Factors associated with uptake of breast and cervical cancer screening among Nepalese women: Evidence from Nepal Demographic and Health Survey 2022
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SUBMITTER: Lamichhane B
PROVIDER: S-EPMC10927089 | biostudies-literature | 2024 Jan
REPOSITORIES: biostudies-literature
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Project description:BackgroundOlder people are more vulnerable and have a higher risk of having a disability. There are very few studies on disability among older people in Nepal. To fill this knowledge and research gap, this study examines the prevalence and analyzes sociodemographic correlates of disability among older people in Nepal.MethodsThe 2022 Nepal Demographic and Health Survey data was used for this study. The study included 3014 older people aged 60 years and above. The Washington Group Short Set Questions were used to measure disability. Disability was categorized as 'with disability' and 'without disability'. Descriptive statistics were used to assess the prevalence of disability while multivariate logistic regression was used as inferential statistics to analyze sociodemographic correlates of disability.ResultsThe results show that more than a quarter (27%) of older people had disabilities. The prevalence of disability was higher among older people aged 80 years and above (54%), females (31%), no education (31%), widowed (40%), residing in Karnali province (39%), and those who belonged to poor household wealth (31%). This pattern was consistent in both older males and females. Older people aged 70-79 or 80 years and above, those who had no education or primary education and who were widowed, were more likely to have a disability. Older people from rich household wealth and from Koshi, Madhesh, Bagmati, Gandaki, Lumbini and Sudurpashchim provinces were less likely to have a disability.ConclusionsThe burden of disability among older people in Nepal is considerable. Therefore, there is a need for health interventions targeting the identified groups at risk of disability to improve the well-being of older people.
| S-EPMC11846169 | biostudies-literature
Project description:IntroductionIntimate partner violence (IPV) is a major public health issue in Nepal. IPV has social and economic impacts on women, family, and the wider society. In this study, we aimed to determine factors associated with IPV among currently partnered women aged 15-49.MethodsWe conducted a secondary data analysis of the Nepal Demographic and Health Survey (NDHS) 2022. The study examines the lifetime prevalence of IPV. IPV was measured in three domains: experience of physical violence, emotional violence, and sexual violence. Weighted univariate and multivariable logistic regression analysis were applied to determine factors associated with IPV. The results of logistic regression were presented as crude odds ratio (COR) and adjusted odds ratio (AOR) and their 95% confidence interval (CI).ResultsOf 3853 women, 27.2% had experienced any form of IPV. The lifetime prevalence of physical violence, emotional violence, and sexual violence were 23.2%, 12.8%, and 7.1%, respectively. Higher odds of physical violence were reported among women aged 35-49 years (AOR: 2.13, 95% CI: 1.58-2.87), women without formal education (AOR: 1.51, 95% CI: 1.10-2.06), and women who justified wife-beating (AOR: 1.23, 95% CI: 1.00-1.52). Women from poor households (AOR: 1.61, 95% CI: 1.12-2.35) and women with uneducated partners (AOR: 1.66, 95% CI: 1.08-2.58) were at higher risk of experiencing sexual violence. Women with unemployed husbands reported a higher risk of physical violence (AOR: 2.72, 95% CI: 1.45-5.06) and emotional violence (AOR: 1.61, 95% CI: 1.12-2.35).ConclusionAlmost one in three currently partnered women experienced some form of IPV in their lifetime. Various sociodemographic, partner-related, and women's empowerment-related factors were associated with experiencing IPV. Acknowledging and addressing these factors is essential to mitigating the high rates of IPV among reproductive aged women.
| S-EPMC11329113 | biostudies-literature
Project description:Menstrual discrimination hampers progress toward Sustainable Development Goals. Examining the spatial heterogeneity of menstrual discriminatory practices may present an opportunity for targeted interventions. Here we evaluate geographical disparities in menstrual-related restrictions and assess their association with socio-economic and demographic factors. We used data from the 2022 Nepal Demographic and Health Survey which included 13,065 women aged 15-49 who reported menstruating within the past year. We explored the spatial heterogeneity of menstrual restriction outcomes using the standard Gaussian kernel density approximation method and the spatial scan statistic. The Poisson regression model with robust standard errors was used to assess the association between the different forms of menstrual restriction and the socio-economic, and demographic factors. Overall, the prevalence of women who reported any form of menstrual restriction was 84.8% and was subject to geographical variations ranging from 79.0% in Bagmati to 95.6% in Sudurpashchim. Religious restrictions were the most prevalent (79.8%) followed by household-level restrictions (39.5%) and then Chhaupadi (6.2%). Geographical variations were more prominent for women experiencing Chhaupadi (primary geographical cluster: relative risk = 7.4, p<0.001). Strikingly, women who reside in households led by female household heads were less likely to report experiencing household-level restriction during menstruation (Adjusted prevalence ratio (aPR) = 0.89, [95%CI: 0.84-0.94], p<0.001) whilst those residing in wealthy households were less likely to report experiencing Chhaupadi (aPR = 0.26, [95%CI: 0.17-0.39], p<0.001; among the richest). Our study demonstrated marked geographical micro-variations in menstrual discriminatory practices in Nepal. Policymakers should implement preventive behavioral interventions in the most vulnerable geographic areas to effectively and efficiently reduce the overall prevalence of menstrual discrimination. It is crucial to prioritize the designing and testing of targeted interventions to determine their effectiveness against Chhaupadi in these high-prevalence settings. Additionally, empowering women appears to be a promising strategy for combating menstrual discrimination within the household.
