scholarly journals Spatial patterns and inequalities in skilled birth attendance and caesarean delivery in sub-Saharan Africa

2021 ◽  
Vol 6 (10) ◽  
pp. e007074
Author(s):  
Firew Tekle Bobo ◽  
Augustine Asante ◽  
Mirkuzie Woldie ◽  
Angela Dawson ◽  
Andrew Hayen
Keyword(s):  
South Africa ◽  
Caesarean Section ◽  
Spatial Patterns ◽  
Caesarean Delivery ◽  
Skilled Birth Attendance ◽  
Health Facilities ◽  
Sub Saharan Africa ◽  
Skilled Attendant ◽  
Birth Attendance ◽  
Sub Saharan

BackgroundImproved access to and quality obstetric care in health facilities reduces maternal and neonatal morbidity and mortality. We examined spatial patterns, within-country wealth-related inequalities and predictors of inequality in skilled birth attendance and caesarean deliveries in sub-Saharan Africa.MethodsWe analysed the most recent Demographic and Health Survey data from 25 sub-Saharan African countries. We used the concentration index to measure within-country wealth-related inequality in skilled birth attendance and caesarean section. We fitted a multilevel Poisson regression model to identify predictors of inequality in having skilled attendant at birth and caesarean section.ResultsThe rate of skilled birth attendance ranged from 24.3% in Chad to 96.7% in South Africa. The overall coverage of caesarean delivery was 5.4% (95% CI 5.2% to 5.6%), ranging from 1.4% in Chad to 24.2% in South Africa. The overall wealth-related absolute inequality in having a skilled attendant at birth was extremely high, with a difference of 46.2 percentage points between the poorest quintile (44.4%) and the richest quintile (90.6%). In 10 out of 25 countries, the caesarean section rate was less than 1% among the poorest quintile, but the rate was more than 15% among the richest quintile in nine countries. Four or more antenatal care contacts, improved maternal education, higher household wealth status and frequently listening to the radio increased the rates of having skilled attendant at birth and caesarean section. Women who reside in rural areas and those who have to travel long distances to access health facilities were less likely to have skilled attendant at birth or caesarean section.ConclusionsThere were significant within-country wealth-related inequalities in having skilled attendant at birth and caesarean delivery. Efforts to improve access to birth at the facility should begin in areas with low coverage and directly consider the needs and experiences of vulnerable populations.

scholarly journals Skilled Birth Attendance among Women in Tharaka-Nithi County, Kenya

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
Eliphas Gitonga
Keyword(s):  
Family Income ◽  
Skilled Birth Attendance ◽  
Sub Saharan Africa ◽  
Systematic Sampling ◽  
Birth Preparedness ◽  
Cross Sectional Survey ◽  
Skilled Attendant ◽  
Chi Square ◽  
Cross Sectional ◽  
Birth Attendance

Background. The burden of maternal mortality is concentrated in sub-Saharan Africa with an estimation of 500 000 deaths annually. In 2012, about forty million births occurred without a skilled attendant in developing countries. Skilled birth attendance improves maternal and newborn survival. The aim of this study therefore was to establish the level of skilled birth attendance and the associated factors. Methods. A cross-sectional survey was carried out using structured questionnaires as tools of data collection. Systematic sampling was used to select the respondents from the facilities that were stratified. The dependent variable was skilled birth attendance. Descriptive statistics were used to generate proportions and percentages while chi-square and Fisher’s exact tests were used to draw inferences. Association was significant if P<0.05. Results. The level of utilisation of skilled birth attendance was 77%. Skilled birth attendance was noted to be associated with age, level of education, average family income, parity, distance to the health facility, timing of initiation of antenatal care, level of facility attended during pregnancy, and birth preparedness status. Conclusion. The level of skilled birth attendance among women in Tharaka-Nithi County, Kenya, despite being higher than in some counties, requires improvement.

scholarly journals Women empowerment and skilled birth attendance in sub-Saharan Africa: A multi-country analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254281
Author(s):  
Kwamena Sekyi Dickson ◽  
Kenneth Setorwu Adde ◽  
Edward Kwabena Ameyaw
Keyword(s):  
Urban Areas ◽  
Working Women ◽  
Skilled Birth Attendance ◽  
Sub Saharan Africa ◽  
Wife Beating ◽  
Demographic And Health Surveys ◽  
Women Empowerment ◽  
Maternal Deaths ◽  
Birth Attendance ◽  
Sub Saharan

