The prevalence of IPV was 30.7% in the 16 countries, ranging from as high as 44% in Uganda to as low as 12.7% in South Africa. The odds of IPV were higher among women in polygamous marriages in Angola, Burundi, Ethiopia, Uganda, Malawi, Mozambique, Zambia and Zimbabwe but was lower among women in polygamous marriages in Cameroon [COR = 0.54, 95% CI = 0.44-0.66] and Nigeria [COR = 0.61, 95% CI = 0.55-0.67], and this persisted after controlling for level of education, place of residence, wealth quintile, media exposure, and justification of violence. This study has found a significant association between polygyny and intimate partner violence. The practice of intimate partner violence in sub-Saharan Africa is fused into the socio-cultural norms and religious traditions of most countries in the sub-Saharan African region. The findings imply that family structures expose women to intimate partner violence. Therefore, global efforts in dealing with intimate partner violence through the Sustainable Development Goals should be done with attention on the socio-cultural norms and traditions around marriage and family structures.
Language	English
Publishing date	2021-01-12
Publishing country	England
Document type	Journal Article
ISSN	2352-8273
ISSN	2352-8273
DOI	10.1016/j.ssmph.2021.100729
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Article ; Online: Men's education and intimate partner violence-Beyond the victim-oriented perspective: Evidence from demographic and health surveys in Central Africa.

Tsala Dimbuene, Zacharie / Ahinkorah, Bright Opoku / Amugsi, Dickson Abanimi

PloS one

2024 Volume 19, Issue 4, Page(s) e0302627

Abstract: Background: Intimate partner violence (IPV) has increasingly received attention in the last three decades. However, IPV-related studies in both high- and low- and middle-income countries adopted a victim-oriented perspective in which men are ... ...

Abstract	Background: Intimate partner violence (IPV) has increasingly received attention in the last three decades. However, IPV-related studies in both high- and low- and middle-income countries adopted a victim-oriented perspective in which men are perpetrators and women, the victims. Using socio-cultural and resource theories as guiding frameworks, this paper assessed the associations between men's education and IPV in Central Africa, using nationally representative data of married and cohabiting women of reproductive ages. Methods: Data included in the analyses come from Demographic and Health Surveys (DHSs) in the Democratic Republic of the Congo (DRC), Cameroon, Gabon, and Chad. Analyzed sub-samples consisted of 3421, 5023, 3930, and 3221 married/cohabiting women of reproductive ages in Chad, DRC, Cameroon, and Gabon, respectively. Results: Findings indicated significant variations of IPV prevalence within and across countries. Previous research demonstrated that men's education is a protective factor in health-related studies. The present study, however, provide no clear evidence on the linkages between men's education and IPV. In contrast, the paper substantiated that highly educated women were at higher risks of IPV when spouses/partners were less educated. Conclusion: These findings have policy and programmatic implications because they might impede progress towards SDG goals on the elimination of all forms of violence against girls and women in Central Africa, which recorded the worst development indicators in sub-Saharan Africa. On a methodological note, studies are increasingly using pooled data to increase statistical power. Those studies can be very limited to devise effective IPV-interventions since they mask geographical variations within and across countries. More effective IPV-interventions should be culturally rooted and accounting for geographical variations because some areas are more affected than others.
MeSH term(s)	Humans ; Female ; Male ; Intimate Partner Violence/statistics & numerical data ; Africa, Central/epidemiology ; Adult ; Health Surveys ; Educational Status ; Adolescent ; Middle Aged ; Young Adult ; Prevalence
Language	English
Publishing date	2024-04-25
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0302627
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Predictors of modern contraceptive use among adolescent girls and young women in sub-Saharan Africa: a mixed effects multilevel analysis of data from 29 demographic and health surveys.

Ahinkorah, Bright Opoku

Contraception and reproductive medicine

2020 Volume 5, Issue 1, Page(s) 32

Abstract: Background: The use of modern contraceptives among adolescent girls and young women (AGYW) in sub-Saharan Africa (SSA) remains an issue that needs urgent attention. This present study assesses the individual and contextual factors associated with modern ...

