scholarly journals Trends and country-level variation in age at first sex in sub-Saharan Africa among birth cohorts entering adulthood between 1985 and 2020

2021 ◽  
Author(s):  
Van Kinh Nguyen ◽  
Jeffrey W Eaton
Keyword(s):  
Gender Gap ◽  
Sexual Debut ◽  
Random Effect Model ◽  
Sub Saharan Africa ◽  
Logistic Distribution ◽  
Birth Cohorts ◽  
First Sex ◽  
Sub Saharan ◽  
Ssa Countries ◽  
Over Time

Background: Debuting sexual intercourse is a life course event marking exposure to pregnancy or fatherhood, and sexually transmitted infections (STIs), including HIV. We systematically analysed the timing, distribution, and trends in age at first sex (AFS) in 42 sub-Saharan Africa (SSA) countries. Methods: We collated individual-level AFS data from nationally representative household surveys across SSA. We used a log-skew-logistic distribution to model the distribution of AFS in a Bayesian spatio-temporal hierarchical random-effect model to estimate national trends of AFS over time and space, adjusting for age at report biases. Findings: Small changes in AFS are observed between the birth cohorts entering adulthood between 1985 and 2020, ranging 0.79 years [-0.01-1.51] and 0.48 [-0.03-1.92] for female and male, respectively. Northern SSA countries show appreciable increase in AFS but its gender gap remains the widest compared with minimal gender gap in the southern countries. The gender gap shows little evidence of change over time in most of the countries. Female's AFS approach to a similar age across SSA while male's AFS varies between regions. Proportion ever had sex under fifteen and eighteen are as high 34% and 83%, respectively. AFS distribution is typically asymmetric with most of sexual debut events occur in a span of 3.9 [3.4-5.0] years. Female teen often reports higher AFS compare to their late twenties while male teen report lower AFS; both sexes tend to recall a higher AFS in older ages compared to their thirties. Interpretation: Women debut sexually earlier and in a shorter span of age than men. Northern and southern SSA gender gap are distinctively different. Since the ratifying of HIV/AIDS intervention programs in SSA, a stagnant trend in AFS had remained in the countries most affected by the epidemic.

scholarly journals A Multilevel Analysis of Risk and Protective Factors for Adolescent Childbearing in Malawi

2021 ◽  
Vol 10 (8) ◽  
pp. 303
Author(s):  
Jesman Chintsanya ◽  
Monica Magadi ◽  
Gloria Likupe
Keyword(s):  
Protective Factors ◽  
Teenage Pregnancy ◽  
Sexual Debut ◽  
Risk And Protective Factors ◽  
Sub Saharan Africa ◽  
Protective Effects ◽  
Teenage Childbearing ◽  
Never Married ◽  
Sub Saharan ◽  
Over Time

Although teenage pregnancy and childbearing has declined throughout sub-Saharan Africa, the recent increase in teenage pregnancy in countries such as Malawi has prompted interest from social researchers. Using Malawi Demographic and Health Survey (MDHS) data from 2004 to 2015, this study employs multilevel logistic regression to examine the magnitude of change over time in risk and protective factors for teenage childbearing. During this period, teenage childbearing declined from 36.1% (C.I.: 31.5–36.7) in 2004 to 25.6% (C.I.: 24.0–27.3) in 2010 before increasing to 29.0% (C.I.: 27.4–30.7) in 2015. Age and being married (compared to never married) were consistently significantly associated with increased odds of teenage childbearing. However, delaying sexual debut, attaining secondary education, belonging to the richest quintile and rural residence offered protective effects against early motherhood, while Muslim affiliation (compared to Christian denominations) was associated with increased likelihood of teenage childbearing among adolescents. Teenage childbearing remains high in the country, largely influenced by adolescents’ early sexual debut and child marriage—risk factors that have hardly changed over time. While individual socioeconomic predictors are useful in explaining the apparent high risk of adolescent fertility among specific subgroups in Malawi, sustained declines in teenage childbearing were not evident at district level.

Achieving Gender Equality and Women’s Empowerment in Sub-Saharan Africa: Lessons from the Experience of Selected Countries

2019 ◽  
Vol 35 (2) ◽  
pp. 256-281
Author(s):  
Theresa Moyo ◽  
Rogers Dhliwayo
Keyword(s):  
Sustainable Development ◽  
United Nations ◽  
Gender Equality ◽  
Gender Gap ◽  
Gender Disparities ◽  
Sub Saharan Africa ◽  
2030 Agenda ◽  
Women And Girls ◽  
Sub Saharan ◽  
Ssa Countries

Despite the progress that has been made towards achieving gender equality and the empowerment of women and girls in sub-Saharan Africa (SSA), evidence shows that gender disparities remain persistent in most countries. The aim of the article is to identify lessons from the experiences of those countries which have made considerable progress in bridging the gender gap. More specifically, the article seeks to identify strategies that will enable SSA countries to achieve the gender equality goal in the United Nations 2030 Agenda for Sustainable Development.

