Knowledge and use of lactational amenorrhea as a family planning method among adolescent mothers in Uganda: a secondary analysis of Demographic and Health Surveys between 2006 and 2016

Objective: To assess the level of knowledge and use of lactational amenorrhea method (LAM) among adolescents in Uganda between 2006 and 2016 using nationally representative data from Demographic and Health Surveys (DHS). Design: Cross-sectional design involving analysis of three DHS (2006, 2011, and 2016) in Uganda. Setting: The data was collected in Uganda. The DHS are nationally representative surveys on a wide range of indicators including contraception knowledge and use. Participants: A total of 8,250 adolescents (15-19 years) and 7,110 young women (20-24 years) were included. Primary outcome measure: Use of LAM among adolescents and young women with a livebirth within six months before each survey. Results: In 2016, less than 1% of eligible adolescents correctly used LAM and 56% were passively benefitting from LAM. The median duration of postpartum amenorrhea (PPA) among adolescents in 2016 was 6.9 months, declining from 8.3 months in 2006. Compared to adolescents, eligible young women had higher knowledge of LAM and higher medianPPA duration in 2016. The percentage of eligible adolescents who met the LAM criteria irrespective of whether they reported LAM use (protected by LAM) decreased from 76% in 2006 to 57% in 2016. More than 50% of eligible adolescents were aware of LAM in 2016, increasing from 6% in 2006, potentially in part due to change in survey question. Conclusion: Despite increasing awareness of LAM, reported and correct use of LAM was low among adolescents who could benefit from this method in Uganda, and declining over time. Support for adolescents to harness the benefits of correct LAM use should be increased. Additional research is needed to better understand the dynamics of LAM use in adolescents, including the transition to use of other modern contraceptive methods.

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Trends in the Prevalence of Overweight and Obesity and Associated Socioeconomic and Household Environmental Factors among Women in Nepal: Findings from the Nepal Demographic and Health Surveys

Obesities ◽

10.3390/obesities1020011 ◽

2021 ◽

Vol 1 (2) ◽

pp. 113-135

Author(s):

Kritika Rana ◽

Puspa Ghimire ◽

Romila Chimoriya ◽

Ritesh Chimoriya

Keyword(s):

Environmental Factors ◽

Health Surveys ◽

Wealth Index ◽

Educational Status ◽

Overweight And Obesity ◽

Demographic And Health Surveys ◽

Cross Sectional ◽

Logistic Regression Models ◽

Toilet Facility ◽

Nationally Representative

This study aimed to examine the trends in the prevalence of overweight and obesity and to determine the associated socioeconomic and household environmental factors among women in Nepal. Using nationally representative data from the 1996, 2001, 2006, 2011, and 2016 cross-sectional Nepal Demographic and Health Surveys (NDHSs) (n = 33,507), the prevalence of overweight–obesity (body mass index (BMI) ≥ 25 kg/m2) and obesity (BMI ≥ 30 kg/m2) among women aged 15–49 years were examined. From the latest NDHS 2016, non-pregnant women with recorded anthropometric measurements (n = 6165) were included in the final analyses. Multivariate logistic regression models were used to determine the socioeconomic and household environmental factors associated with BMI ≥ 25 and BMI ≥ 30. Between 1996 and 2016, the prevalence of overweight–obesity increased from 1.8% to 19.7%, while the prevalence of obesity increased from 0.2% to 4.1%. Age, marital status, wealth index, province of residence, type of cooking fuel, and household possessions—refrigerator and bicycle were significantly associated with having overweight–obesity and obesity. Similarly, educational status, religion, type of toilet facility, and household possessions—television and mobile phone were significantly associated with having overweight–obesity. Given the alarming increase in the prevalence of overweight and obesity among Nepalese women, there is an urgent need for interventions addressing these critical socioeconomic and household environmental factors.