| S-EPMC11560001 | biostudies-literature
Project description:Breast and cervical cancers are the most prevalent diagnosed in women worldwide, significantly contributing to maternal morbidity and mortality. We examined socio-demographic and behavioral factors associated with breast and cervical cancer screening among Cambodian women aged 15-49 years old. We analyzed women's data from the 2022 Cambodia Demographic and Health Survey (CDHS). In total, 19,496 women were interviewed. Multiple logistic regression was performed using STATA V17 to examine factors associated with breast and cervical cancer screening. The proportion of breast and cervical cancer screenings was 10.6% and 15.3%, respectively. After being adjusted, factors independently associated with breast cancer screening included age group 20-29 years [AOR = 2.51; 95% CI: 1.55-4.06], 30-39 years [AOR = 4.34; 95% CI: 2.66-7.09], and 40-49 years [AOR = 4.66; 95% CI: 2.81-7.71], higher education [AOR = 1.92; 95% CI: 1.26-2.93], exposure media [AOR = 1.66; 95% CI: 1.32-2.10], and rich wealth quintile [AOR = 1.50; 95% CI: 1.25-1.80]. Similarly, the odds of having cervical cancer screening were age group 20-29 years [AOR = 2.88; 95% CI: 1.76-4.71], 30-39 years [AOR = 5.94; 95% CI: 3.58-9.83], and 40-49 years [AOR = 7.61; 95% CI: 4.55-12.73], higher education [AOR = 1.55; 95% CI: 1.55-2.73], exposure media [AOR = 1.62; 95% CI: 1.35,1.95], and rich wealth quintile [AOR = 2.14; 95% CI: 1.78-2.5f8]. In conclusion, this study shows the low screening proportion for both breast and cervical cancers, and it also highlights that socio-economic factors are significantly important in determining the health care seeking for these two main cancer screening services among women aged 15-49 years in Cambodia. Therefore, increase of exposure media with health education focusing on these cancer screenings should be made better accessible to women, particularly those of low socio-economic status.
| S-EPMC11781645 | biostudies-literature
Project description:ObjectivesTo identify the determinants of institutional delivery among young married women in Nepal.DesignNepal Demographic and Health Survey (NDHS) data sets 2011 were analysed. Bivariate and multivariate logistic regression analyses were performed using a subset of 1662 ever-married young women (aged 15-24 years).Outcome measurePlace of delivery.ResultsThe rate of institutional delivery among young married women was 46%, which is higher than the national average (35%) among all women of reproductive age. Young women who had more than four antenatal care (ANC) visits were three times more likely to deliver in a health institution compared with women who had no antenatal care visit (OR: 3.05; 95% CI: 2.40 to 3.87). The probability of delivering in an institution was 69% higher among young urban women than among young women who lived in rural areas. Young women who had secondary or above secondary level education were 1.63 times more likely to choose institutional delivery than young women who had no formal education (OR: 1.626; 95% CI: 1.171 to 2.258). Lower use of a health institution for delivery was also observed among poor young women. Results showed that wealthy young women were 2.12 times more likely to deliver their child in an institution compared with poor young women (OR: 2.107; 95% CI: 1.53 to 2.898). Other factors such as the age of the young woman, religion, ethnicity, and ecological zone were also associated with institutional delivery.ConclusionsMaternal health programs should be designed to encourage young women to receive adequate ANC (at least four visits). Moreover, health programs should target poor, less educated, rural, young women who live in mountain regions, are of Janajati ethnicity and have at least one child as such women are less likely to choose institutional delivery in Nepal.
