Women’s empowerment and short- and long-acting contraceptive method use in Egypt

Egypt is ranked one of the most gender unequal countries, and fertility is at a two-decade high of 3.5 births per woman. Women’s empowerment is a strategy used to promote contraceptive use and lower fertility, yet evidence from the Middle East is limited. This study uses 2005, 2008 and 2014 Egyptian Demographic and Health Survey data to examine recent patterns of contraceptive method choice and how women’s empowerment is associated with contraceptive method type: none, short-acting or long-acting reversible contraceptive (LARC) methods. Using a nationally representative sample of 47,545 married women in their childbearing years, multinomial logistic regression models examine women’s agency, specifically household decision-making and attitudes towards intimate partner violence and contraceptive method type. In 2014, LARC use significantly declined and short-acting method use was higher than in 2008. Women who made household decisions and were less accepting of intimate partner violence were more likely to use LARC (vs. no method). Women who made more joint decisions with spouses were more likely to use LARC (vs. no method) compared to those making individual decisions. Findings have implications for family planning programmes, and efforts involving men to increase household gender equality and lower the acceptance of intimate partner violence may promote LARC use in Egypt.     

First birth and the trajectory of women’s empowerment in Egypt

Background

Women’s empowerment is often used to explain changes in reproductive behavior, but no consideration is given to how reproductive events can shape women’s empowerment over time. Fertility may cause changes in women’s empowerment, or they may be mutually influencing. Research on women’s empowerment and fertility relies on cross-sectional data from South Asia, which limits the understanding of the direction of association between women’s empowerment and fertility in other global contexts. This study uses two waves of a panel survey from a prominent Middle Eastern country, Egypt, to examine the trajectory of women’s empowerment and the relationship between first and subsequent births and empowerment over time.

Methods

Using longitudinal data from the 2006 and 2012 Egyptian Labor Market Panel Survey, a nationally representative sample of households in Egypt, for 4660 married women 15 to 49 years old, multilevel negative binomial, ordinary least squares, and logistic regression models estimate women’s empowerment and consider whether a first and subsequent births are associated with empowerment later in life. Women’s empowerment is operationalized through four measures of agency: individual household decision-making, joint household decision-making, mobility, and financial autonomy.

Results

A first birth and subsequent births are significantly positively associated with all measures of empowerment except financial autonomy in 2012. Women who have not had a birth make 30% fewer individual household decisions and 14% fewer joint household decisions in 2012 compared to women with a first birth. There is also a positive relationship with mobility, as women with a first birth have more freedom of movement compared to women with no births. Earlier empowerment is also an important predictor of empowerment later in life.

Conclusions

Incorporating the influence of life events like first and subsequent births helps account for the possibility that empowerment is dynamic and that life course experiences shape women’s empowerment. This and the notion that empowerment builds over time helps portray women’s lives more completely, demonstrates the importance of empowerment early in the life course, and addresses issues of temporality in empowerment fertility research.

     

Morbidity and nutrition status of rural drug-naïve Kenyan women living with HIV

This paper describes morbidity in a group of HIV-positive drug-naïve rural women in western Kenya. A total of 226 drug-naïve HIV-positive women were evaluated for baseline morbidity, immune function, and anthropometry before a food-based nutrition intervention. Kenyan nurses visited women in their homes and conducted semi-structured interviews regarding symptoms and physical signs experienced at the time of the visit and during the previous week and physical inspection. Blood and urine samples were examined for determination of immune function (CD4, CD8, and total lymphocyte counts), anaemia, malaria, and pregnancy status. Intradermal skin testing with tuberculin (PPD), candida, and tetanus toxoid antigens was also performed to evaluate cell-mediated immunity. Anthropometry was measured, and body mass index (BMI) was calculated. Seventy-six per cent of the women reported being sick on the day of the interview or within the previous week. Illnesses considered serious were reported by 13.7% of women. The most frequent morbidity episodes reported were upper respiratory tract infections (13.3%), suspected malaria (5.85%), skeletal pain (4.87%), and stomach pain (4.42%). The most common morbidity signs on physical inspection were respiratory symptoms, most commonly rhinorrhea and coughing. Confirmed malaria and severe diarrhea were significantly associated with a higher BMI.     

‘He supported me 100%’: Mexican-immigrant fathers,daughters, and adolescent sexual health

ABSTRACT

Objective: First and second generation Mexican-origin adolescents in the U.S. face social and economic disadvantage and sexual health disparities. Although fathers can support child and adolescent development, the literature has portrayed Mexican-origin immigrant fathers as emotionally distant and sexist. This study aims to treat migration as a social determinant of health to examine father-daughter relationships and adolescent sexual health in Mexican-origin immigrant families.