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Levels and trends in family planning method use among urban adolescents and young women in Guinea: analysis of Demographic and Health Surveys from 1999 to 2018

10.21203/rs.3.rs-50093/v1 ◽

2020 ◽

Author(s):

Sidikiba Sidibe ◽

Alexandre Delamou ◽

Bienvenu Salim Camara ◽

Nafissatou Camara ◽

Hawa Manet ◽

...

Keyword(s):

Family Planning ◽

Ethnic Groups ◽

Young Women ◽

Health Surveys ◽

Urban Adolescents ◽

Contraceptive Use ◽

Unmet Need ◽

Health Concern ◽

Demographic And Health Surveys ◽

Modern Contraceptive

Abstract Background Despite improvements, adolescent fertility remains high in Africa. In Guinea, high fertility among adolescents and young women in urban areas remains a public health concern. This study aims to describe levels and trends in, and factors associated with using modern family planning (FP) methods among urban adolescents and young women in Guinea.Methods We used four Guinea Demographic and Health Surveys (DHS) conducted in 1999, 2005, 2012, and 2018. Among urban adolescents and young women (15–24 years), we examined trends over time in four key indicators: 1. Contraceptive use (% using any using any FP method among all and among those in need for FP), 2. Unmet need for FP (% not using any FP method among all and among those in need for FP) and 3.Modern contraceptive use (% of using modern FP methods and among those in need of FP), and 4. % using modern FP method (demand satisfied). We multivariable logistic regression to examine association between socio-demographic factors and modern FP use (indicator 2) on the most recent DHS dataset (2018).Results We found a statistically significant changes over the time period exmained in modern contracetive use (8.4% in 1999 to 12.8% in 2018, p < 0.01), demand satisfied (29.0% in 1999, 54.1% in 2018, p < 0.001), and halving of unmet need for FP (from 15.8% in 1999 to 8.6% in 2018, p < 0.001). The most important changes in these two indicators occurred between 1999 and 2005.. Compared to those 15–19 years, young women (20–24) more likely to use modern FP methods. Those living in Faranah and Kankan more likely to use modern FP method than those in Conakry. Middle and richer wealth quintile households were more likely to use modern FP compared to poorer. Married women compared to nevever married and those from the Peulh and Malinke ethnic groups compared to Soussou were less likely to use modern FP methods.Conclusion Despite some progress, efforts are still needed to improve FP method use among urban adolescent and you women. Future policies and intervention programs should emphasize on improving adolescents’ reproductive health knowledge and increasing awareness of FP method use. The focus should also be on adolescents aged 15–19 years, disparities of urban administrative regions, ethnic groups, and wealth index, especially the poor quintiles.

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Depends Who's Asking: Interviewer Effects in Demographic and Health Surveys Abortion Data

Demography ◽

10.1215/00703370-8937468 ◽

2021 ◽

Vol 58 (1) ◽

pp. 31-50

Author(s):

Tiziana Leone ◽

Laura Sochas ◽

Ernestina Coast

Keyword(s):

Health Surveys ◽

Demographic Data ◽

Demographic And Health Surveys ◽

Household Surveys ◽

Gender Based Violence ◽

Interviewer Effects ◽

Survey Questions ◽

Wide Range ◽

Nationally Representative ◽

The Impact

Abstract Responses to survey questions about abortion are affected by a wide range of factors, including stigma, fear, and cultural norms. However, we know little about how interviewers might affect responses to survey questions on abortion. The aim of this study is to assess how interviewers affect the probability of women reporting abortions in nationally representative household surveys: Demographic and Health Surveys (DHS). We use cross-classified random intercepts at the level of the interviewer and the sampling cluster in a Bayesian framework to analyze the impact of interviewers on the probability of reporting abortions in 22 DHS conducted worldwide. Household surveys are the only available data we can use to study the determinants and pathways of abortion in detail and in a representative manner. Our analyses are motivated by improving our understanding of the reliability of these data. Results show an interviewer effect accounting for between 0.2% and 50% of the variance in the odds of a woman reporting ever having had an abortion, after women's demographic characteristics are controlled for. In contrast, sampling cluster effects are much lower in magnitude. Our findings suggest the need for additional effort in assessing the causes of abortion underreporting in household surveys, including interviewers' skills and characteristics. This study also has important implications for improving the collection of other sensitive demographic data (e.g., gender-based violence and sexual health). Data quality of responses to sensitive questions could be improved with more attention to interviewers—their recruitment, training, and characteristics. Future analyses will need to account for the role of interviewer to more fully understand possible data biases.

