Analysis of Couples’ Discordance on Fertility Desire in Ghana

Yeboah, Isaac; Okyere, Joshua; Duah, Henry Ofori; Conduah, Andrew Kweku; Essiaw, Mary Naana

doi:10.3390/genealogy7030048

Cited by 4 publications

(1 citation statement)

References 32 publications

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“…In low and middle income countries fertility desired is determined by the husband (7).and male dominance in decision making as far sexual and reproductive health concerned (7-10) which negatively affects women intentions to conceive. Further evidence also showed that discordance in fertility desire among couples (11). Women intentions to conceive is an integral part of reproductive health (RH) right and can be consider as decision making over their fertility.…”

Section: Introductionmentioning

confidence: 99%

One Year Postpartum Emotional Fertility Intentions among a Cohort of Pregnant Women followed for 2 Years and its Correlates in Ethiopia: Community based longitudinal data from Performance Monitoring for Action; Generalized Ordered Logistics Regression Modeling

Damtew,

Shiferaw,

Gidey

et al. 2024

Preprint

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Background: Emotional health and couples communication are key during pregnancy and childbirth with simultaneous minimization of reproductive coercion which should be maintained in the postpartum period to maintain inter pregnancy period healthy and make the next pregnancy planned and successful. The postpartum period is key in the newborn development milestone and maintain maternal health. Women intentions to conceive are an integral part of Reproductive Health (RH) right and can be consider as decision making on their fertility control. However, in low and middle income countries including Ethiopia where male dominance is culturally constructed and socially acceptable, males take the lead in every decision making process for the family ranging from house level decision including to determine number of children that the family and new born RH rights and RH health service use. In such a scenario women may say not have heard likely hence, this study aimed at determining the level of women emotional fertility readiness and its correlates so as to avail actionable evidence for the ministry and partners working Reproductive and women health so as to be used as an action point to empower women on their reproductive health right to control their fertility. Methods: Nationally representative 2-year cohort data collected from pregnant women in four rounds were used. Frequency was computed to describe the study participant’s characteristics. Generalized ordered logistics regression was employed to identify correlates of the hierarchical variation in one year postpartum women fertility intention if they became pregnant. Results were presented in the form percentages and odds ratio with 95% Confidence Intervals. Candidate variables were selected using p-value of0.25. Statistical significance was declared at p-value of 0.05. Results: One in 20, (4.63% (3.60%, 5.94%)) postpartum women have reported that they felt very happy. Nearly two third 64.87% (62.20%, 67.45%) of one year postpartum women have reported that they very or a sort of unhappy by one year post-partum when asked what do they feel if they became pregnant. Nearly one in 6, (17.12% (15.15%, 19.29%)) women reported mixed feeling in the same period. Women who reported they have ever used contraceptive and those who reported that they have started contraceptive use one year postpartum had a proportional cumulative logit of 0.66 (0.44, 0.97) and 0.43 (0.29, 0.63) respectively across the higher level categories of one year postpartum women emotional fertility intention compared with their counter parts. The likelihood of one year postpartum emotional fertility intention among women with higher birth order and those who do not wanted additional child was found lower and asymmetrically across the higher level categories. Conclusion: Nearly 2/3 of one year post-partum women have reported very unhappy or a sort of unhappy if they became pregnant while one in 6 and one in five felt mixed feeling if they became pregnant one year postpartum respectively calls up on intended and spaced pregnancies by ensuring women reproductive decision making to control over their fertility. Activities and efforts that promote intended and spaced pregnancies; and diversifying access to contraceptive methods are likely to improve the level of one year postpartum women emotional fertility intention. Activities that enable women to decide their contraceptive use along with patient centered contraceptive use counseling as well. The implication the findings is that awareness creation on preconception and availing the service is also hoped to address the varying level of one year postpartum emotional fertility intention.

