scholarly journals Immediate postnatal care following childbirth in Ugandan health facilities: an analysis of Demographic and Health Surveys between 2001 and 2016

2021 ◽  
Vol 6 (4) ◽  
pp. e004230
Author(s):  
Teesta Dey ◽  
Sam Ononge ◽  
Andrew Weeks ◽  
Lenka Benova
Keyword(s):  
Postnatal Care ◽  
Health Surveys ◽  
Post Partum ◽  
Quality Care ◽  
Critical Time ◽  
Healthcare Facility ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Changes Over Time ◽  
Over Time

IntroductionProgress in reducing maternal and neonatal mortality, particularly in sub-Saharan Africa, is insufficient to achieve the Sustainable Developmental Goals by 2030. The first 24 hours following childbirth (immediate postnatal period), where the majority of morbidity and mortality occurs, is critical for mothers and babies. In Uganda,<50% of women reported receiving such care. This paper describes the coverage, changes over time and determinants of immediate postnatal care in Uganda after facility births between 2001 and 2016.MethodsWe analysed the 2006, 2011 and 2016 Ugandan Demographic and Health Surveys, including women 15–49 years with most recent live birth in a healthcare facility during the survey 5-year recall period. Immediate postnatal care coverage and changes over time were presented descriptively. Multivariable logistic regression was used to examine determinants of immediate postnatal care.ResultsData from 12 872 mothers were analysed. Between 2006 and 2016, births in healthcare facilities increased from 44.6% (95% CI: 41.9% to 47.3%) to 75.2% (95% CI: 73.4% to 77.0%) and coverage of immediate maternal postnatal care from 35.7% (95% CI 33.4% to 38.1%) to 65.0% (95% CI: 63.2% to 66.7%). The majority of first checks occurred between 1 and 4 hours post partum; the median time reduced from 4 hours to 1 hour. The most important factor associated with receipt of immediate postnatal care was women having a caesarean section birth adjusted OR (aOR) 2.93 (95% CI: 2.28 to 3.75). Other significant factors included exposure to mass media aOR 1.38 (95% CI: 1.15 to 1.65), baby being weighed at birth aOR 1.84 (95% CI: 1.58 to 2.14) and receipt of antenatal care with 4+Antenatal visits aOR 2.34 (95% CI: 1.50 to 3.64).ConclusionIn Uganda, a large gap in coverage remains and universal immediate postnatal care has not materialised through increasing facility-based births or longer length of stay. To ensure universal coverage of high-quality care during this critical time, we recommend that maternal and newborn services should be integrated and actively involve mothers and their partners.

scholarly journals National trends of childhood vaccination coverage in Bangladesh: Understanding gaps from 2011, 2014 and 2017-18 Demographic and Health Surveys data

2021 ◽  
Author(s):  
Satyajit Kundu ◽  
Subarna Kundu ◽  
Bright Opoku Ahinkorah ◽  
Abdul-Aziz Seidu ◽  
Joshua Okyere ◽  
...  
Keyword(s):  
Vaccination Coverage ◽  
Urban Areas ◽  
Health Surveys ◽  
Maternal Education ◽  
Vaccine Coverage ◽  
Immunization Coverage ◽  
Childhood Vaccination ◽  
Demographic And Health Surveys ◽  
Changes Over Time ◽  
Over Time