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The Forgotten Agenda of Wasting in Southeast Asia: Burden, Determinants and Overlap with Stunting: A Review of Nationally Representative Cross-Sectional Demographic and Health Surveys in Six Countries

Nutrients ◽

10.3390/nu12020559 ◽

2020 ◽

Vol 12 (2) ◽

pp. 559 ◽

Cited By ~ 1

Author(s):

Mueni Mutunga ◽

Severine Frison ◽

Matteo Rava ◽

Paluku Bahwere

Keyword(s):

Public Health ◽

Southeast Asia ◽

Health Problem ◽

Health Surveys ◽

Public Health Problem ◽

Wealth Index ◽

Absolute Number ◽

Demographic And Health Surveys ◽

Cross Sectional ◽

Nationally Representative

Childhood wasting is among the most prevalent forms of undernutrition globally. The Southeast Asia region is home to many wasted children, but wasting is not recognized as a public health problem and its epidemiology is yet to be fully examined. This analysis aimed to determine the burden of wasting, its predictors, and the level of wasting and stunting concurrence. Datasets from Demographic and Health Surveys and Multiple Indicator Cluster Surveys in six countries in the region were analyzed. The pooled weighted prevalence for wasting and concurrent wasting and stunting among children 0–59 months in the six countries was 8.9%, 95% CI (8.0–9.9) and 1.6%, 95% CI (1.5–1.8), respectively. This prevalence is approximately 12-fold higher than the 0.7% prevalence of high-income countries; and translated into an absolute number of 1,088,747 children affected by wasting and 272,563 concurrent wasting and stunting. Wasting prevalence was 50 percent higher in the 0–23-month age group. Predictors for wasting included source of drinking water, wealth index, urban residence, child’s age and history of illness and mother’s body mass index. In conclusion, our analysis showed that wasting is a serious public health problem in the region that should be addressed urgently using both preventive and curative approaches.

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Trends in obesity by socioeconomic status among non-pregnant women aged 15–49 y: a cross-sectional, multi-dimensional equity analysis of demographic and health surveys in 11 sub-Saharan Africa countries, 1994–2015

International Health ◽

10.1093/inthealth/ihaa093 ◽

2020 ◽

Author(s):

Oghenebrume Wariri ◽

Jacob Albin Korem Alhassan ◽

Godwin Mark ◽

Oyinkansola Adesiyan ◽

Lori Hanson

Keyword(s):

Health Surveys ◽

Reproductive Age ◽

Sub Saharan Africa ◽

Demographic And Health Surveys ◽

Women Of Reproductive Age ◽

Or Education ◽

Cross Sectional ◽

Nationally Representative ◽

Sub Saharan ◽

Ssa Countries

Abstract Background Global obesity estimates show a steadily increasing pattern across socioeconomic and geographical divides, especially among women. Our analysis tracked and described obesity trends across multiple equity dimensions among women of reproductive age (15–49 y) in 11 sub-Saharan African (SSA) countries during 1994–2015. Methods This study consisted of a cross-sectional series analysis using nationally representative demographic and health surveys (DHS) data. The countries included were Cameroon, Comoros, Congo, Cote d'Ivoire, Ghana, Kenya, Lesotho, Nigeria, Senegal, Zambia and Zimbabwe. The data reported are from a reanalysis conducted using the WHO Health Equity Assessment Toolkit that assesses inter- and intra-country health inequalities across socioeconomic and geographical dimensions. We generated equiplots to display intra- and inter-country equity gaps. Results There was an increasing trend in obesity among women of reproductive age across all 11 SSA countries. Obesity increased unequally across wealth categories, place of residence and educational measures of inequality. The wealthiest, most educated and urban dwellers in most countries had a higher prevalence of obesity. However, in Comoros, obesity did not increase consistently with increasing wealth or education compared with other countries. The most educated and wealthiest women in Comoros had lower obesity rates compared with their less wealthy and less well-educated counterparts. Conclusion A window of opportunity is presented to governments to act structurally and at policy level to reduce obesity generally and prevent a greater burden on disadvantaged subpopulation groups in sub-Saharan Africa.

