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Prevalence of major depressive disorder and its determinants among young married women and unmarried girls: Findings from the second round of UDAYA survey
No full textIntroduction: Depression is a prevalent and debilitating mental illness affecting young women worldwide. This study aimed to identify psychosocial determinants of major depressive disorder (MDD) among young women in Bihar and Uttar Pradesh, India. Methods: Data from Understanding the Lives of Adolescents and Young Adults (UDAYA) study (2018-19) for young women aged 12-23 years, both married and unmarried was used for this paper. MDD was evaluated using the Patient Health Questionnaire PHQ-9 with a cut-off score of ≤10. The determinants of MDD were identified through multilevel binary logistic regression analysis. Results: The prevalence of MDD was 13.6% (95% CL 12.2-15.2) and 5.1% (95% CL 4.2-6.1) for young married women and unmarried girls, respectively. Among the young married women, community-level variables like dowry-related humiliation (1.74, 95% CI 1.15-2.64), and sexual assaults (2.15, 95% CI 1.24-3.73) were significantly associated with MDD. For unmarried girls, reporting of family violence \u3c10% of participants (0.45, 95% CI 0.24-0.85), family violence (≥10% of participants) % (0.35 95% CI 0.19-0.68) and interpartner violence (\u3e25% of participants) (0.42; 95% CI 0.23-0.74) remain significant predictors of MDD. At individual level, for both the groups, age, participation in decision making (on education), social capital (currently attending school/educational course and number of friends), self-efficacy, telephonic harassment, and physical activity were associated with MDD. Wealth index, job seeking, participation in decision making (on health-seeking), parental interactions and physical abuse (for unmarried girls only) and education, reported last sexual intercourse, pressure from the in-laws’ to conceive (for young married women only) were associated with MDD. Conclusions: For young married women, community level targeted interventions should focus on the social ecology to foster a sense of safe community environment. For unmarried girls, additionally, interventions should aim to optimize their family environment for effective mental health outcomes
Regulatory challenges of new male contraceptive methods
No full textIntroduction: Progress in male contraception development faces the challenge of a lack of regulatory precedent and guidelines on the evidence (trial design and primary endpoint) required for marketing approval. Moreover, the development of a male contraceptive is complicated by the fact that the clinical treatment effect; prevention of pregnancy, is not measured in the patient receiving the intervention. Discussion: Regulatory precedent and guidelines exist for female hormonal contraceptives but their applicability to male contraceptive products likely varies based on the mode of action and the anticipated pharmacodynamic effects of the product. The unique attributes of male contraceptives, including the frequent delay between the intervention (e.g., vasectomy and hormonal methods) and ultimate contraceptive effect, sperm suppression near azoospermia, and pregnancy prevention need to be addressed. Conclusion: This article describes the regulatory challenges faced by developers of male contraceptive products and offers proposals, paving the way for the development of both hormonal methods and non-hormonal approaches. Our article intends to suggest the directions but cannot substitute for the advice of regulatory agencies
Influencing programme plans, practices, actions, and investments in humanitarian settings: Case Study One
Get PDFThis case study describes the Baobab Research Programme Consortium\u27s pathway to influencing programme plans, practices, actions, and investments in refugee contexts in Uganda, and the efforts which culminated in the collaborative piloting of a Para-Social Worker-driven intervention in Kiryandongo Settlement by Baobab and Uganda’s Ministry of Gender, Labour and Social Development, with support from the Department of Refugees
Pattern and determinants of contraceptive use among the muslim women in Wajir and Lamu counties in Kenya: A cross-sectional study
No full textBackground: Improving access to family planning (FP) is associated with positive health benefits that includes averting nearly a third of all maternal deaths and 10% of childhood deaths. Kenya has made great strides in improving access to family planning services. However, amid this considerable progress, regional variation has been noted which begs the need for a clearer understanding of the the patterns and determinants that drive these inconsistencies. Methods: We conducted a cross-sectional study that involved 663 Muslim women of reproductive age (15–49 years) from Wajir and Lamu counties in Kenya between March and October 2018.The objective of this study was to understand patterns and determinants of contraceptive use in two predominantly Muslim settings of Lamu and Wajir counties that have varying contraceptive uptake. Eligible women were interviewed using a semi-structured questionnaire containing socio-demographic information and history of family planning use. Simple and multiple logistic regression were used to identify determinants of family planning use. The results were presented as Crude Odds Ratio (COR) and Adjusted Odds Ratio (AOR) ratios at 95% confidence interval. A p-value of 0.05 was considered statistically significant. Results: Of the 663 Muslim women of reproductive age consenting to participate in the study, 51.5%, n = 342 and 48.5%, n = 321 were from Lamu and Wajir County, respectively. The prevalence of women currently using contraceptive was 18.6% (n = 123). In Lamu, the prevalence was 32.8%, while in Wajir, it was 3.4%. The determinants of current contraceptive use in Lamu include; marital status, age at marriage, employment status, discussion with a partner on FP, acceptability of FP in culture, and willingness to obtain information on FP. While in Wajir, determinants of current contraceptive use were education, and the belief that family planning is allowed in Islam. Conclusions: Our study found moderately high use of contraceptives among Muslim women of reproductive age in Lamu county and very low contraceptive use among women in Wajir. Given the role of men in decision making, it is critical to design male involvement strategy particularly in Wajir where the male influence is very prominent. It is critical for the government to invest in women and girls’ education to enhance their ability to make informed decisions; particularly in Wajir where FP uptake is low with low education attainment. Further, our findings highlight the need for culturally appropriate messages and involvement of religious leaders to demystify the myths and misconception around family planning and Islam particularly in Wajir
