Background: Proper umbilical cord care prevents neonatal infections and reduces neonatal mortality. Despite global recommendations for evidence-based cord care practices, traditional beliefs, and inadequate maternal knowledge often lead to unsafe practices, particularly in low-resource settings like Bangladesh. This study aimed to assess the understanding of umbilical cord care among mothers of neonates in Sherpur District, Bangladesh, and identify factors associated with knowledge levels. Methods: A descriptive cross-sectional study was conducted from July to October 2020 at Sherpur Sadar Hospital. A total of 193 mothers of neonates were recruited using a non-randomized purposive sampling method. Data was collected through a pre-tested, semi-structured, interviewer-administered questionnaire. Knowledge levels were categorized as "Good" (>6) or "Poor" (≤6) based on responses to 10 structured questions. Statistical analyses, including chi-square tests and crude odds ratios (COR), were performed to identify socio-demographic factors associated with knowledge levels. Results: Of the 193 participants, 48.7% demonstrated "Good" knowledge, while 51.3% had "Poor" knowledge. Education level (p = 0.01), occupation (p = 0.02), family type (p < 0.001), and family size (p = 0.04) were significantly associated with knowledge levels. Mothers with higher education and those from joint families exhibited better knowledge. However, 28.5% of respondents were unaware of the typical umbilical cord-shedding timeframe, and 44% could not identify signs of infection. Unsafe practices, such as using medications (14.5%) or hot compression (7.2%) for drying the cord, were reported. Conclusion: The study reveals significant gaps in maternal knowledge regarding umbilical cord care in Sherpur District, driven by socio-demographic disparities and cultural practices. Targeted health education programs, emphasizing evidence-based cord care practices and leveraging local social structures, are urgently needed to improve neonatal health outcomes in similar resource-limited settings. Future research should evaluate the effectiveness of these interventions to inform policy and practice.

Introduction: Pain is considered as the fifth vital sign that should be considered in assessing patients. For clinicians to evaluate and determine the right pain interventions, there should be parameters such as pain scale. Our objective in this study is to determine factors affecting pain scale preferences in suburban and rural populations. The pain scales used in this study are FPS-R (Faces Pain Scale-Revised), VRS (Verbal Rating Scale), VAS (Visual Analogue Scale), and NRS (Numering Rating Scale). Method: This study uses observational design with an interview approach and a cross-sectional study. Areas covered are within Indonesia, which are marginal areas of Tangerang district border, and two rural areas in Serukam, West Kalimantan, and Soe, East Nusa Tenggara. Data collected will be analyzed using SPSS 25 software. Result: Populations within the suburban areas prefer NRS (52.08%) as their pain scale, and populations in rural areas prefer FPS-R 76.92%). Factors affecting pain scale preferences are location areas, as well as last education, with statistical significance of p<0.05. Discussion: Our study showed that the choice of several pain scales is not appropriate for specific demographics due to the complexity of these scales. Factors that should be considered are the location areas and education level, as some population in remote areas have better understanding of simpler pain scales. Conclusion: Complexity or simpler components may be an underlying reason for the preference of score selection to assess pain scales in some population. Therefore, the selection of pain scales should be adjusted to specific demographics so that clinicians can provide appropriate management with appropriate pain scales.

Silver nanoparticles (Ag⁺NPs) contamination in the environment is a serious concern. This study investigated selected heavy metal (Ag⁺, Cd^2+, Cr²⁺ and Pb²⁺) concentrations at different sampling points to assess the risk to human health (infants, children, and adults). To do this, an enclosed area (laboratory) of 12.6 m X 8.5 m (107.1 m²) was clearly marked at different coded distances of S1, S2, S3, and S4 representing 2, 4, 6, and 8 m, while unpolluted atmosphere at 50 m away without Ag⁺NPs served as the control (S5). The silver fireworks were allowed to burn for an approximate 00h03m30s at each sampling points using a high-volume air sampler mounted at the Environmental Engineering Departmental Laboratory, Rivers State University, with windows and doors closed to simulate indoor conditions. Samples were digested using a mixture of analytical-grade nitric acid, analytical-grade hydrochloric acid and analyzed to evaluate the levels of heavy metals by atomic absorption spectrophotometry. The Ag⁺ result at S1 shows 30,000 µg/cm³, S2 was 29,000 µg/cm³, while S3 was 28000 µg/cm³ and then S4 was 13,000 µg/cm³. These results exceeded the permissible values of the United States National Ambient Air Concentration for rural, urban and industrial areas (0.0005, 0.004 and 0.6 µg/cm³, respectively). The result for the control (S5) (0.037 µg/cm³) was within the maximum allowable value. Results from other heavy metals such as Cd were 1000, 743, 401, 153, 0.001 µg/cm³, Cr was 5000, 4000, 3729, 2960, 0.002 µg/cm³, Pb was 0.048, 0.041, 0.035, 0.034 and 0.01, µg/cm³, respectively. However, higher values of Ag⁺, Cd, and Cr indicated a higher propensity for the metals to be toxic (bioavailable). In addition, the assessment of the potential health risk posed by these metals proved contaminated and harmful. Visitors recorded high values in exposure concentration (EC) and low values in average daily dose (ADD).