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Changes over time in HIV testing and counselling uptake and associated factors among youth in Zambia: a cross-sectional analysis of demographic and health surveys from 2007 to 2018

BMC Public Health ◽

10.1186/s12889-021-10472-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Aimé Bitakuya Heri ◽

Francesca L. Cavallaro ◽

Nurilign Ahmed ◽

Maurice Mubuyaeta Musheke ◽

Mitsuaki Matsui

Keyword(s):

Pregnant Women ◽

Hiv Testing ◽

Health Surveys ◽

Health Centre ◽

Demographic And Health Surveys ◽

Common Source ◽

Cross Sectional ◽

Government Health ◽

Hiv Testing And Counselling ◽

Testing Uptake

Abstract Introduction Zambia is among the countries with the highest HIV burden and where youth remain disproportionally affected. Access to HIV testing and counselling (HTC) is a crucial step to ensure the reduction of HIV transmission. This study examines the changes that occurred between 2007 and 2018 in access to HTC, inequities in testing uptake, and determinants of HTC uptake among youth. Methods We carried out repeated cross-sectional analyses using three Zambian Demographic and Health Surveys (2007, 2013–14, and 2018). We calculated the percentage of women and men ages 15–24 years old who were tested for HIV in the last 12 months. We analysed inequity in HTC coverage using indicators of absolute inequality. We performed bivariate and multivariate logistic regression analyses to identify predictors of HTC uptake in the last 12 months. Results HIV testing uptake increased between 2007 and 2018, from 45 to 92% among pregnant women, 10 to 58% among non-pregnant women, and from 10 to 49% among men. By 2018 roughly 60% of youth tested in the past 12 months used a government health centre. Mobile clinics were the second most common source reaching up to 32% among adolescent boys by 2018. Multivariate analysis conducted among men and non-pregnant women showed higher odds of testing among 20–24 year-olds than adolescents (aOR = 1.55 [95%CI:1.30–1.84], among men; and aOR = 1.74 [1.40–2.15] among women). Among men, being circumcised (aOR = 1.57 [1.32–1.88]) and in a union (aOR = 2.44 [1.83–3.25]) were associated with increased odds of testing. For women greater odds of testing were associated with higher levels of education (aOR = 6.97 [2.82–17.19]). Education-based inequity was considerably widened among women than men by 2018. Conclusion HTC uptake among Zambian youth improved considerably by 2018 and reached 65 and 49% tested in the last 12 months for women and men, respectively. However, achieving the goal of 95% envisioned by 2020 will require sustaining the success gained through government health centres, and scaling up the community-led approaches that have proven acceptable and effective in reaching young men and adolescent girls who are less easy to reach through the government facilities.

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Trends in stunting and overweight in Peruvian pre-schoolers from 1991 to 2011: findings from the Demographic and Health Surveys

Public Health Nutrition ◽

10.1017/s1368980014000275 ◽

2014 ◽

Vol 17 (11) ◽

pp. 2407-2418 ◽

Cited By ~ 16

Author(s):

Helga Bjørnøy Urke ◽

Maurice B Mittelmark ◽

Martín Valdivia

Keyword(s):