Introduction In 2017, the highest global maternal deaths occurred in sub-Saharan Africa (SSA). The WHO advocates that maternal deaths can be mitigated with the assistance of skilled birth attendants (SBAs) at childbirth. Women empowerment is also acknowledged as an enabling factor to women’s functionality and healthcare utilisation including use of SBAs’ services. Consequently, this study investigated the association between women empowerment and skilled birth attendance in SSA. Materials and methods This study involved the analysis of secondary data from the Demographic and Health Surveys of 29 countries conducted between January 1, 2010, and December 3, 2018. For this study, only women who had given birth in the five years prior to the surveys were included, which is 166,022. At 95% confidence interval, Binary Logistic Regression analyses were conducted and findings were presented as adjusted odds ratios (aORs). Results The overall prevalence of skilled birth attendance was 63.0%, with the lowest prevalence in Tanzania (13.8%) and highest in Rwanda (91.2%). Women who were empowered with high level of knowledge (aOR = 1.60, 95% CI = 1.51, 1.71), high decision-making power (aOR = 1.19, 95% CI = 1.15, 1.23), and low acceptance of wife beating had higher likelihood of skill birth attendance after adjusting for socio-demographic characteristics. Women from rural areas had lesser likelihood (OR = 0.53, 95% CI = 0.51–0.55) of skilled birth attendance compared to women from urban areas. Working women had a lesser likelihood of skilled birth attendance (OR = 0.91, 95% CI = 0.88–0.94) as compared to those not working. Women with secondary (OR = 2.13, 95% CI = 2.03–2.22), or higher education (OR = 4.40, 95% CI = 3.81–5.07), and women in the richest wealth status (OR = 3.50, 95% CI = 3.29–3.73) had higher likelihood of skilled birth attendance. Conclusion These findings accentuate that going forward, successful skilled birth attendant interventions are the ones that can prioritise the empowerment of women.

scholarly journals Spatial patterns of child mortality in Nanoro HDSS site, Burkina Faso

2020 ◽  
Author(s):  
Navideh Noori ◽  
Karim Derra ◽  
Innocent Valea ◽  
Assaf P. Oron ◽  
Aminata Welgo ◽  
...  
Keyword(s):  
Burkina Faso ◽  
Child Mortality ◽  
Spatial Patterns ◽  
Health Facilities ◽  
Sub Saharan Africa ◽  
Wet Season ◽  
Inpatient Facility ◽  
Child Deaths ◽  
Sub Saharan ◽  
Geographical Accessibility

AbstractBackgroundHalf of global child deaths occur in sub-Saharan Africa. Understanding child mortality patterns and risk factors will help inform interventions to reduce this heavy toll. The Nanoro Health and Demographic Surveillance System (HDSS), Burkina Faso was described previously, but spatial patterns of child mortality in the district had not been studied. Similar studies in other districts indicated accessibility to health facilities as a risk factor, usually without distinction between facility types.MethodsUsing Nanoro HDSS data from 2009 to 2013, we estimated the association between under-5 mortality and accessibility to inpatient and outpatient health facilities, seasonality of death, and age group.ResultsLiving in homes 40-60 minutes and >60 minutes travel time from an inpatient facility was associated with 1.52 (95% CI: 1.13-2.06) and 1.74 (1.27-2.40) greater hazard of under-5 mortality, respectively, than living in homes <20 minutes from an inpatient facility. No such association was found for outpatient facilities. Seasonality of death was significantly associated with under-5 mortality, and the wet season (July-November) was associated with 1.28 (1.07, 1.53) higher under-5 mortality than the dry season (December-June), likely reflecting the malaria season.ConclusionsOur results emphasize the importance of geographical accessibility to health care, and also distinguish between inpatient and outpatient facilities.

scholarly journals Early age at first childbirth and skilled birth attendance during delivery among young women in sub-Saharan Africa

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Eugene Budu ◽  
Vijay Kumar Chattu ◽  
Bright Opoku Ahinkorah ◽  
Abdul-Aziz Seidu ◽  
Aliu Mohammed ◽  
...  
Keyword(s):  
Adolescent Mothers ◽  
Young Women ◽  
Skilled Birth Attendance ◽  
Sub Saharan Africa ◽  
Early Age ◽  
First Birth ◽  
African Countries ◽  
Skilled Assistance ◽  
Birth Attendance ◽  
Sub Saharan