Abstract Background Vaccination is a safe and cost-effective strategy for protecting children from life-threatening diseases. This study aimed to investigate the changes over time in proportion of vaccination coverage across demographic subgroups in Bangladesh. Method Vaccination coverage for children 12–59 months of age was obtained from Bangladesh’s 2011, 2014, and 2017-18 Demographic and Health Surveys. Three multivariable binary logistic regression models with complete vaccination status at each survey data were used to generate adjusted odds ratios to uncover immunization variations across socio-demographic categories. Further, to detect potential geographic disparities, changes over time were analyzed at both the country and district levels. Findings Vaccination coverage grew from 88.1% in 2011 to 89.2% in 2017–2018, indicating a gap of more than ten percent for complete immunization coverage among children aged 12–59 months. Children aged 23–35 were more likely to have full vaccination compared to those aged 12–23 in 2011 (AOR = 1.6, 95% CI = 1.3–1.9), 2014 (AOR = 1.6, 95% CI = 1.3-2.0), and 2017-18 (AOR = 1.4, 95% CI = 1.1–1.7). The likelihood of full vaccination of children increased with maternal education with the highest odds among women with higher education in 2011 (AOR = 7.2, 95% CI = 4.0-12.9), 2014 (AOR = 4.0, 95% CI = 2.7–5.9), and 2017-18 (AOR = 5.8, 95% CI = 3.5–9.6) compared to those with no formal education. Children born to mothers who lived in urban areas were more likely to have full vaccination in 2011 (AOR = 1.5, 95% CI = 1.3–1.8), 2014 (AOR = 1.4, 95% CI = 1.2–1.7), and 2017-18 (AOR = 1.4, 95% CI = 1.1–1.7) compared to those who lived in rural areas. Children born to mothers who had at least 4 ANC visits were more likely to have full vaccination compared to those with less than 3 ANC visits in 2011 (AOR = 1.6, 95% CI = 1.2-2.0), 2014 (AOR = 1.5, 95% CI = 1.2-2.0), and 2017-18 (AOR = 1.6, 95% CI = 1.2–2.1 During these three surveys, Rangpur division had the highest vaccine coverage rate, while Sylhet division had the lowest vaccination coverage. Conclusion Although there was an improvement in these nationally representative surveys from 2011 to 2017-18, a portion of children still needs to be vaccinated to ensure full immunization coverage. To achieve 100% immunization coverage for all Bangladeshi children, policymakers must integrate vaccine programs with personalized health messaging and assurances of health safety for impoverished children and low-educated mothers. Increased institutional deliveries and prenatal care visits by mothers could assist increase their children's vaccination coverage.

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.

Changing sex differences in undernutrition of African children: findings from Demographic and Health Surveys

2021 ◽  
pp. 1-11
Author(s):  
Michel Garenne ◽  
Susan Thurstans ◽  
André Briend ◽  
Carmel Dolan ◽  
Tanya Khara ◽  
...  
Keyword(s):  
Sex Differences ◽  
Health Surveys ◽  
Sex Ratios ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Growth Charts ◽  
Sub Saharan ◽  
Male To Female ◽  
Height For Age ◽  
Weight For Age

Abstract The study investigates sex differences in the prevalence of undernutrition in sub-Saharan Africa. Undernutrition was defined by Z-scores using the CDC-2000 growth charts. Some 128 Demographic and Health Surveys (DHS) were analysed, totalling 700,114 children under-five. The results revealed a higher susceptibility of boys to undernutrition. Male-to-female ratios of prevalence averaged 1.18 for stunting (height-for-age Z-score <−2.0); 1.01 for wasting (weight-for-height Z-score <−2.0); 1.05 for underweight (weight-for-age Z-score <−2.0); and 1.29 for concurrent wasting and stunting (weight-for-height and height-for-age Z-scores <−2.0). Sex ratios of prevalence varied with age for stunting and concurrent wasting and stunting, with higher values for children age 0–23 months and lower values for children age 24–59 months. Sex ratios of prevalence tended to increase with declining level of mortality for stunting, underweight and concurrent wasting and stunting, but remained stable for wasting. Comparisons were made with other anthropometric reference sets (NCHS-1977 and WHO-2006), and the results were found to differ somewhat from those obtained with CDC-2000. Possible rationales for these patterns are discussed.

scholarly journals 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 ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e025355 ◽  
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.

The paradox of water accessibility: understanding the temporal and spatial dimensions of access to improved water sources in Rwanda

2015 ◽  
Vol 5 (4) ◽  
pp. 553-564 ◽  
Author(s):  
Lydia Osei ◽  
Jonathan Amoyaw ◽  
Godfred Odei Boateng ◽  
Sheila Boamah ◽  
Isaac Luginaah
Keyword(s):  
Drinking Water ◽  
Water Sources ◽  
Regional Disparities ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Logistic Regression Models ◽  
The People ◽  
Spatial Dimensions ◽  
Sub Saharan ◽  
Over Time

According to the United Nations, the world has met the Millennium Development Goal target of halving the proportion of people without access to safe drinking water. However, global figures mask massive disparities between regions and countries, and within countries. For instance, only 64% of the people in sub-Saharan Africa have access to improved water sources. Over 40% of all people globally who lack access to drinking water live in sub-Saharan Africa. Rwanda is used as a case in point in this study. Despite the abundance of water resources in the country, access to improved water sources is limited. Using the Rwandan Demographic and Health Surveys (2000–2010), we examined regional disparities in access to improved water sources. Results from logistic regression models show that overall, access to improved water has declined between 2000 and 2010; except in the western region, where access to water marginally improved. Educated individuals, wealthier and urban dwellers were more likely to have access to improved water sources over time compared to their uneducated, poor and rural counterparts. The persistence of regional disparities in access to improved water over time suggests the need for policy to address insufficient investments in water infrastructure in Rwanda.

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