SPOUSAL AGREEMENT ON PREFERRED WAITING TIME TO NEXT BIRTH IN SUB-SAHARAN AFRICA

2011 ◽  
Vol 43 (4) ◽  
pp. 385-400 ◽  
Author(s):  
TESFAYI GEBRESELASSIE ◽  
VINOD MISHRA
Keyword(s):  
Socioeconomic Factors ◽  
Waiting Time ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Wealth Status ◽  
Number Of Children ◽  
Spousal Communication ◽  
Sub Saharan ◽  
Living Children ◽  
Social Demographic

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.

scholarly journals Drivers of desire for more children among childbearing women in sub-Saharan Africa: implications for fertility control

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Bright Opoku Ahinkorah ◽  
Abdul-Aziz Seidu ◽  
Ebenezer Kwesi Armah-Ansah ◽  
Eugene Budu ◽  
Edward Kwabena Ameyaw ◽  
...  
Keyword(s):  
Higher Education ◽  
Fertility Control ◽  
Sub Saharan Africa ◽  
Outcome Variable ◽  
Demographic And Health Surveys ◽  
Number Of Children ◽  
Ideal Number ◽  
Sub Saharan ◽  
Living Children ◽  
Childbearing Women

Abstract Background Despite the extensive research on fertility desires among women the world over, there is a relative dearth of literature on the desire for more children in sub-Saharan Africa (SSA). This study, therefore, examined the desire for more children and its predictors among childbearing women in SSA. Methods We pooled data from 32 sub-Saharan African countries’ Demographic and Health Surveys. A total of 232,784 married and cohabiting women with birth history, who had complete information on desire for more children made up the sample for the study. The outcome variable for the study was desire for more children. Multilevel logistic regression analysis was conducted. Results were presented using adjusted odds ratios (aOR), with their corresponding 95% confidence intervals (CI). Results The overall prevalence of the desire for more children was 64.95%, ranging from 34.9% in South Africa to 89.43% in Niger. Results of the individual level predictors showed that women aged 45–49 [AOR = 0.04, CI = 0.03–0.05], those with higher education [AOR = 0.80, CI = 0.74–0.87], those whose partners had higher education [AOR = 0.88; CI = 0.83–0.94], women with four or more births [AOR = 0.10, CI = 0.09–0.11], those who were using contraceptives [AOR = 0.68, CI = 0.66–0.70] and those who had four or more living children [AOR = 0.09 CI = 0.07–0.12] were less likely to desire for more children. On the other hand, the odds of desire for more children was high among women who considered six or more children as the ideal number of children [AOR = 16.74, CI = 16.06–17.45] and women who did not take decisions alone [AOR = 1.58, CI = 1.51–1.65]. With the contextual factors, the odds of desire for more children was high among women who lived in rural areas compared to urban areas [AOR = 1.07, CI = 1.04–1.13]. Conclusions This study found relatively high prevalence of women desiring more children. The factors associated with desire for more children are age, educational level, partners’ education, parity, current contraceptive use, ideal number of children, decision-making capacity, number of living children and place of residence. Specific public health interventions on fertility control and those aiming to design and/or strengthen existing fertility programs in SSA ought to critically consider these factors.

scholarly journals Geographic variation and risk factors for teenage pregnancy in Uganda

2020 ◽  
Vol 20 (4) ◽  
pp. 1898-907
Author(s):  
Joseph Byonanebye ◽  
Ruta Brazauskas ◽  
Nazarius Tumwesigye ◽  
Staci Young ◽  
Thomas May ◽  
...  
Keyword(s):  
Risk Factors ◽  
Teenage Pregnancy ◽  
Sub Saharan Africa ◽  
Health Issue ◽  
Bivariate Analysis ◽  
Demographic And Health Surveys ◽  
Wealth Status ◽  
Pregnancy Risk ◽  
Global Health Issue ◽  
Sub Saharan

