The study aimed at examining the relationship between contraceptive use and fertility in Western region, Uganda, using a sample of 1993 women from the Uganda Demographic Health Survey of 2000-2001. Uganda Demographic Health Survey (UDHS) 2000-2001 is the third survey conducted by the Ugandan Ministry of Health. Chi-square, Logistic regression and multiple regression were used to test and determine factors contributing to the high fertility levels and low contraceptive usage in the region. Results show that the region has a total fertility rate of 6.4, and childbearing is not evenly distributed among age groups. Fertility peaks at ages 20-29, and reduces sharply with women in their late reproduction span. Contraception and fertility are inversely correlated. Though knowledge on contraception is universal, contraceptive prevalence remains low (95% and 16% respectively) among women of reproductive age. Family planning approval is inversely related with contraceptive use. Findings reveal that contraceptive prevalence plays minor role in explaining fertility levels as compared to some socioeconomic factors. Education is significantly and inversely related with fertility, but positively correlated with contraceptive use. The government should revisit the population policy to actively promote family planning activities by promoting and facilitating debates about family size, and the means to achieve. Women education needs to be emphasized in order to promote innovative reproductive behavior. More research to explore whether women are using contraception for spacing rather than limiting is required.

Background Religion is widely known to affect the acceptance of modern contraception among people, thus affecting their reproductive behavioural outcomes in sub-Saharan Africa. The significance of religion on the use of contraceptives has been currently neglected in SSA. Fertility transitions have been widely attributed to the increased use of contraceptives among women worldwide. Given that religion plays an important role in post-colonial Kenya, this study examined the differentials in contraceptive use by religious affiliation as well as the demographic and socio-economic factors that affect the use of contraceptives in Kenya. Methodology The study obtained data from the Kenyan Demographic and Health Survey (KDHS, 2008-2009) that uses a national cross sectional study design. The study population was women of reproductive ages (15-49 years) who were sexually active and the sample size was 4, 207. This study made use of descriptive statistics, chi-square tests and logistic regression. Results Religious affiliation is a significant predictor of contraceptive use in Kenya. Muslims were 51% less likely to use modern methods of contraceptives compared to Christians. There was no significant difference in the use of contraceptives among Roman Catholics and Protestants. Demographic and socio-economic factors - specifically age, education, number of living children, fertility intention, wealth and marital status - were significantly associated with the use of modern methods of contraceptives. Conclusion Religious affiliation affects the use of contraceptives and plays a vital role in the reproductive behaviours of women in Kenya. The low levels of contraceptive use among Muslims are accounted for by their low socio-economic characteristics in addition to Islam’s pro-natal doctrine. The lack of contraceptive use differentials among Roman Catholics and Protestants is as a result of their similar socio-economic characteristics, regardless of Roman Catholics pro-natal doctrine. Thus, a frontier for further study is to examine how religious involvement affects contraceptive use in addition to religious affiliation.

acase@tulane.edu / Background As a region, Francophone sub-Saharan Africa (SSA) continues to have among the highest fertility rates and lowest contraceptive prevalence rates in the world. As of the latest Demographic and Health Survey (DHS) data available for each country, total fertility rates range from 4.1 (Gabon 2012) to 7.6 births per woman (Niger 2012). Modern contraceptive prevalence rates for married women range from a low of 3.3% (Guinea 2012) to a high of 20.1% (Senegal 2014). Methods Three analyses were completed utilizing nationally representative DHS data available for each Francophone SSA country. For each paper, bivariate and multivariate analyses were performed with weighted data to take into account the two-stage cluster sampling design of the DHS survey. In paper one, we determine whether being Muslim and/or being in a polygynous union impacts the use of modern contraceptives. In paper two, we provide detailed information on the characteristics that define users of specific contraceptive methods in this region. In the final paper, we provide a clearer picture of the reproductive health dynamic in young never married women in Francophone SSA. Results In paper #1, we found that religion and marital type generally were not predictive of modern contraceptive use. The typical predictors – education, age, residence (urban/rural) – were consistently significant across the included countries. In paper #2, profiles of users of the most common contraceptive methods in each country were created. For example, condom users had the most consistent profile across the 12 countries, with marital status, parity and education being clearly associated with condom use. For paper #3, education level was found to be the key predictor of both sexual activity and becoming pregnant for young, never married women in this region. In general, those with primary or secondary and higher education were more likely to be sexually active than those with no education. Conclusion These findings provide valuable information to government, private and nongovernmental organizations working toward increasing the numbers of contraceptive users in Francophone SSA. / 1 / Margaret Farrell

