Menu
Menu
Menu
Menu
Background: Sexual and reproductive health is crucial to a normal and healthy female life. However, little interest has been placed on this subject particularly in the resource-limited settings of Cameroon. The study assessed the sexual and reproductive health of women in union, resident in the Cameroon Development Corporation (CDC) plantation camps, Cameroon. Methods: This was a cross-sectional study carried out from December 2019 to February 2020 in which a multi-stage sampling was applied in two purposively selected CDC plantation camps (Tiko and Penda Mboko). Out of the 16 clusters making up the camps, 8 were randomly selected using simple balloting. The main street junctions of the sampled clusters were identified and a direction of sampling randomly chosen. All houses left to the data collectors were sampled for eligible participants (one participant per household) and data were collected using validated interviewer-administered questionnaires. The number of participants per cluster was proportionate to population size of cluster. Data was analysed using SPSS 16 and statistical significance was set at p < 0.05. Regression analysis was used to determine predictors of unmet need for family planning. Results: Out of the 414 participants included, primary education was the highest level of education for a majority (43.0%). Most of the participants (44.7%) earned between 44.5–89.0USD/month. Relatively high proportions of some sexual and reproductive indicators like early sexual contacts (before 15 years) [87(21.0%)], grand multiparity [41(9.9%)], and abortion ≥ 3 [8(1.9%)] were recorded in the study. Two hundred and seventy-eight (278) participants (67.1%) [95%CI:62.4–71.7] used contraceptives and 90 (21.7%) [95%CI:17.9–26.0] had an unmet need for family planning with 3 major reasons for non-use of contraception among them being fear of side effects, discouragement from the partner, and lack of sufficient information on contraception. Of the different predictors of unmet need for family planning assessed, nulliparity/primiparity were protective for unmet need, and this was statistically significant (AOR = 0.284[0.086–0.934]). Conclusion: The sexual and reproductive health of CDC plantation camp residents is poor, and a health intervention is needed to improve it.
The study was conducted in the CDC plantation camp. These sites were purposively determined as intervention and control sites for a clustered non-randomized controlled trial that aimed at assessing the impact of family planning intervention on maternal and infant mortality in the Tiko CDC plantation camp, a high maternal mortality zone. The CDC plantation that has existed since 1947 has several camps all over the country, with over 22,409 employees living within the camps [31]. Among the largest and well-known are Camp Tilo, Camp Nkoume and the SOCAPALM in Nkappa, in the Dibombari Health District in Littoral region. However, the study was conducted in the CDC camps settings of Tiko (in the South West region) and Penda Mboko (in the Littoral Region), purposively selected for their accessibility and representativity. Tiko is bounded by Limbe, Buea, Muyuka, Dibombari and Bonaberi to the West, North, North-East, East and South, respectively and has a total surface area of 4,840 km2. Tiko CDC camp has geographical coordinates 4º 4′ 30″ North and 9º 22′ 0″ East, and the Penda Mboko camp coordinates 4º 16′ 30″ North and 9º 26′ 30″ East. The camps consist of clusters of settlements constructed to harbour CDC plantation workers, for which there are over 600 houses in the Tiko camp and 450 in the Penda Mboko camp. A typical labourer works 5 working days a week from 7 am to 6 pm with minimal wages. They also benefit from a free health dispensary within the camps, which provides first-line health management to the labourers. However, this units do not have any functional family planning services. The study was a community-based cross-sectional study in which participants were enrolled in their settlements in the CDC plantation camps of Tiko and Penda Mboko. The study was conducted from December 2019 to February 2020. Women of reproductive age group (15–49 years) in union, who had been resident in the Tiko or Penda Mboko CDC plantation Camps for at least 2 years prior to the study and provided informed consent/assent for participation in the study. Those who did not fulfil these requirements were not included. We calculated the minimum sample size using Cochran’s formula [32]. where Z = 1.96 at a 95% confidence interval, from a previous survey in Cameroon, we estimate the unmet need for family planning (P) = 20% = 0.20 (estimated unmet need for family planning in Cameroon) [21], d = 5% = 0.05 (error margin), Design effect (Deff) = 1.1. However, a total sample of 414 women in union of reproductive age was used in the study because we had available resources and desired to work at a higher power with a better precision. The selection of the participants was based on probability proportionate to size. Two CDC plantation camps (Tiko and Penda Mboko) located in two different regions (South West and Littoral regions, respectively) were purposively selected. Each of these camps was divided into clusters which represented their pre-existing camp quarters. Tiko had nine (9) clusters from which we randomly selected four (4) clusters using a simple ballot. Likewise, Penda Mboko had seven (7) clusters