By: Dr. Kevin Pawlak, Ph.D
Recently, I had the privilege of working on a research project with my colleague Dr. Jonathan Lambo, and a group of five MD2 students: Mr. Paul Ademola, Mr. Albert Otoo Annan, Ms. Armelle Leukeu, Ms. Jennifer Khan and Ms. Frankelle Outten. Since several of the students were from Ghana and Nigeria, we decided to focus on sub-Saharan Africa. After some preliminary research, a few interesting facts stood out to the students. The first was that worldwide contraceptive prevalence was 63.3% in 2010, versus 14.4% in Nigeria, 24.2% in Ghana, and 25.6% in Cameroon. The second was that, in Ghana, the adolescent population is 22.4%. Of all the births registered in 2014, 30% were by adolescents. This was also accompanied by highly increased chances of birth complications and much higher mortality rates.
Because of this research, we decided to do a study looking at fertility rates and contraception used in adolescent women in 3 sub-Saharan African countries: Ghana, Nigeria and Cameroon. The students showed real interest and dedication and had several video calls with Dr. Lambo over the Christmas holidays to discuss how we were going to organize the data and what we were going to focus on. This was followed by many meetings during the first two months of this semester.
To do the study, data was extracted for all women of reproductive age (15-49 years old) from recent Demography and Health Surveys (DHS) conducted in three sub-Saharan countries in West Africa, namely, Cameroon (2011), Ghana (2014) and Nigeria (2013). Each DHS survey is a population based household survey comprising a nationally representative sample of households across a country.
Some of the conclusions we were able to make from the study included:
- When we compare age specific fertility rates in the three countries, Nigeria and Cameroon both show that the use of contraceptives can be very effective at significantly reducing fertility rates in adolescent women.
- Contraceptive use is significantly lower in adolescent women compared to the population of reproductive age women in all three countries.
- Contraceptive use in adolescent women is significantly lower in both Nigeria and Ghana compared to Cameroon.
- When we did a comparison of current fertility rates compared to religion we observed significantly higher fertility rates associated with the Islamic faith compared to Catholics or other Christians in both Nigeria and Cameroon. There were no significant differences in the data from Ghana.
- The prevalence of contraceptive use in adolescent women significantly increases from age 15 to 19 in all three countries (Cameroon, Nigeria, and Ghana).
After completing the first stage of our research on this topic, we had the privilege of presenting this data at XUSOM research day on February 23rd, 2018. It was an invaluable experience for the students because they were able to prepare a poster of their research and talk about their findings with all of their interested colleagues and professors. Ms. Frankelle Outten and I were also given the opportunity to give a 10 minute oral presentation of our findings to the entire medical school, and hopefully encourage some of the other students to participate in other research projects and show some of the important research that is being done at XUSOM.
We will now begin writing a journal article about our findings and have it published in a peer reviewed journal. Currently, our research group is working on how we will proceed from here and in which direction we will take this project in the future. One of the directions we are planning to take is to look at the availability of modern contraceptives and which contraceptives are most prevalent.