The spiny xeromorphic shrublands on serpentine (cuabales) constitute outstanding plant formations for the conservation of Cuban biodiversity, due to their floristic richness, high number of endemic species and local endemism, as well as their economic, social, cultural value and functions environmental. In the Callejón de Los Patos of Santa Clara, there are relicts of cuabal, although they show a high level of deterioration due to human activity. This article presents the main results of an investigation, which focused on implementing actions for the development of Community Environmental Education, with emphasis on the conservation of cuabal, in Callejón de Los Patos. For the intervention process, the Community Self-Development Methodology was used, which is qualitative par excellence, and the investigative methods: document analysis, participant observation, in-depth, group and structured interviews, drawing directed, the reflective group, techniques group and triangulation of data. The main results of the research are: the diagnosis and implementation of actions, designed from the process of Community Environmental Education, which was developed at the Carlos Manuel de Céspedes National Rural School, of said settlement. During the intervention process, the development of cognitive, procedural and attitudinal knowledge for the conservation of cuabal was verified in the schoolchildren, contributing to the strengthening of the school as the most important cultural center of the community, as aspired in the Cuban National Education System.

This work presents the results of an ethnobotanical research carried out in the territory of Serre Calabre, province of Vibo Valentia (Calabria, southern Italy). In this territory, the bond between the residents and the rural environment is still strong, because the small urban centers are placed in a predominantly agricultural and forestry environment still managed in a traditional way. The survey took place between January 2019 and July 2021. Data were collected through semi-structured interviews with locals. As many as 17 informants were interviewed and a total of 185 interviews were recorded. Plant specimens were collected under the indication of the informants and then deposited at the herbarium of the Mediterranean University of Reggio Calabria (REGGIO). The data were stored on a digital database and then statistically analyzed some synthetic indexes have also been calculated, such as Relative Frequency of Citation (RFC) and the Cultural Importance Index (CI). The investigation allowed to identify 84 taxa belonging to 39 different families, among which the most represented are Lamiaceae (23 interviews, 9 taxa), Asteraceae (22 interviews, 12 taxa). The identified taxa were prevalently cited for alimentary (46 interviews, 32 taxa) and healing (55, 27) uses. The results obtained show how the traditional knowledge about plants in the Serre Calabre area is still alive, however it is exclusive heritage of elderly people and often only in one or just a few informants. In fact, many practices are no longer in use and will not be transferred to the new generations.

The reduction of the native forests coverage in mainland Portugal increased in the past centuries, leading to a marked decrease in biodiversity in general, especially on typical species of mature forest environments. However, urban biodiversity seems to resist more effectively than rural to disturbances due to the lower incidence of fires, as well as to agriculture expansion. Thus, in this work, we analyzed the dynamics of the natural vegetation potential in each biogeographic sector, and selected, based on the evolutionary stages of the vegetation, a set of priority taxa for conservation. The criteria used are intended to highlight plants with ornamental value, but at the same time, some of them have high patrimonial value, belonging to the Red List of Vascular Flora of Mainland Portugal or protected by Annexes II, IV and V of the Sectorial Plan of the Natura 2000 Network at the European level. Our analysis resulted in the identification of 62 plants that can be increased in public spaces in order to improve their conservation status. For each biogeographic sector, the plants best adapted to the local edaphoclimatic conditions are presented. Forest habitats can now, through micro-reserves in urban areas, ensure their long-term conservation and greater awareness among the population. An integrated planning, where the socio-ecological strategy is designed for the long term, will benefit the quality of life of citizens in an urban environment. Furthermore, the creation of micro-reserves in urban parks (gardens) can prevent the extinction of many botanical values in the landscapes of the western Mediterranean Basin.