| S-EPMC5594213 | biostudies-literature
Project description:BackgroundCervical cancer ranks as the most common cancer among Nepalese women with a high incidence and mortality. Despite evidence that effective screening programs reduce disease burden, screening services are under-utilized. Cancer stigma can be a major barrier to cervical cancer screening uptake among Nepalese women.ObjectivesThis study assessed the association between cancer stigma and cervical cancer screening uptake among women residing in semi-urban areas of Kavrepalanchok district (Dhulikhel and Banepa), Nepal.MethodsWe conducted a cross-sectional study among 426 women aged 30-60 years using telephone interview method from 15th June to 15th October 2021. A validated Cancer Stigma Scale (CASS) was used to measure cancer stigma and categorized women as presence of cancer stigma if the mean total score was greater than three. We obtained information on cervical cancer screening uptake through self-reported responses. Univariable and multivariable logistic regression were performed to assess the association between cancer stigma and cervical cancer screening uptake. We adjusted socio-demographic: age, ethnicity, occupation, religion and education, and reproductive health variables: parity, family planning user, age of menarche and age at first sexual intercourse during multivariable logistic regression.ResultsTwenty-three percent of women had cancer stigma and 27 percent reported that they had ever been screened for cervical cancer. The odds of being screened was 0.23 times lower among women who had stigma compared to those who had no stigma (95% CI: 0.11-0.49) after adjusting for confounders: age, ethnicity, occupation, religion, education, parity, contraceptive use, age of menarche and age at first sexual intercourse.ConclusionWomen residing in semi-urban areas of Nepal and had cancer stigma were less likely to have been screened for cervical cancer. De-stigmatizing interventions may alleviate cancer stigma and contribute to higher uptake of cervical cancer screening.
| S-EPMC10194964 | biostudies-literature
Project description:ObjectiveTo examine socioeconomic inequalities in the use of cervical cancer screening among women in sub-Saharan Africa.DesignSecondary data from the Demographic and Health Survey data in sub-Saharan Africa.SettingSub-Saharan Africa.ParticipantsWomen aged 15-64 years.Outcome measuresSocioeconomic inequalities in cervical cancer screening uptake and the pooled prevalence of cervical cancer screening.ResultsThe pooled prevalence of cervical cancer screening among women in sub-Saharan African countries was 10.51% (95% CI: 7.54% to 13.48%). Cervical cancer screening uptake showed a significant pro-rich distribution of wealth-related inequalities, with a weighted Erreygers normalised concentration index of 0.084 and an SE of 0.003 (p value <0.0001). This finding suggests that disparities in cervical cancer screening uptake among women are related to wealth. Decomposition analysis revealed that the wealth index, educational status, place of residence and media exposure were the most important factors contributing to this pro-rich socioeconomic inequality in cervical cancer screening.ConclusionThis study emphasises the importance of addressing modifiable factors such as improving educational opportunities, increasing media exposure accessibility in households and improving the country's economy to reduce wealth disparities and improve cervical cancer screening uptake among women.
| S-EPMC11647397 | biostudies-literature
Project description:BackgroundMen can play a crucial role in the effective use of contraceptives, both by utilizing themselves and by supporting their partners in preventing unwanted pregnancies; and addressing reproductive health issues. This study aims to examine the association of men's contraceptive knowledge, attitudes, and behaviors (KAB) with the use of modern contraceptives.MethodsThis study utilized data from the Nepal Demographic and Health Survey 2022, which included a total weighted sample of 2,649 married men aged 15-49 years. The Demographic and Health Survey is a nationally representative cross-sectional study. A weighted analysis of the samples was carried out accounting for the complex survey design. Bivariable and multivariable logistic regression analyses were conducted and the odds ratio (OR) with 95% confidence intervals (CIs) were presented to determine the association between men's KAB and the use of modern contraception in Nepal.ResultsThe findings revealed that half of the married men (51.2%; CI: 48.5, 53.9) or their spouses have used some form of modern contraceptives. Interestingly, all men (100%) knew at least one type of modern contraceptive, while only one-third (33.7%; CI 3.12, 3.64) were aware of the ovulatory cycle period. Men with no knowledge of the ovulatory cycle (aOR: 1.31; CI: 1.07, 1.60), men who disagreed that women using contraceptives may become promiscuous (aOR: 1.27; CI:1.01,1.61) and men who discussed family planning with health workers (aOR: 1.72; CI:1.30, 2.28) were more likely to use modern contraceptives. Additionally, the use of modern contraceptives was more likely among men aged 20 to 29 (aOR: 8.04; CI: 2.19, 22.18), 30 to 39 (aOR: 17.11; CI: 6.20, 47.20), and 40 to 49 years (aOR: 23.25; CI: 8.41, 64.30) than their counterparts less than 20 years, as well as among men living in rural areas (aOR: 1.33; CI: 1.05, 1.67). Conversely, modern contraceptive use was less likely among highly educated men (aOR: 0.57; CI: 0.33, 0.97) and men living in Gandaki province (aOR: 0.87; CI: 0.59, 1.29).ConclusionThis study highlights significant role of men's KAB in the utilization of modern contraception among married men in Nepal. Contraceptive use can be promoted by enhancing the knowledge of men, developing a positive attitude, and encouraging supportive behaviors regarding reproductive health. The appropriate use of contraceptives can improve the reproductive health outcomes of both men and women. Providing a conducive environment for men to learn more about reproductive health including contraception is a key to positive health outcomes in Nepal.
