Women's involvement in decision-making and association with reproductive health behaviors: findings from a cross-sectional survey in Niger.

BACKGROUND: Though women in Niger are largely responsible for the familial health and caretaking, prior research shows limited female autonomy in healthcare decisions. This study extends current understanding of women's participation in decision-making and its influence on reproductive health behaviors. METHODS: Cross-sectional survey with married women (15-49 years, N = 2,672) in Maradi and Zinder Niger assessed women's participation in household decision-making in health and non-health issues. Analyses examined [1] if participation in household decision-making was associated with modern contraceptive use, antenatal care (ANC) attendance, and skilled birth attendance at last delivery and [2] what individual, interpersonal, and community-level factors were associated with women's participation in decision-making. RESULTS: Only 16% of the respondents were involved-either autonomously or jointly with their spouse-in all three types of household decisions: (1) large purchase, (2) visiting family/parents, and (3) decisions about own healthcare. Involvement in decision making was significantly associated with increased odds of current modern contraceptive use [aOR:1.36 (95% CI: 1.06-1.75)] and four or more ANC visits during their recent pregnancy [aOR:1.34 (95% CI: 1.00-1.79)], when adjusting for socio-demographic characteristics. There was no significant association between involvement in decision-making and skilled birth attendance at recent delivery. Odds of involvement in decision-making was significantly associated with increasing age and household wealth status, listening to radio, and involvement in decision-making about their own marriage. CONCLUSION: Women's engagement in decision-making positively influences their reproductive health. Social and behavior change strategies to shift social norms and increase opportunities for women's involvement in household decision making are needed. For example, radio programs can be used to inform specific target groups on how women's decision-making can positively influence reproductive health while also providing specific actions to achieve change. Opportunities exist to enhance women's voice either before women enter marital partnerships or after (for instance, using health and social programming).

"My Mother Persuaded Me to Have More Children", Understanding the Influence of Social Network on Fertility Behavior in Sub-Saharan Africa.

Introduction: Despite the adoption of an antenatal demographic transition model in sub-Saharan Africa, population growth continues to soar in the region. The reasons for population growth are nebulous and should be approached from different perspectives. Inadequate attention has been paid to how social pressures shape reproductive behavior. Thus, this study examines the association between social networks and fertility behavior in sub-Saharan Africa. Methods: This study used a cross-sectional design that employed a qualitative method to conduct 28 in-depth interviews among married women. Data was collected in 2023. Thematic analyses were utilized to interpret the results. Results: Parental pressure, the desire for more children, the desire for male children, values placed on children, norms, and pronatalist culture were associated with high fertility in sub-Saharan Africa. Conclusions: Thus, there is a need for more awareness of family planning and contraceptive use in order to reduce fertility in sub-Saharan Africa.

[The choice of a life without children under the influence of societal concerns]. / Le choix d'une vie sans enfant sous l'influence des préoccupations sociétales.

THE CHOICE OF A LIFE WITHOUT CHILDREN UNDER THE INFLUENCE OF SOCIETAL CONCERNS. Previously unpublished data from 2021 provide an update on the motivations of people who choose not to have children, considering a context of strong social pressure to conceive and a declining birth rate in France. Moreover, childlessness is still a minority phenomenon, and still subject to a certain amount of stigmatization It is part of a social context with a growing concern for ecological issues and the difficulties to achieve gender equality. Taking all of this into consideration, people who choose not to have children are in many ways well anchored in current issues.

LE CHOIX D'UNE VIE SANS ENFANT SOUS L'INFLUENCE DES PRÉOCCUPATIONS SOCIÉTALES. Des données inédites datant de 2021 permettent de faire le point sur les motivations des personnes volontairement sans enfant dans un contexte de forte pression sociale à concevoir et de baisse de la natalité en France. En outre, le non-désir d'enfant est toujours un phénomène minoritaire et encore sujet à une certaine forme de stigmatisation. Par ailleurs, il s'inscrit dans un contexte social où la question écologique prend de l'ampleur et où l'égalité femmes-hommes peine toujours à se réaliser. Les personnes volontairement sans enfant sont, en ce sens, bien ancrées dans la société actuelle.

[The social hygienic aspects of reproductive behavior of women aged 40-45 years].

