scholarly journals Young motherhood: levels and socioeconomic determinants of adolescent fertility in Ghana

2021 ◽  
Vol 1 (10) ◽  
Author(s):  
Samuel H. Nyarko ◽  
Lloyd Potter

AbstractAdolescent fertility levels have shown considerable improvements globally over the past decades. However, adolescent childbearing remains high in developing countries, particularly in sub-Saharan Africa. This study, thus, examines the levels and socioeconomic factors associated with adolescent fertility in Ghana. The study drew on data from the 2003, 2008, to the 2014 Ghana Demographic and Health Surveys to perform a logistic regression analysis of socioeconomic factors associated with adolescent fertility. The results show that adolescent childbearing levels have not shown any considerable improvements over the study periods (10%, 10%, and 11% for 2003, 2008, and 2014, respectively). Socioeconomic factors such as household wealth status, working status, employer status, and employment period were associated with adolescent fertility. Female adolescents from poor households, employed and self-employed adolescents, as well as regular workers, were linked to higher adolescent fertility risks. Older adolescents, and ever married adolescents also show significantly higher childbearing risks while the risk levels steadily increased over time. Promoting economic empowerment among female adolescents and targeting employed female adolescents in fertility control measures may have considerable positive implications for adolescent fertility levels in Ghana.

2021 ◽  
Vol 6 (1) ◽  
pp. e003773
Author(s):  
Edward Kwabena Ameyaw ◽  
Yusuf Olushola Kareem ◽  
Bright Opoku Ahinkorah ◽  
Abdul-Aziz Seidu ◽  
Sanni Yaya

BackgroundAbout 31 million children in sub-Saharan Africa (SSA) suffer from immunisation preventable diseases yearly and more than half a million children die because of lack of access to immunisation. Immunisation coverage has stagnated at 72% in SSA over the past 6 years. Due to evidence that full immunisation of children may be determined by place of residence, this study aimed at investigating the rural–urban differential in full childhood immunisation in SSA.MethodsThe data used for this study consisted of 26 241 children pooled from 23 Demographic and Health Surveys conducted between 2010 and 2018 in SSA. We performed a Poisson regression analysis with robust Standard Errors (SEs) to determine the factors associated with full immunisation status for rural and urban children. Likewise, a multivariate decomposition analysis for non-linear response model was used to examine the contribution of the covariates to the observed rural and urban differential in full childhood immunisation. All analyses were performed using Stata software V.15.0 and associations with a p<0.05 were considered statistically significant.ResultsMore than half of children in urban settings were fully immunised (52.8%) while 59.3% of rural residents were not fully immunised. In all, 76.5% of rural–urban variation in full immunisation was attributable to differences in child and maternal characteristics. Household wealth was an important component contributing to the rural–urban gap. Specifically, richest wealth status substantially accounted for immunisation disparity (35.7%). First and sixth birth orders contributed 7.3% and 14.9%, respectively, towards the disparity while 7.9% of the disparity was attributable to distance to health facility.ConclusionThis study has emphasised the rural–urban disparity in childhood immunisation, with children in the urban settings more likely to complete immunisation. Subregional, national and community-level interventions to obviate this disparity should target children in rural settings, those from poor households and women who have difficulties in accessing healthcare facilities due to distance.


2008 ◽  
Vol 29 (1) ◽  
pp. 32-42 ◽  
Author(s):  
Jonathan Rivers ◽  
John Mason ◽  
Eva Silvestre ◽  
Stuart Gillespie ◽  
Mary Mahy ◽  
...  