Background: Teenage pregnancy is a global health issue with high rates in sub-Saharan Africa. In Uganda, teenage pregnan- cy is a public and community health issue. Objectives: This study hypothesized that there would be regional variations in rates, risk factors and trends of teenage pregnancy in Uganda. Methods: Data were analyzed from the Uganda Demographic and Health Surveys (UDHS) in 2006 and 2011. The outcome of interest was current pregnancy for females 15 to 19 years of age at the time of the survey. Bivariate analysis was per- formed for each year to examine the rate and trends of pregnancy by various demographic characteristics. Logistic regres- sion was conducted to assess the association between teenage pregnancy and sociodemographic variables. Results: Uganda’s rate of teenage pregnancy increased from 7.3/1000 in 2006 to 8.1/1000 in 2011. The East Central region consistently had the highest rates than other regions. In 2006, teenage pregnancy was significantly associated with being mar- ried, living with a partner or separated, as compared to those who were single. Marital and wealth status were also significant predictors of teenage pregnancy based on the 2011 survey. Conclusion: The rate of teenage pregnancy in Uganda is high and the trend demonstrated regional variation. Future inter- ventions could focus on regions with high poverty and low education. Keywords: Teenage pregnancy; risk factors; Uganda demographic; health survey.

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

2021 ◽  
Vol 1 (10) ◽  
Author(s):  
Samuel H. Nyarko ◽  
Lloyd Potter
Keyword(s):  
Socioeconomic Factors ◽  
Household Wealth ◽  
Control Measures ◽  
Sub Saharan Africa ◽  
Female Adolescents ◽  
Demographic And Health Surveys ◽  
Wealth Status ◽  
Adolescent Childbearing ◽  
Factors Associated ◽  
Adolescent Fertility

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.

scholarly journals Impact of Orphanhood on Underweight Prevalence in Sub-Saharan Africa

2008 ◽  
Vol 29 (1) ◽  
pp. 32-42 ◽  
Author(s):  
Jonathan Rivers ◽  
John Mason ◽  
Eva Silvestre ◽  
Stuart Gillespie ◽  
Mary Mahy ◽  
...  
Keyword(s):  
Household Wealth ◽  
Household Structure ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Wealth Status ◽  
Orphan Status ◽  
Confounding Variables ◽  
Multiple Indicator ◽  
Sub Saharan ◽  
Child Nutritional Status

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.

scholarly journals Individual- and country-level correlates of female permanent contraception use in sub-Saharan Africa

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
Keyword(s):  
Household Wealth ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Modern Contraceptive ◽  
Contraceptive Methods ◽  
Factors Associated ◽  
Country Level ◽  
Permanent Contraception ◽  
Sub Saharan ◽  
Living Children

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.

scholarly journals Profiling Household Double and Triple Burden of Malnutrition in sub-Saharan Africa: Prevalence and Influencing Household Factors

2021 ◽  
pp. 1-32
Author(s):  
Aaron K. Christian ◽  
Fidelia A. A. Dake
Keyword(s):  
Household Head ◽  
Household Wealth ◽  
Overweight And Obesity ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
Health Concern ◽  
Demographic And Health Surveys ◽  
Wealth Status ◽  
Women And Children ◽  
Sub Saharan

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.

Interactions between ecological and socio-economic drivers of Buruli ulcer burden in Sub-Saharan Africa: opportunities for an improved control

2018 ◽  
Author(s):  
Andes Garchitorena ◽  
Matthew H. Bonds ◽  
Jean-Francois Guégan ◽  
Benjamin Roche
Keyword(s):  
Socioeconomic Factors ◽  
Disease Transmission ◽  
Access To Health Care ◽  
Buruli Ulcer ◽  
Mycobacterium Ulcerans ◽  
Sub Saharan Africa ◽  
Aquatic Environments ◽  
Human Populations ◽  
Complex Interactions ◽  
Sub Saharan