In the context of forecasted decreasing of natality, actuality of studying its causes for organizational decision-making increases. The purpose of the study was to determine factors affecting reproductive behavior of women aged 40-45 years residing in areas with different natality levels in 2020-2021. The cohort, analytical, sociological methods were applied. The results of study demonstrated that in areas with high natality level most of urban women with higher education and high income resides in conditions of dormitory or mortgage flat and working in profile of their specialty. They are characterized by belated marriage that results in postponed child-bearing. The areas with low natality are characterized by dwelling of rural women with secondary or secondary specialized education. They reside in their own homes and work in other occupations than their specialty. The analysis of social status of women of different age groups will permit more selective approach in developing measures of increasing natality in modern conditions.

Development and psychometric evaluation of the questionnaire on the contributing factors of tendency towards voluntary single-childedness and childlessness: a mixed method study.

Couples' tendency towards voluntary single-childedness and childlessness (VSCC) has turned into a major challenge in all societies and led to different problems such as population aging. A key step to VSCC management is to determine its contributing factors through valid and reliable instruments. This exploratory sequential mixed method study (qualitative-quantitative) was conducted in 2020-2021. Phases of qualitative consists of all couples aged 15-49 in Babol, Iran, who were single or childless. Sampling is based on the purpose, and the number of samples is 20 couples. To collect data, face-to-face and semi-structured interviews were conducted with the participants. Sampling continued until data saturation. The data were analyzed by the conventional content analysis method and quantitative phase. Initially, a qualitative study was conducted on twenty couples, and were analyzed through conventional content analysis. Findings were used to develop QFT-VSCC and then, the face, content, and construct validity as well as reliability were assessed. Construct validity was assessed through exploratory and confirmatory factor analyses and reliability was assessed through internal consistency and stability assessments. The results of the qualitative part analysis consist of 140 codes, 30 primary categories, and nine main categories and two themes (individual limitations and social limitations). The primary QFT-VSCC had 78 items. Fifty-eight items were omitted during validity assessment and the remaining twenty-two items were loaded on five factors during factor analysis. These factors were threatened priorities, inappropriate familial context for childbearing, sense of occupational and social insecurity for the child, social modeling of childlessness, and tendency towards change or stability in marital life. The five factors explained 52.56% of the total variance. All model fit indices in confirmatory factor analysis were acceptable and the Cronbach's alpha values of QFT-VSCC and all its factors were more than 0.70. The results of convergent validity analysis revealed that all factors had an AVE value greater than 0.5, and the HTMT index for all factors was less than 0.85. This indicated that discriminant validity had been achieved. QFT-VSCC is a simple valid and reliable instrument for VSCC assessment among both men and women.

Determinants of high-risk fertility behavior among women of reproductive age in Kenya: a multilevel analysis based on 2022 Kenyan demographic and health survey.

BACKGROUND: Women's high-risk fertility behavior (HRFB), which is characterized by narrow birth intervals, high birth order, and younger maternal age at birth, have been scientifically reported to have detrimental effects on the mother and child's health. To date, there has been limited research into the underlying factors contributing to high-risk fertility behavior in Kenya. Thus, the aim of this study is to identify the factors associated with high-risk fertility behavior among women of reproductive age in Kenya. METHOD: The 2022 Kenyan Demography and Health Survey data was used for the current study. This study included 15,483 women of reproductive age. To account for the clustering effects of DHS data and the binary nature of the outcome variable, a multilevel binary logistic regression model was applied. An adjusted odds ratio with a 95% confidence interval was reported to declare the statistical significance. In addition, the model that had the lowest deviance was the one that best fit the data. RESULTS: The overall prevalence of HRFB among Kenyan women were 70.86% (95%CI = 69.96, 71.40). Women with primary, secondary, and higher educational levels, Protestant and Muslim religion followers, women whose husbands/partners had secondary and higher educational levels, a high household wealth index, ever had a terminated pregnancy, and rural residence, all of these factors were found to be strongly associated with high-risk fertility behavior. CONCLUSION: As per the findings of our study, in Kenya a significant proportion of women has experienced HRFB. This is a matter of concern as it poses a significant challenge to the healthcare system. The high prevalence of HRFB indicates that there is an urgent need to take appropriate measures in order to mitigate its impact. The situation calls for a comprehensive and coordinated approach involving all stakeholders to address this issue effectively. It would benefit policymakers to create programs that consider factors like education, wealth, and residence that make women more susceptible to HRFB. Targeting women living in high HRFB-prevalence areas could help address the root causes of the issue. This approach can alleviate negative impacts and ensure effective and sustainable solutions.

