Examining trends in family planning among harder-to-reach women in Senegal 1992–2014

Cavallaro, Francesca; Beňová, Lenka; Macleod, David; Faye, Adama; Lynch, Caroline A.

doi:10.1038/srep41006

Cited by 20 publications

(32 citation statements)

References 26 publications

(40 reference statements)

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“…In Senegal, despite numerous health interventions, the unmet need for contraception remains high. At the same time, the prevalence of contraceptives has increased in recent years [31]. This study showed an unmet need rate of 26.2% among Senegalese women.…”

Section: Factors Associated With Decision-making Autonomy Among Senegmentioning

confidence: 60%

Women’s autonomy in health decision-making and its effect on access to family planning services in Senegal in 2017: a propensity score analysis

Sougou¹,

Bassoum²,

Faye³

et al. 2020

BMC Public Health

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Background: The effect of women's autonomy in decision-making for fertility control has been highlighted by research. The objective of this study was to analyze the effect of women's autonomy over decision-making regarding their health and access to family planning in Senegal in 2017. Methods: The analyses in this study were carried out using data from the Senegal Demographic and Health Survey in 2017. The sample consisted of 8865 women aged 15-49. The propensity score-matching method was applied. Autonomy in health decision-making was considered the treatment variable. Matching was performed using confounding variables. The outcome variables were the current use of modern contraceptive methods and the existence of unmet needs. The common support condition had been met. The analysis was conducted using STATA.15 software. Results: This study showed that 6.26% of women had decision-making autonomy in relation to their health. For 80.33% of the women, their husbands/partners made health-related decisions for them. Decision-making autonomy increased significantly with the age of the woman (p < 0.05). In addition, 15.24% of women were using a modern method of contraception. An estimated 26.2% of women had unmet needs. Propensity score matching split the women into two groups based on autonomy over decision-making for their health. After matching, there was no longer a significant difference between women who were autonomous with respect to their decision-making and those who were not autonomous with respect to their current use of a modern contraceptive method. On the other hand, there was a 14.42% reduction (p < 0.05) in unmet needs for family planning in the group of women who were autonomous with respect to their health decision-making. Conclusion: Autonomy in health decision-making would reduce unmet needs among Senegalese women. These results show the importance of accounting for gender in health interventions for the accessibility of family planning services.

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Section: Factors Associated With Decision-making Autonomy Among Senegmentioning

confidence: 60%

Women’s autonomy in health decision-making and its effect on access to family planning services in Senegal in 2017: a propensity score analysis

Sougou¹,

Bassoum²,

Faye³

et al. 2020

BMC Public Health

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“…The other major implication is about reaching out to underserved populations. In a study in Senegal, on “harder to reach” populations, these are defined as “less exposed to external influence and at risk of being underserved despite their high level of need”, and considered to belong to the three categories: adolescents, unmarried and rural poor [ 23 ]. Changing attitudes in communities which are far from everything is a true challenge [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Contraception determinants in youths of Sierra Leone are largely behavioral

Labat

Medina²,

Elhassein³

et al. 2018

Reprod Health

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BackgroundSexual initiation occurs early in Sierra Leone. This study aims to analyze the determinants of condom and/or contraceptive use among a representative sample of young persons (10 to 24 years) in Sierra Leone.MethodsThis is a secondary analysis of data from a study conducted to monitor the implementation of a UNFPA package of interventions directed to improve SRH in young people of Sierra Leone. This assessment was conducted in 2016 at the end of the Ebola outbreak. In consequence, determinants linked to healthy lifestyle behaviors and UNFPA interventions were explored in addition to the usual determinants: socio demographic and sexual lifestyle. This study is a household quantitative survey with open ended questions used to illustrate and complete the analysis.ResultsA total of 1409 young people were interviewed: of these, 216 boys and 381 girls were sexually active. Those who were pregnant or wished for pregnancy were excluded, leaving 194 boys and 268 girls for the analysis of determinants. The proportion of young people using neither condom nor other contraception at their last sexual intercourse in the whole sample was 40.5% and there was no statistically significant difference between boys and girls (42.3 vs 39.2; P = 0.504). Determinants were assessed and, after multivariable analysis, results differed between boys and girls and showed the importance of behavioral aspects. Four determinants were common to boys and girls: literacy, distance, negotiation capacity and hand washing. However, the distance factor for girls was to the health facility and for boys it was to school. Three more determinants remained in the boy’s model: sleeping under a bednet, number of sexual partners and knowledge of contraceptive methods. Opinions about condoms and contraception revealed important barriers; opposition to contraceptive use was the main reason for non-use for both boys and girls, while lack of access was an important reason for boys.ConclusionThere is a need to reach out to the 40% of young people who are sexually active and neither pregnant nor with pregnancy desire, and are not using condom or contraception.

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“…Improving quality of care is a huge challenge requiring substantial financial and programme investments from the Senegalese government and reproductive health partners. Improving access to safe abortion in addition to existing contraception efforts,73 74 and increasing female education, would help prevent higher-risk births and abortion-related mortality.…”

Section: Discussionmentioning

confidence: 99%

What the percentage of births in facilities does not measure: readiness for emergency obstetric care and referral in Senegal

Cavallaro

Beňová

Dioukhane³

et al. 2020

BMJ Glob Health

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IntroductionIncreases in facility deliveries in sub-Saharan Africa have not yielded expected declines in maternal mortality, raising concerns about the quality of care provided in facilities. The readiness of facilities at different health system levels to provide both emergency obstetric and newborn care (EmONC) as well as referral is unknown. We describe this combined readiness by facility level and region in Senegal.MethodsFor this cross-sectional study, we used data from nine Demographic and Health Surveys between 1992 and 2017 in Senegal to describe trends in location of births over time. We used data from the 2017 Service Provision Assessment to describe EmONC and emergency referral readiness across facility levels in the public system, where 94% of facility births occur. A national global positioning system facility census was used to map access from lower-level facilities to the nearest facility performing caesareans.ResultsBirths in facilities increased from 47% in 1992 to 80% in 2016, driven by births in lower-level health posts, where half of facility births now occur. Caesarean rates in rural areas more than doubled but only to 3.7%, indicating minor improvements in EmONC access. Only 9% of health posts had full readiness for basic EmONC, and 62% had adequate referral readiness (vehicle on-site or telephone and vehicle access elsewhere). Although public facilities accounted for three-quarters of all births in 2016, only 16% of such births occurred in facilities able to provide adequate combined readiness for EmONC and referral.ConclusionsOur findings imply that many lower-level public facilities—the most common place of birth in Senegal—are unable to treat or refer women with obstetric complications, especially in rural areas. In light of rising lower-level facility births in Senegal and elsewhere, improvements in EmONC and referral readiness are urgently needed to accelerate reductions in maternal and perinatal mortality.

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Examining trends in family planning among harder-to-reach women in Senegal 1992–2014

Cited by 20 publications

References 26 publications

Women’s autonomy in health decision-making and its effect on access to family planning services in Senegal in 2017: a propensity score analysis

Women’s autonomy in health decision-making and its effect on access to family planning services in Senegal in 2017: a propensity score analysis

Contraception determinants in youths of Sierra Leone are largely behavioral

What the percentage of births in facilities does not measure: readiness for emergency obstetric care and referral in Senegal

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