Corrigendum: Factors related to married or cohabiting women's decision to use modern contraceptive methods in Mafikeng, South Africa.

No abstract available.

Factors related to married or cohabiting women's decision to use modern contraceptive methods in Mahikeng, South Africa.

BACKGROUND:  Sexual and reproductive decision-making has emerged as an important health indicator in family reproductive health issues. While there is evidence of male dominance in sexual and reproductive health decisions, the role of socio-demographic factors on women's decision to use contraception is not well understood. AIM:  This study aimed at exploring the socio-demographic factors associated with married women's decision-making to use contraception. SETTING:  The study was conducted in Mahikeng local municipality in the Modiri Molema District Municipality. METHODS:  Data were generated in Mahikeng from married and cohabiting women, aged 18-49 years, from a survey comprising 568 participants. Data were collected on women's demographic characteristics and contraceptive behaviour. Descriptive, bivariate and multivariate analyses were used to examine factors related to decision-making on contraceptive use. RESULTS:  The result revealed that 57% of the participants were currently using contraception and 45% stated jointly-made decision regarding the use of contraception. Decisions on use of contraceptives were associated with education, occupation, religion, duration of union and home language. Other factors associated with decision-making on contraceptive use were perception on husband's right to sex, use of force for sex and spousal communication about sex. CONCLUSION:  Empowering women to use contraception to meet their fertility desire should aim at improving their socio-economic status and spousal communication. Family planning providers should recognise socio-cultural barriers under which the relationships exist and how women can navigate these contextual factors.

COHABITATION AND UNION DISSOLUTION IN CENTRAL UGANDA: DIFFERENCES BETWEEN COHABITORS AND NON-COHABITORS.

The aim of this paper was to establish whether the differences in the risks of union dissolution between cohabitors and non-cohabitors in Uganda have converged over time using event history data. Data were collected in 2013 from 1200 women in central Uganda using retrospective methods. Of these, 839 provided information on three types of first union: women who married directly (without first cohabiting), those who married following cohabitation and those who were still cohabiting. The data were analysed using decrement lifetable analysis. Though the analysis indicated a small difference in the timing of first union dissolution for women who married directly, no evidence was found that the difference in the risk of union dissolution between cohabitors and non-cohabitors had converged over the 9-year period following first union. Women's union/marriage status, number of living children in a union, parental union status and birth cohort were found to significantly influence the timing of union dissolution. Overall, the rate of union dissolution was fairly high, regardless of type of union.

Prevalence of maternal near miss and community-based risk factors in Central Uganda.

OBJECTIVE: To examine the prevalence of maternal near-miss (MNM) and its associated risk factors in a community setting in Central Uganda. METHODS: A cross-sectional research design employing multi-stage sampling collected data from women aged 15-49 years in Rakai, Uganda, who had been pregnant in the 3years preceding the survey, conducted between August 10 and December 31, 2013. Additionally, in-depth interviews were conducted. WHO-based disease and management criteria were used to identify MNM. Binary logistic regression was used to predict MNM risk factors. Content analysis was performed for qualitative data. RESULTS: Survey data were collected from 1557 women and 40 in-depth interviews were conducted. The MNM prevalence was 287.7 per 1000 pregnancies; the majority of MNMs resulted from hemorrhage. Unwanted pregnancies, a history of MNM, primipara, pregnancy danger signs, Banyakore ethnicity, and a partner who had completed primary education only were associated with increased odds of MNM (all P<0.05). CONCLUSIONS: MNM morbidity is a significant burden in Central Uganda. The present study demonstrated higher MNM rates compared with studies employing organ-failure MNM-diagnostic criteria. These findings illustrate the need to look beyond mortality statistics when assessing maternal health outcomes. Concerted efforts to increase supervised deliveries, access to emergency obstetric care, and access to contraceptives are warranted.

Prevalence and Predictors of Elder Abuse in Mafikeng Local Municipality in South Africa

Elder abuse is widespread in South Africa and is a serious public health problem. This paper estimated the prevalence and identified the forms and predictors of elder abuse. The paper used cross-sectional data on 506 elderly people from Mafikeng Local Municipality in South Africa; and used the chi-square statistic and the logistic regression model to analyse the data. Overall 64.3 of men and 60.3 of women experienced elder abuse. Physical abuse was more common among men while emotional; financial and sexual abuses were more common among women. Having no working children; being currently single; living in elderly couple family; living in rural areas; having a poor self-perception of health and having a disability were significantly associated with elder abuse. We conclude that the prevalence of elder abuse is high and common; which calls for strategies to prevent the vice

Rates and predictors of consistent condom-use by people living with HIV/AIDS on antiretroviral treatment in Uganda.

Antiretroviral treatment (ART) has been recognized as one of the methods for reducing the risk of HIV transmission, and access to this is being rapidly expanded. However, in a generalized HIV epidemic, ART could increase unprotected sex by people living with HIV/AIDS (PHAs). This paper assessed the rates and predictors of consistent condom-use by sexually-active PHAs after initiating ART. The study used cross-sectional data on sexual behaviour of 269 sexually-active ART-experienced individuals (95 males and 174 females) aged 18 years and above. The results revealed that 65% (70% of men and 61% of women) used condom consistently after initiating ART. Consistent use of condom was more likely if PHAs had secondary- or tertiary-level education and had more than one sex partner in the 12 months preceding the study. However, PHAs were less likely to have used condom consistently if they worked in the informal and formal sectors, belonged to the medium- and high-income groups, and were married. PHAs, who were on ART for less than 1 year and 1-2 year(s), had a good self-perception of health, had a sexual partner who was HIV-negative or a partner with unknown HIV status, and desired to bear children, were also less likely to have used condom consistently. The paper concluded that, although the majority of PHAs consistently used condom, there was potential for unprotected sex by PHAs on ART.