Patients' and providers' perspectives on the decision to undergo non-urgent egg freezing: a needs assessment.

BACKGROUND: Previous research has demonstrated that patients have difficulty with the decision to undergo non-urgent egg freezing (EF). This study aimed to investigate the decisional difficulties and possible decisional support mechanisms for patients considering EF, and for their providers. METHODS: This qualitative study involved a needs assessment via individual interviews. Participants included patients considering EF at one academic fertility clinic and providers from across Canada who counsel patients considering EF. 25 participants were included (13 providers and 12 patients). The interview guide was developed according to the Ottawa Decision Support Framework. Interviews were transcribed, and transcripts analyzed for themes and concepts using NVIVO 12. FINDINGS: Multiple factors contributing to decisional difficulty were identified, including: (1) multiple reproductive options available with differing views from patients/providers regarding their importance; (2) a decision typically made under the pressure of reproductive aging; (3) uncertainty surrounding the technology/inadequate outcome data; (4) the financial burden of EF; (5) inherent uncertainty relating to potential decision regret; and (6) differing perceptions between patients/providers regarding the role providers should play in the decision. Additionally, potential sources of decisional support were identified, including provision of basic information before and/or during initial consultation, followed by an opportunity during or after initial consultation for clarifying information and helping with value judgements. Individualized counselling based on patient values, adequate follow-up, psychosocial counselling, and peer support were also emphasized. CONCLUSIONS: More decisional support for women considering EF is needed. Suggestions include a patient decision aid in conjunction with modified healthcare provider counselling, support and follow up.

Factores de riesgo en la edad reproductiva / Risk Factors in the Reproductive Age

Por medio de la presente y motivados por la lectura y análisis del artículo Características clínicas y microbiológicas de la infección de vías urinarias bajas en población ambulatoria,1 quisiéramos llamar la atención sobre un tema que últimamente tiene poca visibilidad en las publicaciones. Se trata de los factores de riesgo presentes en la edad reproductiva y que inciden negativamente en futuros embarazos, lo que se conoce como factores de riesgo preconcepcional. Al revisar lo publicado en los últimos cinco años apenas se aborda directamente el tema, que por demás mantiene vigencia capital cuando de salud materno infantil se trata. En el trabajo que motiva el análisis, se expresa la frecuencia de aparición de las infecciones urinarias bajas en ambos sexos, más frecuentes en mujeres...(AU)

Differences by age group in gender-related attitudes in Oromia, Ethiopia: Findings from a cross-sectional study of women of reproductive age.

Attitudes on gender roles affect decision-making dynamics, resource distribution, and income-generating opportunities. However, little is known about how attitudes on gender roles differ by age group. Cross-sectional data collected from 1,113 households in Oromia, Ethiopia were used to assess differences in gender-related attitudes across female "youth" (ages 15-24), "young adults" (ages 25-34), and "older adults" (ages 35-49). Fifteen survey questions using a Likert scale measured attitudes on sexual and reproductive behaviors, expectations around livelihood activities, and perceived influence in household decision making. Associations between attitudes and age group were assessed using the Chi-squared test. Measures of perceived influence in decision making differed significantly by age group for household decisions about participation in wage employment, and use of revenue generated from wage employment, and crop and livestock production. Response patterns were consistent, with youth least likely to feel they have influence in decision making. The results suggest that policies and programs should continue to support the agency of female youth.

Reproductive behavior of Atlantic halibut (Hippoglossus hippoglossus) interpreted from electronic tags.

Reproductive timing, location, and behavior are important characteristics that determine marine population dynamics, structure, and resilience to threats, including fishing and climate change. It is challenging to evaluate factors driving variability in these reproductive traits in wild fishes because of the difficulty observing individuals in their natural environments. In the present study, we used high-resolution depth, temperature, and acceleration time series recorded by pop-up satellite archival tags to (1) identify and characterize patterns in depth and acceleration that may be indicative of spawning events in large Atlantic halibut (Hippoglossus hippoglossus), and (2) estimate the effects of individual traits (body size and sex) and environmental factors (location and temperature) on spawning time and frequency. Unique rapid rises observed in the winter depth profiles were interpreted as spawning events. The initiation of the first presumed spawning rise was negatively correlated to water temperature experienced during the prespawning season, suggesting that currently increasing water temperature in the Gulf of St. Lawrence may induce phenological change in halibut spawning time. The number of rises of batch-spawning females was unrelated to female body size. The present study demonstrates how electronic tagging can be used for in-depth characterization of timing, location, and behaviors associated with spawning in a large flatfish species. Such information can inform spatiotemporal management and conservation measures aiming to protect species from directed fishing and by-catch during spawning.