Methods: Integrating qualitative data from life history interviews with 21 Mexican-origin young women in immigrant families with quantitative data on first and second generation Mexican-origin young women in the National Longitudinal Study of Adolescent to Adult Health, this study describes father-daughter relationships, examines the association between father-daughter relationships and daughters’ early sexual initiation, and considers the impact of migration on the father-daughter relationship and sexual health among Mexican-origin young women.

Results: Qualitative data identify four types of father-daughter relationships: ‘good,’ hostile, distant, and conflicted. Supporting the qualitative patterns, quantitative data find that positive or ‘good’ father-daughter relationship quality is significantly associated with reduced risk of early sexual initiation. Importantly, father-daughter separation across borders and economic inequality facing immigrant families is associated with hostile or distant father-daughter relationship quality and increased risk of early sexual initiation.

Conclusions: Reports of good father-daughter relationships are common and may protect against early sexual initiation in Mexican-origin immigrant families. Policies that keep families together and reduce economic inequality among immigrants may also reduce sexual health disparities among immigrant adolescents.     

An exploratory study on the lived experiences of hoarding in Singapore

Research studies have revealed that people with hoarding typically collect and keep items due to their aesthetic appeal, utility and strong emotional attachment to the items resulting in clutter and limiting living spaces. This study aims to explore the experiences of individuals with hoarding disorder to understand and describe—the patterns and reasons for hoarding, experiences with decluttering and the impact of hoarding disorder on significant others and society in the context of a multi‐ethnic urban Asian country. A total of 12 participants with hoarding disorder were recruited and interviewed using a simple semi‐structured interview guide designed for the study. The resulting transcribed interviews were analysed using thematic analysis. The mean age of the participants was 56.7 years (SD = 14.5). Nine super‐ordinate and discrete but interconnecting themes emerged from the qualitative interviews: types of hoarded items, sources of hoarded items, ways of storing/arranging hoarded items, help‐seeking/treatment contact, reasons for hoarding, experiences with decluttering, impact upon family, community and self, restricting hoarding behaviours and insight. Key themes identified in the study are consistent with the literature on studies on hoarding which have been done in other populations. Hoarding in the community has serious consequences for individuals with hoarding disorder and others living in the community, which is compounded by the lack of insight among these individuals. There is a pressing need to increase public awareness and recognition of hoarding behaviours to aid efforts in bringing timely and appropriate services to the affected individuals.     

Breast cancer screening among females in Iran and recommendations for improved practice: a review

Breast cancer is the second most common cancer amongst women, in Iran comprising 21.4% of female cancers. There are several screening modalities for breast cancer including breast self-examination, clinical breast examination and mammography. This research reviews the literature surrounding the implementation of these screening approaches in the Islamic Republic of Iran. After initial results produced approximately 208 articles, a total of 96 articles were included because they specifically addressed epidemiological characteristics of breast cancer, culture, religion, health seeking behavior, screening programs and the health system in Iran. Literature showed that breast self-examination and clinical breast examination were most common as there is no population-based mammography screening program in Iran. Additionally, most women appear to obtain information through the mass media. Results also indicate that Islamic beliefs and preventative medicine are very much aligned and can be used to promote breast cancer screening in Iran. These results highlight that there is a need for aggressive preventative measures focusing on breast self examination and gradually moving towards national mammography programs in Iran ideally disseminated through the media with government support.     

Toxin-induced tail phosphorylation of hepatocellular S6 kinase: evidence for a dual involvement of the AMP-activated protein kinase in S6 kinase regulation.

Several protein phosphatase-inhibitory toxins (okadaic acid, microcystin, calyculin A, cantharidin, tautomycin) administered to isolated rat hepatocytes were found to induce phosphorylation in the tail region of S6 kinase (S6K; p70S6K1) as detected with a phosphospecific antibody against doubly phosphorylated Thr-421/Ser424. 5-Aminoimidazole-4-carboxamide riboside (AICAR), an adenosine analogue that elicits activation of the hepatocellular AMP-activated protein kinase (AMPK), similarly stimulated S6K tail phosphorylation. The flavonoid naringin prevented the effects of AICAR, okadaic acid, and microcystin on AMPK activation as well as on S6K tail phosphorylation, suggesting AMPK as a mediator of the latter. The effects of AICAR and the toxins were rapamycin resistant; in contrast, amino acids induced an S6K tail phosphorylation that was rapamycin sensitive, suggesting mediation by the protein kinase mammalian target of rapamycin (mTOR). Amino acids activated S6K by phosphorylation at Thr-389, but the toxins did not, and AICAR in fact suppressed the activating phosphorylation induced by the amino acids. The possibility thus must be considered that the phosphorylated S6K tail may transmit a toxin-induced signal independently of S6K enzymatic activity. Despite their inability to activate S6K, the toxins (but not AICAR) stimulated phosphorylation of the ribosomal protein S6, presumably by activating some other S6-phosphorylating protein kinase.