Abstract	Background: The use of modern contraceptives among adolescent girls and young women (AGYW) in sub-Saharan Africa (SSA) remains an issue that needs urgent attention. This present study assesses the individual and contextual factors associated with modern contraceptive use among AGYW in SSA. Methods: Data for this study was obtained from the latest Demographic and Health Surveys (DHS) conducted between January 2010 and December 2018 across 29 countries in SSA. Data were analysed with Stata version 14.2 by employing both Pearson's chi-square test of independence and a multilevel binary logistic regression. The selection of variables for the multilevel models was based on their statistical significance at the chi-square test at a p < 0.05. Model fitness for the multilevel models was checked using the log likelihood ratios and Akaike's Information Criterion (AIC) and the results were presented using adjusted odds ratios (aOR) at 95% confidence interval (CI). Results: It was found that 24.7% of AGYW in SSA use modern contraceptives. In terms of the individual level factors, the study showed that AGYW aged 15-19 [aOR = 0.86, CI = 0.83-0.90], those who were married [aOR = 0.83, CI = 0.79-0.87], Muslims [aOR = 0.59, CI = 0.57-0.62], working [aOR = 0.92, CI = 0.89-0.95], those who had no child [aOR = 0.44, CI = 0.42-0.47], those who had no exposure to newspaper/magazine [aOR = 0.44, CI = 0.63-0.71] and radio [aOR = 0.82, CI = 0.78-0.86] had lower odds of using modern contraceptives. Conversely, the use of modern contraceptives was high among AGYW whose age at first sex was 15-19 years [aOR = 1.20, CI = 1.12-1.28]. With the contextual factors, the odds of using modern contraceptives was low among AGYW who lived in rural areas [aOR = 0.89, CI = 0.85-0.93] and in communities with low literacy level [aOR = 0.73, CI = 0.70-0.77] and low socio-economic status [aOR = 0.69, CI = 0.65-0.73]. Conclusion: Several individual and contextual factors are associated with modern contraceptive use among AGYW in SSA. Therefore, Governments in the various countries considered in this study should intensify mass education on the use of modern contraceptives. This education should be more centered on AGYW who are in socio-economically disadvantaged communities, those who are not married, Muslims, those with high parity and high fertility preferences and those who are working.
Language	English
Publishing date	2020-11-19
Publishing country	England
Document type	Journal Article
ISSN	2055-7426
ISSN (online)	2055-7426
DOI	10.1186/s40834-020-00138-1
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Article ; Online: Individual and contextual factors associated with mistimed and unwanted pregnancies among adolescent girls and young women in selected high fertility countries in sub-Saharan Africa: A multilevel mixed effects analysis.

Ahinkorah, Bright Opoku

PloS one

2020 Volume 15, Issue 10, Page(s) e0241050

Abstract: Introduction: Unintended pregnancies are associated with a number of risk factors such as malnutrition, mental illness, unsafe abortion, maternal mortality and horizontal transmission of HIV to children. These risks are predominant among adolescent ... ...

Abstract	Introduction: Unintended pregnancies are associated with a number of risk factors such as malnutrition, mental illness, unsafe abortion, maternal mortality and horizontal transmission of HIV to children. These risks are predominant among adolescent girls and young women compared to older women. This study examined the individual and contextual factors associated with unintended pregnancy among adolescent girls and young women in selected high fertility countries in sub-Saharan Africa. Materials and methods: Data for this study was obtained from recent Demographic and Health Surveys carried out between 2010 and 2018 in 10 countries in sub-Sahara Africa. The sample size for this study was made up of 6,791 adolescent girls and young women (aged 15-24), who were pregnant during the surveys and had complete responses on all the variables considered in the study. Unintended pregnancy was the outcome variable in this study. Descriptive and multilevel logistic regression analyses were performed and the fixed effect results of the multilevel logistic regression analysis were reported as adjusted odds ratios at 95% confidence interval. Results: Unintended pregnancy in the selected countries was 22.4%, with Angola, recording the highest prevalence of 46.6% while Gambia had the lowest prevalence of 10.2%. The likelihood of unintended pregnancy was high among adolescent girls and young women aged 15-19 [aOR = 1.48; 95% CI = 1.26-1.73], those with primary [aOR = 1.99; 95% CI = 1.69-2.33] and secondary/higher [aOR = 2.30; 95% CI = 1.90-2.78] levels of education, single (never married/separated/divorced/widowed) adolescent girls and young women [aOR = 9.23; 95% CI = 7.55-11.28] and those who were cohabiting [aOR = 2.53; 95% CI = 2.16-2.96]. The odds of unintended pregnancy also increased with increasing birth order, with adolescent girls and young women having three or more births more likely to have unintended pregnancies compared to those with one birth [aOR = 1.99; 95% CI = 1.59-2.48]. Adolescent girls and young women who had ever used contraceptives (modern or traditional), had higher odds of unintended pregnancies compared to those who had never used contraceptives [aOR = 1.32; 95% CI = 1.12-1.54]. Finally, adolescent girls and young women who belonged to the rich wealth quintile were more likely to have unintended pregnancy compared to those in the poor wealth quintile [1.28; 95% CI = 1.08-1.51]. Conclusion: The study found that age, marital status, level of education, parity, use of contraceptives and wealth quintile are associated with unintended pregnancy among adolescent girls and young women in high fertility sub-Saharan African countries. These findings call for the need for government and non-governmental organisations in high fertility sub-Saharan African countries to restructure sexual and reproductive health services, taking into consideration these individual and contextual level characteristics of adolescent girls and young women.
MeSH term(s)	Adolescent ; Adult ; Africa South of the Sahara ; Contraception Behavior ; Economic Status ; Educational Status ; Female ; Humans ; Marital Status ; Parity ; Pregnancy ; Pregnancy, Unplanned ; Pregnancy, Unwanted ; Sexual Behavior ; Young Adult
Language	English
Publishing date	2020-10-22
Publishing country	United States
Document type	Journal Article
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0241050
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Predictors of unmet need for contraception among adolescent girls and young women in selected high fertility countries in sub-Saharan Africa: A multilevel mixed effects analysis.

