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Contraceptive use intention among women in Pakistan: Application of theory of planned behavior

by Zoya Waqas, Aisha Irum, Muhammad Ibrahim, Maheen Sughra, Sanaa Khan, Ayesha Khan, Adnan Ahmad Khan

Introduction

Unintended pregnancies remain a major public health concern globally and in Pakistan, where family planning (FP) uptake continues to be hindered by entrenched social and behavioral barriers. This study applies the Theory of Planned Behavior (TPB) to examine how attitudes, subjective norms, and perceived behavioral control (PBC) shape women’s contraceptive intentions in Pakistan.

Methods

We analyzed data from 13,335 non-pregnant women aged 15–49 using the Pakistan Demographic and Health Survey (PDHS) 2017–18. Partial Least Squares Structural Equation Modeling (PLS-SEM) was used to test TPB pathways. Model reliability, validity, and fit were assessed using Composite Reliability, Average Variance Extracted, discriminant validity indices, and bootstrapped estimates to ensure analytical rigor.

Results

Over half of respondents lacked formal education, and most (84%) were unemployed. Only 23% had FP knowledge, and 96% were unaware of contraceptive side effects. Subjective norms negatively influenced contraceptive intentions (β = −0.056, p  Conclusion

The study demonstrates the applicability of TPB for understanding contraceptive intentions in a collectivist, patriarchal context. Subjective norms and PBC emerge as critical determinants, underscoring the need for interventions that engage families, strengthen women’s autonomy, and improve access to FP services. The findings offer a theoretically grounded and policy-relevant framework for designing behaviorally informed family planning programs in Pakistan.

Phase II multicentre double-blind randomised controlled trial of a Bivalent VaccInation against Salmonella Typhi and Paratyphi A (BiVISTA) using a controlled human infection model of paratyphoid A infection: study protocol

Por: Paganotti Vicentine · M. · McCann · N. · Hennigan · O. · Maria · N. · Juarez Molina · C. I. · Koleva · S. · Islam · M. K. · Jones · E. · Flaxman · A. · Day · N. · MacDonald · A. · Adnan · M. · Singh · N. · Vernon · S. · Wilson · E. · Potey · A. V. · Dharmadhikari · A. · Gaidhane · S. · Kul
Introduction

Enteric fever, primarily caused by Salmonella enterica Typhi and Salmonella enterica Paratyphi A (SPA), is endemic mainly in South Asia, disproportionately affecting school-age children. Although typhoid conjugate vaccines (TCVs) are effective and implemented in many countries, no licensed vaccine exists against paratyphoid A. Bivalent vaccines targeting both S. Typhi and SPA may address this gap. Although field efficacy trials are not considered feasible, controlled human infection models (CHIMs) offer an alternative pathway for evaluating vaccine efficacy. This will be the first efficacy study of a bivalent vaccine against typhoid and paratyphoid A using a paratyphoid CHIM.

Methods and analysis

This is a phase II multicentre, double-blind, randomised controlled trial assessing the efficacy and immunogenicity of a bivalent conjugate vaccine candidate, Serum Institute of India Typhoid Conjugate Vaccine (Bivalent) (SII-TCV(B)), against SPA using a CHIM in healthy UK adults aged 18–55 years. A total of 192 participants will be randomised 1:1 to receive either SII-TCV(B) or a licensed Vi-polysaccharide typhoid vaccine (Vi-PS). All participants will be orally challenged with S. Paratyphi A (strain NVGH308) 28 days postvaccination. Participants will be monitored closely for 14 days and treated at 14 days postchallenge or promptly on diagnosis, according to prespecified criteria. The primary objective is to evaluate vaccine efficacy of SII-TCV(B) against paratyphoid infection using a CHIM. The coprimary immunogenicity objective is to assess non-inferiority of the typhoid IgG response compared with a licensed Vi-PS control.

Ethics and dissemination

The study has received ethical approval from the Berkshire Research Ethics Committee (24/SC/0309) and regulatory approval from the UK Medicines and Healthcare products Regulatory Agency. Results will be disseminated via peer-reviewed publications and scientific meetings.

Trial registration number

ISRCTN65855590.

Associations of functional foods consumption with gastrointestinal and musculoskeletal conditions: a cross-sectional study among Bangladeshi adults

Por: Mazumdar · S. · Shuvo · S. D. · Khuku · T. K. · Adnan · M. M. · Hossain · M. S. · Kamal · M. M. · Fardaus · F. · Zohra · F.-T. · Ahammed · T.
Objectives

Functional foods have demonstrated potential in preventing gastrointestinal and musculoskeletal (osteo-related) disorders; however, evidence from cross-sectional studies in adults remains limited. This study aimed to examine the relationship between the frequency of functional food consumption and the prevalence of gastrointestinal and osteo-related conditions among adults in Bangladesh.

Design

Cross-sectional study.

Setting

A face-to-face interview was conducted in Southern Bangladesh.

Participants

A total of 959 adults participated. Socio-demographic characteristics, lifestyle factors, health status and patterns of functional food consumption were collected using a structured questionnaire.

Main outcome measures

The prevalence of gastrointestinal and musculoskeletal (osteo-related) diseases, as well as their associations with the frequency of functional food consumption, were assessed using binary logistic regression.

Results

Gastrointestinal and musculoskeletal (osteo-related) diseases were reported by 55.4% and 44.1% of participants, respectively. Multivariate logistic regression showed that several functional foods were associated with lower odds of gastrointestinal conditions, including regular seed intake (OR=0.35, p=0.034), weekly fibre-rich foods (OR=0.48, p=0.021), weekly probiotics (OR=0.26, p=0.012), monthly probiotics (OR=0.33, p

Conclusions

The consumption of functional foods, particularly seeds, probiotics, fibre-rich foods, nuts, tea/coffee and natural products were associated with a lower risk of gastrointestinal and musculoskeletal diseases in adults. These findings provide robust evidence to inform future prospective studies and support public health strategies in Bangladesh aimed at promoting the consumption of functional foods to prevent diet-related health conditions.

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