Background Malawi is one of the countries in SSA with the highest TFR. This study aimed to explore factors associated with modern contraceptive use and intention to use contraceptives among women of reproductive ages (15–49 years) in Malawi. Methods The study used secondary data from 2015 to 16 Malawi Demographic and Health Survey (MDHS) dataset. Logistic regression models were used to derive adjusted odd ratios as the measures of association between need, predisposing and enabling factors, and contraceptive use and the intention to use contraceptives among women. The sample constituted 24,562 women who were successfully interviewed during the MDHS. All comparisons are considered statistically significant at 5% level. Results Overall 54.8% of women were currently using contraceptives, while 69.1% had the intention to use contraceptives. The odds of contraceptive use were significantly low among, women aged 15–19 years, 20–24 years, 25–29 years, 30–34 years, 35–39 years and 40–44 years compared to women aged 45–49 years; women of Tonga ethnic group (OR = O.60, CI = 0.43 0.84) compared to women of Nyanga ethnic group; women from poor households (OR = 0.78, CI = 0.68–0.90) and middle income households (OR = 0.84, CI = 0.74–0.95) compared to women from rich household. Nonetheless, women with no past experience of terminated pregnancy (OR = 1.50, CI = 1.34–1.68) were more likely to use contraceptives compared to women with past experience of terminated pregnancy. Similarly, Women with primary education (OR = 1.56, CI = 1.16–2.09) and secondary education (OR = 1.39, CI = 1.04–1.85) were more likely to use contraceptives compared to women with higher education. While the odds of intending to use contraceptives were significantly high with age only thus among women aged 15–19 years, (OR = 15.18, CI = 5.94–38.77); 20–24 years (OR = 16.77, CI = 7.46–37.71); 25–29 years (OR = 6.75, CI = 3.16–14.45); 30–34 years (OR = 7.75, CI = 3.61–16.65) and 35–39 years (OR = 5.05, CI = 2.29–11.12) compared to women aged 45–49 years. Conclusion As direct policy measure; information, education and communication programmes on family planning among poor and middle income women, and all women in reproductive ages should be strengthened.

Background Power inequality within the household and sexual relationships is linked to poor reproductive health. Malawi Government through National Sexual and Reproductive Health and Rights policy is committed to women empowerment as well fertility reduction. However, there is limited evidence in Malawi regarding whether women’s autonomy in the household is an independent determinant of fertility. With this background, the aim of this study is to investigate whether women’s autonomy in the household is a determinant of fertility in a poor socioeconomic and cultural setting. Methods This study used Malawi Demographic and Health Survey, 2015–2016. A multivariable Poisson regression model was used to investigate if women’s autonomy in the household in Malawi determines fertility. The outcome measure, children ever born, was used as a measure of fertility. Women’s autonomy was measured with two dimensions, such as women’s household related decision makings and women’s sexual autonomy. The individual recode and household recode were merged for the analysis. The final study sample was 15,952 women who were cohabiting or married at the time of the survey. Results The level of autonomy among women in the household related decisions and sexual autonomy was 49.1% and 64.0% respectively. Controlling for covariates, the study found no significant association between women’s autonomy dimensions in the household and number of children ever born. On the other hand, living in urban area (IRR = 0.91, CI 0.88–0.93); having less than tertiary education thus, no education (IRR = 1.83, CI 1.67–1.99) or primary education (IRR = 1.55, CI 1.42–1.69) or secondary education (IRR = 1.23, CI 1.13–1.33); poor households (IRR = 1.05, CI 1.01–1.09), starting cohabiting at the age of 19 years or less (AIRR = 1.15, CI 1.13–1.18) and not using modern contraceptive methods (AIRR = 1.17, CI 1.15–1.19) were significantly associated with fertility. Conclusions and recommendations Though women’s autonomy does not have independent effect on fertility, it may be interacting with other sociocultural norms prevailing in the society. The study recommends that the Government of Malawi should come up with economic hardship emancipation policy for poor households. The government should also come up with a girl-child secondary school completion policy. Furthermore, the government should accelerate the implementation, monitoring and evaluation of National Gender Policy to ensure the women empowerment/autonomy is having positive effect at all level including the household.

