BACKGROUND: Teenage pregnancies are a global concern. Malawi is one of the countries with the highest teenage pregnancy rates despite government efforts to reverse the situation and yet studies on determinants of teenage pregnancy are rare with some factors remaining unexplored. Therefore, this study aimed to identify factors associated with teenage pregnancies in Malawi.
METHODS: This was a community-based case-control study that used secondary data from the 2015-16 Malawi Demographic and Health Survey from all 28 districts of Malawi. The study population comprised women aged 20-24 who participated in the survey. The study ran from September 2021 to October 2022 and used a sample size of 3,435 participants who were all women aged 20-24 in the dataset who met the inclusion criteria. Data were analysed using Stata 16 software. Logistic regression analyses were used to determine factors. Variables with a P value of < 0.1 in the univariable analysis were included in the multivariable analyses, where statistical significance was obtained at a P value < 0. 05.
RESULTS: Data on 3435 participants were analysed. In multivariable analyses: no teenage marriage (AOR 0.13); secondary education (AOR 0.26); higher education (AOR 0.39); richest category of wealth index (AOR 0.51), use of contraception (AOR 3.08), domestic violence by father or mother (AOR 0.37) were found to be significant factors.
CONCLUSIONS: This study identified determinants of teenage pregnancy. The government has to sustain and expand initiatives that increase protection from teenage pregnancy, reinforce the implementation of amended marriage legislation, introduce policies to improve the socioeconomic status of vulnerable girls and increase contraceptive use among adolescent girls before their first pregnancy. Further research is also recommended to resolve inconclusive results.

Developments over time in the prevalence of marriage and cohabitation formation has long received much interest, but less is known about more recent developments for different population subgroups in European countries. This applies as well to Sweden, a country considered a forerunner in family-demographic change. In contrast, much attention has been paid to the falling birth rates during the 2010s, and explanations that focus on the role of increasing uncertainties. In the Swedish case, the fertility decline has been documented across all main socio-demographic subgroups. The objective of this study is to examine whether the same situation holds for first marriage and cohabitation formation during the 2010s and the exceptional years of the Covid-19 pandemic. Based on Swedish population registers, including with new cohabitation data, we present annual indices of first marriage formation (1991-2022) and cohabitation formation (2012-2022) across a number of socio-demographic strata. We demonstrate a continuous decline in first marriage formation since the early 2010s with an additional sharp dip during the pandemic and a post-pandemic recovery. In contrast, there was a remarkable stability in cohabitation formation during 2012-2022. Although socio-demographic groups differ in their overall levels of marriage and cohabitation formation, the recent trends are strikingly similar across groups. Cohabiting couples, across population subgroups, have become less inclined to transition their union status to a more committed level, as manifested by marriage or parenthood. This occurred in spite of a positive economic climate in the 2010s and stable family policies, indicating that other forces are at play.

OBJECTIVE: The aim of this study is to determine the correlation between domestic violence awareness and attitudes toward child marriages among individuals living in Iğdır city.
METHODS: The correlational survey model was used in the study. The sample consisted of 814 adult individuals who lived in Iğdır city, did not have any health problem, and volunteered to participate in the study between September 2022 and January 2023. Personal Information Form, Domestic Violence Awareness Scale, and Attitude Toward Child(Girls) Marriages Scale were used to collect data. Data were obtained through online environment and face-to-face interview.
RESULTS: It was found that 59.5% of the sample group were female and 27% were aged between 18 and 24 years. 61.9% of the participants were married and 88.1% were married when they were over the age of 18. In addition, 51.9% were university graduates while 50.9% of them stated that they had witnessed domestic violence. The results of the study revealed that while the variables of gender, age, marital status, education level, and place of residence affected the attitudes toward child marriages, the variables of gender, age, age at marriage, education level, place of residence and witnessing domestic violence affected domestic violence awareness. Furthermore, when examining the scales used, it was concluded that the attitude toward child marriages affected the awareness of domestic violence.
CONCLUSIONS: Since domestic violence and child marriages are very common, it is recommended to conduct further studies on these issues and to identify support systems that will increase the awareness of the society on these issues.

