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Background Young women were less likely to practise consistent contraceptive use and are also known to exhibit risky sexual behaviours, which could lead to unintended pregnancy. Studies have also shown that about half of the Kenyan population is young, an age bracket that predominantly experiences unwanted pregnancy. However, adequate attention has not been given to the relationship between pregnancy termination and contraceptive use among this teeming population in Kenya. Thus, this study examined the association between pregnancy termination history and contraceptive use among women aged 15–24 years old in Kenya. Methods A total of 12,166 women aged 15–24 years old from Kenya were drawn using a secondary dataset from the most recent Kenya Demographic Health Surveys conducted in the year 2022. Frequency distribution and multilevel logistic regression analyses were employed to determine the association between contraceptive use and pregnancy termination history among young women aged 15–24 years old with covariates at p  < 0.05. Results The results showed that the higher percentage of contraceptive users among young women are those aged 15–19 years (50.1%); consequently, a higher percentage of pregnancy termination was also found among women who reported the use of contraceptive methods (6.2%) compared to 2.9% among non-users. The main findings of the study showed that young women who reported using contraceptives were more likely to have a history of pregnancy termination [aOR = 1.03; 95% CI: 0.80–1.26] compared to those who were non-users. Also, age, marital status, and parity are significantly associated with the history of pregnancy termination. Conclusion Our analyses established an association between history of contraceptive use and termination of pregnancy among young women between 20 and 24 years in Kenya. Place of residence, age, wealth index, level of education, and met needs of children have been identified as risk factors. Intervention to reduce pregnancy termination in Kenya should focus on women aged 20–24 years, those with no formal education, urban residence, and women with met need for children.

Background Violence against women is a major human rights violation, and the continuous occurrence of this can have many implications for women’s social and health outcomes. The experience of violence from an intimate partner could be more intriguing, especially if such women experienced their mother’s intimate partner violence (IPV) issues. Thus, this study examined the vertical transmission of IPV among women in sub-Saharan Africa (SSA). Methods A total of 97,542 eligible women were drawn from 27 countries in SSA using a retrospective secondary dataset from Demographic Health Surveys conducted between 2010 and 2019. Multivariable analysis was employed to determine the association between the vertical transmission of IPV from mother to daughter and the covariates associated with IPV in SSA at p < 0.05. Results The results showed that 40% of the respondents had experienced lifetime IPV, whilst 25% of those women reported that their mothers experienced it in childhood in SSA. Country-specific variations showed the highest prevalence of IPV experienced in Sierra Leone (60%) and the lowest in Comoros (9%). Results from model 1 showed that women who reported that their mothers experienced IPV were found to be significantly more than two times more likely to have experienced any form of IPV compared to those whose mothers did not (aOR = 2.66; 95% CI: 2.59–2.74), after adjusting for cofounders in Model 2, the result still showed that women who reported that their mothers experienced IPV were found to be significantly more than two times more likely to have experienced any form of IPV compared to those whose mothers did not (aOR = 2.56; 95% CI: 2.48–2.63). On the other hand, women with higher-educated partners, women in rural areas, and those from female-headed households were less likely to experience IPV. Conclusion This study concluded that women whose mothers experienced IPV were more likely to have experienced IPV. Our study also identified that education, rural areas, and female-headed households were protective factors against experiencing IPV. To address the groups of women at higher risk for experiencing IPV, we recommend ensuring that girls complete their education to promote greater wealth and resources.

Child marriage is a bane to sustainable development, as it has been associated with the prevalence of sexually transmitted diseases, intimate partner violence, and maternal mortality. This study examines the association between education and child marriage is sub-Saharan Africa. A subsample of one thousand, four hundred and sixty-one females, aged 12 years to 18 years was extracted from the 2018 Nigeria Demographic and Health Survey dataset. The independent variables were intra-regional groups and education. The dependent variable was child marriage (<18 years). The associations between intra-regional groups and education on child marriage were examined from the ever-given birth subsample to estimate odds ratios (ORs) and 95% CIs, using binary logistic regression models. There was a positive significant relationship between maternal education (χ2 = 65.5, p < 0.05) and intra-regional ethnic groups (χ2 = 106.58, p < 0.05) on child marriage. The odds were higher among the Hausa/Fulani groups that do not have a formal education (OR = 1.34; p < 0.05), have a poor financial status (OR = 1.67; p < 0.05), and those who had previously terminated a pregnancy (OR = 1.24; p < 0.05). The findings indicate that the intra-regional ethnic group affiliation and the lack of a formal education influences the incidence of child marriage, especially among socio-economically disadvantage females. Interventions aimed at curtailing child marriage should utilize community-based education to engage relevant stakeholders within the grassroots.

