scholarly journals Relationship between socioeconomic status and HIV infection: findings from a survey in the Free State and Western Cape Provinces of South Africa

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e016232 ◽  
Author(s):  
Erick Wekesa Bunyasi ◽  
David John Coetzee
Keyword(s):  
South Africa ◽  
Socioeconomic Status ◽  
Hiv Infection ◽  
Formal Education ◽  
Household Wealth ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
Free State ◽  
Western Cape ◽  
Women Of Reproductive Age

BackgroundStudies have shown a mixed association between socioeconomic status (SES) and prevalent HIV infection across and within settings in sub-Saharan Africa. In general, the relationship between years of formal education and HIV infection changed from a positive to a negative association with maturity of the HIV epidemic. Our objective was to determine the association between SES and HIV in women of reproductive age in the Free State (FSP) and Western Cape Provinces (WCP) of South Africa (SA).Study designCross-sectional.SettingSA.MethodsWe conducted secondary analysis on 1906 women of reproductive age from a 2007 to 2008 survey that evaluated effectiveness of Prevention of Mother-to-Child HIV Transmission Programmes. SES was measured by household wealth quintiles, years of formal education and employment status. Our analysis principally used logistic regression for survey data.ResultsThere was a significant negative trend between prevalent HIV infection and wealth quintile in WCP (P<0.001) and FSP (P=0.025). In adjusted analysis, every additional year of formal education was associated with a 10% (adjusted OR (aOR) 0.90 (95% CI 0.85 to 0.96)) significant reduction in risk of prevalent HIV infection in WCP but no significant association was observed in FSP (aOR 0.99; 95% CI 0.89 to 1.11). There was no significant association between employment and prevalent HIV in each province: (aOR 1.54; 95% CI 0.84 to 2.84) in WCP and (aOR 0.96; 95% CI 0.71 to 1.30) in FSP.ConclusionThe association between HIV infection and SES differed by province and by measure of SES and underscores the disproportionately higher burden of prevalent HIV infection among poorer and lowly educated women. Our findings suggest the need for re-evaluation of whether current HIV prevention efforts meet needs of the least educated (in WCP) and the poorest women (both WCP and FSP), and point to the need to investigate additional or tailored strategies for these women.

scholarly journals Prevalence and determinants of cervical cancer awareness among women of reproductive age: evidence from Benin and Zimbabwe population-based data

2020 ◽  
Vol 40 (1) ◽  
Author(s):  
Amadou Barrow ◽  
Adeyinka Onikan ◽  
Chimezie Igwegbe Nzoputam ◽  
Michael Ekholuenetale
Keyword(s):  
Cervical Cancer ◽  
Health Survey ◽  
Household Wealth ◽  
Population Based ◽  
Demographic And Health Survey ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
Women Of Reproductive Age ◽  
Incidence And Mortality ◽  
Sub Saharan

Abstract Background Cervical cancer is a prominently diagnosed form of cancer in several resource-constrained settings particularly within the sub-Saharan African region. Globally, Africa region has the highest incidence and mortality rates of cervical cancer. The high prevalence has been attributed to several factors including lack of awareness of the disease. The aim of this paper is to explore the prevalence and factors associated with awareness of cervical cancer among women of reproductive age in Republic of Benin and Zimbabwe, sub-Saharan Africa. Methods We used population-based cross-sectional data from Benin Demographic and Health Survey (BDHS) and Zimbabwe Demographic and Health Survey (ZDHS) respectively. BDHS 2017–18 and ZDHS - 2015 are the 5th and 6th rounds of the surveys respectively. About 15,928 and 9955 women aged 15–49 years were included in this study respectively. The awareness of cervical cancer among women of reproductive age in Benin and Zimbabwe was measured dichotomously; yes (if a woman heard of cervical cancer) vs. no (if a woman has not heard of cervical cancer). All significant variables from the bivariate analysis were included in the multivariable logistic regression model to calculate the adjusted odds ratios (AOR) with corresponding 95% confidence interval. Results While majority (79.2%) of women from Zimbabwe have heard about cervical cancer, only about one-tenth (10.2%) of their Beninese counterparts have heard about the disease. Advanced maternal age, having formal education, use of internet, having professional/technical/managerial occupation significantly increased the odds of awareness of cervical cancer after adjusting for other confounders. However, in Benin, women who resided in the rural area and those of Islamic belief had 20% (AOR = 0.80; 95%CI: 0.64, 0.99) and 35% (AOR = 0.65; 95%CI: 0.50, 0.86) reduction in the odds of awareness of cervical cancer respectively, when compared with women from urban residence and Christianity. Results from the predictive marginal effects showed that, assuming the distribution of all factors remained the same among women, but every woman is an urban dweller, we would expect 11.0 and 81.0% level of awareness of cervical cancer; If everywoman had higher education, we would expect 20.0 and 90% level of awareness of cervical cancer and if instead the distribution of other maternal factors were as observed and other covariates remained the same among women, but all women were in the richest household wealth quintile, we would expect about 11.0 and 83.0% level of awareness of cervical cancer, among women of reproductive age from Benin and Zimbabwe respectively. Conclusion The study has revealed that socio-demographical factors including geographical location and selected economic factors explained the inequality in distribution of women’s awareness on cervical cancer in both countries. Designing an effective population-based health education and promotion intervention programs on cervical cancer will be a great way forward to improving women’s awareness level on cervical cancer.

