Articles

<b>Background</b>: Reproductive health is a critical component of overall health and development. Unmet contraceptive needs are one of the regularly cited measures of the efficacy of family planning (FP) initiatives. This study set out to determine the magnitude and associated factors of unmet need for FP among women of reproductive-aged (15-49 years) in the provincial areas of The Gambia. <b>Methods</b>: The study used a community-based cross-sectional analytical design. A multistage sampling strategy, comprising simple random and cluster sampling, was utilized to obtain a sample of 643 childbearing women (15-49 years) from rural Gambia's sampled clusters. Data collection was conducted using pre-tested structured interview questionnaires. The association was examined using chi-square/fisher's exact test with a significance level of p<0.05. Binary logistic regression analysis was performed to examine the effect of sociodemographic and cultural determinants on unmet FP need, with corresponding computed adjusted odds ratios (aOR). IBM SPSS version 24 was used for data entry and analysis. <b>Results: </b>The unmet need for FP among the study participants was 25.2%; unmet need for spacing and unmet need for limiting was 17.4% and 7.8%, respectively. The total demand for FP was 59.4%, while the satisfaction of demand for FP was 57.6%. The significant predictors of unmet need for FP were woman’s age at first pregnancy (aOR=0.899, p=0.033), LGA of origin (aOR=0.240, p=0.001) and frequency of using contraceptives (aOR=1.587, p=0.032). <b>Conclusion:</b> The present study demonstrated a high unmet need for FP among rural women in The Gambia, with the most often cited reason for non-use being fear of side effects. Hence, it is necessary to concentrate FP services for rural populations, stressing education regarding contraceptive side effects, service quality, and gender equality. Additionally, the study suggests that male participation and religious leaders' involvement in FP programs be strengthened and mainstreamed, as well as the establishment of a communication program that specifically promotes inter-spousal communication.

<b>Background:</b> Acute respiratory infections (ARIs) generally describe a group of infections caused by a range of organisms whose site of action includes the nostrils, through the pharynx to the alveoli. ARIs are reportedly key contributing factors to childhood morbidities and deaths, with a higher impact on children less than the age of five years. This paper aimed at exploring the prevalence of ARIs and their contextual determinants among children less than 60 months of age in the rural settings of the Gambia. <b>Method:</b> The Gambia Demographic and Health Survey (GDHS) in 2019-20 was used for this study. Data were obtained from 1364 rural women aged 15-49 with children less than 60 months through a stratified two-stage cluster sampling approach. Percentages and chi-square tests were used and variables with p-value <0.15 were included in the model. A multivariable logistic regression model was used to assess the predictors of acute respiratory infection at 95% confidence interval (CIs) with computed adjusted odds ratios (aORs). All the study data were analyzed using Stata version 17. <b>Results:</b> The weighted prevalence of ARIs among children under 60 months of age in the rural Gambia was 37.1% with 95% CI (34.5% - 39.6%). The magnitude of ARI was higher among children 25-60 months age group (38.6%), male children (38.9%) unvaccinated children (42.9%), and those whose fathers and mothers were not working at 60.5% and 38.7%, respectively. In the adjusted model, children whose mother had primary education (aOR=0.65, 95% CI= 0.46-0.91), currently non-breastfed children (aOR=1.40, 95% CI= 1.09-1.79) and those whose father were not working (aOR=2.65, 95% CI= 1.47-4.17) were found to be associated with ARIs among children less than 60 months in The Gambia. <b>Conclusion:</b> The prevalence of ARI was moderately high across children under 5 years of age in rural Gambia, low mother’s educational levels, and unemployed fathers. The program must consider improvements in the quality of care provided to children in both primary, secondary and tertiary healthcare levels in rural settings. Partner support and adapting community-based supporting systems on child health strategies should be strengthened especially in rural settings.

<b>Background:</b> Family planning is one of the key cornerstones of safe parenthood and a reproductive rights issue. In underdeveloped nations, women experiencing unmet FP needs formed a considerable proportion of all women of reproductive age and are ongoing public health concerns in The Gambia. The study was set out to explore the influence of socio-demographic and cultural factors on contraceptive uptake among rural women in The Gambia. <b>Methods:</b> The study used a community-based cross-sectional analytical design. A multistage sampling strategy, comprising simple random and cluster sampling, was utilized to obtain a sample of 634 childbearing women (15-49 years) from rural Gambia's sampled clusters. Data collection was conducted using pre-tested structured interview questionnaires. The association was examined using chi-square/fisher's exact test with a significance level set at p<0.05. Binary logistic regression analysis was performed to examine the effect of socio-demographic and cultural determinants on uptake of contraceptives, with corresponding computed adjusted odds ratios (aOR). IBM SPSS version 25 was used for data entry and analysis. <b>Results:</b> The uptake of contraceptives among the study participants was 30.4%. The total demand for FP was 59.4% while the satisfaction of demand for FP was 57.6%. The significant predictors of FP uptake were the age of women (aOR=1.097, p=0.014), reason for using FP (aOR=1.139, p=0.011), use of contraceptives before (aOR=24.416, p<0.001) and reason for not discussing FP with a partner (aOR=1.787, p=0.029). <b>Conclusion:</b> The study showed low contraceptive uptake among women in rural communities. Thus, spousal communications on FP concerns are key intermediate steps towards eventual acceptance and sustained usage of FP services. The program should focus on improving access to and availability of FP services in rural areas. The program should prioritize addressing women's needs through consistent community-based interventions including targeted home visits.