Beyond counting intended pregnancies among young women to understanding their associated factors in sub-Saharan Africa

Abstract Background In this article we report the prevalence and determinants of intended or wanted pregnancies among young women 15–24 y of age in selected sub-Saharan African countries. Methods This cross-sectional study used pooled data from current Demographic and Health Surveys conducted between 1 January 2010 and 31 December 2019 in 29 countries in sub-Saharan Africa (SSA). The sample size comprised 14 257 young women (15–24 y of age). Multivariable binary logistic regression models were used to present the results as adjusted odds ratios. Results The prevalence of intended pregnancies was 67.7%, with the highest and lowest prevalence in Gambia (89.9%) and Namibia (37.7%), respectively. Intended pregnancy was lower among young women who had knowledge of modern contraceptives, those with a secondary/higher education and those with four or more births. Lower odds of intended pregnancy were observed among young women in the richer wealth quintile and those who lived in southern Africa. Conclusions To reduce intended pregnancies in sub-Saharan African countries such as Gambia, Burkina Faso and Nigeria, there is a need for government and non-governmental organisations to recalibrate current and past interventions such as investment in increasing formal education for women and poverty alleviation programmes, as well as augmenting job creation, including skill-building. These interventions have to be sensitive to the cultural realities of each setting, especially with regards to early marriages and womanhood.

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Birth registration and child undernutrition in sub-Saharan Africa

Public Health Nutrition ◽

10.1017/s136898001500333x ◽

2015 ◽

Vol 19 (10) ◽

pp. 1757-1767 ◽

Cited By ~ 11

Author(s):

Ornella Comandini ◽

Stefano Cabras ◽

Elisabetta Marini

Keyword(s):

Nutritional Status ◽

Permutation Test ◽

Negative Relationship ◽

Wealth Quintile ◽

Sub Saharan Africa ◽

Demographic And Health Surveys ◽

Birth Registration ◽

African Countries ◽

Cross Sectional ◽

Sub Saharan

AbstractObjectiveIn many countries of the world millions of people are not registered at birth. However, in order to assess children’s nutritional status it is necessary to have an exact knowledge of their age. In the present paper we discuss the effects of insufficient or imprecise age data on estimates of undernutrition prevalence.DesignBirth registration rates and levels of stunting, underweight and wasting were retrieved from Multiple Indicator Cluster Surveys and Demographic and Health Surveys of thirty-seven sub-Saharan African countries, considering the subdivision in wealth quintiles. The composition of the cross-sectional sample used for nutritional evaluation was analysed using a permutation test. Logistic regression was applied to analyse the relationship between birth registration and undernutrition. The 95 % probability intervals and Student’s t test were used to evaluate the effect of age bias and error.ResultsHeterogeneous sampling designs were detected among countries, with different percentages of children selected for anthropometry. Further, registered children were slightly more represented within samples used for nutritional analysis than in the total sample. A negative relationship between birth registration and undernutrition was recognized, with registered children showing a better nutritional status than unregistered ones, even within each wealth quintile. The over- or underestimation of undernutrition in the case of systematic over- or underestimation of age, respectively, the latter being more probable, was quantified up to 28 %. Age imprecision was shown to slightly overestimate undernutrition.ConclusionsSelection bias towards registered children and underestimation of children’s age can lead to an underestimation of the prevalence of undernutrition.

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Socio-economic and demographic predictors of unmet need for contraception among young women in sub-Saharan Africa: evidence from cross-sectional surveys

Reproductive Health ◽

10.1186/s12978-020-01018-2 ◽

2020 ◽

Vol 17 (1) ◽

Author(s):

Bright Opoku Ahinkorah ◽

Edward Kwabena Ameyaw ◽

Abdul-Aziz Seidu

Keyword(s):

