Iron-deficiency anemia is common during pregnancy and can lead to serious health consequences for mothers and babies. Antenatal iron supplementation has been associated with lower anemia prevalence and improved pregnancy outcomes and is recommended by WHO to all pregnant women via daily oral iron (30-60 mg) and folic acid (0.4 mg) supplements. Nevertheless, data on uptake and adherence to iron supplementation among pregnant women in many countries tends to be outdated and fragmented, with few studies having comprehensively summarized barriers and facilitators to supplementation. We conducted a secondary analysis of demographic and health surveys from 69 low- and middle-income countries, to determine uptake and adherence to iron-containing supplements among pregnant women and explore associations between socio-demographic characteristics and antenatal care and supplements consumption. Results show that 86% of all respondents reported receiving iron supplements during pregnancy, and that, among those receiving the supplements, 46.1% reported consuming 90 or more supplements, while 23.3% reported 120 or more, and 7.1% 180 or more. Higher education, wealth, and access to media were strongly associated with higher odds of initiating iron supplementation (OR: 1.32; 95%CI: 1.25-1.38; OR: 1.29; 95%CI: 1.20-1.38; OR: 1.15; 95%CI: 1.05-1.26 respectively) and adhering to the regimen (OR: 1.16; 95%CI: 1.12-1.21; OR: 1.21; 95%CI: 1.13-1.30; OR: 1.14; 95%CI: 1.08-1.20 respectively). Finally, attending antenatal care, and especially attending earlier during the pregnancy, was associated with higher odds of consuming the supplements. Country-specific antenatal care guidelines are needed to provide clear guidance on the timing and frequency of antenatal care attendance and supplementation.

There is a demonstrated link between intimate partner violence (IPV) and pregnancy termination, and this association has received much attention in developed settings. Despite the high prevalence of IPV in Papua New Guinea (PNG), little is known about the association between these experiences and pregnancy termination. This study examined the association between IPV and pregnancy termination in PNG. The present study used population-based data from the PNG’s first Demographic and Health Survey (DHS) conducted in 2016–2018. The analysis involved women aged 15–49 years who were in intimate unions (married or co-habiting). We used binary logistic regression modelling to analyse the association between IPV and pregnancy termination. Results were reported as crude odds ratios (cOR) and adjusted odds ratios (aOR) with 95% confidence intervals (CIs). Overall, 6.3% of women involved in this study had ever terminated a pregnancy, and 6 in 10 women (61.5%) reported having experienced IPV in the last 12 months preceding the survey. Of those women who experienced IPV, 7.4% had ever terminated a pregnancy. Women who had experienced IPV had a 1.75 higher odds of reporting pregnancy termination (cOR: 1.75; 95% CI: 1.29–2.37) than women who did not experience IPV. After controlling for theoretically and empirically relevant socio-demographic and economic factors, IPV remained a strong and significant determinant of pregnancy termination (aOR: 1.67, 95% CI: 1.22–2.30). The strong association between IPV and pregnancy termination among women in intimate unions in PNG calls for targeted policies and interventions that address the high prevalence of IPV. The provision of comprehensive sexual reproductive health, public education, and awareness creation on the consequences of IPV, regular assessment, and referral to appropriate services for IPV may reduce the incidence of pregnancy termination in PNG.

Women’s ability to negotiate for safer sex has effects on their sexual and reproductive health. This study investigated the association between safer sex negotiation and parity among women in sub-Saharan Africa. The data were sourced from the Demographic and Health Surveys of 28 sub-Saharan African countries conducted from 2010 to 2019. A total of 215,397 women aged 15–49 were included in the study. Multilevel logistic analysis was conducted to examine the association between safer sex negotiation and parity among women in sub-Saharan Africa. The results were presented as adjusted odds ratios (aOR) and the significance level set at p<0.05. The overall prevalences of safer sex negotiation and high parity among women in sub-Saharan Africa were 82.7% and 52.1%, respectively. The prevalence of high parity ranged from 32.3% in Chad to 72.1% in Lesotho. The lowest prevalence of safer sex negotiation was in Chad (16.8%) while the highest prevalence was recorded in Rwanda (99.7%). Women who had the capacity to negotiate for safer sex were less likely to have high parity compared with those who had no capacity to negotiate for safer sex (aOR = 0.78, CI: 0.75–0.81). Other factors that were associated with high parity were age, educational level, marital status, exposure to media, contraceptive use, religion, wealth quintile, sex of household head, and place of residence. The study identified significant association between safer sex negotiation and high parity among women of reproductive age in sub-Saharan Africa. It is worth noting that women’s ability to negotiate for safer sex could reduce high parity among women in sub-Saharan Africa. Therefore, policies and programmes aimed at birth control or reducing high parity among women could be targeted at improving their capacity to negotiate for safer sex through education.