scholarly journals Thirty-year trends in the prevalence and severity of female genital mutilation: a comparison of 22 countries

2017 ◽  
Vol 2 (4) ◽  
pp. bmjgh-2017-000467 ◽  
Author(s):  
Alissa Koski ◽  
Jody Heymann
Keyword(s):  
Female Genital Mutilation ◽  
Household Survey ◽  
Well Being ◽  
Sub Saharan Africa ◽  
Birth Cohorts ◽  
Rigorous Evaluation ◽  
Genital Mutilation ◽  
Sub Saharan ◽  
Over Time ◽  
Female Genital

IntroductionFemale genital mutilation (FGM) harms women’s health and well-being and is widely considered a violation of human rights. The United Nations has called for elimination of the practice by 2030.MethodsWe used household survey data to measure trends in the prevalence of FGM in 22 countries. We also examined trends in the severity of the practice by measuring changes in the prevalence of flesh removal, infibulation and symbolic ‘nicking’ of the genitals. We evaluated the extent to which measurement error may have influenced our estimates by observing the consistency of reports for the same birth cohorts over successive survey waves.ResultsThe prevalence of all types of FGM fell in 17 of 22 countries we examined. The vast majority of women who undergo FGM have flesh removed from their genitals, likely corresponding to the partial or total removal of the clitoris and labia. Infibulation is still practised throughout much of sub-Saharan Africa. Its prevalence has declined in most countries, but in Chad, Mali and Sierra Leone the prevalence has increased by 2–8 percentage points over 30 years. Symbolic nicking of the genitals is relatively rare but becoming more common in Burkina Faso, Chad, Guinea and Mali.ConclusionFGM is becoming less common over time, but it remains a pervasive practice in some countries: more than half of women in 7 of the 22 countries we examined still experience FGM. The severity of the procedures has not changed substantially over time. Rigorous evaluation of interventions aimed at eliminating or reducing the harms associated with the practice is needed.

Breaking the Metal Ceiling

2018 ◽  
Author(s):  
Francisco Campos ◽  
Markus Goldstein ◽  
Laura McGorman ◽  
Ana Maria Munoz Boudet ◽  
Obert Pimhidzai
Keyword(s):  
Labour Market ◽  
Gender Gap ◽  
Role Models ◽  
Occupational Segregation ◽  
Gender Segregation ◽  
Sub Saharan Africa ◽  
Small Enterprises ◽  
Labour Market Participation ◽  
Female Labour Market Participation ◽  
Sub Saharan

Evidence from developed and developing countries indicates that there is significant gender segregation within the labour market, with women more likely to work in low-productivity sectors or less profitable businesses. This chapter looks at occupational segregation which significantly contributes to the earnings gender gap worldwide. The chapter studies the differences in outcomes for male and female enterprises and their sectors in sub-Saharan Africa, a region of high female labour market participation and entrepreneurship. Data on Uganda show that women breaking into male-dominated sectors make as much as men, and three times more than women staying in female-dominated sectors. Factors including entrepreneurial skill/abilities and credit/human capital constraints do not explain women’s sectoral choices. However, information about profitability of their small enterprises, male role models’ influence, and exposure to the sector from family and friends are critical in helping women circumvent or overcome norms undergirding occupational segregation.

scholarly journals A Review of Energy Communities in Sub-Saharan Africa as a Transition Pathway to Energy Democracy

2021 ◽  
Vol 13 (4) ◽  
pp. 2128
Author(s):  
Amollo Ambole ◽  
Kweku Koranteng ◽  
Peris Njoroge ◽  
Douglas Logedi Luhangala
Keyword(s):  
Stakeholder Engagement ◽  
Energy Systems ◽  
Sub Saharan Africa ◽  
Energy Access ◽  
Energy Projects ◽  
Global North ◽  
Sub Saharan ◽  
Energy Justice ◽  
Design Proposal ◽  
Ssa Countries

Energy communities have received considerable attention in the Global North, especially in Europe, due to their potential for achieving sustainable energy transitions. In Sub-Saharan Africa (SSA), energy communities have received less attention partly due to the nascent energy systems in many emerging SSA states. In this paper, we argue that these nascent energy systems offer an opportunity to co-create energy communities that can tackle the energy access challenges faced by most SSA countries. To understand how such energy communities are realised in the sub-region, we undertake a systematic review of research on energy communities in 46 SSA countries. Our findings show that only a few energy projects exhibit the conventional characteristics of energy communities; In most of these projects, local communities are inadequately resourced to institute and manage their own projects. We thus look to stakeholder engagement approaches to propose co-design as a strategy for strengthening energy communities in SSA. We further embed our co-design proposal in energy democracy thinking to argue that energy communities can be a pathway towards equity and energy justice in SSA. We conclude that energy communities can indeed contribute to improving energy access in Africa, but they need an enabling policy environment to foster their growth and sustainability.