This chapter provides an overview of the complex interactions between ecological and socioeconomic factors for the development and control of Buruli ulcer in Sub-Saharan Africa. We review key ecological and evolutionary processes driving the environmental persistence and proliferation of Mycobacterium ulcerans, the causative agent, within aquatic environments, as well as transmission processes from these aquatic environments to human populations. We also outline key socioeconomic factors driving the economic and health burden of Buruli ulcer in endemic regions, revealed by reciprocal feedbacks between poverty, disease transmission from exposure aquatic environments and disease progression to severe stages owing to low access to health care. The implications of such insights for disease control, both in terms of limitations of current strategies and directions for the future, are discussed.

scholarly journals Decomposing the rural–urban gap in factors associated with childhood immunisation in sub-Saharan Africa: evidence from surveys in 23 countries

2021 ◽  
Vol 6 (1) ◽  
pp. e003773
Author(s):  
Edward Kwabena Ameyaw ◽  
Yusuf Olushola Kareem ◽  
Bright Opoku Ahinkorah ◽  
Abdul-Aziz Seidu ◽  
Sanni Yaya
Keyword(s):  
Decomposition Analysis ◽  
Household Wealth ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Childhood Immunisation ◽  
Urban Settings ◽  
Factors Associated ◽  
Rural And Urban ◽  
Full Immunisation ◽  
Sub Saharan

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.

scholarly journals Wealth-related inequalities in demand for family planning satisfied among married and unmarried adolescent girls and young women in sub-Saharan Africa

2021 ◽  
Vol 18 (S1) ◽  
Author(s):  
Martin K. Mutua ◽  
Yohannes D. Wado ◽  
Monica Malata ◽  
Caroline W. Kabiru ◽  
Elsie Akwara ◽  
...  
Keyword(s):  
Family Planning ◽  
West Africa ◽  
Adolescent Girls ◽  
Young Women ◽  
Rate Of Change ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Sexually Active ◽  
Sub Saharan ◽  
Over Time

Abstract Background The use of modern contraception has increased in much of sub-Saharan Africa (SSA). However, the extent to which changes have occurred across the wealth spectrum among adolescents is not well known. We examine poor-rich gaps in demand for family planning satisfied by modern methods (DFPSm) among sexually active adolescent girls and young women (AGYW) using data from national household surveys. Methods We used recent Demographic and Health Surveys and Multiple Indicator Cluster Surveys to describe levels of wealth-related inequalities in DFPSm among sexually active AGYW using an asset index as an indicator of wealth. Further, we used data from countries with more than one survey conducted from 2000 to assess DFPSm trends. We fitted linear models to estimate annual average rate of change (AARC) by country. We fitted random effects regression models to estimate regional AARC in DFPSm. All analysis were stratified by marital status. Results Overall, there was significant wealth-related disparities in DFPSm in West Africa only (17.8 percentage points (pp)) among married AGYW. The disparities were significant in 5 out of 10 countries in Eastern, 2 out of 6 in Central, and 7 out of 12 in West among married AGYW and in 2 out of 6 in Central and 2 out of 9 in West Africa among unmarried AGYW. Overall, DFPSm among married AGYW increased over time in both poorest (AARC = 1.6%, p < 0.001) and richest (AARC = 1.4%, p < 0.001) households and among unmarried AGYW from poorest households (AARC = 0.8%, p = 0.045). DPFSm increased over time among married and unmarried AGYW from poorest households in Eastern (AARC = 2.4%, p < 0.001) and Southern sub-regions (AARC = 2.1%, p = 0.030) respectively. Rwanda and Liberia had the largest increases in DPFSm among married AGYW from poorest (AARC = 5.2%, p < 0.001) and richest (AARC = 5.3%, p < 0.001) households respectively. There were decreasing DFPSm trends among both married (AARC = − 1.7%, p < 0.001) and unmarried (AARC = − 4.7%, p < 0.001) AGYW from poorest households in Mozambique. Conclusion Despite rapid improvements in DFPSm among married AGYW from the poorest households in many SSA countries there have been only modest reductions in wealth-related inequalities. Significant inequalities remain, especially among married AGYW. DFPSm stalled in most sub-regions among unmarried AGYW.

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