DISAGREEMENT IN SPOUSAL REPORTS OF CURRENT CONTRACEPTIVE USE IN SUB-SAHARAN AFRICA

2005 ◽  
Vol 38 (6) ◽  
pp. 779-796 ◽  
Author(s):  
STAN BECKER ◽  
MIAN B. HOSSAIN ◽  
ELIZABETH THOMSON

Contraceptive prevalence is a key variable estimated from Demographic and Health Surveys. But the prevalence estimated from reports of husbands differs widely from that estimated for wives. In this research, using data from six Demographic and Health Surveys of sub-Saharan Africa, reports from spouses in monogamous couples with no other reported sex partners in the recent period are examined. Agreement ranged from 47% to 82%, but among couples in which one or both reported use, the ‘both’ category represented less than half in all nations except Zimbabwe. Husbands generally had higher reports of condoms, periodic abstinence and pills but fewer reports of the IUD, injections and female sterilization. Either discussion of family planning with the spouse and/or higher socioeconomic status was associated with agreement in most of the surveys. Ambiguities in the survey question regarding current use need to be reduced, perhaps with an added probe question for non-permanent methods.

2017 ◽  
Vol 50 (3) ◽  
pp. 326-346 ◽  
Author(s):  
Natalie C. Gasca ◽  
Stan Becker

SummarySubstantial numbers of married women use contraceptives without their partner’s knowledge in sub-Saharan Africa, but studies of female covert use across time are rare. This study investigates the levels, trends and correlates of covert use in nine countries and determines which contraceptive methods are more frequently used covertly by women. Data from monogamous couples in Demographic and Health Surveys were used from nine sub-Saharan African countries that had experienced an increase of 10 percentage points in current modern contraceptive use between an earlier (1991–2004) and later (2007–2011) survey. Covert use was indirectly estimated as the percentage of women who reported a female modern method whose husband did not report a modern method. The percentage of women using covertly increased in eight of the countries studied (significantly in three of them), yet when comparing across countries cross-sectionally, covert use was lower where contraceptive prevalence was higher. In general, women with more years of schooling and those with larger spousal schooling gaps had lower odds of covert use. There was no significant difference between covert and open injectable use, though more than half of both groups used this method in the later surveys. Encouraging couple communication about contraception, where the woman feels it is safe to do so, could be an important strategy to minimize covert use. Further research is needed to better identify the contraceptive prevalence and social context in which covert use declines within a country.


2007 ◽  
Vol 39 (4) ◽  
pp. 493-515 ◽  
Author(s):  
MARK BROWN

SummaryExtended durations of postpartum non-susceptibility (PPNS) comprising lactational amenorrhoea and associated taboos on sex have been a central component of traditional reproductive regimes in sub-Saharan Africa. In situations of rising contraceptive prevalence this paper draws on data from the Demographic Health Surveys to consider the neglected interface between ancient and modern methods of regulation. The analysis reports striking contrasts between countries. At one extreme a woman’s natural susceptibility status appears to have little bearing on the decision to use contraception in Zimbabwe, with widespread ‘double-protection’. By contrast, contraceptive use in Kenya and Ghana builds directly onto underlying patterns of PPNS. Possible explanations for the differences and the implications for theory and policy are discussed.


2021 ◽  
pp. 1-11
Author(s):  
Michel Garenne ◽  
Susan Thurstans ◽  
André Briend ◽  
Carmel Dolan ◽  
Tanya Khara ◽  
...  

Abstract The study investigates sex differences in the prevalence of undernutrition in sub-Saharan Africa. Undernutrition was defined by Z-scores using the CDC-2000 growth charts. Some 128 Demographic and Health Surveys (DHS) were analysed, totalling 700,114 children under-five. The results revealed a higher susceptibility of boys to undernutrition. Male-to-female ratios of prevalence averaged 1.18 for stunting (height-for-age Z-score <−2.0); 1.01 for wasting (weight-for-height Z-score <−2.0); 1.05 for underweight (weight-for-age Z-score <−2.0); and 1.29 for concurrent wasting and stunting (weight-for-height and height-for-age Z-scores <−2.0). Sex ratios of prevalence varied with age for stunting and concurrent wasting and stunting, with higher values for children age 0–23 months and lower values for children age 24–59 months. Sex ratios of prevalence tended to increase with declining level of mortality for stunting, underweight and concurrent wasting and stunting, but remained stable for wasting. Comparisons were made with other anthropometric reference sets (NCHS-1977 and WHO-2006), and the results were found to differ somewhat from those obtained with CDC-2000. Possible rationales for these patterns are discussed.


BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e025355 ◽  
Author(s):  
Dennis Juma Matanda ◽  
Pooja Sripad ◽  
Charity Ndwiga

ObjectivesLiterature on associations between female genital mutilation/cutting (FGM/C) and fistula points to a common belief that FGM/C predisposes women to developing fistula. This study explores this association using nationally representative survey data.DesignA secondary statistical analysis of cross-sectional data from Demographic and Health Surveys was conducted to explore the association between FGM/C and fistula.SettingSub-Saharan Africa.ParticipantsWomen aged 15–49 years in Burkina Faso (n=17 087), Chad (n=17 719), Côte d’Ivoire (n=10 060), Ethiopia (n=14 070), Guinea (n=9142), Kenya (n=31 079), Mali (n=10 424), Nigeria (n=33 385), Senegal (n=15 688) and Sierra Leone (n=16 658).Main outcome measuresFistula symptoms.ResultsMultivariate logit modelling using pooled data from 10 countries showed that the odds of reporting fistula symptoms were 1.5 times (CI 1.06 to 2.21) higher for women whose genitals were cut and sewn closed than those who had undergone other types of FGM/C. Women who attended antenatal care (ANC) (adjusted odds ratio (AOR) 0.51, CI 0.36 to 0.71) and those who lived in urban areas (AOR 0.62, CI 0.44 to 0.89) were less likely to report fistula symptoms than those who did not attend ANC or lived in rural areas.ConclusionsSevere forms of FGM/C (infibulation) may predispose women to fistula. Contextual and socioeconomic factors may increase the likelihood of fistula. Multisectoral interventions that concurrently address harmful traditional practices such as FGM/C and other contextual factors that drive the occurrence of fistula are warranted. Promotion of ANC utilisation could be a starting point in the prevention of fistulas.


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