Unintended pregnancy is a global public health threat that affects the lives of women, families, communities, and society. In 2008, the rate of unintended pregnancy in Ethiopia was 101 per 1,000 women aged 14 to 44 years. Although Ethiopia has experienced a steady increase in modern contraceptive use since 2004, this increase did not result in a proportional decline in unintended pregnancy, total fertility rates, or rapid population growth. In this cross-sectional study, associations between individual, interpersonal, community, and societal factors and contraceptive uptake were tested using a sample of 3,863 women aged 15 to 49 years who participated in the 2016 Ethiopian Demographic and Health Surveys. Statistically significant predictors of contraceptive use were included in the logistic regression model. Findings showed that age, education, marital status, type of residence, and wealth index reliably predicted contraceptive use. Increase in age, highest level of education, and wealth index were associated with 13%, 15%, and 65% increase in the odds of contraceptive use, respectively. Being married was associated with 85% decrease in the odds of contraceptive use and being from an urban residence was associated with 56% increase in the odds of contraceptive use. Results of the study can be used to develop targeted family planning interventions to increase contraceptive use and reduce unintended pregnancy, child and maternal mortality, total fertility rates, and rapid population growth in Ethiopia.

No description available.

This study explores the gender differences in how parents exhibit parenting dimensions (control, monitoring, support and warmth) towards sons and daughters and how those dimensions influence contraceptive use. The data analysis uses the Add Health data and the sample includes 918 adolescents within two-parent homes. This study adds to the existing literature in three ways. First, this study investigates four different parenting dimensions whereas previous research focuses on control and communication. Second, this study looks at how each dimension influences contraceptive use. Third, this study examines how parents exhibit parenting dimensions differently towards sons and daughters and whether each dimension influences contraceptive use differently for sons and daughters. The results reveal three significant findings. First, mothers’ and fathers’ parenting dimensions and the dimensions sons and daughters experience are similar. Second, warmth and support influence contraceptive use among sons and daughters. Third, boys are influenced by parenting dimensions more than girls.

The aim of this study was to examine sexual behavior, contraceptive use, self-rated health, lifestyle factors and the prevalence of HPV vaccination among last year high school students. The study was a quantitative cross-sectional study which was a substudy of the longitudinal study " Pornography, Youth and Health". Results showed that the majority of students had had sexual intercourse (75 %, n=524) and both performed (67 %, n=479) and received oralsex (70 %, n=498). Forty percent (n=282) of the students had had one night stand, a quarter (n=159) anal sex and 29 (n=202) percent sex with a friend. The contraceptive use increased from the first to the last intercourse while the use of condoms decreased. Five percent (n=38) of the students reported a sexually transmitted disease, more women than men. Significant difference in sexual experience was shown between students in vocational versus theoretical study programs, between students with low and high self-rated health as well as between students with low versus high risk behavior regarding lifestyle factors. Two thirds of the female students were vaccinated against HPV. No significant difference regarding condom use was shown between the female students who were vaccinated against HPV compared with non-vaccinated. The knowledge of existing differences between gender, between students at different high school programs and attention to risk factors can improve sex education and contraceptive counseling in which the midwife has an important role. / Syftet med föreliggande studie var att undersöka sexualvanor, preventivmedelsanvändning, egen upplevd hälsa, livsstilsfaktorer och förekomsten av HPV-vaccination bland elever som gick sista året på gymnasiet. Studien var en kvantitativ tvärsnittsstudie som var en del av den longitudinella studien "Pornografi, ungdomar och hälsa". Resultat visade att majoriteten av eleverna hade haft samlag (75 %, n=524) samt både givit (67 %, n=479) och fått oralsex (70 %, n=498). Fyrtio procent (n=282) av eleverna hade haft one night stand, en fjärdedel (n=159) analsex och 29 procent (n=202) sex med en kompis. Preventivmedelsanvändningen ökade från första samlaget till det senaste medan kondomanvändningen minskade. Fem procent (n=38) av eleverna hade haft en könssjukdom, fler kvinnor än män. Signifikanta skillnader avseende sexuella erfarenheter fanns mellan elever på yrkesförberedande- respektive studieförberedande gymnasieprogram, mellan elever med låg- och hög självskattad hälsa samt mellan elever med lågt- och högt riskbeteende beträffande livsstilsfaktorer. Två tredjedelar av de kvinnliga eleverna var vaccinerade mot HPV. Ingen signifikant skillnad med avseende på kondomanvändning fanns mellan de kvinnliga eleverna som var vaccinerade respektive ej vaccinerade mot HPV. Kunskap om dessa skillnader mellan kön och mellan elever på olika studieprogram samt att riskfaktorer uppmärksammas kan förbättra sexualundervisning och preventivmedelsrådgivning i vilka barnmorskan har en viktig roll.