Background In Africa, approximately 25 million people live with HIV/AIDS and 12 million children are orphaned. Although evidence indicates that orphans risk losing opportunities for adequate education, health care, and future employment, the immediate effects of orphanhood on child nutritional status remain poorly understood. Objective This paper assesses the nutritional impact of orphanhood, with particular emphasis on taking account of various factors potentially confounding or masking these impacts. Methods Child anthropometry and orphan status were examined in 23 Multiple Indicator Cluster Surveys and Demographic and Health Surveys throughout sub-Saharan Africa, which were subsequently merged into larger, region-specific datasets (East, West, and Southern Africa). To compare orphans and nonorphans, linear regression and probit models were developed, taking account of orphan status and type, presence of a surviving parent in the household, household structure, child age and sex, urban versus rural residence, and current wealth status. Results Few differences emerged between orphans and nonorphans in controlled and uncontrolled comparisons, regardless of orphan type, presence of surviving parent, or household structure. Age differentials did confound nutritional comparisons, although in the counterintuitive direction, with orphans (who were 8 months older on average) becoming less malnourished when age differences were taken into account. Wealth did appear to be associated with orphanhood status, although it did not significantly confound nutritional comparisons. Conclusions Orphans were not consistently more malnourished than nonorphans, even when potential confounding variables were examined. Since household wealth status is likely to change after becoming affected by HIV, ruling out wealth as a potential confounder would require more detailed, prospective studies.


2021 ◽  
Vol 11 (4) ◽  
pp. 397-404
Author(s):  
Sanni Yaya ◽  
Ziad El-Khatib ◽  
Bright Opoku Ahinkorah ◽  
Eugene Budu ◽  
Ghose Bishwajit

Abstract Background The emerging burden of high blood pressure (HBP) and diabetes in sub-Saharan Africa will create new challenges to health systems in African countries. There is a scarcity of studies that have reported associations of diabetes and HBP with socioeconomic factors on women within the population. We assessed the prevalence and socioeconomic factors of diabetes and high blood pressure among women in Kenya. Methods We analysed cross-sectional data from the 2014 Kenya Demographic and Health Survey. Subjects were women aged 15–49 years. Self-reported status of HBP and diabetes was used to measure the prevalences. The association between educational and wealth index with HBP and diabetes was assessed by multivariable binary logistic regression. Results The prevalences of self-reported HBP and diabetes were 9.4% and 1.3%, respectively. Women with secondary [aOR = 1.53; 95% CI = 1.15–2.02] and primary [aOR = 1.48; 95% CI = 1.15–1.92] levels of education were more likely to report having HBP, compared to those with no formal education. However, there was no significant association between educational level and self-reported diabetes. In terms of wealth quintile, we found that women with higher wealth quintile were more likely to report having HBP and diabetes compared to those with poorest wealth quintile. Specifically, the highest odds of self-reported HBP was found among women with richest wealth quintile compared to those with poorest wealth quintile [aOR = 2.22; 95% CI = 1.71–2.88]. Also, women with poorer wealth quintile were more likely to have self-reported diabetes compared to those with poorest wealth quintile [aOR = 1.89; 95% CI = 1.08–2.38]. Conclusion The prevalence of HBP and diabetes was low among women in Kenya. Household wealth status was associated with HBP and diabetes. No causation can be inferred from the data; hence, longitudinal studies focusing on health-related behaviour associated with NCDs are recommended. Proper dissemination of health information regarding the risk factors for HBP and diabetes may prove to be beneficial for NCD prevention programmes.


2011 ◽  
Vol 43 (4) ◽  
pp. 385-400 ◽  
Author(s):  
TESFAYI GEBRESELASSIE ◽  
VINOD MISHRA

SummaryThis study investigates how various social, demographic and economic factors affect spousal agreement on preferred waiting time to next birth. Data for matched cohabiting couples from ten Demographic and Health Surveys in sub-Saharan Africa (Benin, Burkina Faso, Ghana, Guinea, Mali, Ethiopia, Kenya, Mozambique, Zambia and Zimbabwe), conducted between 2003 and 2006, were analysed to compare reported waiting time to next birth by the husband and the wife. Couples where the reported waiting time to next birth was the same for both partners (difference is 0 months) were defined as having agreement on waiting time to next birth. In sub-Saharan Africa, spousal agreement on waiting time to next birth was found to be associated with wanting the next child sooner. When the spouses disagree on waiting time to next birth, the wives want to wait longer than their husbands in most cases. Additionally, the study found that demographic factors are the primary determinants of spousal agreement on waiting time to next birth, not socioeconomic factors. The strongest predictors of spousal agreement on waiting time to next birth were number of living children, difference between the number of ideal and living children and wife's age. Couples with fewer children, a younger wife and those with a difference of five or more children between ideal and living number of children were more likely to agree on waiting time to next birth. Effects of socioeconomic factors, such as education and wealth status, on spousal agreement on waiting time to next birth were generally weak and inconsistent. The findings highlight some of the challenges in developing programmes to promote spousal communication and birth spacing and underscore the need for programmes to be gender-sensitive.


PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243316
Author(s):  
Babayemi O. Olakunde ◽  
Jennifer R. Pharr ◽  
Lung-Chang Chien ◽  
Rebecca D. Benfield ◽  
Francisco S. Sy

Background Female permanent contraception is a cost-effective contraceptive method that can help clients with the desire to limit childbearing achieve their reproductive intention. However, despite its benefits, the use of FPC remains low in sub-Saharan Africa (SSA), and limited studies have examined the correlates of its uptake. In this study, we assessed the individual- and country-level factors associated with the use of FPC among married or in-union women using modern contraceptive methods to limit childbearing in SSA. Methods This study was a secondary data analysis of individual- and country-level data obtained from the Demographic and Health Surveys (DHS) Program and three open data repositories. The study included 29,777 married or in-union women aged 15–49 years using modern contraceptive methods to limit childbearing from DHS conducted in 33 sub-Sahara African countries between 2010 and 2018. We performed descriptive statistics and fitted multilevel logistic regression models to determine the predisposing, enabling, and need factors associated with the use of FPC. Results Approximately 13% of the women used FPC. About 20% of the variance in the odds of using FPC was attributable to between-country differences. In the full model, the significant individual-level factors associated with the use of FPC compared with other modern contraceptive methods were: age (odds ratio [OR] = 1.10; 95%CI = 1.08–1.12), living children (OR = 1.11, 95%CI = 1.04–1.16), high household wealth (OR = 1.39, 95%CI = 1.18–1.64), rural residence (OR = 0.83, 95% CI = 0.71–0.97), joint contraceptive decision with partner (OR = 1.68, 95% = 1.43–1.99), contraceptive decision by partner and others (OR = 2.46, 95% = 1.97–3.07), and the number of living children less than the ideal number of children (OR = 1.40, 95%CI = 1.21–1.62). The significantly associated country-level factors were births attended by skilled health providers (OR = 1.03, 95%CI = 1.00–1.05) and density of medical doctors (OR = 1.37, 95%CI = 1.01–1.85). Conclusions Our results suggest that both individual- and country-level factors affect uptake of FPC in SSA. Increasing geographic, economic, and psychosocial access to FPC may improve its uptake in SSA.


2021 ◽  
pp. 1-32
Author(s):  
Aaron K. Christian ◽  
Fidelia A. A. Dake

Abstract Objective: Undernutrition and anaemia - the commonest micronutrient deficiency, continue to remain prevalent and persistent in sub-Saharan Africa (SSA) alongside a rising prevalence of overweight and obesity. However, there has been little research on the co-existence of all three conditions in the same household in recent years. This study examines the co-existence and correlates of the different conditions of household burden of malnutrition in the same household across SSA. Setting: The study involved twenty-three countries across SSA who conducted demographic and health surveys between 2008 and 2017. Participants: The analytical sample includes 145,020 households with valid data on the nutritional status of women and children pairs (i.e. women of reproductive age; 15-49 years and children under-five years). Design: Logistic regression analyses were used to determine household correlates of household burden of malnutrition. Results: Anaemia was the most common form of household burden of malnutrition, affecting about 7 out of 10 households. Double and Triple burden of malnutrition though less common, was also found to be present in 8 and 5 percent of the households respectively. The age of the household head, location of the household, access to improved toilet facilities and household wealth status were found to be associated with various conditions of household burden of malnutrition. Conclusions: The findings of this study reveal that, both double and triple burden of malnutrition is of public health concern in SSA, thus nutrition and health interventions in SSA must not be skewed towards addressing undernutrition only, but also address overweight/obesity and anaemia.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elizabeth Katana ◽  
Bob Omoda Amodan ◽  
Lilian Bulage ◽  
Alex R. Ario ◽  
Joseph Nelson Siewe Fodjo ◽  
...  