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Section: Introductionmentioning

confidence: 99%

One Year Postpartum Emotional Fertility Intentions among a Cohort of Pregnant Women followed for 2 Years and its Correlates in Ethiopia: Community based longitudinal data from Performance Monitoring for Action; Generalized Ordered Logistics Regression Modeling

Damtew,

Shiferaw,

Gidey

et al. 2024

Preprint

View full text Add to dashboard Cite

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Emotional Fertility Intention and its correlates in Ethiopia among married contraceptive user women: using linked community and health facility data from performance monitoring for action; a generalized ordered logistics regression modeling

Damtew,

Gidey,

Fantaye

et al. 2024

BMC Public Health

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Background Emotional fertility intention and couples communication are key during pregnancy and childbirth with simultaneous minimization of reproductive coercion. Intention to conceive is an integral part of the reproductive health (RH) right and can be considered as decision making on fertility, family wellbeing and the country’s population demographic dividend and composition. However, in low and middle income countries including Ethiopia where males dominance is culturally constructed and socially accepted, males took the lead in every decision making process. In the aforementioned context, women are less likely for their voices to be heard, hence, this study aimed at determining the level of womens´ emotional fertility readiness and its correlates. The finding provided actionable evidence for the ministry and developmental partners working on reproductive and womens´ health so as to be used as an action point to empower women in terms of their reproductive health right to have control over their fertility. Methods Linked community and facility data with nationally representation from Performance Monitoring for Action (PMA Ethiopia) 2020 Survey Ethiopia except Tigray Region were used for this study. A total of 2,069 current and/or recent contraceptive user women of child bearing age who are currently married/living together as a partner were included in this analysis. Frequency was computed to describe the study participant’s characteristics. Generalized Ordered logistics regression modeling was employed to identify correlates of the hierarchical variation in women fertility intention if they became pregnant. Results were presented in the form of percentages and odds ratio with 95% Confidence Intervals. Candidate variables were selected using p-value of 0.25. Statistical significance was declared at p-value of 0.05. Results The proportion of womens´ emotional fertility intention of feeling unhappiness was 48.73% (95%CI: 46.21%, 51.23%). On the contrary, 22.88%, 11.36% and 17.03% of them reported that they felt sort of happy, very happy and mixed feeling. An increase in age,10 and above years marriage duration, the type of decision maker for contraceptive use were found to increase the odds of women emotional fertility intention across the higher level categories by (AOR: 95% CI: 6.75 (3.11, 14.62) times higher among elder women aged 35 to 49 years, (AOR: 95% CI: 3.79 (1.72, 8.31) times higher for women with a 10 or more years of marriage duration; and 1.83 (1.03,3.24) times higher for women whose contraceptive use was decided by the health care provide alone. A higher birth order lowered the cumulative odds of womens´ emotional fertility intention symmetrically across the higher level categories by 86% (AOR: 95% CI: 0.14 (0.07, 0.29). Women who wanted to have additional child and whose nearest facility provided 5 or more methods had an increased odds of being in the higher level categories of women emotional fertility intention with disproportional association across the cumulative logit. Accordingly, women whose nearest health facility provided 5 or more methods had an 49% (AOR: 95%CI:1.49 (1.01, 2.19) increased likelihood of being in the mixed or happy category than being very/sort of unhappy category of the emotional fertility intention while the number of methods had no significant association with emotional fertility intention at higher cumulative logit: 1.34 (0.87,2.10). Those who wanted to have an additional child had a 3.16 (2.28, 4.36) higher odds to be in the mixed or happy category than being in unhappy category. Further, this tendency was even stronger at higher categories of emotional fertility intention: 4.83 (3.23, 7.23). Conclusion Nearly one in two women reported being unhappy while 17.03% felt mixed emotion calling up on intended and spaced pregnancies by ensuring women reproductive and economic empowerment to empower women to have control over their fertility. Activities and efforts that promote intended and spaced pregnancies; and diversifying access to contraceptive methods in the nearest health facilities are likely to improve women emotional fertility intention; and activities that enable women to decide their contraceptive as well. The finding that health care provider decides on women current/recent contraceptive use calls for activities to improve quality of contraceptive use counseling to enable women to decide their contraceptive use by the themselves while the access of diversified methods in the nearby health facility create an opportunity for women to obtain the method they preferred to use and make them emotionally well. These activities are hoped to enable women to plan their fertility thereby increasing their emotional well-being. These activities and interventions need to be tailored across regions and need to be age sensitive.