| S-EPMC11812148 | biostudies-literature
Project description:ObjectivesAntenatal screening for HIV remains low in Nepal. Identifying factors associated with the uptake of antenatal screening is essential to increase uptake and prevent mother-to-child transmission (MTCT). This study investigated the effects of individual-level and district-level characteristics on the utilisation of antenatal screening for HIV in Nepal and how these effects changed between 2016 and 2022.DesignWe used publicly available cross-sectional data from 2016 to 2022 Nepal Demographic and Health Surveys.SettingStratified, multistage, random sampling was used to collect nationally representative data.Participants1978 and 2007 women aged 15-49 years who gave birth in the 2 years preceding the surveys.Primary and secondary outcome measuresWe used multilevel models to estimate associations between antenatal screening and potential factors influencing it in 2016 and 2022. We used districts as a random effect and looked at the intraclass correlation coefficients to disentangle the geographical effects. To distinguish barriers to HIV screening from barriers to accessing antenatal care (ANC) services, we performed similar analyses with whether the woman attended at least one ANC visit as the dependent variable.ResultsFactors associated with antenatal screening have not changed significantly between 2016 and 2022. Higher uptake of HIV screening was found among women with higher education, the pregnancy being desired later and women who had four or more ANC visits. Being from a poorer family and having low knowledge of MTCT and the medicines to prevent transmission were associated with lower uptake. From the supply side, no factors had a significant effect on antenatal screening. Factors associated with antenatal screening and those associated with any ANC were different. Our results also showed a partial importance of geographical factors on screening uptake.ConclusionsOur results supported that antenatal screening could be improved by enhancing access to information and improving the availability of free screening.
| S-EPMC10749024 | biostudies-literature
Project description:IntroductionCervical cancer is the second dominant type of cancer among Ivorian women with an estimated age-standardised incidence and mortality rate of 31.2 cases and 22.8 deaths per 100,000 women in 2020, respectively. The Ivorian government through its Ministry of Health implemented the National Cancer Control Programme (NCCP) in 2003 with the aim of improving the prevention, early detection and treatment of cancers in Côte d'Ivoire. Yet, there is a low uptake of CCS (1.2%). Thus, making CCS uptake an important public health concern in the country. Understanding of the extent to which reproductive factors predict CCS uptake is limited in literature. This study aimed to investigate reproductive factors as a predictor of women's uptake of CCS in Côte d'Ivoire.MethodsData from the 2021 Côte d'Ivoire Demographic and Health Survey. A sample of 9,078 women aged 25-49 years were analyzed. The outcome variable was CCS uptake while other variables considered included age at menarche, history of STI, sexual debut, parity, age, educational level, wealth index, health insurance, place of residence, and media exposure. A multivariable logistic regression model was fitted to examine the association between the outcome of interest and predictors at 95% confidence interval.ResultsApproximately, 7.52% of women aged 25-49 years had ever undergone testing for cervical cancer by a healthcare provider. Early menarche was associated with lower odds of CCS uptake [AOR = 0.78; CI = 0.65-0.95]. Compared to those who had no STI, women with a history of STI were more likely to screen for cervical cancer [AOR = 2.63; CI = 2.02-3.42]. Increasing age, higher educational attainment, having health insurance, and being exposed to media were significantly associated with CCS uptake.ConclusionIn Cote d'Ivoire, age at menarche and STI history constitute reproductive factors that were significantly associated with women's uptake of CCS. It is imperative for public policy to focus on increasing CCS in these higher-risk women (i.e., women who experienced early menarche, women with early sexual debut and higher parity) through increased sensitization on cervical cancer risk factors.
| S-EPMC10993584 | biostudies-literature