Abstract Background Despite the numerous policy interventions targeted at preventing early age at first childbirth globally, the prevalence of adolescent childbirth remains high. Meanwhile, skilled birth attendance is considered essential in preventing childbirth-related complications and deaths among adolescent mothers. Therefore, we estimated the prevalence of early age at first childbirth and skilled birth attendance among young women in sub-Saharan Africa and investigated the association between them. Methods Demographic and Health Survey data of 29 sub-Saharan African countries was utilized. Skilled birth attendance and age at first birth were the outcome and the key explanatory variables in this study respectively. Overall, a total of 52,875 young women aged 20-24 years were included in our study. A multilevel binary logistic regression analysis was performed and the results presented as crude and adjusted odds ratios at 95% confidence interval. Results Approximately 73% of young women had their first birth when they were less than 20 years with Chad having the highest proportion (85.7%) and Rwanda recording the lowest (43.3%). The average proportion of those who had skilled assistance during delivery in the 29 sub-Saharan African countries was 75.3% and this ranged from 38.4% in Chad to 93.7% in Rwanda. Young women who had their first birth at the age of 20-24 were more likely to have skilled birth attendance during delivery (aOR = 2.4, CI = 2.24-2.53) than those who had their first birth before 20 years. Conclusion Early age at first childbirth has been found to be associated with low skilled assistance during delivery. These findings re-emphasize the need for sub-Saharan African countries to implement programs that will sensitize and encourage the patronage of skilled birth attendance among young women in order to reduce complications and maternal mortalities. The lower likelihood of skilled birth attendance among young women who had their first birth when they were adolescents could mean that this cohort of young women face some barriers in accessing maternal healthcare services.

scholarly journals Determinants of antenatal care and skilled birth attendance in sub‐Saharan Africa: A multilevel analysis

2019 ◽  
Vol 54 (5) ◽  
pp. 1110-1118
Author(s):  
Mulu Abraha Woldegiorgis ◽  
Janet Hiller ◽  
Wubegzier Mekonnen ◽  
Denny Meyer ◽  
Jahar Bhowmik
Keyword(s):  
Antenatal Care ◽  
Multilevel Analysis ◽  
Skilled Birth Attendance ◽  
Sub Saharan Africa ◽  
Birth Attendance ◽  
Sub Saharan

African Islam and Islam in Africa

2009 ◽  
Vol 26 (3) ◽  
pp. i-xi
Author(s):  
Ali A. Mazrui
Keyword(s):  
South Africa ◽  
Muslim World ◽  
Sub Saharan Africa ◽  
Black Africa ◽  
Sub Saharan ◽  
Definition Of

Sub-Saharan Africa is often regarded as part of the periphery, rather thanpart of the center, of the Muslim world. In the Abrahamic world, Africa isoften marginalized. But is there anything special about Islam’s relationshipwith Africa? Are there unique aspects of African Islam? Islam has exerted anenormous influence upon Africa and its peoples; but has Africa had anyimpact upon Islam? While the impressive range of articles presented in thisspecial issue do not directly address such questions, my short editorialattempts to put those articles within the context of Africa’s uniqueness in theannals of Islam. One note: Although these articles concentrate on sub-Saharan Africa (“Black Africa”), our definition of Africa encompasses thecontinent as a whole – from South Africa to Egypt, Angola to Algeria, andMozambique to Mauritania ...

scholarly journals HIV and cardiovascular disease in sub-Saharan Africa: Demographic and Health Survey data for 4 countries

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Leonard E. Egede ◽  
Rebekah J. Walker ◽  
Patricia Monroe ◽  
Joni S. Williams ◽  
Jennifer A. Campbell ◽  
...  
Keyword(s):  
South Africa ◽  
Cardiovascular Disease ◽  
Health Survey ◽  
Survey Design ◽  
Logistic Models ◽  
Population Data ◽  
Demographic And Health Survey ◽  
Sub Saharan Africa ◽  
Sub Saharan ◽  
The Relationship