BACKGROUND: Routine program data indicates positivity rates under 2% from HIV testing services (HTS) at sites supported by Centre for Health Solutions-Kenya in Central Kenya. Achieving the UNAIDS 95:95:95 goals requires continuous identification of people living with HIV in an environment of diminishing resources. We assessed non-clinical and clinical characteristics of persons who tested HIV-positive aimed at improving the process of HTS through Provider-Initiated HIV Testing & Counseling (PITC).
METHODS: We conducted a retrospective analysis of routine PITC program data collected between October 2018 and September 2019 from six health facilities located in three counties in central Kenya. Stratification was based on county and facility volume. A multivariable logistic regression model, clustered adjusted for facility using robust standard errors, was used to determine predictors of a positive HIV result.
RESULTS: The total sample was 80,693 with an overall positivity rate of 1.2%. Most, (65.5%), were female and 6.1% were < 15 years. Most clients, 55,464 (68.7%), had previously tested for HIV. Client characteristics associated with a higher odds of positivity on multivariable analysis included: being female (adjusted odds ratio [aOR] 1.27, 95% confidence interval [CI] (1.03-1.57); adults 15 years and above compared to children < 15 years, divorced and married polygamous compared to married monogamous [aOR 3.98, 95% CI (2.12-7.29) and aOR 2.41 95% CI (1.48-3.94) respectively]; clients testing for the first time compared to repeat testers in less than 12 months [aOR 1.39, 95% CI (1.27-1.51)]. Similarly, repeat testers in more than 12 months compared to repeat testers in less than 12 months [aOR 1.90, 95% CI (1.55-2.32)]; presumptive TB clients compared to those without signs of TB [aOR 16.25, 95% CI (10.63-24.84)]. Clients tested at inpatient departments (IPD) were more likely to get a positive HIV result compared to those tested at outpatient departments (OPD), and other departments.
CONCLUSIONS: The study findings highlight client characteristics such as age, marital status, HIV test entry point, first-time test, repeat test after 12 months, and TB status as factors that could influence PITC results and could be used to develop a screening tool to target eligible clients for HTS in low HIV prevalence settings.

Child death rates are often regarded as reliable indicators for overall welfare of a country since they give insight of health accessibility and development. For planning and controlling purposes, it is important to understand which ages are at higher risks of experiencing child death as well as determinants thereof.
We used the Sierra Leone DHS 2019 data which was collected using two stage sampling methods. Data collection involved interviewing women aged from 15-49 to obtain information about children they had in the past up to 2019. Age at death of child was modelled using discrete-time survival analysis with a logit link at the same time applying survey weights. The analysis also sought to estimate the determinants of child death (under-five mortality). The baseline hazard was modelled with a polynomial function.
Results showed that children from rural areas had significantly lower odds of dying compared with those from urban areas (odds ratio (OR) = 0.861, p-value = 0.0003). Children of mothers who were currently using contraceptives, and those whose mothers had been using since their last birth were at higher odds of child death compared to children whose mothers had never used contraceptives before (currently using: OR = 1.118, p-value =  < .0001; used since last birth: OR = 1.372, p-value =  < .0001). Children with no health insurance had significantly higher odds of death than those with health insurance (OR = 1.036, p-value =  < .0001). Children of women who were married, and of women who were formerly married were at significantly higher odds of experiencing child death than children of women who had never been in union (married: OR = 1.207, p-value = 0.0003; formerly married: OR = 1.308, p-value = 0.0009 compared to those that have never been married). Increase in the age group of mothers increases the odds of their children experiencing child death compared to mothers in their teenage years (20-29: OR = 1.943, p-value =  < .0001, 30-39: OR = 2.397, p-value =  < .0001 and >  = 40: OR = 2.895, p-value =  < .0001 compared to mothers in their 15-19 years).
The study provides evidence that residing in urban areas, marital union of the mother, children having no health insurance, use of contraceptives by mother, older ages of the mother and no health insurance significantly increase the odds of child death. This points out to a possible need for improved health infrastructure to be made available to citizens in all places of delivery and more awareness on pregnancy related complications.

Meckel-Gruber syndrome is a lethal disorder characterized by occipital encephalocele, polycystic kidneys, and polydactyly. In most cases, it is identified and terminated antenatally. In this report, the authors present a case of Meckel-Gruber syndrome together with Dandy-Walker malformation. A pregnant woman referred at the 28th week of gestation with an abnormal ultrasound scan showing posterior encephalocele and bilaterally enlarged kidneys. Further imaging also indicated communication between the 4th ventricle and posterior cerebellar cerebrospinal fluid space, after which the fetus was diagnosed with Meckel-Gruber syndrome and Dandy-Walker malformation. Pregnancy termination was refused by the parents and the offspring was prematurely born to be the 2nd recurrence of Meckel-Gruber syndrome in this consanguine family. Remarkably, at the 3 different pregnancies, ultrasound was inconclusive before the 7th month of gestation. Though up to date Meckel-Gruber syndrome is ultimately lethal, the lifespan of affected newborns varied greatly. We suggest developing a severity classification to estimate life expectancy in unterminated cases.