from which we randomly selected four (4) using the same method. The main street junctions of each cluster were identified, and then a direction of household data collection within each cluster was randomly selected by rotating a plastic bottle. The direction of the head of the bottle indicated the direction of data collection. At the start of this main junction and moving in the selected direction, data collectors systematically visited all houses situated on their left-hand side. At the household level, only one eligible participant was selected; this was the first eligible participant encountered by the data collector. The number of participants per cluster was selected using probability proportionate to size. Administrative clearances were obtained from the Regional Delegation of Health of the South West Region and Littoral Region. A written authorization was obtained from the Director of Human Resources of the CDC. The study was approved by the Institutional Ethics Committee for Research on Human Health of the University of Douala (Ref.:2069 IEC¬ UD/12/2019/T), informed consent/assent was obtained from all subjects and/or their legal guardian(s). All experiment protocol for involving humans was in accordance with national/international/institutional guidelines. Twenty (20) questionnaires were pretested in one of the CDC plantation camps clusters to ensure that the questions were well understandable and had the same meaning to both the data collectors and potential participants. After the pretesting, some adjustments were made to the questionnaire, and it was validated after review by research experts in the field of study. Major modifications made included reformulating some questions and elimination of question of gender since all the participants were women. Pretested questionnaires were not included in the data analysis. One week prior to data collection, a three days training seminar for the data collectors led by the principal investigator was done. The data collectors for this study had a minimum academic qualification of Bachelor’s degree in a biomedical science field and a working experience of at least two previous community research data collection. Adult learning techniques were used in training, including presentations, questions and answers, brainstorming and role play. The training seminar had three modules, one for each day; module 01 covered the importance of family planning and the study objectives, module 02 covered the details of the structured questionnaire and module 03 covered community entry procedures, how to carry out the fieldwork and anticipated challenges. After collecting the ethical clearance and administrative authorizations, community chiefs and quarter heads were visited, from whom authorization to access the communities was obtained. Access into the communities was led and guided by community health workers (CHWs) of the Tiko and Penda Mboko health districts in their respective districts. Trained data collectors collected data in the two districts simultaneously throughout the study. Surveyors visited each sampled household and inquired whether or not there was a potential participant (women in union) in the household. In households where participants were presently on sit, data were collected; otherwise, surveyors revisited the sampled household as many times as possible until the eligible participant (if present) was met and interviewed. Only one participant was selected per household, and this was the first eligible participant encountered in that home. In cases where the first contacted eligible participant in a particular household refused to participate, subsequent eligible participants of the same household were contacted. After providing informed consent/assent to participate in the study, they were required to answer the interviewer-administered study questionnaire on a one-to-one basis in a quiet location away from the hearing of the other household members. Data were captured using a pretested interviewer-administered semi-structured questionnaire. The questionnaire covered socio-demographic information of the study participants, including age, marital status, education and income level. The questionnaire also covered reproductive health indicators and a history of contraception. Filled questionnaires were checked by the principal investigator, and those that lacked important information (identification number, age, etc.) were excluded. Data were entered into the EpiData version 3.1 data entry form created to contain checks so as to avoid entry errors. The database was then cleaned in the same software, and exported and analysed in SPSS version 16. Frequencies were calculated for categorical variables, while means were used to describe continuous variables. Unmet need for family planning was calculated using the Westoff/Demographic and Health Survey method [33]. See Fig. 1. Odd ratio (and 95% confidence interval) was used to measure the strength of association between unmet need for family planning and the different covariates selected based on previous studies in this field. Multivariate analysis was done by introducing all covariates for which simple logistic regression analysis showed statistically significant association with unmet need into the multiple logistic regression model. Statistical significance was considered at p-value < 0.05 for both the simple and multiple logistic regression.
N/A