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.

scholarly journals Contrasting Monetary and Multidimensional Poverty Measures in a Low-Income Sub-Saharan African Country

2020 ◽  
Vol 151 (2) ◽  
pp. 547-574 ◽  
Author(s):  
Lukas Salecker ◽  
Anar K. Ahmadov ◽  
Leyla Karimli
Keyword(s):  
Risk Factors ◽  
Low Income ◽  
Multidimensional Poverty ◽  
Poverty Measurement ◽  
Sub Saharan Africa ◽  
Analytical Strategy ◽  
Poverty Risk ◽  
Two Measures ◽  
Sub Saharan ◽  
Over Time

AbstractDespite significant progress in poverty measurement, few studies have undertaken an in-depth comparison of monetary and multidimensional measures in the context of low-income countries and fewer still in Sub-Saharan Africa. Yet the differences can be particularly consequential in these settings. We address this gap by applying a distinct analytical strategy to the case of Rwanda. Using data from two waves of the Rwandan Integrated Household Living Conditions Survey, we combine comparing poverty rates cross-sectionally and over time, examining the overlaps and differences in the two measures, investigating poverty rates within population sub-groups, and estimating several statistical models to assess the differences between the two measures in identifying poverty risk factors. We find that using a monetary measure alone does not capture high incidence of multidimensional poverty in both waves, that it is possible to be multidimensional poor without being monetary poor, and that using a monetary measure alone overlooks significant change in multidimensional poverty over time. The two measures also differ in which poverty risk factors they put emphasis on. Relying only on monetary measures in low-income sub-Saharan Africa can send inaccurate signals to policymakers regarding the optimal design of social policies as well as monitoring their effectiveness.

scholarly journals Household structure, maternal characteristics and children’s stunting in sub-Saharan Africa: evidence from 35 countries

2020 ◽  
Author(s):  
Sanni Yaya ◽  
Olanrewaju Oladimeji ◽  
Emmanuel Kolawole Odusina ◽  
Ghose Bishwajit
Keyword(s):  
Birth Interval ◽  
Household Wealth ◽  
Household Structure ◽  
Sub Saharan Africa ◽  
Physical Growth ◽  
Multiple Birth ◽  
Rural Children ◽  
Sub Saharan ◽  
Ssa Countries ◽  
Childhood Stunting

Abstract Background Adequate nutrition in early childhood is a necessity to achieve healthy growth and development, as well as a strong immune system and good cognitive development. The period from conception to infancy is especially vital for optimal physical growth, health and development. In this study we examined the influence of household structure on stunting in children &lt;5 yrs of age in sub-Saharan Africa (SSA) countries. Methods Demographic and Health Survey data from birth histories in 35 SSA countries were used in this study. The total sample of children born within the 5 yrs before the surveys (2008 and 2018) was 384 928. Children whose height-for-age z-score throughout was &lt;−2 SDs from the median of the WHO reference population were considered stunted. Percentages and χ2 tests were used to explore prevalence and bivariate associations of stunting. In addition, a multivariable logistic regression model was fitted to stunted children. All statistical tests were conducted at a p&lt;0.05 level of significance. Results More than one-third of children in SSA countries were reportedly stunted. The leading countries include Burundi (55.9%), Madagascar (50.1%), Niger (43.9%) and the Democratic Republic of the Congo (42.7%). The percentage of stunted children was higher among males than females and among rural children than their urban counterparts in SSA countries. Children from polygamous families and from mothers who had been in multiple unions had a 5% increase in stunting compared with children from monogamous families and mothers who had only one union (AOR 1.05 [95% CI 1.02 to 1.09]). Furthermore, rural children were 1.23 times as likely to be stunted compared with urban children (AOR 1.23 [95% CI 1.16 to 1.29]). Children having a &lt;24-mo preceding birth interval were 1.32 times as likely to be stunted compared with first births (AOR 1.32 [95% CI 1.26 to 1.38]). In addition, there was a 2% increase in stunted children for every unit increase in the age (mo) of children (AOR 1.02 [95% CI 1.01 to 1.02]). Multiple-birth children were 2.09 times as likely to be stunted compared with a singleton (AOR 2.09 [95% CI 1.91 to 2.28]). Conclusions The study revealed that more than one-third of children were stunted in SSA countries. Risk factors for childhood stunting were also identified. Effective interventions targeting factors associated with childhood stunting, such as maternal education, advanced maternal age, male sex, child’s age, longer birth interval, multiple-birth polygamy, improved household wealth and history of mothers’ involvement in multiple unions, are required to reduce childhood stunting in the region.