An established negative association between socio-economic status (SES) and divorce has applied to most Western nations since 1960. We expected a positive association between SES and divorce for low-divorce contexts historically because only individuals in higher social strata had the resources to overcome barriers to divorce. According to Goode\'s socio-economic growth theory, this relationship was reversed as industrialization and modernization began removing the economic and normative barriers. Making use of longitudinal data from parish registers, we investigated SES and other micro-level determinants of divorce among men and women in northern Sweden who married between 1880 and 1954. Results indicated a positive association between SES and divorce among those who married 1880-1919, with the middle class, not the elite, featuring the highest divorce risks. This association changed for couples who married in the 1920s, for whom divorce became more common and the working class faced similar divorce risks to the higher social strata.

UNASSIGNED: Pregnancy and birth complications experienced by adolescents are also problems of older women. But it is severe among the young due to physical immaturity and social condemnation from basic reproductive health services. The study was aimed to analyze determinants of adolescent childbearing in Ethiopia using the Ethiopian demographic and health survey.
UNASSIGNED: The data source for this study was the 2016 demographic and health survey. Records of 359 cases and 1436 randomly selected controls (1:4 ratio) were included in the analysis. Adolescent childbearing was the main outcome variable and the independent variables were sociodemographic and sexual & reproductive factors. Multivariable logistic regression analysis was used to identify factors associated with adolescent childbearing.
UNASSIGNED: The mean age of girls at first cohabitation was 15.28 ±1.64 and the mean age of first birth was 16.47±1.35. Adolescent childbearing was found to be higher in the Afar region (34.8%), and the lowest was in Addis Ababa city (4.1%). Finding from the multivariable analysis showed that place of residence, survey time age, and age at first sexual intercourse were the factors that have an association with adolescent childbearing. The odd of childbearing was higher among rural residents (AOR = 1.74; 95 % CI: 1.12, 2.72), early (<18 years) initiation of sexual intercourse (AOR =12.5; 95% CI: 5.97,25.18) and the risk is also higher among older teenagers (AOR =7.92; CI:3.92,15.90).
UNASSIGNED: Place of residents, age, and timing of first sexual intercourse was found to be the influencing factors of adolescent childbearing. Our finding indicates that the place of residence of the adolescent mothers must be considered in planning policies that attempt to disrupt successive cycles of socioeconomic deprivation. Public health interventions should focus their programs to be based on community and aim on prevention of early sexual intercourse and marriage.

Multiparous women are supposed to be able to end their reproductive cycle to decrease population growth. This study aimed to analyze barriers for multiparous women to use long-term contraceptive methods (LTCM) in the Philippines and Indonesia.
The study population was women aged 15-49 years old who have given birth to a live baby > 1 in the Philippines and Indonesia. The weighted sample size was 12,085 Philippines women and 25,543 Indonesian women. To identify variables associated with the use of LTCM, we analyzed place of residence, age group, education level, marital status, employment status, and wealth status. The final step employed multinomial logistic regression.
In both countries, the results showed that variables associated with non-user LTCM were younger women, living in rural areas with poor education. Women without partner and unemployed had higher probability to not use LTCM. Finally, low wealth status had a higher probability than the richest multiparous to not use LTCM.
The study concluded that there were six barriers for multiparous women to use LTCM in the Philippines and Indonesia. The six obstacles were living in rural areas, being younger, poor education, single, unemployed, and low wealth.

UNASSIGNED: Sexual relationships, sexual functions are all parts of the female sexual identity and which influence physiological, psychological, and reproductive functions of women.
UNASSIGNED: The study aimed to identify prevalence of Female Sexual Dysfunction (FSD) in women affected by type 1 and type 2 Diabetes Mellitus (DM) and to evaluate the impact of diabetes on female sexuality.
UNASSIGNED: This cross-sectional study was carried out on 400 married females who were interviewed to answer Female Sexual Function Index (FSFI) questionnaire and were divided into two groups: the first group included 300 diabetes patients (134 patients with type 1 DM and 166 patients with type 2 DM), while the second included 100 women not diagnosed with diabetes who served as controls.
UNASSIGNED: Considering female sexual dysfunction (score < 26.55), there was statistically significant increase of patients with female sexual dysfunction (FSD) in Type 1 DM (50.7%) when compared to type 2 DM patients (28.9%) or control group (10.0%).
UNASSIGNED: FSD is a significant health problem in premenopausal women complaining of DM. Females with type 1 DM were more affected than females with type 2 DM, who in turn were more affected than healthy controls. Long duration of the disease was the main risk factor for developing FSD.