Analysis of anthropometric outcomes in Indian children during the COVID-19 pandemic using National Family Health Survey data
No full textBackground: Disruptions in food, health, and economic systems during the COVID-19 pandemic may have adversely affected child health. There is currently limited research on the potential effects of the COVID-19 pandemic on stunting, wasting, and underweight status of young children. Methods: We examine the short-term associations between the pandemic and anthropometric outcomes of under-5 children (n = 232,920) in India, using data from the National Family Health Survey (2019–2021). Children surveyed after March 2020 are considered as the post-COVID group, while those surveyed earlier are considered as pre-COVID. Potential biases arising from differences in socioeconomic characteristics of the two groups are mitigated using propensity score matching methods. Results: Post-COVID children surveyed in 2020 and 2021 have 1.2% higher underweight rates, 1.2% lower wasting rates, 0.1 lower height-for-age z-scores (HAZ), and 0.04 lower weight-for-height z-scores as compared with matched pre-COVID children. Post-COVID children surveyed in 2020 have 1.6%, 4.6%, and 2.4% higher stunting, underweight, and wasting rates, respectively, and 0.07 lower HAZ, as compared with matched pre-COVID children. Reductions in nutritional status are largest among children from households in the poorest wealth quintiles. Conclusions: These findings indicate a trend towards a recovery in child anthropometric outcomes in 2021 after the initial post-pandemic reductions. The resilience of health and food systems to shocks such as COVID-19 should be strengthened while immediate investments are required to decrease child malnutrition and improve broader child health outcomes
Fertility transitions in low- and middle-income countries: The role of preferences
No full textSince the mid-twentieth century, the Global South has experienced unprecedently rapid and pervasive changes in reproductive behavior with fertility declining from high pre-transitional levels to below 3 births per woman in most low- and middle-income countries (LMICs). Over time a rough consensus has been reached on major theories about the causes of these declines. However, a controversy remains about the widely held view that changing reproductive preferences (i.e., declining desired family size and rising demand for birth limitation) are the dominant drivers of fertility transitions. Several studies question this conclusion and suggest instead that the rising implementation of existing demand is the main cause of the reproductive revolution in LMICs. The objective of this study is to reconcile the competing “demand” and “implementation” perspectives. This paper assesses the strengths and weaknesses of published decompositions which take trends in the observed total fertility and contraceptive prevalence and break them down into their respective demand and implementation components. The main conclusion from this exercise is that fertility transitions are driven by changes in both preferences and their implementation. Claims of a completely dominant role for either demand or implementation are based on flawed methods and hence must be rejected
The PrEP Ring Quarterly—Edition 1, October 2024
Get PDFThis is the first edition of The PrEP Ring Quarterly newsletter, which provides information, updates, and resources dedicated to the dapivirine vaginal ring (DVR) also known as PrEP ring
Acceptability and feasibility study for the Dapivirine Vaginal Ring in Cambodia: A qualitative study on the Dapivirine Vaginal Ring for use amongst cisgender women at substantial HIV risk in Cambodia
Get PDFBuilding resilience among adolescent girls in the Sahel: Regional summary report of a mixed-methods participatory research
No full textRecent evidence shows that major efforts are needed to improve the lives and protect the rights of adolescent girls in the Sahel. UNICEF’s Building Resilience in the Sahel (BRS) programme implemented in Mali, Mauritania and Niger, funded by the German Federal Ministry for Economic Cooperation and Development and designed with the World Food Programme and the German Agency for International Cooperation, supports innovative approaches and strategies to increase access to basic social services, through catalysing change in national and decentralized government systems, in communities and in individuals, to improve the lives of children and adolescents.
This study on adolescent girls’ resilience conducted by UNICEF in Mali, Mauritania and Niger in 2023–2024 aimed to make important discoveries about the contexts and capabilities of adolescent girls in the Sahel and the change strategies required. The study findings presented in this report contribute to developing a new model for the resilience of adolescent girls in the Sahel.
This report also provides recommendations for technical and financial partners, decision-makers, practitioners and researchers
Facilitators and barriers to maternal immunization and strategies to improve uptake in low-income and lower-middle income countries: A systematic review
No full textMaternal immunization (MI) is an emerging strategy to combat infant mortality in low-income (LIC) and lower-middle income countries (LMIC). We conducted a systematic review to identify the facilitators and barriers to MI and strategies that improve uptake in LICs and LMICs. We searched PubMed, Cochrane Library, and Scopus for quantitative, qualitative, and mixed-methods studies published in English from January 1, 2011, to October 31, 2021, from all LICs and LMICs. Data was appraised using the Mixed Methods Appraisal Tool. 55 studies were included. The major barriers were low knowledge and concern of vaccine safety among pregnant women and healthcare providers (HCP). HCP’s recommendation, maternal knowledge, vaccine confidence and ≥4 antenatal care (ANC) visits facilitated uptake. The key strategies encompassed health financing, reminders, intersectoral coordination, integration, community engagement, capacity building, and education. Community-based delivery models were effective. Tailored programs are needed to improve ANC access, and educate pregnant women and HCPs