scholarly journals Non-prescription dispensing of antibiotic agents among community drug retail outlets in Sub-Saharan African countries: a systematic review and meta-analysis

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Sewunet Admasu Belachew ◽  
Lisa Hall ◽  
Linda A. Selvey
Keyword(s):  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Acute Diarrhoea ◽  
Upper Respiratory Tract ◽  
Cross Sectional ◽  
Retail Outlets ◽  
Sub Saharan ◽  
Tract Infections ◽  
Ssa Countries

Abstract Background The development of antimicrobial resistance, which is partially attributable to the overuse and/or misuse of antibiotics in health care, is one of the greatest global public health challenges. In Sub-Saharan African (SSA) countries, non-prescribed dispensing of antibiotics in community drug retail outlets (CDROs) has been flagged as one of the contributing factors for the widespread misuse of antibiotics in the community. Objective The current review aimed to estimate the proportion of non-prescription antibiotics requests or consultations that resulted in provision of antibiotics without a valid prescription among CDROs in SSA region, and describe the type of antibiotics dispensed. Methods A literature search was conducted using PubMed, CINAHL, Scopus and Google Scholar. We also searched reference lists of relevant articles. Random effect model meta-analysis was employed to determine the pooled proportion of over the counter sale of antibiotics. Subgroup and meta-regression was undertaken to explore the potential cause of heterogeneity in effect size across studies. Results Of 671 total citations retrieved, 23 met the inclusion criteria (seven cross-sectional questionnaire-based surveys and 16 cross-sectional client-based studies). The overall pooled proportion of non-prescription antibiotics requests or consultations that resulted in supply of antibiotics without prescription was 69% (95% CI 58–80). Upper respiratory tract infections and/or acute diarrhoea were the most frequently presented case scenarios, and amoxicillin and co-trimoxazole were the most frequently dispensed antibiotics to treat those symptoms. Conclusions Non-prescribed dispensing of antibiotics was found to be a common practice among CDROs in several SSA countries. Ease of access to and overuse of antibiotics can potentially accelerate the emergence of resistance to antibiotics available in the region. Our review highlights the need for a stringent enforcement of existing policies and/or enacting new regulatory frameworks that would regulate antibiotic supply, and training and educational support for pharmacy personnel (e.g. pharmacists, pharmacy assistants) regarding judicious use of antibiotics and the importance of antimicrobial stewardship.

Preconception Care in Sub Saharan Africa: A Systematic Review and Meta-analysis on Prevalence and Its Correlation With Knowledge Level Among Women in Reproductive Age Group

2021 ◽  
Author(s):  
Demelash Woldeyohannes ◽  
Yohannes Tekalegn ◽  
Biniyam Sahiledengle ◽  
Desta Erkalo ◽  
Zeleke Hailemariam ◽  
...  
Keyword(s):  
Preconception Care ◽  
Meta Analysis ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
Good Knowledge ◽  
Age Group ◽  
Knowledge Level ◽  
Sub Saharan ◽  
Ssa Countries ◽  
Reproductive Age Group

Abstract BackgroundThe aim of the preconception care (PCC) is to promote the health of women in the reproductive age before the conception in order to reduce preventable poor pregnancy outcomes. Although there are several published primary studies from Sub Saharan African (SSA) countries on PCC, they do not quantify the extent of PCC Utilisation, Knowledge level about PCC and the association between them among women in the reproductive age group in this region. This systematic review and meta-analysis aimed to estimate the pooled utilisation of PCC, Pooled knowledge level about PCC and their association among women in the reproductive age group in Sub Saharan Africa.MethodsDatabases including PubMed, Science Direct, Hinari, Google Scholar and Cochrane library were systematically searched for literature. Additionally, the references of appended articles were checked for further possible sources. The Cochrane Q test statistics and I2 tests were used to assess the heterogeneity of the included studies. A random-effect meta-analysis model was used to estimate pooled the prevalence of PCC, knowledge level of PCC and their correlation among reproductive aged women in Sub-Saharan African countries.ResultsOf the identified 1593 articles, 20 studies were included in the final analysis. The pooled utilisation of PCC and good knowledge level towards PCC among women of reproductive age group in Sub Saharan Africa were found to be 24.05% (95% CI: 16.61, 31.49) and 33.27% (95% CI: 24.78, 41.77), respectively. Women in the reproductive age group with good knowledge level were two times more likely to utilize the PCC than the women with poor knowledge level in Sub Saharan Africa (OR: 2.35, 95% CI: 1.16, 4.76). ConclusionIn SSA Countries, the utilisation of PCC and knowledge towards PCC were low. Additionally, the current meta-analysis found good knowledge level to be significantly associated with utilisation of PCC among women in the reproductive age. These findings indicate that, it is imperative to launch programs to uplift knowledge level about PCC utilisation among women in reproductive age group in SSA countries.

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