scholarly journals Mixed effects analysis of factors associated with health insurance coverage among women in sub-Saharan Africa

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248411
Author(s):  
Hubert Amu ◽  
Abdul-Aziz Seidu ◽  
Ebenezer Agbaglo ◽  
Robert Kokou Dowou ◽  
Edward Kwabena Ameyaw ◽  
...  
Keyword(s):  
Health Insurance ◽  
Formal Education ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
Health Coverage ◽  
Women Of Reproductive Age ◽  
African Countries ◽  
Sub Saharan

Introduction In the pursuit of achieving the Sustainable Development Goal targets of universal health coverage and reducing maternal mortality, many countries in sub-Saharan Africa have implemented health insurance policies over the last two decades. Given that there is a paucity of empirical literature at the sub-regional level, we examined the prevalence and factors associated with health insurance coverage among women in in sub-Saharan Africa. Materials and methods We analysed cross-sectional data of 307,611 reproductive-aged women from the most recent demographic and health surveys of 24 sub-Saharan African countries. Bivariable and multivariable analyses were performed using chi-square test of independence and multi-level logistic regression respectively. Results are presented as adjusted Odds Ratios (aOR) for the multilevel logistic regression analysis. Statistical significance was set at p<0.05. Results The overall coverage of health insurance was 8.5%, with cross-country variations. The lowest coverage was recorded in Chad (0.9%) and the highest in Ghana (62.4%). Individual-level factors significantly associated with health insurance coverage included age, place of residence, level of formal education, frequency of reading newspaper/magazine and watching television. Wealth status and place of residence were the contextual factors significantly associated with health insurance coverage. Women with no formal education were 78% less likely to be covered by health insurance (aOR = 0.22, 95% CI = 0.21–0.24), compared with those who had higher education. Urban women, however, had higher odds of being covered by health insurance, compared with those in the rural areas [aOR = 1.20, 95%CI = 1.15–1.25]. Conclusion We found an overall relatively low prevalence of health insurance coverage among women of reproductive age in sub-Saharan Africa. As sub-Saharan African countries work toward achieving the Sustainable Development Goal targets of universal health coverage and lowering maternal mortality to less than 70 deaths per 100,000 live births, it is important that countries with low coverage of health insurance among women of reproductive age integrate measures such as free maternal healthcare into their respective development plans. Interventions aimed at expanding health insurance coverage should be directed at younger women of reproductive age, rural women, and women who do not read newspapers/magazines or watch television.

Community-Centred Infrastructure Design Process for Resilience Building in South African Informal Settlements: The “Genius of Space” Solid Waste and Greywater Infrastructure Project

2018 ◽  
Vol 2 (1) ◽  
pp. 1-10
Author(s):  
Lauren Hermanus ◽  
Sean Andrew
Keyword(s):  
South Africa ◽  
Local Governments ◽  
Informal Settlements ◽  
Interdisciplinary Approach ◽  
Urban Environments ◽  
Sub Saharan Africa ◽  
Wastewater Management ◽  
Western Cape ◽  
Water And Sanitation ◽  
Public And Private Sector

Due to a lack of adequate water and sanitation infrastructure, growing, unplanned urban settlements in South Africa and elsewhere have been linked to pollution of critical river systems. The same dynamics undermine local resilience, understood as the capacity to adapt and develop in response to changes, persistent social and ecological risks, and disasters. Water and sanitation challenges undermine resilience by causing and compounding risks to individuals, and to household and community health and livelihoods, in a complex context in which communities and local governments have limited capacity and resources to respond appropriately. Household and community resilience in informal settlements is drawing increasing policy focus, given the persistence of these kinds of neighbourhoods in cities and towns in Sub-Saharan Africa and South Africa, in particular. This case considers whether bottom-up responses that combine public and private sector resources, including community participation, and use an interdisciplinary approach can support the production of novel resilience-fostering solutions. This article presents an analysis of the case of Genius of Space waste and wastewater management infrastructure in the Western Cape, South Africa. While the process has been imperfect and slow to show results, this analysis reflects on the gains, lessons and potential for replication that this work has produced. The Genius of Space approach adds to a growing area of practice-based experimentation focussed on incrementalism and adaptive development practices in urban environments, particularly in developing countries.