Abstract Background Investigate the relationship between two common cardiovascular diseases and HIV in adults living in sub-Saharan Africa using population data provided through the Demographic and Health Survey. Methods Data for four sub-Saharan countries were used. All adults asked questions regarding diagnosis of HIV, diabetes, and hypertension were included in the sample totaling 5356 in Lesotho, 3294 in Namibia, 9917 in Senegal, and 1051 in South Africa. Logistic models were run for each country separately, with self-reported diabetes as the first outcome and self-reported hypertension as the second outcome and HIV status as the primary independent variable. Models were adjusted for age, gender, rural/urban residence and BMI. Complex survey design allowed weighting to the population. Results Prevalence of self-reported diabetes ranged from 3.8% in Namibia to 0.5% in Senegal. Prevalence of self-reported hypertension ranged from 22.9% in Namibia to 0.6% in Senegal. In unadjusted models, individuals with HIV in Lesotho were 2 times more likely to have self-reported diabetes (OR = 2.01, 95% CI 1.08–3.73), however the relationship lost significance after adjustment. Individuals with HIV were less likely to have self-reported diabetes after adjustment in Namibia (OR = 0.29, 95% CI 0.12–0.72) and less likely to have self-reported hypertension after adjustment in Lesotho (OR = 0.63, 95% CI 0.47–0.83). Relationships were not significant for Senegal or South Africa. Discussion HIV did not serve as a risk factor for self-reported cardiovascular disease in sub-Saharan Africa during the years included in this study. However, given the growing prevalence of diabetes and hypertension in the region, and the high prevalence of undiagnosed cardiovascular disease, it will be important to continue to track and monitor cardiovascular disease at the population level and in individuals with and without HIV. Conclusions The odds of self-reported diabetes in individuals with HIV was high in Lesotho and low in Namibia, while the odds of self-reported hypertension in individuals with HIV was low across all 4 countries included in this study. Programs are needed to target individuals that need to manage multiple diseases at once and should consider increasing access to cardiovascular disease management programs for older adults, individuals with high BMI, women, and those living in urban settings.

scholarly journals Relationships with caregivers and mental health outcomes among adolescents living with HIV: a prospective cohort study in South Africa

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yulia Shenderovich ◽  
Mark Boyes ◽  
Michelle Degli Esposti ◽  
Marisa Casale ◽  
Elona Toska ◽  
...  
Keyword(s):  
Mental Health ◽  
South Africa ◽  
Cohort Study ◽  
Mental Health Problems ◽  
Health Problems ◽  
Sub Saharan Africa ◽  
Depression Symptoms ◽  
Sub Saharan ◽  
Positive Caregiving ◽  
Living With Hiv

Abstract Background Mental health problems may impact adherence to anti-retroviral treatment, retention in care, and consequently the survival of adolescents living with HIV. The adolescent-caregiver relationship is an important potential source of resilience. However, there is a lack of longitudinal research in sub-Saharan Africa on which aspects of adolescent-caregiver relationships can promote mental health among adolescents living with HIV. We draw on a prospective longitudinal cohort study undertaken in South Africa to address this question. Methods The study traced adolescents aged 10–19 initiated on antiretroviral treatment in government health facilities (n = 53) within a health district of the Eastern Cape province. The adolescents completed standardised questionnaires during three data collection waves between 2014 and 2018. We used within-between multilevel regressions to examine the links between three aspects of adolescent-caregiver relationships (caregiver supervision, positive caregiving, and adolescent-caregiver communication) and adolescent mental health (depression symptoms and anxiety symptoms), controlling for potential confounders (age, sex, rural/urban residence, mode of infection, household resources), n=926 adolescents. Results Improvements in caregiver supervision were associated with reductions in anxiety (0.98, 95% CI 0.97–0.99, p=0.0002) but not depression symptoms (0.99, 95% CI 0.98–1.00, p=.151), while changes in positive caregiving were not associated with changes in mental health symptoms reported by adolescents. Improvements in adolescent-caregiver communication over time were associated with reductions in both depression (IRR=0.94, 95% CI 0.92–0.97, p<.0001) and anxiety (0.91, 95% CI 0.89–0.94, p<.0001) symptoms reported by adolescents. Conclusions Findings highlight open and supportive adolescent-caregiver communication and good caregiver supervision as potential factors for guarding against mental health problems among adolescents living with HIV in South Africa. Several evidence-informed parenting programmes aim to improve adolescent-caregiver communication and caregiver supervision, and their effect on depression and anxiety among adolescents living with HIV should be rigorously tested in sub-Saharan Africa. How to improve communication in other settings, such as schools and clinics, and provide communication support for caregivers, adolescents, and service providers through these existing services should also be considered.

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