This paper presents the results of an ethnobotanical survey carried out in the Peloritani Mounts (NE Sicily). This investigation aims to illustrate the first record known of the traditional uses of plants in this territory through the case study of a small rural suburb named Tipoldo (Messina). The data were collected from 20 informants over the age of 66, who were mainly farmers and shepherds, and were analyzed using two quantitative ethnobotanical indicators. For each plant was reported the Latin name, life form, vernacular name, parts used, ethnobotany category, claimed uses, status, and their relative indexes. Based on semi-structured interviews carried out between February 2017 and May 2018, a listing was compiled of 126 wild plants belonging to 51 families, the most predominant being Asteraceae (19 species) and Fabaceae (15 species). The most common ethnobotanical uses reported are medicinal (30%) and agropastoral use (19%). Among the preparation methods indicated, leaves (39%) were the most commonly used parts of the plants, while the species most mentioned in connection with ethnobotanical applied indexes were: Crepis vesicaria, Dittrichia graveolens, Hypochaeris radicata, Salvia Rosmarinus and Clinopodium nepeta. These practices are presently performed only by a few elderly people, who rely on plants solely for a few activities. Furthermore, ethnobotanical studies are fundamental to clear up the knowledge on the traditional plant uses that are still current in this part of Sicily, to preserve this cultural heritage for future generations.

Background: Socioeconomic status (SES) is widely associated with improved health, behavioral, and educational outcomes. However, emerging research suggests that these benefits are not uniformly experienced across populations or contexts. The theory of Marginalization-related Diminished Returns (MDRs) has primarily focused on racial and ethnic disparities, showing that individuals from racially marginalized groups often experience weaker protective effects of SES. There is a lack of evidence on geography—particularly rural residence—as a moderator of SES effects. Objective: This review explores how place, especially rural contexts in the U.S., shapes the extent to which SES translates into improved outcomes. We extend the MDRs framework to include place-based and geography-based marginalization, arguing that even among non-Hispanic White populations, rural residence can lead to diminished returns on education, income, and other forms of capital. Content: Drawing on theoretical models such as Fundamental Cause Theory and Bronfenbrenner’s Ecological Systems Theory, and synthesizing empirical findings from studies of academic achievement, substance use, and educational aspirations, this review highlights how structural disadvantages in rural areas weaken the effectiveness of individual and family-level resources. Conclusion: Rural health and educational disparities are not solely due to a lack of resources but may also reflect systemic conditions that erode the value of existing resources. Policy interventions must be place-aware and address the contextual constraints that limit opportunity. Future research should more explicitly test how geography moderates the effects of SES across a range of outcomes and populations.

This literature review delves deeply into the epidemiology, structural and cultural challenges, and management strategies of status epilepticus (SE) in sub-Saharan Africa (SSA). Incidence rates of SE vary significantly between countries, with notable disparities associated with socio-economic contexts, healthcare infrastructures, and cultural perceptions of epilepsy. The management of SE in this region is often hindered by constraints in medical infrastructure, inadequate access to specialist diagnostics such as electroencephalogram, and limited availability of essential anti-epileptic drugs, which are frequently out of reach for rural populations. These challenges are further exacerbated by the social stigma and cultural beliefs surrounding epilepsy, impeding access to care and widening inequalities. Moreover, the scarcity of qualified medical personnel undermines the efficient and prompt management of this neurological emergency. The review underscores the pressing need to enhance healthcare infrastructures, boost the capabilities of healthcare professionals, and conduct community awareness initiatives to destigmatize epilepsy and lessen prejudice. Additionally, practical recommendations are put forward for enhancing local capacity, fostering equity in care access, and mitigating regional health disparities in SSA.

