RESUMO
Globally, the region of South Asia reports the highest number of women (87 million) with unmet needs of contraception. Amongst the lower-middle-income countries of South Asia, Pakistan has performed poorly in enhancing contraceptive prevalence, as evident by the Contraceptive Prevalence Rate (CPR) of 34%. Factors including restricted access to contraception, a restricted selection of techniques, cultural/religious resistance, gender-based hurdles, and societal factors, such as the couple's education level, are among the most important causes for this gap in desire and usage. Thus, this study aimed to evaluate the association between couple's education level and their influence on their choice of contraception. In addition, the study also assessed the role of socioeconomic status in modifying the association between couple's education and contraception choice. Using PDHS 2017-18 data, couple's education status, preferences of contraceptive use and wealth quintiles were analyzed through multinomial logistic regression after adjusting for other confounding factors. The findings of our study revealed that out of the total sample of 14,368 women, 67.52% (n = 9701) were categorized as non-users, 23.55% (n = 3383) employed modern contraceptive methods, and 8.94% (n = 1284) utilized traditional contraceptive methods. Multivariable analysis showed that educated couples belonging to higher socioeconomic status (SES) had the highest adjusted odds ratio [7.66 (CI: 4.89-11.96)] of using modern contraceptives as opposed to uneducated couples of low socioeconomic statuses. Our analysis also revealed that the odds of using modern contraceptives were higher amongst mothers with five or more children [8.55 (CI:7.09-10.31)] as compared to mothers with less children when adjusted for other covariates. Thus, this study concludes the dynamic interplay between couple's level of education, contraceptive preference, and socioeconomic status This study contributes valuable insights for the policy makers and stakeholders to understand the intricate relationship between these factors.
RESUMO
This review aims to assess the prevalence of malaria in pregnancy during antenatal visits and delivery, species-specific burden together with regional variation in the burden of disease. It also aims to estimate the proportions of adverse pregnancy outcomes in malaria-positive women. Based on the PRISMA guidelines, a thorough and systematic search was conducted in July 2023 across two electronic databases (including PubMed and CENTRAL). Forest plots were constructed for each outcome of interest highlighting the effect measure, confidence interval, sample size, and its associated weightage. All the statistical meta-analysis were conducted using R-Studio version 2022.07. Sensitivity analyses, publication bias assessment, and meta-regression analyses were also performed to ensure robustness of the review. According to the pooled estimates of 253 studies, the overall prevalence of malaria was 18.95% (95% CI: 16.95-21.11), during antenatal visits was 20.09% (95% CI: 17.43-23.06), and at delivery was 17.32% (95% CI: 14.47-20.61). The highest proportion of malarial infection was observed in Africa approximating 21.50% (95% CI: 18.52-24.81) during ANC and 20.41% (95% CI: 17.04-24.24) at the time of delivery. Our analysis also revealed that the odds of having anaemia were 2.40 times (95% CI: 1.87-3.06), having low birthweight were 1.99 times (95% CI: 1.60-2.48), having preterm birth were 1.65 times (95% CI: 1.29-2.10), and having stillbirths were 1.40 times (95% CI: 1.15-1.71) in pregnant women with malaria.