Changes in reproductive behavior associated with the perception and individual experiences of the COVID-19 pandemic.

This study evaluates the impacts of the COVID-19 pandemic on the reproductive behavior of men and women during the most restrictive period of the pandemic in Czechia. At the end of this period, data was collected for the Czech GGS COVID Pilot-Follow-up Study (April 2021), which included additional questions on reproductive plans and perceptions of the pandemic related to fertility. The study focuses in detail on the evaluation of the favorability of fertility during this period by considering the impact of the pandemic on the lives of individuals in various life areas. It subsequently attempts to determine to what extent this evaluation and personal experiences of the pandemic affected reproductive behavior (the intended number of children, current attempts to conceive and short-term fertility intentions). In summary, in most cases the respondents considered the most severe period of the pandemic to be unfavorable in terms of childbirth. Women provided an overall negative assessment of the favorability of childbirth in this period, which was reflected in a reduction in the planned number of children, while the men who considered this period favorable declared a higher chance of short-term fertility intentions.

Monogenoidea Communities Differ Between Male Morphotypes of Bluegill Sunfish (Lepomis macrochirus).

PURPOSE: Bluegill sunfish (Lepomis macrochirus) are a North American sport fish that exhibit two different male morphotypes. Alpha-males are large, colorful, territorial, and have significant parental investment, while ß-males are small, drab, and have two reproductive phenotypes, neither of which involves parental investment. Due to the two different reproductive strategies, the level of interaction between congenerics varies, which may impact parasites that are spread via close contact, such as Monogenoidea that infect the gills. Monogeneans are ectoparasites on the gills and skin of fish hosts that may cause significant pathology in high numbers and be an indicator of host behavior and interaction between hosts. METHODS: In this study, 328 L. macrochirus (106 α-males, 92 ß-males, and 130 females) were necropsied from 8 lakes and ponds in northwestern Virginia to identify and enumerate monogenean parasites from the gills. RESULTS: Alpha-males had a significantly greater parasite abundance and species richness compared to ß-males. This may be due to the increased size and surface area of gills in α-males, increased interaction with females during mating, and stationary behavior when guarding nests, which enhanced the chances of α-males contracting the parasites. This also led to significant differences in the monogenean communities infecting the two morphotypes, which were also significantly influenced by the size of the hosts. CONCLUSIONS: It is important in future studies regarding parasitism that behavioral morphotypes within a sex, such as α-male and ß-male L. macrochirus in this study, be treated separately as behavioral and morphometric differences between them can potentially lead to differences in parasitism.

Construction and validation of a reproductive behavior questionnaire for female patients with rheumatic diseases.

INTRODUCTION/OBJECTIVES: Active autoimmune rheumatic diseases (ARDs) before conception increase the risk of flares and adverse pregnancy outcomes. We aimed to construct and validate a reproductive behavior questionnaire in Spanish for patients with ARDs to assess their knowledge and their reproductive behavior. METHOD: We constructed and validated a reproductive behavior questionnaire in two phases: (1) a literature review followed by interviews of reproductive-age female patients, and (2) a cross-sectional study to complete validation. Convenience sampling was carried out with 165 female patients: 65 participated in the cross-cultural adaptation phase and 100 in the validation phase. The internal consistency was evaluated by estimating Cronbach's alpha and tetrachoric correlation coefficients. Values ≥ 0.40 were considered acceptable (p < 0.05). RESULTS: The initial instrument included 38 questions. Thematic analysis identified 8 important dimensions or topics, which were combined to create the Rheuma Reproductive Behavior interview questionnaire. A final total of 41 items across 10 dimensions were obtained. The test-retest analysis showed perfect correlations in 34 of the 41 items, moderate in 6 items, and negative in one of the items. The mean age of the patients was 35.65 years (SD 9.02), and the mean time to answer the survey was 13.66 min (SD 7.1). CONCLUSIONS: The Rheuma Reproductive Behavior questionnaire showed good reliability and consistency capturing patients' reproductive health knowledge and reproductive behavior. Key Points • We designed and validated a questionnaire to assess reproductive health knowledge and reproductive behavior among female patients with ARDs. • The questionnaire was comprehensible for participants, and showed good reliability and consistency capturing reproductive knowledge and behavior. • This tool may aid in the design of strategies to improve reproductive decision-making for female patients with ARDs.