scholarly journals Prevalence and Associated Factors of Vitamin A Deficiency among Children and Women in Senegal

2020 ◽  
Vol 8 (2) ◽  
pp. 1-11
Author(s):  
Mane Hélène Faye ◽  
Nicole Idohou-Dossou ◽  
Abdou Badiane ◽  
Anta Agne-Djigo ◽  
Papa Mamadou DD Sylla ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Logistic Regression ◽  
Vitamin A ◽  
Pregnant Women ◽  
Vitamin A Deficiency ◽  
Plasma Concentrations ◽  
Reproductive Age ◽  
Subclinical Inflammation ◽  
Women Of Reproductive Age ◽  
Factors Associated

Background: Like many developing countries, Senegal does not have data on the extent of vitamin A deficiency (VAD) that is representative of its population. The present survey was conducted to fill this gap and to identify factors associated with VAD, prior to the introduction of a large-scale vitamin A oil fortification program. Procedures: A nationwide representative cross-sectional survey involving 1887 children 12 to 59 months old and 1316 women of reproductive age (WRA) was conducted. Blood samples were collected and plasma concentrations of retinol (PR), C-reactive protein (CRP), and alpha-1-acidglycoprotein were measured. PR was adjusted for subclinical inflammation using the BRINDA regression methodology. Multivariate logistic regression was used to identify factors associated with VAD. Findings: The adjusted prevalence of VAD (PR ≤ 0.7 μmol/L) in children was 15.3% and differed by age group, area of residence, and socioeconomic status and half of them had subclinical inflammation. Among WRA, VAD was low (2.3%) and 18.1% had vitamin A insufficiency (VAI). Pregnant women were more affected by VAI (28.4%) and Dakar had lower figures compared with other cities and rural strata. Prevalence of VAI decreased with increasing wealth quintile. In logistic regression, abnormal CRP, poverty, scarce consumption of poultry, oysters, melon, red palm oil, palm kernel oil, Saba senegalensis fruit pulp (Maad) and cowpea, frequent consumption of leeks and consumption of Leptadenia hastata leaves (Mbuum tiakhat), were associated with VAD in children. For women, lower socioeconomic status, fair or poor health status and anemia were negatively associated with VAI. Conclusions: In Senegal, VAD is a moderate public health problem in children and slight among women. Particular attention should be paid to children older than 23 months, pregnant women, rural populations, and poorest households. Nutritional interventions should be implemented alongside morbidity prevention and control. Keywords: vitamin A deficiency, children 12-59 months, women of reproductive age, Senegal.

scholarly journals Clustering of hypertension, diabetes and overweight/obesity according to socioeconomic status among Bangladeshi adults

2020 ◽  
pp. 1-10
Author(s):  
Gulam Muhammed Al Kibria ◽  
Mohammad Rashidul Hashan ◽  
Md Mahbub Hossain ◽  
Sojib Bin Zaman ◽  
Christina A. Stennett
Keyword(s):  
Socioeconomic Status ◽  
Formal Education ◽  
Healthy Lifestyle ◽  
Wealth Quintile ◽  
Household Wealth ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Education Levels ◽  
Healthy Lifestyle Interventions ◽  
Fasting Plasma Glucose Concentration

Abstract The prevalences of hypertension, diabetes and overweight/obesity are increasing in most developing countries, including Bangladesh. Although earlier studies have investigated the factors associated with these three conditions, little is known about whether socioeconomic status is associated with their co-existence. This cross-sectional study analysed data from the 2011 Bangladesh Demographic and Health Survey. An individual was considered hypertensive, diabetic and overweight/obese if their systolic/diastolic blood pressure, fasting plasma glucose concentration, and body mass index were ≥130/80 mmHg, ≥7 mmol/l and ≥23 kg/m2, respectively. Furthermore, individuals who reported taking anti-hypertensive and anti-diabetic drugs were also considered as hypertensive and diabetic, respectively. Two socioeconomic variables were investigated: education level and household wealth quintile. Descriptive analyses and multilevel logistic regression were conducted. Among the 7932 respondents (50.5% female) aged ≥35 years, the prevalences of hypertension, diabetes, overweight/obesity, any one condition and the co-existence of the three conditions were 48.0%, 11.0%, 25.3%, 60.9% and 3.6%, respectively. In adjusted analysis, individuals with secondary (adjusted odds ratio [AOR]: 1.8, 95% confidence interval [CI]: 1.2–2.8) and college or above (AOR: 3.6; 95% CI: 2.2–5.7) education levels had higher odds of the co-existence of all three conditions compared with those with no formal education. Similarly, compared with the poorest wealth quintile, the richer (AOR: 4.6; 95% CI: 2.2–9.4) and richest (AOR: 11.8; 95% CI: 5.8–24.1) wealth quintiles had higher odds of co-existence of these three conditions. Education and wealth quintile also showed significant relationships with each of the three conditions separately. In conclusion, in Bangladesh, hypertension, diabetes and overweight/obesity are associated with indicators of higher socioeconomic status. These findings highlight the importance of developing healthy lifestyle interventions (e.g. physical exercise and dietary modification) targeting individuals of higher socioeconomic status to minimize the burden of these non-communicable diseases.