Young Women ◽

Formal Education ◽

Economic Status ◽

Unmet Need ◽

Wealth Quintile ◽

Sub Saharan Africa ◽

African Countries ◽

Socio Economic Status ◽

Sub Saharan ◽

Unmet Need For Contraception

Abstract Introduction Globally, sub-Saharan Africa (SSA) bears the highest proportion of women with unmet need for contraception as nearly 25% of women of reproductive age in the sub-region have unmet need for contraception. Unmet need for contraception is predominant among young women. We examined the association between socio-economic and demographic factors and unmet need for contraception among young women in SSA. Methods Data for this study obtained from current Demographic and Health Surveys (DHS) conducted between January 1, 2010 and December 31, 2018 in 30 sub-Saharan African countries. The sample size consisted of young women (aged 15–24), who were either married or cohabiting and had complete cases on all the variables of interest (N = 59,864). Both bivariate and multivariable binary logistic regression analyses were performed using STATA version 14.0. Results The overall prevalence of unmet need for contraception among young women was 26.90% [95% CI: 23.82–29.921], ranging from 11.30% [95% CI: 5.1–17.49] in Zimbabwe to 46.7% [95% CI: 36.92–56.48] in Comoros. Results on socio-economic status and unmet need for contraception showed that young women who had primary [aOR = 1.18; CI = 1.12–1.25, p < 0.001] and secondary/higher levels of formal education [aOR = 1.27; CI = 1.20–1.35, p < 0.001] had higher odds of unmet need for contraception compared to those with no formal education. With wealth status, young women in the richest wealth quintile had lower odds of unmet need for contraception compared with those in the poorest wealth quintile [aOR = 0.89; CI = 0.81–0.97, p < 0.01]. With the demographic factors, the odds of unmet need for contraception was lower among young women aged 20–24 [aOR = 0.74; CI = 0.70–0.77, p < 0.001], compared with 15–19 aged young women. Also, young women who were cohabiting had higher odds of unmet need for contraception compared to those who were married [aOR = 1.35; CI = 1.28–1.43, p < 0.001]. Conclusion Our study has demonstrated that unmet need for contraception is relatively high among young women in SSA and this is associated with socio-economic status. Age, marital status, parity, occupation, sex of household head, and access to mass media (newspaper) are also associated with unmet need for contraception. It is therefore, prudent that organisations such as UNICEF and UNFPA and the Bill & Melinda Gates Foundation who have implemented policies and programmes on contraception meant towards reducing unmet need for contraception among women take these factors into consideration when designing interventions in sub-Saharan African countries to address the problem of high unmet need for contraception among young women.

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Mastalgia: Prevalence at a Sub-Saharan African Tertiary Hospital

Pain Research and Treatment ◽

10.1155/2014/972726 ◽

2014 ◽

Vol 2014 ◽

pp. 1-3

Author(s):

T. Makumbi ◽

M. Galukande ◽

A. Gakwaya

Keyword(s):

Tertiary Hospital ◽

Cross Sectional Study ◽

Sub Saharan Africa ◽

Western World ◽

African Countries ◽

Breast Clinic ◽

Cross Sectional ◽

Ethical Approval ◽

Sub Saharan ◽

Cyclical Mastalgia

Introduction. Mastalgia is a common breast condition among women referred to breast clinics worldwide. Whereas the prevalence is known in the Western world and Asia, the prevalence of the disease is unknown in many African countries. The aim of this study therefore was to determine the prevalence and describe factors associated with mastalgia among women attending a tertiary hospital in sub-Saharan Africa. Methods. A cross-sectional study was done in Kampala, Uganda. Mastalgia was defined as self-reported breast pain (unilateral or bilateral) for a period not less than two months. A pretested questionnaire was used to collect the data and statistical analysis was performed using SPSS version 11. Ethical approval was obtained. Results. Out of the 1048 women who presented to the breast clinic during the study period, 168 (16%) were diagnosed with mastalgia in the absence of breast cancer. Noncyclical and cyclical mastalgia were 22/168 (13%) and 5/168 (3%), respectively. The onset of noncyclical category as compared to the cyclical type of mastalgia was observed to manifest before 24 years of age (P=0.006). Conclusion. Mastalgia was a common condition among women in this sub-Saharan African setting as is elsewhere. The early onset mastalgia in this sub-Saharan African study requires further exploration for determination of its risk factors.

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Investigation of the Possible Moderators of Alcohol-Related Intimate Partner Violence in Sub-Saharan Africa

African Journal of Biology and Medical Research ◽

10.52589/ajbmr-oaebs2xl ◽

2021 ◽

Vol 4 (2) ◽

pp. 67-83

Author(s):

Ekpenyong M.S. ◽

Tawari E. P.2

Keyword(s):