Perfil reprodutivo de uma população de alta vulnerabilidade / Reproductive profile of a high vulnerability population

Introdução: padrões sexuais e reprodutivos são influenciados por fatores biopsicossociais. Dentre esses fatores, há a vulnerabilidade, conceito amplo, complexo e que determina maior atenção das políticas públicas. Objetivo: conhecer o perfil reprodutivo das mulheres que residem em uma área de alta vulnerabilidade na cidade de Curitiba-PR. Metodologia: descritivo, documental de caráter analítico observacional transversal. Coleta e análise de dados das Declarações de Nascidos Vivos (DNV) na Unidade de Saúde do Capanema e análise de dados públicos fornecidos pelo IBGE. Resultados: foram analisados 1199 DNVs, sendo 1011 mulheres com idades entre 13 e 49 anos, compreendidos entre os anos de 2003 a 2018. Foi possível a análise da Taxa de Fecundidade Total (TFT), via de parto, estado civil e escolaridade das parturientes. Discussão: a menor TFT foi apresentada na faixa etária de 13 a 15 anos (1,05 filhos/mulher) e a maior entre 36 a 49 anos (4,47 filhos/mulher). A via de parto vaginal correspondeu a 64% dos partos, enquanto que a via cirúrgica por cesárea aconteceu em 36% dos casos. Em relação à escolaridade, 3% apresentaram-se como analfabetas; 48% possuíam nível fundamental; 40% nível médio completo e 9% possuíam nível superior completo ou incompleto. Houve 0,5% de omissão da que escolaridade no momento do preenchimento dos dados. Os dados coletados sobre o estado civil foram considerados inconclusivos. Conclusão: Conclui-se que a Taxa de Fecundidade da população estudada está acima da Taxa de Fecundidade Total projetada para 2015 no Brasil nas faixas etárias acima de 19 anos e da taxa de fecundidade ideal para que haja uma reposição da população segundo o DATASUS (2021). Tais dados podem estar relacionados com a vulnerabilidade da comunidade em questão, corroborando com estudos que relatam maiores taxas de fecundidade relacionada a menor renda e menor escolaridade.

Introduction: sexual and reproductive patterns are influenced by biopsychosocial factors. Among these factors, there is vulnerability, a broad and complex concept that requires greater attention from public policies. Objective: to know the reproductive profile of women who live in an area of high vulnerability in the city of Curitiba-PR. Methodology: descriptive, documental, cross-sectional observational analysis. Collection and analysis of data from the Birth Certificates (BC) at the Capanema Health Unit and analysis of public data provided by the IBGE. Results: 1199 BCs were analysed, with 1011 women aged between 13 and 49 years old, between the years 2003 and 2018. It was possible to analyse the Total Fertility Rate (TFR), mode of delivery, marital status and level of education of the parturients. Discussion: the lowest TFR was observed in the age group from 13 to 15 years old (1.05 children/woman) and the highest between 36 to 49 years old (4.47 children/woman). Vaginal delivery corresponded to 64% of deliveries, while surgical caesarean section occurred in 36% of cases. Regarding schooling, 3% were illiterate; 48% had a fundamental level; 40% completed high school and 9% had completed or incomplete higher education. There was 0.5% omission of schooling attainment at the time of filling in the data. Data collected on marital status were considered inconclusive. Conclusion: it is concluded that the Fertility Rate of the studied population is above the Total Fertility Rate projected for 2015 in Brazil in the age groups above 19 years and the ideal fertility rate so that there is a replacement of the population according to DATASUS (2021). Such data may be related to the vulnerability of the community in question, corroborating with studies that report higher fertility rates related to lower income and lower education.

Reproductive behaviour and longevity: Evidence from Chinese centenarians.