Smartphone use among adolescents has surged globally, reshaping communication and learning patterns, especially in developing countries. However, the implications of such digital habits on students in rural or under-resourced areas remain underexplored. This study aims to examine the patterns of smartphone usage and its effects on learning among high school students in Tarutung, a developing region of North Sumatra, Indonesia. Utilizing a quantitative descriptive approach, data were collected from 358 students using structured questionnaires. The results show that 96.05% of students own personal smartphones regardless of socioeconomic background, with an average daily usage of 4 hours and 45 minutes. While 91.81% believe smartphones support their learning, 25.99% report declining academic performance. Alarmingly, 20.62% of students admitted involvement in cyberbullying activities, highlighting a critical digital risk impacting the school environment and student well-being. The study concludes that although smartphones offer educational benefits, their misuse can lead to negative academic, social, and psychological outcomes. This study recommends digital literacy curricula and structured cooperation between parents and educators to prevent risks while optimizing educational opportunities in smartphone use.

Background: Nicotine pouches, gummies, and candies have emerged as popular alternatives to traditional tobacco products among U.S. adolescents. While parental educational attainment is generally associated with youth substance use, marginalization-related diminished returns (MDRs) suggest that this effect may be weaker in marginalized populations, including non-Latino White communities. In particular, place-based marginalization—such as neighborhood economic disadvantage and school-level poverty—may attenuate the benefits of parental education. This study examines MDRs in the relationship between parental educational attainment and nicotine pouch/gummy/candy use among non-Latino White 12th graders in the 2024 Monitoring the Future (MTF) study. Methods: This study analyzed nationally representative data from the 2024 MTF study, focusing on non-Latino White 12th graders who reported parental education levels and adolescents’ use of nicotine pouch/gummy/candy. Structural equation modeling (SEM) was used to estimate the effects of parental education on adolescents’ use of nicotine pouches, gummies, and candies, while adjusting for demographic covariates. Place-based marginalization was operationalized using rural vs urban /suburban residence. Interaction terms tested whether the effect of parental education varied based on place of residence. Results: Higher parental educational attainment was associated with lower use of nicotine pouches, gummies, and candies. However, this effect was significantly weaker in rural areas. Conclusion: Public health interventions should account for place-based disparities rather than assuming a uniform effect of SES factors. This study highlights the need for policy responses that address structural inequities beyond individual family SES.

Background: The Motivational Theory of Life-Span Development suggests that individual aspirations are shaped by both internal and external resources. Parental education is a key determinant of educational aspirations, yet its effects may vary by geographic location, demonstrating spatial patterns of Minorities’ Diminished Returns (MDRs). Objectives: This study examines the association between parental education and aspirations for graduate or professional education among non-Latino White adolescents, with a specific focus on urban-suburban versus rural differences. Methods: Using data from the 12th-grade cohort of the Monitoring the Future (MTF) 2024 survey, we conducted multivariate analyses to assess the relationship between parental education and aspirations for graduate or professional education. We further examined whether this association was moderated by geographic location (urban-suburban vs. rural) to identify place-based MDRs. Results: Higher parental education was associated with greater aspirations for advanced education; however, this effect was weaker in rural areas compared to urban and suburban settings. These findings highlight that even among non-Latino White adolescents, rural residence diminishes the benefits of socioeconomic resources, providing evidence of place-based MDRs. Conclusion: Rural residents face a dual disadvantage—both lower socioeconomic status and weaker returns on those resources—necessitating targeted interventions beyond resource allocation. To address disparities in educational aspirations in rural areas, policymakers should focus on improving equitable access to educational opportunities and ensuring that these resources translate into comparable outcomes across different social and geographic contexts.