Background Studies have shown that emergency contraception (EC) remains underutilised in preventing unintended pregnancy in sub-Saharan Africa (SSA). Small-scale surveys have attributed EC underutilisation to gaps in EC awareness among SSA women and girls. However, limited studies have explored trends in EC awareness in SSA. We address this gap by examining trends in EC awareness using data from 28 SSA countries. Our analysis was disaggregated by age distribution, place of residence, level of education, and wealth to show differences in EC awareness trend. Methods We analysed the Demographic and Health Surveys (DHS) data of 1,030,029 women aged 15 to 49 on emergency contraception awareness. EC awareness was defined as having ever heard of special pills to prevent pregnancy within 3 days after unprotected sexual intercourse. Frequencies and percentages were used to summarise trends in EC awareness between years 2000 and 2019. Results Overall, there was an upward shift in the level of EC awareness in all countries, except in Burkina Faso, Niger, Chad, and Ethiopia. While some countries recorded a significant upward trend in EC awareness, others recorded just a slight increase. Women in Kenya, Ghana, Gabon, and Cameroon had the highest upward shift in EC awareness. For example, only 28% of women were aware of EC in Ghana in 2003, but in 2014, 64% of women knew about EC, an increase of over 36 percentage points. Increase in EC awareness was starker among women aged 20–24 years, those who resided in urban areas, had higher education, and belong to the highest wealth quintile, than those aged 15–19, in rural areas, with no formal education and belonging to the lowest wealth quintile. Conclusion Our analysis shows that the level of EC awareness has increased substantially in most SSA countries. However, EC awareness still differs widely within and between SSA countries. Intervention to improve EC awareness should focus on women aged 15 to 19, those with no formal education, residing in rural areas, and within the lowest quintile, especially, in countries such as Chad, Niger, Burkina Faso, and Ethiopia where level of EC is low with lagging progress.

Background: Liminality brings confusion among children as they cannot progress to the next stage of life, neither could they regress to their previous state of events. The situation is precarious for socioeconomic deprived children in Africa as it cast aspersion on their career, health and well-being. The study, therefore, examines the experiences’ of children who were supposed to be in school but were observed working at the informal market space in Africa. Methods: Qualitative data was collected through referral and non-discriminative snowballing. Fourty-eight participants (48-KII 2, IDI 10, FGD 6–6 person per group, total 36) from Aleshinloye and Bodija markets in Southwest Nigeria were included in the study. Results: Parental poverty, poor education facilities, peer influence, and the frequent strike by education institutions (pre-tertiary and tertiary) were implicated for the prevalence of child labour in the informal market space in Southwest Nigeria. Conclusions: The negative consequences of the liminality stage far outweigh the positive. Therefore, there is a need for conscientious efforts by community leaders, parents, and relevant stakeholders in the society to eradicate snags within the liminality of children’s education in order to curb child labour. This is necessary to achieve the sustainable development goals by 2030.

Introduction: Despite the adoption of an antenatal demographic transition model in sub-Saharan Africa, population growth continues to soar in the region. The reasons for population growth are nebulous and should be approached from different perspectives. Inadequate attention has been paid to how social pressures shape reproductive behavior. Thus, this study examines the association between social networks and fertility behavior in sub-Saharan Africa. Methods: This study used a cross-sectional design that employed a qualitative method to conduct 28 in-depth interviews among married women. Data was collected in 2023. Thematic analyses were utilized to interpret the results. Results: Parental pressure, the desire for more children, the desire for male children, values placed on children, norms, and pronatalist culture were associated with high fertility in sub-Saharan Africa. Conclusions: Thus, there is a need for more awareness of family planning and contraceptive use in order to reduce fertility in sub-Saharan Africa.