Philosophiae Doctor - PhD / This thesis extends the literature on the trends and magnitude of health inequalities in the area of maternal and reproductive health services in Sierra Leone, and particular across sub-Saharan Africa. It attempted to provide a good understanding of, not only the determinants of maternal and reproductive healthcare use, but also factors that enable health inequalities to exist in Sierra Leone. This is an appropriate topic in population health studies as it aims to address important questions on the research agenda in the context of sub-Saharan Africa, particularly in a country with poor health outcomes such as Sierra Leone. A proper understanding of not only the coverage rates of population health outcomes but also the extent of health inequalities as well as the factors that contribute to these inequalities is crucial for any government. The thesis applied various techniques in the analysis of DHS data (from 2008 and 2013 rounds) in an attempt to answer the research questions.

Background: Approximately 70% of US adults currently receiving opioid agonist treatment (OAT) for opioid use disorder are of reproductive age. Among women receiving OAT at risk of having an unintended pregnancy, typically less than half report any current contraceptive use compared to 90% in the general population. In addition, the rate of unintended pregnancy among women receiving OAT is disproportionately higher than the general population (~80% vs. 45%, respectively). Lack of knowledge about family planning may be contributing to decreased rates of contraceptive use and increased rates of unintended pregnancy among women receiving OAT. Method: Participants were a convenience sample of women and men receiving OAT or a comparison group receiving primary care (PC) services. Family planning knowledge was assessed with the recently validated Contraceptive Knowledge Assessment (CKA), a self-administered 25-question multiple-choice survey. A two-way ANOVA, with fixed factors (i.e. patient sample and sex), compared the total number of correct responses for all questions and five more specific content areas (p<.05). Results: Overall, 332 participants completed this survey. The mean percent of total correct responses was significantly lower in the OAT sample (n=167) compared to the PC sample (n=165), 47% vs. 53% correct, respectively (p<.001) or approximately 1.5 questions less. The mean percent of correct responses in four of the five content areas was also lower among the OAT sample compared to the PC sample (ps<.01). The mean percent of total correct responses was significantly higher among women (n=169) than men (n=163), 56% vs. 44% correct, respectively (p<.0001) or approximately 3 questions more. The percent of correct responses in four of the five content areas was also higher among women than men (ps<.01). Conclusion: Given the substantial discrepancy in rates of contraceptive use and unintended pregnancy between individuals receiving OAT and the general population, it is somewhat unexpected that individuals receiving OAT did not have lower levels of family planning knowledge, although patients in both samples only answered approximately 50% of the questions correctly. Results from the present study suggest deficits in family planning knowledge, while statistically significant, may be less clinically so. Overall, lack of family planning knowledge is likely only playing a small role in population differences in contraceptive use and unintended pregnancy and interventions aimed at decreasing these differences will need to address other barriers to accessing family planning services and utilizing contraception in this population.

The aim of this research was to study the correlation between tissue tumor marker expression and HR-HPV infection, smoking, hormonal contraceptive use and sex steroids in women with cervical intraepithelial neoplasia or normal epithelium. The study investigated the expression of 11 tumor markers in cervical biopsies obtained from 228 women with different diagnoses ranging from normal cervical epithelium to various stages of CIN. 188 women were recruited at our colposcopy clinic (out-patient surgery, Department of Obstetrics and Gynecology, Falun Hospital) for laser cervical conization or a directed punch biopsy, either because of a vaginal smear (Pap smear) that showed cytological findings suggesting CIN, or because of repeated findings showing atypical squamous cells of undetermined significance (ASCUS). For 40 volunteers, punch biopsies were taken from the normal cervical epithelium. The time period for this study was 2005-2007. Study I :  228 women, of whom 116 were tested, 64 were positive to HR-HPV. The results showed that Ki67 tumor cell proliferation index was the only marker that independently correlated to both the presence of HR-HPV and the severity of cervical lesions. Study II:  228 women, of whom 83 were smokers (36, 9%). Smokers showed lower expression of p53, FHIT (tumor suppressor markers) and interleukin-10 .Higher expression of Cox-2 and Ki-67 (tumor proliferation markers). Study III:  195 women who were premenopausal. There was increased p53 expression (tumor suppressor) in the progestin-IUD users compared to non-users. Decreased IL-10 expression (immunological marker) was observed in both COC users and any progestin-only users. Study IV: Serum from 80 premenopausal women was available. The main finding was that the increased levels of serum progesterone and estradiol were associated with increased Cox-2 expression (proliferation marker). Serum progesterone and estradiol levels influence cellular and extracellular proteins which have been associated with neoplastic development in normal epithelium and CIN. Conclusion: The results of these studies support previous epidemiological findings on the role of smoking, contraceptive use and sex steroids as co-factors in development of CIN and that tumor marker expression varies in different grades of CIN.