Sexual and Reproductive Health Services

Breastfeeding was associated with an 84% reduction in odds of never having been tested for HIV, the strongest effect among reproductive health factors. Gabon had significantly lower unmet needs for antenatal care (16.8%) and postnatal care (14.8%) compared to all other African countries in the study. India had the lowest unmet needs across all SRH indicators among the six study countries, at 6.7% for contraception and 13.1% for both antenatal and postnatal care. Benin had the highest unmet needs for contraception at 26.3% and postnatal care at 46.3% among the study countries. The broad SRH definition includes safe abortion services and treatment for complications of unsafe abortion. Contraceptive use was associated with a 72% reduction in the odds of never being tested, consistent with the healthcare contact hypothesis. Pregnancy was associated with 63% lower odds of never being tested, reflecting routine integration of HIV testing into antenatal care. Women who engage with reproductive health facilities encounter routine HIV testing opportunities that those outside such programmes do not. India's lower SRH unmet needs are partly explained by a higher density of nurses and midwive…