Abstract Background In March 2020, the World Health Organization (WHO) declared COVID-19 a pandemic. Many countries in Sub-Saharan Africa, Uganda inclusive, implemented lockdowns, curfew, banning of both private and public transport systems, and mass gatherings to minimize spread. Social control measures for COVID-19 are reported to increase violence and discrimination globally, including in Uganda as some may be difficult to implement resulting in the heavy deployment of law enforcement. Media reports indicated that cases of violence and discrimination had increased in Uganda’s communities following the lockdown. We estimated the incidence and factors associated with experiencing violence and discrimination among Ugandans during the COVID-19 lockdown to inform control and prevention measures. Methods In April 2020, we conducted a secondary analysis of cross-sectional data under the International Citizen Project (ICP) to assess adherence to public health measures and their impact on the COVID-19 outbreak in Uganda. We analyzed data on violence and discrimination from the ICP study. We performed descriptive statistics for all the participants’ characteristics and created a binary outcome variable called experiencing violence and/or discrimination. We performed logistic regression analysis to identify the factors associated with experiencing violence and discrimination. Results Of the 1726 ICP study participants, 1051 (58.8%) were males, 841 (48.7%) were currently living with a spouse or partner, and 376 (21.8%) had physically attended work for more than 3 days in the past week. Overall, 145 (8.4%) experienced any form of violence and/or discrimination by any perpetrator, and 46 (31.7%) of the 145 reported that it was perpetrated by a law enforcement officer. Factors associated with experiencing violence or discrimination were: being male (AOR = 1.60 CI:1.10–2.33), having attended work physically for more than 3 days in the past week (AOR = 1.52 CI:1.03–2.23), and inability to access social or essential health services since the epidemic started (AOR = 3.10 CI:2.14–4.50). Conclusion A substantial proportion of Ugandan residents experienced violence and/or discrimination during the COVID-19 lockdown, mostly perpetrated by law enforcement officers. We recommend mitigation of the collateral impact of lockdowns with interventions that focus on improving policing quality, ensuring continuity of essential services, and strengthening support systems for vulnerable groups including males.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tsegaye Gebremedhin ◽  
Demiss Mulatu Geberu ◽  
Asmamaw Atnafu

Abstract Background The burden of low coverage of exclusive breastfeeding (EBF) has a significant impact on the health of a newborn and also on the family and social economy in the long term. Even though the prevalence of EBF practices in Ethiopia is low, the practices in the pastoral communities, in particular, are significantly low and affected by individual and community-level factors. Besides, its adverse outcomes are mostly unrecognised. Therefore, this study aimed to assess the individual and community-level factors of low coverage of EBF practices in the emerging regions of Ethiopia. Methods In this analysis, data from 2016 Ethiopian Demographic and Health Survey (EDHS) were used. A two-stage stratified sampling technique was used to identify 1406 children aged 0 to 23 months in the emerging regions of Ethiopia. A multilevel mixed-effect binary logistic regression analysis was used to determine the individual and community level factors associated with exclusive breastfeeding practices. In the final model, variables with a p-value of < 0.05 and Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) were found to be statistically significant factors that affect exclusive breastfeeding practices. Results Overall, 17.6% (95% CI: 15.6–19.6) of the children aged 0 to 23 months have received exclusive breastfeeding. Employed mothers (AOR: 0.33, 95% CI: 0.21–0.53), richer household wealth status (AOR: 0.39, 95% CI: 0.16–0.96), mothers undecided to have more children (AOR: 2.29, 95% CI: 1.21–4.29), a child with a history of diarrhoea (AOR: 0.31, 95% CI: 0.16–0.61) were the individual-level factors, whereas Benishangul region (AOR: 2.63, 95% CI: 1.44–4.82) was the community-level factors associated with the exclusive breastfeeding practices. Conclusions Less than one-fifth of the mothers have practised exclusive breastfeeding in the emerging regions of Ethiopia. The individual-level factors such as mother’s employment status, household wealth status, desire for more children, presence of diarrhoea and community-level factors such as region have contributed to the low coverage of exclusive breastfeeding. Therefore, the federal and regional health bureaus and other implementers should emphasise to those emerging regions by creating awareness and strengthening the existing community-based health extension program to enhance exclusive breastfeeding practices.