Intimate Partner Violence ◽

Partner Violence ◽

Meta Analysis ◽

Intimate Partner ◽

Sub Saharan Africa ◽

Public Health Issue ◽

Demographic And Health Surveys ◽

African Countries ◽

Cross Sectional ◽

Sub Saharan

Alcohol-related intimate partner violence (IPV) is a serious public health issue which has attracted a lot of research and debates. While some studies have reported the relationship between alcohol and IPV to be linear, others have reported threshold effects. While some studies have found the link to be strong, others have reported it to be weak or to show no association. The aim of this study was to determine the possible moderators on the alcohol-IPV link in sub-Saharan Africa. For the quantitative study, secondary analysis and meta-analysis were used to analyze cross-sectional data from the demographic and health surveys of ten countries in sub-Saharan Africa (Burkina Faso, Ghana, Kenya, Liberia, Malawi, Nigeria, Sao Tome and Principe, Tanzania, Zambia, and Zimbabwe). Logistic regression analysis of possible moderators of the alcohol-IPV link was determined in ten sub-Saharan African countries. The nature of moderation was different among countries. The results of this study can be applied in planning country-specific and multi-faceted intervention programmes.

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Safer sex negotiation and parity among women in sub-Saharan Africa

Journal of Biosocial Science ◽

10.1017/s0021932021000651 ◽

2022 ◽

pp. 1-13

Author(s):

Collins Adu ◽

James Boadu Frimpong ◽

Aliu Mohammed ◽

Justice Kanor Tetteh ◽

Eugene Budu ◽

...

Keyword(s):

Safer Sex ◽

Household Head ◽

Wealth Quintile ◽

Reproductive Age ◽

Sub Saharan Africa ◽

Demographic And Health Surveys ◽

African Countries ◽

High Parity ◽

Significance Level ◽

Sub Saharan

Abstract Women’s ability to negotiate for safer sex has effects on their sexual and reproductive health. This study investigated the association between safer sex negotiation and parity among women in sub-Saharan Africa. The data were sourced from the Demographic and Health Surveys of 28 sub-Saharan African countries conducted from 2010 to 2019. A total of 215,397 women aged 15–49 were included in the study. Multilevel logistic analysis was conducted to examine the association between safer sex negotiation and parity among women in sub-Saharan Africa. The results were presented as adjusted odds ratios (aOR) and the significance level set at p<0.05. The overall prevalences of safer sex negotiation and high parity among women in sub-Saharan Africa were 82.7% and 52.1%, respectively. The prevalence of high parity ranged from 32.3% in Chad to 72.1% in Lesotho. The lowest prevalence of safer sex negotiation was in Chad (16.8%) while the highest prevalence was recorded in Rwanda (99.7%). Women who had the capacity to negotiate for safer sex were less likely to have high parity compared with those who had no capacity to negotiate for safer sex (aOR = 0.78, CI: 0.75–0.81). Other factors that were associated with high parity were age, educational level, marital status, exposure to media, contraceptive use, religion, wealth quintile, sex of household head, and place of residence. The study identified significant association between safer sex negotiation and high parity among women of reproductive age in sub-Saharan Africa. It is worth noting that women’s ability to negotiate for safer sex could reduce high parity among women in sub-Saharan Africa. Therefore, policies and programmes aimed at birth control or reducing high parity among women could be targeted at improving their capacity to negotiate for safer sex through education.

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Effects of deworming medication on anaemia among children aged 6–59 months in sub-Saharan Africa

Parasites & Vectors ◽

10.1186/s13071-021-05123-4 ◽

2022 ◽

Vol 15 (1) ◽

Author(s):

Andy Bauleni ◽

Fentanesh N. Tiruneh ◽

Tisungane E. Mwenyenkulu ◽

Owen Nkoka ◽

Gowokani C. Chirwa ◽

...

Keyword(s):

Cross Sectional Study ◽

Preschool Age ◽

Sub Saharan Africa ◽

Demographic And Health Surveys ◽

Cross Sectional ◽

Resource Limited ◽

Sub Saharan ◽

Using Data ◽

Hb Concentration ◽

Health Programmes

Abstract Background Despite the limited knowledge regarding the effects of deworming medication (DM) on nutritional indicators in sub-Saharan Africa (SSA), deworming programmes continue to be implemented in resource-limited countries. Therefore, the current study aimed to examine the effects of DM on anaemia among children aged 6–59 months in SSA. Methods The analysis was performed using data obtained from 17 demographic and health surveys (DHSs) conducted in SSA. Children were considered to be anaemic if their haemoglobin (Hb) concentration was less than 11.0 g/dl, adjusting for altitude. To account for both multiple measures at the cluster level and the clustering of children within the same country, generalized linear mixed models were used to analyse the anaemia outcomes in 50,075 children aged 6–59 months. Results Overall, anaemia was reported in 61.8% of the children, and their median Hb concentration was 10.5 g/dl (interquartile range 9.4–11.5). The prevalence of anaemia ranged from 34.5% in Rwanda to 81.1% in Mali. Multivariate analyses showed that children who did not receive DM had increased odds of being anaemic (adjusted odds ratio [aOR]: 1.11; 95% confidence interval [CI] 1.07–1.16). Conclusions The current study revealed that DM can decrease the risk of anaemia among preschool-age children (pre-SAC) in SSA. Thus, tailored public health programmes aimed at reducing childhood anaemia need to consider deworming. However, longitudinal studies are needed to validate the association that has been reported in this cross-sectional study. Graphical Abstract