Understanding socio-economic determinants of childhood mortality: a retrospective analysis in Uganda.

BACKGROUND: Teso sub-region of Eastern Uganda had superior indices of childhood survival during the period 1959 to 1969 compared to the national average. We analysed the reasons that could explain this situation with a view of suggesting strategies for reducing childhood mortality. METHODS: We compared the childhood mortalities and their average annual reduction rate (AARR) of Teso sub-region with those of Uganda for the period 1959 to 1969. We also compared indicators of social economic well being (such as livestock per capita and per capita intake of protein/energy). In addition data was compared on other important determinants of child survival such as level of education and rate of urbanisation. FINDINGS: In 1969 the infant mortality rate (IMR) for Teso was 94 per 1000 live births compared to the 120 for Uganda. Between 1959 and 1969 the AARR for IMR for Teso was 4.57% compared to 3% for Uganda. It was interesting that the AARR for Teso was higher than that that of 4.4.% required to achieve millennium development goal number four (MDG4). The rate of urbanisation and the level of education were higher in Uganda compared to Teso during the same period. Teso had a per capita ownership of cattle of 1.12 compared to Uganda's 0.44. Teso sub region had about 3 times the amount of protein and about 2 times the amount of calories compared to Uganda. CONCLUSIONS: We surmise that higher ownership of cattle and growing of high protein and energy foods might have been responsible for better childhood survival in Teso compared to Uganda.

Why the increase in under five mortality in Uganda from 1995 to 2000? A retrospective analysis.

BACKGROUND: From 1995-2000 the under five mortality rate in Uganda increased from 147.3 to 151.5 deaths per 1000 live births and reasons for the increase were not clear. This study was undertaken to understand factors influencing the increase in under five mortality rate during 1995-2000 in Uganda with a view of suggesting remedial actions. METHODS: We performed a comparative retrospective analysis of data derived from the 1995 and the 2000 Uganda demographic and health surveys. We correlated the change of under five mortality rate in Uganda desegregated by region (central, eastern, north and western) with change in major known determinants of under five mortality such social economic circumstances, maternal factors, access to health services, and level of nutrition. RESULTS: The increase in under five mortality rate only happened in western Uganda with the other 3 regions of Uganda (eastern, northern and central) showing a decrease. The changes in U5MR could not be explained by changes in poverty, maternal conditions, level of nutrition, or in access to health and other social services and in the prevalence of HIV among women attending for ante-natal care. All these factors did not reach statistical significance (P > 0.05) using Pearson's correlation coefficient. CONCLUSION: In order to explain these findings, there is need to find something that happened in western Uganda (but not other parts of the country) during the period 1995-2000 and has the potential to change the under five mortality by a big margin. We hypothesize that the increase in under five mortality could be explained by the severe malaria epidemic that occurred in western Uganda (but not other regions) in 1997/98.

Has the HIV/AIDS epidemic changed sexual behaviour of high risk groups in Uganda?

BACKGROUND: Uganda, was the first country in sub-Saharan Africa to reverse its HIV/AIDS epidemic. Long distance drivers, prostitutes and barmaids have been identified as the groups that engage in risky sex, which promotes HIV transmission in Uganda and other countries across the continent. This paper investigates whether and why there were changes of sexual behaviour and practices among five risky groups in Uganda as a consequence of HIV/AIDS epidemic. METHODOLOGY: The paper is based on data generated from a survey on 'resistance to sexual behaviour change in the African AIDS epidemic', which was conducted in the districts of Kabale, Kampala and Lira in 1999. For purposes of this paper, only data from the focus group discussions with high-risk groups have been analysed. These include commercial sex workers, street children, long haul truck drivers, bar maids and adolescents in three towns of Uganda (Kabale, Kampala, Lira). RESULTS: Results indicate that despite the HIV/AIDS epidemic, these groups had only changed their sexual behaviour a little, and they reported to be continuing with multiple sexual partners for a variety of reasons. The adolescents and street children were under peer pressure and a lot of sexual urge; commercial sex workers and bar maids attributed their risky behaviour to the need to survive due to the existing poverty; and the truck drivers reflected on the need for female company to reduce their stress while on the long lonely travels across Africa. Nevertheless, they are all aware and perceive people with multiple sexual partners as being highly vulnerable to contracting HIV and they all reported to have adopted condom use as an HIV preventive strategy. They also observed that married people were at a high risk of contracting HIV due to non-use of condoms in marital relationships and unfaithfulness of spouses. CONCLUSIONS Females engage in high-risk sexual relations as a means of economic survival, and perceive their acts as a strategy to improve their socio-economic well being. On the contrary, men in these high-risk categories do such acts out of pleasure and as avenues for attaining fulfilled sexual lives. The search for money among women and the constant desire for men to have sexual pleasure, which are greatly facilitated by their financial status are the forces behind reckless sexual behaviour among high-risk groups.