Background Adolescent substance use is often influenced by socioeconomic and geographical factors. While higher parental education is typically associated with lower substance use, these protective effects may be weaker for marginalized groups facing structural disadvantages that limit the utility and returns of their economic and social resources. Rural areas, characterized by fewer employment opportunities and limited recreational activities, may contribute to marginalization-related diminished returns (MDRs) of parental education on adolescent substance use, including inhalant use. Objectives This study applies the MDRs framework to examine whether the protective effect of higher parental education on current inhalant use (past 30 days) among 12th-grade American adolescents varies by geographic location. Specifically, we assess whether youth from highly educated families in rural areas are at a disproportionate risk of inhalant use compared to their urban and suburban peers. Methods Using data from the 2024 Monitoring the Future (MTF) study, a nationally representative survey of 12th-grade adolescents in the U.S., we tested main effects and statistical interactions between parental education and residence (rural vs. urban/suburban) in predicting the odds of inhalant use over the past 30 days. Logistic regression models, both with and without interaction terms, were applied to evaluate whether the protective effects of parental education varied by residence location, controlling for relevant demographic and socioeconomic factors. Results Findings indicate a significant interaction between parental education and rural residence. While higher parental education was associated with lower odds of inhalant use in urban and suburban areas, this protective effect was substantially weaker in rural settings. Adolescents from highly educated families in rural areas exhibited a higher-than-expected risk of inhalant use, suggesting that geographic marginalization attenuates the benefits of parental socioeconomic resources. Conclusions These results highlight the role of place-based marginalization in shaping adolescent substance use disparities, demonstrating that MDRs extend beyond race and ethnicity to location-based disadvantages. Rural youths from highly educated families may face unique structural and social challenges that counteract the protective effects of parental education. Public health efforts should consider place-based interventions that address the economic, recreational, and social limitations of rural environments to reduce substance use risk among high-SES adolescents residing in rural areas.

The study aimed to assess the impact of off-season vegetable farming on farmers in the Savelugu Municipality in the Northern Region. The study population consisted of all respondents to off-season vegetable farming in the Savelugu Municipality in the five selected communities in the Northern Region. A purposive sampling technique was used for a sample size of fifty (50) off-season farmers in the selected communities. An interview guide and questionnaire were used to solicit data to conclude the findings. The data derived from the questionnaire were analysed in a step-by-step thematic analysis that included reading the transcriptions several times, coding, generating codes, and reviewing and naming themes. Afterwards, the questionnaire and interview guide responses were transferred into Microsoft Excel under assigned variable names. Descriptive statistics, namely frequency, means, and percentages, were used to analyse the data. Off-season vegetable production technology can be gained by using different agro-climatic regions, maintaining or adjusting planting time, selecting varieties, and creating artificial and controlled environments through tunnels, polytene houses, glass houses, hotbeds, etc. Moreover, Off-Season vegetables helped earn income and ranked highest with an overall mean score of 1. Nearly all the trained farmers said their primary constraint was the high incidence of pests and diseases. It is evident that off-season cultivation is profitable and significantly impacts the farmers' consumption expenditure and food security status. Therefore, providing improved and modern agricultural inputs to off-season farmers is essential for rural agricultural development.

One of the current issues facing humanity is ensuring sustained global food security in the face of devastating effects of climate change; this challenge is particularly pressing on the African continent. Here, I present an opinion piece identifying local animal genetic resources as "African leverage point" that provide the highest chances to cushion rural fork to climate change, enhance environmental sustainability and food security in Africa. When it comes to boosting food production, coping with climate change, or bolstering the delivery of a wide range of ecosystem services, I believe that African animal genetic resources are essential alternatives for the sustainable growth of the livestock industry and its contribution to food security. Africa needs to address the support and development of indigenous animal genetic resources in order to meet the basic food needs of more than 1 billion people, address numerous environmental issues with continental implications, and focus on more effective and resilient food systems with the greatest impact on food security. The indigenous animal resources diversity and support actions to this unique group could provide a boost in protein that is lacking to constitute healthy diets in Africa. The priorities of nonprofit organizations, foundations, governments, citizens' groups, and companies can be influenced by this leverage point in the African food system. Due to continuous food insecurity, which appears to be becoming worse with climate change and makes it even harder to accomplish the SDGs on the continent, Africa has paid a hefty price for being misled about the worth of its own animal genetic resources. To the contrary, it is highly improbable that a strategy to improve food security and rural livelihoods that undermines the utilization of indigenous animal genetic resources will be viable in long-term. If Africa makes an effort, is committed, and fully commits resources to putting indigenous animal genetic resources at the forefront of combating food insecurity and accelerating the achievement of SDGs, it can achieve more under the adverse prevailing climate change induce environmental conditions. Our personal opinion is that we would not have had the ongoing food problems, even in the face of climate change, if Africa had over the years implemented the necessary mechanisms to develop and promote local animal genetic resources. What lies ahead in terms of climate change effect on food security in Africa is anyone's guess – but whatever it is, promoting continental adapted indigenous animal genetic resources portfolio is ready to handle it. Development and promotion of African animal genetic resources should be part of a continental strategy to transform smallholder animal production by 2050, in line with the goals of achieving the SGDs, to improve rural household food security, and bringing rural economy prosperity, resilience, sustainability, and all other desired animal related food outcomes for rural healthy diets. African animal genetic resources are the most important but underutilized resource to address the issue of ongoing food insecurity. The responsible use of local animal genetic resources through climate smart animal husbandry practices also contributes to food security, rural development and increased employment opportunities. African genetic improvement programs involving indigenous animal genetic resources must be considered as regards to local agriculture and livestock development aspirations, appropriateness to local reality and livelihood security, as well as environmental friendliness. Animal agriculture will fill in the enormous gaps in the continent's food supply if this animal group receives adequate attention and is used integrated properly in crop and livestock systems which characterize smallholder farming sector in Africa. Because they have evolved over time to accommodate the various climatic conditions and environmental pressures on the continent, Africa's native animal genetic resources are particularly resilient. Indirectly, the impact of climate change offers a chance to use native animal genetics from Africa. The use of local animal genetic diversity has the potential to substantially improve Africa's food security landscape hence should be given special consideration for sociocultural, environmental, and economic aspects, and with regard for smallholder farmer-specific factors of interest. African animal genetic resources have contributed significantly to the food and nutrition security aspects of the millions of people in their communities of origin and custody in Africa. The purpose of the perception piece is to educate the reader about the fundamental mechanisms that control the use of continental animal genetic resources and how the outlook for these mechanisms can be manipulated in the future for the benefit of improving food security in Africa. The discussion provides in-depth insight into the pertinent literature in understanding the significance of local animal genetic resources in terms of their contribution to food security in Africa.