With the implementation of the three-child policy in China, the debate between fertility and health and longevity has again become a hot topic in the era of increasing ageing. This study aimed to explore the association between reproductive behaviour and longevity of older women and men in China. Based on data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 2014 to 2018, a total of 1428 deceased older people were enrolled in the study, including 421 centenarians and 1007 non-centenarians. The analysis of the association between fertility and longevity was conducted in the multivariate logistic regression. Compared to women aged 99 years and below, centenarian women had significantly fewer children (p < 0.01), fewer sons (p < 0.01) and fewer daughters. Centenarian men had more children, more daughters and fewer sons. For both men and women, centenarians were significantly characterized by later age at first birth (p < 0.01) and later age at last birth (p < 0.01). Centenarians were significantly characterized by having children and having a daughter, however, non-centenarians were significantly characterized by having a son (p < 0.01). The association between fertility and health of both men and women should be taken into account in the development of fertility policies and supporting policies. Fertility levels should be increased without compromising the health benefits of individuals in their later years.

Family orientation, working years and childbearing age: evidence from the China Family Panel Study 2014.

This article reports the results of a study investigating the impact of family orientation, the number of years spent working, and their interaction on childbearing age among women who have recently completed their childbearing.We find that a traditional family orientation and a higher number of working years contribute to delaying the childbearing age. People with a traditional family orientation can delay childbearing because they want to make elaborate material preparations for raising their children. Women who have worked many years are more aware of gender inequality in the domestic sphere (having been exposed to gender equality in the workplace). This is especially the case for women with a modern family orientation. However, this does not necessarily lead people with a modern family orientation to delay childbearing. They may advance their childbearing in an effort to escape an oppressive domestic environment in their families of origin.

The effect of estrogen and progesterone on melanin-concentrating hormone producing-neurons in brain areas related to reproductive behavior in lactating dams.

The hypothalamus plays a role in reproductive cycle control, and it is a site of action of steroid hormones. Throughout the production of melanin-concentrating hormone (MCH), the hypothalamus shows adaptive changes during lactation. Therefore, in this work, we aimed to test the effects of estrogen and progesterone manipulation on MCH-immunoreactive (ir) neurons in hypothalamic brain areas related to reproductive behavior and on the MCH serum concentration. Our results show that the removal of steroid hormones by ovariectomy increases the number of MCH-ir neurons in the medial preoptic area (MPOA) and incerto-hypothalamic area (IHy) but not in the anterior part of the paraventricular nucleus of the hypothalamus (PVHa). The MCH in the serum levels also increases. In accordance, the injection of estradiol alone or estradiol and progesterone decreased the number of MCH-ir neurons in the MPOA and IHy, as well as its serum levels. The MPOA and IHy are the brain areas targeted by the steroid hormone inhibitory effect of the MCH system during lactation. This effect is also reflected in the MCH serum levels.

Caesarean deliveries, subsequent reproductive behaviour and children ever born in India.

Against the backdrop of the alarming rise in Caesarean section (C-section) births in India, this study aimed to examine the association between C-section births, fertility decline and female sterilization in the country. A cross-sectional design was used to investigate the association between C-section delivery and subsequent reproductive behaviour in women in India. Data were from the National Family Health Survey (NFHS-4). The study sample comprised 255,726 currently married women in the age group of 15-49 years. The results showed a strong positive relationship between C-section births and female sterilization. The predicted probabilities (PP) from the multivariate regression model indicated a higher chance of female sterilization in women with C-section births (PP = 0.39, p<0.01) compared with those with non-C-section births (PP = 0.20, p<0.01). Both state-level correlation plots and Poisson regression estimates showed a strong negative relationship between C-section births and mean children ever born (CEB). Based on the results, it may be concluded that the use of C-sections and sterilization were strongly correlated in India at the time of the NFHS-4, thus together contributing to fertility decline. A strong negative association was found between the occurrence of C-sections and CEB. The increased and undesired use of C-section births and consequent female sterilization is a regressive socio-demographic process that often violates women's rights. Fertility decline should happen through informed choice of family planning and must protect the reproductive rights of women.