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Maternal age at first childbirth and under-five morbidity in sub-Saharan Africa: analysis of cross-sectional data of 32 countries

Archives of Public Health ◽

10.1186/s13690-021-00674-5 ◽

2021 ◽

Vol 79 (1) ◽

Author(s):

Bright Opoku Ahinkorah

Keyword(s):

Maternal Age ◽

Cross Sectional Study ◽

Sub Saharan Africa ◽

Outcome Variable ◽

Demographic And Health Surveys ◽

Odds Ratios ◽

Cross Sectional ◽

Children Under Five ◽

Under Five ◽

Sub Saharan

Abstract Background The prevalence of childhood morbidity remains high in low-and middle-income countries, including sub-Saharan Africa (SSA). In this study, the association between maternal age at first childbirth and under-five morbidity in SSA was examined. Methods This was a cross-sectional study involving nationally-representative data from the most recent Demographic and Health Surveys conducted in 32 countries in SSA from 2010 to 2019. A sample size of 311,603 mothers of children under-five was considered. The outcome variable for this study was under-five morbidity. This variable was derived from the experience of fever, cough, and diarrhoea among children under-five. Both multilevel and binary logistic regression models were used to test the hypothesis that adolescent childbirth is associated with under-five morbidity. The results were presented as crude odds ratios (cORs) and adjusted odds ratios (aORs), with 95 % confidence intervals (CIs). Results Children born to mothers whose first childbirth occurred at < 20 years were 16 % times more likely to suffer from under-five morbidity, compared to those whose mothers’ first childbirth occurred at age ≥ 20 years [cOR = 1.16; CI = 1.13–1.19], and this persisted but with reduced odds after controlling for covariates [aOR = 1.10; CI = 1.07–1.12]. At the country level, children born to mothers whose first childbirth occurred at < 20 years were more likely to suffer from under-five morbidity, compared to those whose mothers’ first childbirth occurred at age ≥ 20 years in Angola, Burundi, Congo DR, Guinea, Kenya, and Uganda. Conclusions In this study, an association between adolescent childbirth and morbidity in children under five in SSA has been established. The study concludes that under-five morbidity is higher among children born to mothers whose first childbirth occurred before 20 years compared to those whose mothers’ first childbirth occurred at 20 years and above. The findings indicate that in order to reduce under-five morbidity, there is the need to deal with adolescent childbearing through cultural and social change, coupled with engagement of adolescents and stakeholders in adolescent sexual and reproductive health programmes.

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Factors Associated with Medication Nonadherence among Hypertensives in Ghana and Nigeria

International Journal of Hypertension ◽

10.1155/2015/205716 ◽

2015 ◽

Vol 2015 ◽

pp. 1-8 ◽

Cited By ~ 19

Author(s):

Vincent Boima ◽

Adebowale Dele Ademola ◽

Aina Olufemi Odusola ◽

Francis Agyekum ◽

Chibuike Eze Nwafor ◽

...

Keyword(s):