Water is essential for food security and animal agricultural productivity, but it is becoming more scarce due to climate change. The interaction between climate change and livestock water resources has received little attention from researchers, despite the significance of small-scale animal husbandry for the rural poor in Africa and the size of the changes that are anticipated to have an impact on smallholder livestock systems. Threats to livestock water are undoubtedly one of the most significant environmental issues that have impacted food security on the continent, given their links to small-scale animal husbandry and the detrimental impacts on productivity. In order to balance the negative effects of climate change scenarios for sustainable animal productivity and contribute to food security through small-scale animal agriculture, the most climate-smart and resilient agricultural water practices and technologies must be used. Changes in rainfall and a decline in the biomass available for grazing and rangelands as a result of water stress brought on by the climate would have the most severe effects. This is due to the rain-fed nature of small-scale livestock farming. The local animal genetic resources are essential for animal productivity and food security in Africa, particularly in areas where livestock water is becoming scarce owing to climate change. Research and development goals on the effects of climate change on livestock water, animal productivity, and food security may need to be reviewed if demands of vulnerable small-scale animal producers are to be successfully addressed in the future decades. It is best to use an interdisciplinary approach to comprehend the relationships between small-scale animal husbandry, food security, and climate change. By navigating the complexities of climate adaptation, small-scale livestock farmers can manage livestock water scarcity by taking adaptation measures that are in line with evolving climate impacts and associated means of implementation based on pertinent and useful knowledge that takes into account a blend of traditional and modern water science. In this paper, an effort is made to close some significant information gaps and shed light on how water-induced stress impacts small-scale animal production, which has an effect on food security.

The purpose of the study was to assess the perceptions and challenges facing in the implementation process of the IN-IN-OUT programme in selected colleges of education in the Ashanti Region of Ghana. The descriptive cross-sectional survey was employed as the research design in this study. The population was made up of supervisors, mentors, and mentees from St. Louis and Wesley Colleges of education who have been posted to various communities in the Ashanti Region of Ghana to practice teaching. Purposive and random Sampling techniques were used to select tutors, teacher-trainees, mentors and assemblymen in the practicing communities. The study's main data collection tools were questionnaires and interview and classroom observation protocols. The data collected were scored and analyzed using the Statistical Package for Social Scientists (SPSS) computer software. Frequencies, percentages, and other measures of central tendencies were calculated. The study revealed that teacher-trainees, mentors, and assemblymen in the two (2) communities saw the IN-IN-OUT programme as useful to a large extent, even though they had varied opinions. While some say the program was merely useful, some see it as very useful and others saw the program as extremely useful. The study also revealed that the challenges faced by the various teacher trainees, mentors, and supervisors include social problems, financial difficulties, and time constraints. It is recommended that teacher trainees are posted to the rural and peri-urban communities, one can be sure that after their certification they will be fully prepared to face the challenges ahead of them. It is also recommended that the government and stakeholders should as a matter of urgency commit more money to this programme.