Reproductive Planning and the Choice of Long-acting Reversible Contraceptive Primary to Health: A Cross-Sectional Study / Planejamento reprodutivo e a escolha do contraceptivo de longa permanência na atenção primária à saúde: um estudo transversal

Abstract Objective Evaluate the different perspectives that involve the choice of long-acting reversible contraceptives (LARCs), the issues related to this process and the consequences of deciding one method in the women's in the primary health care (PHC) center in Sousas, a district in Campinas, SP (Brazil). Methods This is an analytical cross-sectional study, it was performed at the PHC in Sousas. Data were collected through the analysis of medical records and interviews with women who live in Sousas and had the insertion of the copper intrauterine device (IUD) (D) from April 2021 to April 2022 or the etonogestrel implant (I) from May to December 2022. The study was approved by the Research Ethics Committee of the Medical Science School at the State University of Campinas (UNICAMP). Results Reason for choosing this LARC: medical (D: 52%; I: 100%), easy adhesion (D: 71%; I: 67%), effectiveness (D: 55%; I: 100%). Indication by health professionals (D: 65%; I: 100%). And improvement of clinical characteristics: mood (D: 77%; I: 67%), body mass index (BMI; D: 52%; I: 33%), and libido (D: 84%; I: 67%). Conclusion It is suggested that women tend to decide between LARCs when guided by their doctor or PHC health professionals, and they select LARCs because of the ease of use and low failure rates. Therefore, this study highlights how LARCs can positively interfere in the aspects that pervade contraception, such as BMI, libido, and mood.

Resumo Objetivo Avaliar as diversas perspectivas que envolvem a escolha dos LARCs, as problemáticas relacionadas a esse processo e as consequências da escolha do método na vida das mulheres no centro de Atenção Primária à Saúde (APS) em Sousas, distrito de Campinas, SP. Métodos Trata-se de um estudo transversal analítico, realizado no Centro de Saúde de Sousas. Os dados foram coletados através da análise de prontuários e de entrevistas das mulheres residentes em Sousas, que inseriram o dispositivo intrauterino (DIU) de cobre (D) entre abril de 2021 a abril de 2022 ou o implante de etonogestrel (I) de maio a dezembro de 2022. O estudo foi aprovado pelo Comitê de Ética em Pesquisa da Faculdade de Ciência Médicas da Universidade Estadual de Campinas (UNICAMP). Resultados O motivo da escolha: por indicação médica (D: 52%; I: 100%), pela facilidade (D: 71%; I: 67%) e pela eficácia (D: 55%; I: 100%). Da indicação por profissionais de saúde (D: 65%; I: 100%). E melhora das características clínicas: humor (D: 77%; I: 67%), índice de massa corporal (IMC; D: 52%; I: 33%) e libido (D: 84%; I: 67%). Conclusão Sugere-se que as mulheres tendem a escolher LARCs quando orientadas pelo seu médico ou por profissionais de saúde da APS e optam pelos LARCs pela facilidade do uso e baixa taxa de falhas. Destaca-se como os LARC's podem interferir positivamente em aspectos que perpassam a contracepção, como o IMC, libido e estado de humor.

Antenatal women's childbearing practices at the Niger Delta university teaching hospital, Okolobiri Nigeria

Background: Overpopulation in a community or a country reflects high fertility desires of its citizens. A country can only progress meaningfully if its resources and amenities can provide for all its citizens. Objectives: To examine the childbearing practices of antenatal attendees at the Niger Delta University Teaching Hospital, Okolobiri, Nigeria and whether there is any suggestion of fertility decline or transition. Materials and Methods: A cross-sectional study of two hundred and fifty-two women who had antenatal care in the hospital during the study period. Data was collected using a structured self-administered questionnaire with a reliability coefficient of 0.85. Data collected were analysed using IBM SPSS Statistics version 25. Statistical significance was a p-value <0.05. Results: The mean age of the respondents was 30.5 ± 5.9 years. More than half (53.6%) had tertiary education and 39.3% had secondary education. Only 29.4% were housewives/unemployed. The median parity was 2 and 229 women accounted for previous deliveries of 596 babies. The median desired total number of children was 4 (range 1 to 8). More than half (56.3%) did not believe in spacing after the first child. Seventy-six (30.2%) had no knowledge of modern contraceptives. There was a significant relationship (p - 0.018) between child sex preference and number of births. Conclusion: With a current median parity of two children/woman and desired total number of children of a median of four children/woman, the childbearing practices of the population studied may not result in a fertility rate far below the Nigeria national average of 5.3 children per woman. Nevertheless, a study to derive the total fertility rate in the study population is necessary to determine whether or not there is ongoing fertility transition.