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Multinomial Logistics Regression Modeling On Pregnant Women Index Pregnancy Emotional Fertility Intention and Its Correlates in Ethiopia: Performance Monitoring for Action Community Based Cohort Study

Damtew,

Atianfu,

Fentaye

et al. 2024

Preprint

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Background Intention to conceive and emotional fertility intention on pregnancy is an integral part of reproductive health (RH) right and can be considered as decision making on fertility. In low and middle income countries including Ethiopia where male dominance is culturally accepted and socially constructed, males take the lead in every decision making process for the family ranging from household level decision to determining fertility and reproduction including reproductive health service use. This dominance interferes on women fertility desire and their health status including their emotional feeling towards conception among others. In such a scenario, women are less likely for their say to be heard. Hence, this study aimed at determining how they would pregnant women felt when learned their index pregnancy and the covariates contributing in Ethiopia so as to generate and avail actionable evidence for the ministry and relevant partners working on reproductive and women health. This evidence can be used as an action point to empower women on their reproductive health right as well as their control over their fertility. Methods Nationally representative data which enrolled and collected data from currently pregnant women from PMA cohort one baseline were used for this study used. Frequency was computed to characterize pregnant women. Multinomial logistics regression was employed to identify correlates affecting pregnant women emotional intention when learned about their index pregnancy. Results were presented in the form percentages and odds ratio with 95% Confidence Intervals. Candidate variables were selected using p-value of 0.25. Statistical significance was declared at p-value of 0.05. Result A little higher than 2/3 (67.81%: 65.38%, 70.13%) of the pregnant women reported that they felt happy or sort of happy (4 in 10 very happy and 1 in 4 sort of happy) when they learned about their index. The proportion of pregnant women who felt very unhappy was 8% (6.64%, 9.5%) while 8.45% (7.13%, 10.0%) and 15.79% (14.01%, 17.76%) of the pregnant women reported that they felt sort of unhappy and mixed happy unhappy respectively. Older women, those from the well to do household, who wanted to have another child were found to have an increased likelihood of being very happy or sort of happy when they learned about their index pregnancy while this this likelihood was lowered among women with high birth order, who intended to have no more child, those who live in Oromiya and in the former SNNPR regions. Moreover, women who attended primary education and whose desired birth attendant was health professional/ Family member had lower likelihood of feeling mixed happy and unhappy when they learned they were pregnant. Conclusion The finding that 2/3 felt very happy or sort of happy calling up on intended and spaced pregnancies by ensuring women reproductive and economic empowerment to take control over their fertility. Activities and efforts that promote intended pregnancy, empowering women economically; increasing women enrollment to secondary education or above and assisting them in identify their desired birth attendant as part of birth preparedness and complication readiness are hoped to improve pregnant women index pregnancy fertility emotion. The activities need to be region and age specific.

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Analysis of Couples’ Discordance on Fertility Desire in Ghana

Cited by 4 publications

References 32 publications

One Year Postpartum Emotional Fertility Intentions among a Cohort of Pregnant Women followed for 2 Years and its Correlates in Ethiopia: Community based longitudinal data from Performance Monitoring for Action; Generalized Ordered Logistics Regression Modeling

One Year Postpartum Emotional Fertility Intentions among a Cohort of Pregnant Women followed for 2 Years and its Correlates in Ethiopia: Community based longitudinal data from Performance Monitoring for Action; Generalized Ordered Logistics Regression Modeling

Emotional Fertility Intention and its correlates in Ethiopia among married contraceptive user women: using linked community and health facility data from performance monitoring for action; a generalized ordered logistics regression modeling

Multinomial Logistics Regression Modeling On Pregnant Women Index Pregnancy Emotional Fertility Intention and Its Correlates in Ethiopia: Performance Monitoring for Action Community Based Cohort Study

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