Ahinkorah, Bright Opoku

PloS one

2020 Volume 15, Issue 8, Page(s) e0236352

Abstract: Introduction: Despite the desire of adolescent girls and young women (AGYW) in sub-Saharan Africa (SSA) to use contraceptives, the majority of them have challenges with access to contraceptive services. This is more evident in high fertility countries ... ...

Abstract	Introduction: Despite the desire of adolescent girls and young women (AGYW) in sub-Saharan Africa (SSA) to use contraceptives, the majority of them have challenges with access to contraceptive services. This is more evident in high fertility countries in SSA. The purpose of this study was to examine the predictors of unmet need for contraception among AGYW in selected high fertility countries in SSA. Materials and methods: Data from current Demographic and Health Surveys (DHS) carried out between 2010 and 2018 in 10 countries in SSA were analysed. A sample size of 24,898 AGYW who were either married or cohabiting was used. Unmet need for contraception was the outcome variable in this study. The explanatory variables were age, marital status, occupation, educational level, frequency of reading newspaper/magazine, frequency of listening to radio, frequency of watching television and parity (individual level variables) and wealth quintile, sex of household head, place of residence and decision-maker in healthcare (household/community level variables). Descriptive and multilevel logistic regression analyses were carried out. The results of the multilevel logistic regression analyses were reported using adjusted odds ratios at 95% confidence interval. Results: The prevalence of unmet need for contraception in all the countries considered in this study was 24.9%, with Angola, recording the highest prevalence of 42.6% while Niger had the lowest prevalence of 17.8%. In terms of the individual level predictors, the likelihood of unmet need for contraception was low among AGYW aged 20-24 [aOR = 0.82; 95% CI = 0.76-0.88], those with primary [aOR = 1.22; 95% CI = 1.13-1.31] and secondary/higher levels of formal education [aOR = 1.18; 95% CI = 1.08-1.28, p < 0.001], cohabiting AGYW [aOR = 1.52; 95% CI = 1.42-1.63] and AGYW with three or more births [aOR = 3.41; 95% CI = 3.02-3.85]. At the household/community level, the odds of unmet need for contraception was highest among poorer AGYW [aOR = 1.36; 95% CI = 1.21-1.53], AGYW in female-headed households [aOR = 1.22; 95% CI = 1.13-1.33], urban AGYW [aOR = 1.21; 95% CI = 1.11-1.32] and AGYW who took healthcare decisions alone [aOR = 1.10; 95% CI = 1.01-1.21]. Conclusion: This study has identified disparities in unmet need for contraception among AGYW in high fertility countries in SSA, with AGYW in Angola having the highest prevalence. Both individual and household/community level factors predicted unmet need for contraception among AGYW in this study. However, based on the ICC values, household/community level factors prevailed the individual level factors. Enhancing access to contraception among poorer AGYW, those in female-headed households, those in urban areas and those who take healthcare decisions alone by both governmental and non-governmental organisations in high fertility countries is recommended.
MeSH term(s)	Adolescent ; Africa South of the Sahara ; Contraception/statistics & numerical data ; Contraception Behavior/statistics & numerical data ; Contraceptive Agents/supply & distribution ; Contraceptive Devices/supply & distribution ; Family Planning Services/statistics & numerical data ; Female ; Health Services Accessibility/statistics & numerical data ; Health Surveys ; Humans ; Marital Status/statistics & numerical data ; Multilevel Analysis/methods ; Socioeconomic Factors ; Young Adult
Chemical Substances	Contraceptive Agents
Language	English
Publishing date	2020-08-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0236352
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Kategorien

Order via subito

More links

Kategorien

Order via subito

Inter-library loan at ZB MED

More links

Kategorien

Order via subito

Inter-library loan at ZB MED

More links

Kategorien

Order via subito