Effects of Hazardous Alcohol use on Neurocognition in HIV Positive Individuals

2017 ◽  
Vol 41 (S1) ◽  
pp. S639-S639
Author(s):  
G. Spies ◽  
G. Hoddinott ◽  
N. Beyers ◽  
S. Seedat
Keyword(s):  
South Africa ◽  
Executive Function ◽  
Alcohol Use ◽  
Hiv Infection ◽  
Test Performance ◽  
Hiv Positive ◽  
Western Cape ◽  
Hazardous Alcohol Use ◽  
Significant Difference ◽  
Hazardous Alcohol

IntroductionThere is significant evidence that HIV is brain degenerative and long-term infection can impair cognitive functioning. In South Africa, alcohol remains the dominant substance of abuse and lifetime alcohol dependence has been found to impair memory, executive function and visuospatial capabilities. The individual liability of alcohol and HIV on neurocognitive function have been well demonstrated, however there is relatively little evidence of the potentially aggravating effects of this dual burden on neurocognitive outcomes.ObjectivesThe present study is ongoing and sought to identify the effects of hazardous alcohol use on neurocognitive functioning in the context of HIV infection.AimsTo describe the association between HIV and harmful alcohol use on neuropsychological test performance in a cohort of adults in the Western Cape of South africa.Methodsparticipants (n = 50) were tested using a battery of neuropsychological tests sensitive to the effects of HIV on the brain. Self-reported alcohol use was recorded using the alcohol use identification test (AUDIT). Results The sample consisted of 47 females and 3 males. All participants were HIV-positive and on antiretroviral therapy. A total of 23 (46%) participants reported no alcohol use and 27 (54%) reported drinking alcohol on the AUDIT.Resultsrevealed a significant difference between groups on the Stroop colour word test, with poorer performance evident among the alcohol users (P = 0.008).ConclusionAlcohol use in the context of HIV infection contributes to poorer executive function. These preliminary data provide evidence for a synergistic relationship between HIV infection and alcohol use.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Food Insecurity among Women of Reproductive Age in Nepal: Prevalence and Correlates

2019 ◽  
Author(s):  
Shanta Pandey ◽  
Vincent Fusaro
Keyword(s):  
Food Insecurity ◽  
Protective Factor ◽  
Household Wealth ◽  
Reproductive Age ◽  
Indigenous Populations ◽  
Household Food Insecurity ◽  
Women Of Reproductive Age ◽  
Household Food ◽  
10Th Grade ◽  
Dalit Women

Abstract Background Food insecurity is widely prevalent in certain sections of society in low and middle income countries. The United Nations has challenged all member countries to eliminate hunger for all people by 2030. This study examines the prevalence and correlates of household food insecurity among women, especially Dalit women of reproductive age in Nepal. Methods Data came from 2016 Nepal Demographic Health Survey, a cross-sectional, nationally representative survey that included 12,862 women between 15 and 49 years of age of which 12% were Dalit. Descriptive analysis was used to assess the prevalence of household food insecurity while logistic regression examined the relationship between women’s ethnicity and the risk of food insecurity after accounting for demographic, economic, cultural, and geo-ecological characteristics. Results About 56% of all women and 76% of Dalit women had experienced food insecurity. Ethnicity is strongly related to food insecurity. Dalit women were most likely to be food insecure, even after accounting for factors such as education and wealth. They were 82%, 85%, 89% and 92% more vulnerable to food insecurity than Muslims, Brahmin/Chhetri, Terai Indigenous, and Hill Indigenous populations, respectively. Education was a protective factor—women with secondary education (6th to 10th grade) were 39% less likely to be food insecure compared to their counterparts without education. With a more than 10th grade education, women were 2.27 times more likely to be food secure compared to their counterparts without education. Marriage was also protective. Economically, household wealth is inversely correlated with food insecurity. Finally, residence in the Mid-Western, Far-Western and Central Development regions was correlated with food insecurity. Conclusion To reduce food insecurity in Nepal, interventions should focus on improving women’s education and wealth, especially among Dalit and those residing in the Far- and Mid-Western regions.

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