Formal Education ◽

Cross Sectional Study ◽

Sub Saharan Africa ◽

Medication Nonadherence ◽

College Hospital ◽

Cross Sectional ◽

Factors Associated ◽

Port Harcourt ◽

Modifiable Factor ◽

Sub Saharan

Background.Blood pressure (BP) control is poor among hypertensives in many parts of sub-Saharan Africa. A potentially modifiable factor for control of BP is medication nonadherence (MNA); our study therefore aimed to determine factors associated with MNA among hypertensives in Ghana and Nigeria.Methodology.We conducted a multicenter cross-sectional study. Patients were recruited from Korle-Bu Hospital (n=120), Ghana; and University of Port Harcourt Teaching Hospital, (n=73) Apapa General Hospital Lagos (n=79) and University College Hospital Ibadan (n=85), Nigeria.Results.357 hypertensive patients (42.6% males) participated. MNA was found in 66.7%. Adherence showed correlation with depression (r=-0.208,P<0.001), concern about medications (r=-0.0347,P=0.002), and knowledge of hypertension (r=0.14,P=0.006). MNA was associated with formal education (P=0.001) and use of herbal preparation (P=0.014). MNA was found in 61.7% of uninsured participants versus 73.1% of insured participants (P=0.032). Poor BP control was observed in 69.7% and there was significant association between MNA and poor BP control (P=0.006).Conclusion. MNA is high among hypertensives in Ghana and Nigeria and is associated with depression, concern about hypertensive medications, formal education, and use of herbal preparations. The negative association between health insurance and MNA suggests interplay of other factors and needs further investigation.

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Undernutrition, polygynous context and family structure: a multilevel analysis of cross-sectional surveys of 350 000 mother–child pairs from 32 countries

BMJ Global Health ◽

10.1136/bmjgh-2020-002637 ◽

2020 ◽

Vol 5 (10) ◽

pp. e002637

Author(s):

Seun Stephen Anjorin ◽

Olalekan A Uthman ◽

Edward Kwabena Ameyaw ◽

Bright Opoku Ahinkorah ◽

Vijay Kumar Chattu ◽

...

Keyword(s):

Health Outcomes ◽

Contextual Factors ◽

Positive Association ◽

Credible Interval ◽

Sub Saharan Africa ◽

Demographic And Health Surveys ◽

African Countries ◽

Cross Sectional ◽

Growth Reference ◽

Sub Saharan

BackgroundContextual factors, especially where people live, has been linked to various health outcomes, therefore, there is an increasing focus on its implication for policies and implementation of health interventions. Polygyny is a widespread practice in sub-Saharan Africa that also reflects socioeconomic and sociocultural features. This study investigated the association between polygynous context and risk of undernutrition.MethodsRecent Demographic and Health Surveys involving 350 000 mother–child pairs from 32 sub-Saharan African countries conducted between 2010 and 2018 as of March 2020, were analysed using relevant descriptive and 3-level multilevel logistic regression modelling. Undernutrition among under-5 was defined as underweight, stunting and wasting using the WHO Multicentre Growth Reference Study. Odd Ratio (OR) at 95% credible interval was used to report the associations.ResultsThe prevalence of contextual polygyny varied widely across the 32 sub-Saharan African countries, the lowest (0%) found in one of the regions in South Africa and the highest (52%) in one of the regions in Uganda. Underweight, stunting and wasting were lowest in Uganda (3.5%, 9.3%–1.27%, respectively), stunting was highest in Mozambique (37.1%) while wasting was highest in Niger (7.7%). Furthermore, the results showed that the contextual prevalence of polygynous practice exacerbates the risk of underweight (1.003 (0.997–1.008)) and wasting (1.014 (1.007–1.021)) among under-5 children, even when gender inequality and sociodemographic indicators were adjusted for. Polygyny was negatively associated with stunting though not significant; multiple births had the strongest and positive association with the risk of undernutrition among under-5 children in sub-Saharan Africa.ConclusionsThis study further corroborates the strong influence of contextual factors on health outcomes—which is undernutrition in this study. In addition to specific interventions aimed at reducing the prevalence of undernutrition, broader strategies that will address contextual issues are required.

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Early Marriage and Correlates among Young Women in Sub-Saharan African Countries

Journal of Asian and African Studies ◽

10.1177/0021909620966778 ◽

2020 ◽

pp. 002190962096677

Author(s):

Jacques M. Elengemoke ◽

A. Sathiya Susuman

Keyword(s):

Young Women ◽

Formal Education ◽

Basic Education ◽

Democratic Republic ◽

Democratic Republic Of Congo ◽

Sub Saharan Africa ◽

Early Marriage ◽

African Countries ◽

Sub Saharan ◽

Ssa Countries

Though several countries have adopted the sexual violence law which criminalizes child marriage, the practice of early marriage persists in Sub-Saharan Africa. This paper examined the socio-economic and demographic determinants of early marriage among young women in four Sub-Saharan African (SSA) countries, namely Niger, Democratic Republic of Congo, Mali and Malawi. Descriptive and multivariate analyses were performed to show that young women without formal education have 1.62, 1.59, 1.55 and 2.08 times more risk of early union than their secondary or higher educated counterparts. The study recommends the implementation of a universal, free and compulsory basic education in SSA countries.

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