Author(s):  
Muhammad Muzammil ◽  
Sameen Zafar ◽  
Shazia Aziz ◽  
Muhammad Usman Bhutta ◽  
Rafi Amir-Ud-Din

Poliomyelitis (polio) is a communicable viral disease that mainly affects under-5 children. This study focuses on the impact of women’s empowerment and women’s working status on the uptake of polio vaccination of children in polio-endemic countries, including Pakistan and Afghanistan, and Nigeria, the latter of which has recently been declared polio-free. The polio vaccination status can be divided into no vaccination (NV), incomplete vaccination (IV), and complete vaccination. We used data from the most recent Demographic and Health Surveys (DHS) rounds for this manuscript. Multinomial logistic regression-based estimates suggest that mothers’ working status, empowerment, age, education, father’s education, and household wealth status reduce the risk of NV and IV in the polio-endemic countries (Afghanistan and Pakistan) and Nigeria. In addition, the mothers’ working status, empowerment, age, education, and father’s education increase the child’s healthcare information that helps complete polio vaccination of the child. On the other hand, the children whose mothers work in the agriculture sector or are engaged in a blue-collar job are more likely to remain unvaccinated than women in white-collar jobs. Similarly, mothers engaged in government jobs are more likely to get their children fully vaccinated than unemployed mothers. Thus, as a child’s polio vaccination is strongly dependent on a mother’s working status and empowerment, the focus of public policy on empowering women and promoting their labor force participation may increase polio vaccination uptake, besides adopting other measures to increase immunization.


2019 ◽  
Vol 3 (12) ◽  
Author(s):  
Djibril M Ba ◽  
Paddy Ssentongo ◽  
Kristen H Kjerulff ◽  
Muzi Na ◽  
Guodong Liu ◽  
...  

ABSTRACT Background Iron deficiency anemia during pregnancy is a significant public health problem in sub-Saharan Africa (SSA) and is associated with serious adverse health outcomes. Although it is recommended that all women receive iron supplementation during pregnancy, little research has been conducted to measure overall compliance with this recommendation or variation across SSA countries. Objectives To assess prevalence and sociodemographic-economic factors associated with adherence to iron supplementation among pregnant women in SSA. Methods This was a weighted population-based cross-sectional study of 148,528 pregnant women aged 15–49 y in 22 SSA countries that participated in the Demographic and Health Surveys (DHS) in 2013–2018 and measured iron supplementation during pregnancy. Adherence to iron supplementation was defined as using iron supplementation for ≥90 d during pregnancy of the most recent birth. Results The overall prevalence of adherence to ≥90 d of iron supplementation during pregnancy was 28.7%, ranging from 1.4% in Burundi to 73.0% in Senegal. Factors associated with adherence included receiving ≥4 antenatal care visits [adjusted Prevalence Ratio (aPR): 25.73; 95% CI: 22.36, 29.60] compared with no antenatal visits; secondary or higher education (aPR: 1.17; 95% CI: 1.14, 1.19) compared with no education; wealthy (aPR: 1.13; 95% CI: 1.10, 1.16) compared with poor; and older women aged 35–49 y (aPR: 1.07; 95% CI: 1.05, 1.10) compared with younger women aged 15–24 y. Conclusions Adherence to iron supplementation during pregnancy in SSA is low and varies substantially across countries and in relation to factors such as number of antenatal visits, education, and level of family wealth. These results underscore the need for increased efforts to improve the uptake of iron supplementation for pregnant women in SSA.


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