Urban Areas ◽

Health Surveys ◽

Maternal Education ◽

Wealth Quintile ◽

Household Wealth ◽

Demographic And Health Surveys ◽

Sampling Weights ◽

Cross Sectional ◽

Growth Standards ◽

Low Educated

AbstractObjectiveTo examine trends in stunting and overweight in Peruvian children, using 2006 WHO Multicentre Growth Reference Study criteria.DesignTrend analyses using nationally representative cross-sectional surveys from Demographic and Health Surveys (1991–2011). We performed logistic regression analyses of stunting and overweight trends in sociodemographic groups (sex, age, urban–rural residence, region, maternal education and household wealth), adjusted for sampling design effects (strata, clusters and sampling weights).SettingPeru.SubjectsChildren aged 0–59 months surveyed in 1991–92 (n 7999), 1996 (n 14 877), 2000 (n 11 754), 2007–08 (n 8232) and 2011 (n 8186).ResultsChild stunting declined (F(1, 5149) = 174·8, P ≤ 0·00) and child overweight was stable in the period 1991–2011 (F(1, 5147) = 0·4, P ≤ 0·54). Over the study period, levels of stunting were highest in rural compared with urban areas, the Andean and Amazon regions compared with the Coast, among children of low-educated mothers and among children living in households in the poorest wealth quintile. The trend in overweight rose among males in coastal areas (F(1, 2250) = 4·779, P ≤ 0·029) and among males in the richest wealth quintile (F(1, 1730) = 5·458, P ≤ 0·020).ConclusionsThe 2011 levels of stunting and overweight were eight times and three and a half times higher, respectively, than the expected levels from the 2006 WHO growth standards. The trend over the study period in stunting declined in most sociodemographic subgroups. The trend in overweight was stable in most sociodemographic subgroups.

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Is there a relationship between female genital mutilation/cutting and fistula? A statistical analysis using cross-sectional data from Demographic and Health Surveys in 10 sub-Saharan Africa countries

BMJ Open ◽

10.1136/bmjopen-2018-025355 ◽

2019 ◽

Vol 9 (7) ◽

pp. e025355 ◽

Cited By ~ 1

Author(s):

Dennis Juma Matanda ◽

Pooja Sripad ◽

Charity Ndwiga

Keyword(s):

Statistical Analysis ◽

Female Genital Mutilation ◽

Health Surveys ◽

Sub Saharan Africa ◽

Demographic And Health Surveys ◽

Common Belief ◽

Cross Sectional ◽

Genital Mutilation ◽

Sub Saharan ◽

Female Genital

ObjectivesLiterature on associations between female genital mutilation/cutting (FGM/C) and fistula points to a common belief that FGM/C predisposes women to developing fistula. This study explores this association using nationally representative survey data.DesignA secondary statistical analysis of cross-sectional data from Demographic and Health Surveys was conducted to explore the association between FGM/C and fistula.SettingSub-Saharan Africa.ParticipantsWomen aged 15–49 years in Burkina Faso (n=17 087), Chad (n=17 719), Côte d’Ivoire (n=10 060), Ethiopia (n=14 070), Guinea (n=9142), Kenya (n=31 079), Mali (n=10 424), Nigeria (n=33 385), Senegal (n=15 688) and Sierra Leone (n=16 658).Main outcome measuresFistula symptoms.ResultsMultivariate logit modelling using pooled data from 10 countries showed that the odds of reporting fistula symptoms were 1.5 times (CI 1.06 to 2.21) higher for women whose genitals were cut and sewn closed than those who had undergone other types of FGM/C. Women who attended antenatal care (ANC) (adjusted odds ratio (AOR) 0.51, CI 0.36 to 0.71) and those who lived in urban areas (AOR 0.62, CI 0.44 to 0.89) were less likely to report fistula symptoms than those who did not attend ANC or lived in rural areas.ConclusionsSevere forms of FGM/C (infibulation) may predispose women to fistula. Contextual and socioeconomic factors may increase the likelihood of fistula. Multisectoral interventions that concurrently address harmful traditional practices such as FGM/C and other contextual factors that drive the occurrence of fistula are warranted. Promotion of ANC utilisation could be a starting point in the prevention of fistulas.

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