RESUMO
Despite commitments and interventions, Female Genital Mutilations (FGM) practice persists in West African countries. This research analyzes the effect of living conditions on FGM practice. Data were sourced from thirty-four demographic and health surveys conducted between 1995 and 2020 in 12 countries. The study sample consisted of 69,971 adolescent girls aged 15-19 years. Meta-regression analysis and binary logistic regression analyses showed the effect and relative contribution of study covariates on the phenomenon. The overall average prevalence of FGM is 40.7%, with a mixed effect of living conditions on FGM practice. The factors associated with FGM practice are, in order of importance, religion, level of education, ethnicity and place of residence. All factors have a direct effect on the studied phenomenon, and the level of education acts as an inhibiter of the effect of living conditions. The study suggests the need to strengthen the involvement of religious, traditional and community leaders in the definition and implementation of actions to combat FGM, as well as girl's education, especially by maintaining them in school till completion of at least secondary school.
Assuntos
Circuncisão Feminina , Condições Sociais , Feminino , Adolescente , Humanos , África Ocidental , Demografia , Genitália , PrevalênciaRESUMO
BACKGROUND: High maternal and neonatal mortality persist in Benin Republic despite recent improvements. Numerous women and newborns continue to suffer preventable deaths. Although factors associated with the attendance of at least one antenatal care (ANC) visit are well documented, there is little evidence on factors related to compliance with World Health Organization (WHO) recommended four ANC visits. The present study determined the extent to which reproductive age mothers received the ANC check-ups at a health facility focussing on the WHO-recommended regimen. METHODS: We examined factors related to ANC services utilisation patterns amongst 8701 women recruited in the 2011/2012 Benin Demographic and Health Survey data using multinomial logistic regression. RESULTS: The percentage of mothers with full ANC attendance was 59.56%, 27.61% received less than 4 visits and 12.84% had never attended ANC services. Results showed that out of 13 variables assessed, only the place of residence was not associated with ANC seeking. Amongst significant variables, household wealth index, female education and desire for pregnancy were the most important factors related to ANC services seeking, especially for the achievement of WHO recommended four ANC visits. The relative risk ratio of ANC attendance, for the achievement of WHO recommended four ANC regimens was high amongst mothers from economically well-off households (adjusted relative risk ratio [aRRR] for richest women = 10.6, 95% confidence interval [CI]: 6.16-18.33), educated women (aRRR for primary level = 4.34, 95% CI: 3.00-6.27) and those with desired pregnancies (aRRR = 3.4, 95% CI: 2.58-4.48). CONCLUSION: To achieve WHO-recommended minimum four ANC visits in Benin Republic, our findings suggest the need to financially support the most economically disadvantaged pregnant women and their families during pregnancy, advocate for reducing unmet needs for family planning, strengthen girls' education, especially by maintaining them in school till completion of at least the secondary school.
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Utilização de Instalações e Serviços , Cuidado Pré-Natal/estatística & dados numéricos , Adulto , Benin , Demografia , Feminino , Inquéritos Epidemiológicos , Humanos , Recém-Nascido , Gravidez , Fatores SocioeconômicosRESUMO
RésuméLa pratique contraceptive moderne augmente lentement parmi les jeunes générations au Bénin. La présente étude analyse les tendances, les déterminants du recours aux contraceptifs et leurs mécanismes d'actions chez les adolescentes. Les approches socio-écologique et intersectionnelle ont été adoptées, avec une méthode d'étude mixte portant sur les adolescentes de 15 à 19 ans sexuellement actives et non enceintes. Le volet quantitatif recourt aux données des cinq enquêtes démographiques et de santé du Bénin entre 1996 et 2017-18, avec une analyse descriptive et une régression logistique binaire pas à pas. Les données qualitatives collectées par des observations, discussions de groupe et entretiens individuels auprès de différents acteurs nationaux, ont fait l'objet d'analyse de contenu. Les résultats révèlent une prévalence contraceptive moderne basse, passant de 4,6% en 1996 à 13,3% en 2017-18, avec le préservatif comme principale méthode utilisée (8,2%). En 2017-18, la probabilité d'utiliser les contraceptifs était plus élevée chez les adolescentes des ménages riches (OR = 2,3), les scolarisées (OR = 2,3), les célibataires (OR = 2,1), celles fréquentant les services de planification familiale (PF) (OR = 1,8), connaissant le cycle menstruel (OR = 1,6), et économiquement actives (OR = 1,5). Cependant, être Yoruba réduit les chances d'utiliser les contraceptifs (OR = 0,5). Les données qualitatives confirment ces résultats et les complètent en mettant en avant l'effet du cadre juridique favorable à la pratique contraceptive, la stigmatisation sociale des utilisatrices, et les infox véhiculées en communauté. Nous recommandons des efforts pour le maintien des filles à l'école, la généralisation des services de PF pour les adolescents, la communication communautaire, et la subvention des contraceptifs.
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Anticoncepcionais , Humanos , Adolescente , BeninRESUMO
Background: Despite the increasing interest in improving access to and utilization of family planning (FP) methods, contraceptives prevalence rates remain low in Benin, and its benefits are not well studied. This study projected FP's benefits for maternal health and child survival over the Sustainable Development Goals period. Methods: The Demographic Dividend Model created by the Health Policy Project using a large range of data was applied based exclusively on assumptions on FP policy options between 2015 and 2030. Results: It was found that, under the base scenario with no improvements in FP, education and economic variables, however unrealistic, the number of children per Beninese woman would be the same in 2030 as it was in 2015 - about 4.5 children per woman. Benin's age structure would remain very young and be dominated by dependents. But, FP-scenarios of improvements in contraceptive variables alone showed a negative and linear relationship between FP use and maternal and child deaths. Under the optimistic scenario, increasing access to and use of FP alone from 7.9% (2015) to 33.95% (2030) will save lives of about 200,000 under five year children and 10,000 mothers by 2030. In addition, the average number of children per woman will fall to 3.5 increasing female life expectancy by 5 years. Benin's age structure will be balanced with more working age people. The country will also record an increase in its human development indicator. Conclusion: To accelerate progresses towards improvement of maternal health and child survival, and get on track in meeting related health targets of SDGs, the present study revealed the importance of strengthening actions toward access to and use of FP in Benin Republic. There is also a need to strengthen education and economic policies to successfully harness the demographic dividend.