Comprehensive, comparable, and timely estimates of demographic metrics—including life expectancy and age-specific mortality—are essential for evaluating, understanding, and addressing trends in population health. The COVID-19 pandemic highlighted the importance of timely and all-cause mortality estimates for being able to respond to changing trends in health outcomes, showing a strong need for demographic analysis tools that can produce all-cause mortality estimates more rapidly with more readily available all-age vital registration (VR) data. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) is an ongoing research effort that quantifies human health by estimating a range of epidemiological quantities of interest across time, age, sex, location, cause, and risk. This study—part of the latest GBD release, GBD 2023—aims to provide new and updated estimates of all-cause mortality and life expectancy for 1950 to 2023 using a novel statistical model that accounts for complex correlation structures in demographic data across age and time. We used 24 025 data sources from VR, sample registration, surveys, censuses, and other sources to estimate all-cause mortality for males, females, and all sexes combined across 25 age groups in 204 countries and territories as well as 660 subnational units in 20 countries and territories, for the years 1950–2023. For the first time, we used complete birth history data for ages 5–14 years, age-specific sibling history data for ages 15–49 years, and age-specific mortality data from Health and Demographic Surveillance Systems. We developed a single statistical model that incorporates both parametric and non-parametric methods, referred to as OneMod, to produce estimates of all-cause mortality for each age-sex-location group. OneMod includes two main steps: a detailed regression analysis with a generalised linear modelling tool that accounts for age-specific covariate effects such as the Socio-demographic Index (SDI) and a population attributable fraction (PAF) for all risk factors combined; and a non-parametric analysis of residuals using a multivariate kernel regression model that smooths across age and time to adaptably follow trends in the data without overfitting. We calibrated asymptotic uncertainty estimates using Pearson residuals to produce 95% uncertainty intervals (UIs) and corresponding 1000 draws. Life expectancy was calculated from age-specific mortality rates with standard demographic methods. For each measure, 95% UIs were calculated with the 25th and 975th ordered values from a 1000-draw posterior distribution. In 2023, 60·1 million (95% UI 59·0–61·1) deaths occurred globally, of which 4·67 million (4·59–4·75) were in children younger than 5 years. Due to considerable population growth and ageing since 1950, the number of annual deaths globally increased by 35·2% (32·2–38·4) over the 1950–2023 study period, during which the global age-standardised all-cause mortality rate declined by 66·6% (65·8–67·3). Trends in age-specific mortality rates between 2011 and 2023 varied by age group and location, with the largest decline in under-5 mortality occurring in east Asia (67·7% decrease); the largest increases in mortality for those aged 5–14 years, 25–29 years, and 30–39 years occurring in high-income North America (11·5%, 31·7%, and 49·9%, respectively); and the largest increases in mortality for those aged 15–19 years and 20–24 years occurring in Eastern Europe (53·9% and 40·1%, respectively). We also identified higher than previously estimated mortality rates in sub-Saharan Africa for all sexes combined aged 5–14 years (87·3% higher in GBD 2023 than GBD 2021 on average across countries and territories over the 1950–2021 period) and for females aged 15–29 years (61·2% higher), as well as lower than previously estimated mortality rates in sub-Saharan Africa for all sexes combined aged 50 years and older (13·2% lower), reflecting advances in our modelling approach. Global life expectancy followed three distinct trends over the study period. First, between 1950 and 2019, there were considerable improvements, from 51·2 (50·6–51·7) years for females and 47·9 (47·4–48·4) years for males in 1950 to 76·3 (76·2–76·4) years for females and 71·4 (71·3–71·5) years for males in 2019. Second, this period was followed by a decrease in life expectancy during the COVID-19 pandemic, to 74·7 (74·6–74·8) years for females and 69·3 (69·2–69·4) years for males in 2021. Finally, the world experienced a period of post-pandemic recovery in 2022 and 2023, wherein life expectancy generally returned to pre-pandemic (2019) levels in 2023 (76·3 [76·0–76·6] years for females and 71·5 [71·2–71·8] years for males). 194 (95·1%) of 204 countries and territories experienced at least partial post-pandemic recovery in age-standardised mortality rates by 2023, with 61·8% (126 of 204) recovering to or falling below pre-pandemic levels. There were several mortality trajectories during and following the pandemic across countries and territories. Long-term mortality trends also varied considerably between age groups and locations, demonstrating the diverse landscape of health outcomes globally. This analysis identified several key differences in mortality trends from previous estimates, including higher rates of adolescent mortality, higher rates of young adult mortality in females, and lower rates of mortality in older age groups in much of sub-Saharan Africa. The findings also highlight stark differences across countries and territories in the timing and scale of changes in all-cause mortality trends during and following the COVID-19 pandemic (2020–23). Our estimates of evolving trends in mortality and life expectancy across locations, ages, sexes, and SDI levels in recent years as well as over the entire 1950–2023 study period provide crucial information for governments, policy makers, and the public to ensure that health-care systems, economies, and societies are prepared to address the world's health needs, particularly in populations with higher rates of mortality than previously known. The estimates from this study provide a robust framework for GBD and a valuable foundation for policy development, implementation, and evaluation around the world. Gates Foundation.