Malaria is a major public health concern in Malawi. This study explored the patterns and correlates of ownership and utilization of ITNs for malaria control among women of reproductive age in Malawi. Data were derived from the multi-stage cross-sectional Malaria Indicator Survey (MIS) conducted in 2017, which followed ITN distribution in 2012 and 2015. Of the 3860 sampled women aged 15–49 years, 88% (3398/3860) and 64% (2473/3860) reported that they owned and utilized ITNs, respectively. Adjusted multivariate logistic regression analysis showed that the odds of ownership of ITNs were significantly low among women with no education (AOR = 0.36, CI = 0.18–0.72), those with primary education (AOR = 0.50, CI = 0.27–0.94) and poor women (AOR = 0.70, CI = 0.51–0.97). Similarly, the odds of utilization of ITNs were significantly low among women with no education, (AOR = 0.40, CI = 0.26–0.63), primary education (AOR = 0.53, CI = 0.36–0.78) and poor women (AOR = 0.70, CI = 0.51–0.97). Furthermore, the odds of utilization of ITNs were significantly low among women living in households without a radio (AOR = 0.79, CI = 0.67–0.93) and those who have not seen or heard a malaria message in the last 6 months (AOR = 0.74, CI = 0.64–0.87). In order to prevent malaria morbidity and mortality among women of reproductive age, especially those from poor households, the Malawi government and relevant stakeholders need to continue the free distribution of ITNs to the poor and encourage social behaviours that promote the ownership and utilization of ITNs.

In Malawi, the prevalence of intimate partner violence (IPV), or closely related violence, is estimated at 42% according to the 2015–16 Malawi Demography and Health Survey (MDHS). This study investigated the association between women’s autonomy in household decision-making participation as well as sexual autonomy and IPV among married and cohabiting women aged 15–49 years in Malawi. Secondary data were taken from the 2015–16 MDHS. Multivariate analysis was performed using a stepwise forward logistic (binary) regression model to assess the association of dimensions of women’s autonomy in the household and selected control variables with IPV. No association was found between dimensions of women’s autonomy in the household and IPV. However, other variables did have an association with some form of IPV, namely women justifying wife beating, having a jealous partner, being accused of unfaithfulness by their partner, having a partner who drinks alcohol and having a partner with another woman or more. In addition, religion, ethnicity, women education level and women’s occupation were found to be associated with the risk of experiencing IPV. The study recommends policy interventions aimed at supporting youth, especially girls, to complete secondary education before they marry or cohabit; the development of accessible and affordable psycho-social counselling specialists and platforms for married and cohabiting couples; nationwide rigorous advocacy and civic education on IPV; and enforcement of Malawi’s 2006 domestic violence law.

Background There is a scarcity of studies on the prevalence and predictors of suicide behaviors among primary and secondary school going adolescents aged 10–19 years in Botswana hence, this study would fill that gap. Methods This study used cross-sectional secondary data from Botswana Youth Risk Behavior and Biological Surveillance Survey (BYRBBSS), 2010. Multivariable binary logistic regression models were used to investigate the predictors of suicide behaviours. Results The study shows that 51.5% of the respondents reported having ever contemplated suicide while 40.1% of the respondents attempted suicide in the last 12 months before the survey. The study found that male learners (AOR = 0.61, 95% CI = 0.44–0.83), learners who were not attacked or threatened or injured by someone (AOR = 0.35, 95% CI = 0.17–0.72), who were not bullied (AOR = 0.22, 95% CI = 0.13–0.39), and who were confident of themselves (AOR = 0.55, 95% CI = 0.39–0.76) were less likely to contemplate suicide. Whereas learners with primary school level education were more likely to contemplate suicide (AOR = 2.12, 95% CI = 1.14–3.95). Males were less likely than their female counterparts to attempt suicide (AOR = 0.68, 95% CI = 0.47–0.97). Regarding attempt, learners who had self-confidence (AOR = 0.35, 95% CI = 0.24–0.50), not being bullied (AOR = 0.20, 95% CI = 0.11–0.35), not being attacked or threatened or injured by someone (AOR = 0.35, 95% CI = 0.18–0.69), not engaging in a physical fight that led to injury (AOR = 0.34, 95% CI = 0.19–0.61) were less likely to attempt suicide. Whereas being at primary school (AOR = 5.29, 95% CI = 2.58–10.86), and missing classes once or more in a week (AOR = 1.70, 95% CI = 1.05–2.76) were associated with increased likelihood of suicide attempt. Conclusion The study shows that suicide behaviours as big challenges in Botswana among primary and secondary school going adolescents aged 10–19 years. Thus, the study recommends policy interventions aiming at including education on peer bullying or fighting or attack at primary and secondary education levels if not already in existence. There should also be interventions aiming at educating guardians and teachers on consequences of bullying or fighting so that they should consistently remind their children not to bully and for them to open up if they are being bullied. The study further recommends that schools and communities at large should have a psychosocial system for bullying or fighting reporting, follow-up, and appropriate corrective interventions for the offenders. There should also be self-confidence instilling education as well as sex/gender-specific interventions for instance girls can be given platform (private if necessary) to express peculiar problems to them that need specific help.