Background: Reproductive health is a critical component of overall health and development. Unmet contraceptive needs are one of the regularly cited measures of the efficacy of family planning (FP) initiatives. This study set out to determine the magnitude and associated factors of unmet need for FP among women of reproductive-aged (15-49 years) in the provincial areas of The Gambia. Methods: The study used a community-based cross-sectional analytical design. A multistage sampling strategy, comprising simple random and cluster sampling, was utilized to obtain a sample of 643 childbearing women (15-49 years) from rural Gambia's sampled clusters. Data collection was conducted using pre-tested structured interview questionnaires. The association was examined using chi-square/fisher's exact test with a significance level of p<0.05. Binary logistic regression analysis was performed to examine the effect of sociodemographic and cultural determinants on unmet FP need, with corresponding computed adjusted odds ratios (aOR). IBM SPSS version 24 was used for data entry and analysis. Results: The unmet need for FP among the study participants was 25.2%; unmet need for spacing and unmet need for limiting was 17.4% and 7.8%, respectively. The total demand for FP was 59.4%, while the satisfaction of demand for FP was 57.6%. The significant predictors of unmet need for FP were woman’s age at first pregnancy (aOR=0.899, p=0.033), LGA of origin (aOR=0.240, p=0.001) and frequency of using contraceptives (aOR=1.587, p=0.032). Conclusion: The present study demonstrated a high unmet need for FP among rural women in The Gambia, with the most often cited reason for non-use being fear of side effects. Hence, it is necessary to concentrate FP services for rural populations, stressing education regarding contraceptive side effects, service quality, and gender equality. Additionally, the study suggests that male participation and religious leaders' involvement in FP programs be strengthened and mainstreamed, as well as the establishment of a communication program that specifically promotes inter-spousal communication.

Background: Family planning (FP) methods have been found as an efficient approach of reducing fertility and are therefore widely supported in order to decrease population growth, particularly in poor nations. Promoting contraception availability among women (15 – 49) age has also been shown to be an efficient public health strategy for improving maternal and newborn health outcomes. This paper aimed at exploring the pooled prevalence of contraceptive uptake and its contextual determinants among women of childbearing age in The Gambia. Methods: The Gambia Demographic and Health Survey (GDHS) in both 2013 and 2019-20 was used for this study. Data were obtained from a pooled 22,098 women aged 15-49 (10,233 for 2013 and 11,865 for 2019-20) through a stratified two-stage cluster sampling approach. Percentages and chi-square tests were used and variables with p-value <0.05 were included into the model. A multivariable logistic regression model was used to assess the predictors of contraceptive usage at 95% confidence interval (CIs) with computed adjusted odds ratios (aORs). All the study data were analyzed using Stata version 15. Results: The weighted pooled prevalence of modern contraceptive utilization in The Gambia was 10.1%. Younger age, compared with women aged 25-29; 30-34; 35-39; 40-44; primary education (aOR=1.25, 95% CI=1.05-1.49); secondary education (aOR=1.57, 95% CI= 1.32-1.85); Higher education (aOR=1.90, 95% CI=1.34-12.69); living in urban areas (aOR=1.49, 95% CI= 1.25-1.79); parity 2-4 (aOR=1.21, 95% CI= 1.01-1.47); told about FP at health facility (aOR=2.97, 95% CI= 2.61-3.38), and no desire for many children (aOR=1.96, 95% CI= 1.62-2.37) were more like to use modern contraceptives among Gambian women. Conclusion: The programme certainly needs to consider improvements in the quality of care being offered to acceptors. Government agencies should target these programs and campaigns on regional FP demands and provide suitable culturally sensitive and regionally adaptive services to the communities' contexts. The programme should intensify its efforts in rural and urban settings to improve accessibility to and availability of FP services.