scholarly journals Social inequalities in low birthweight outcomes in Sri Lanka: evidence from the Demographic and Health Survey 2016

BMJ Open ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. e037223
Author(s):  
Gayathri Abeywickrama ◽  
Sabu S Padmadas ◽  
Andrew Hinde

ObjectiveTo investigate social inequalities underlying low birthweight (LBW) outcomes in Sri Lanka.DesignCross-sectional study.SettingThis study used the Sri Lanka Demographic and Health Survey 2016, the first such survey to cover the entire country since the Civil War ended in 2001.ParticipantsBirthweight data extracted from the child health development records available for 7713 babies born between January 2011 and the date of interview in 2016.Outcome measuresThe main outcome variable was birth weight, classified as LBW (≤2500 g) and normal.MethodsWe applied random intercept three-level logistic regression to examine the association between LBW and maternal, socioeconomic and geographic variables. Concentration indices were estimated for different population subgroups.ResultsThe population-level prevalence of LBW was 16.9% but was significantly higher in the estate sector (28.4%) compared with rural (16.6%) and urban (13.6%) areas. Negative concentration indices suggest a relatively higher concentration of LBW in poor households in rural areas and the estate sector. Results from fixed effects logistic regression models confirmed our hypothesis of significantly higher risk of LBW outcomes across poorer households and Indian Tamil communities (AOR 1.70, 95% CI 1.02 to 2.83, p<0.05). Results from random intercept models confirmed there was substantial unobserved variation in LBW outcomes at the mother level. The effect of maternal biological variables was larger than that of socioeconomic factors.ConclusionLBW rates are significantly higher among babies born in poorer households and Indian Tamil communities. The findings highlight the need for nutrition interventions targeting pregnant women of Indian Tamil ethnicity and those living in economically deprived households.

2019 ◽  
Author(s):  
Gedefaw Diress ◽  
Mohammed Ahmed ◽  
Seteamlak Adane ◽  
Melese Linger ◽  
Birhan Aleminew

Abstract Background HIV testing is the critical first step in identifying and linking HIV infected people to the treatment cascade and it also provides an important opportunity to reinforce HIV prevention among the negatives. The aim of this study was examine factors associated with HIV testing among youth women. Methods A community-based cross-sectional study design was used and a nationally representative secondary data analysis was done on the 2016 Ethiopian Demographic and Health Survey(EDHS). A total of 6401 youth women were eligible in the study. The data were analyzed by SPSS version 20. Frequencies and weighted percentage of the variables were calculated. Chi-square tests and logistic regression models were used to assess predictors of HIV testing. Multivariate logistic regression analysis was conducted to control confounders and to identify the independent contribution of each variable to the outcome variable. Result A total of 6401 youth women aged 15 to 24 years of age were included. Only 37.7% (95% CI:(33.6-39.1%)) of participants were ever tested for HIV in their life. In the final multivariable model age, marital status, level of educational, media access, number of sexual partner, STIs in Past 12 months and comprehensive knowledge to HIV, were significantly associated with ever been tested for HIV. Youth women who were in the age group between 20 to 24 (AOR=2.18; 95CI:(1.800-2.652), who were married (AOR=4.70; 95% CI:(3.674-6.008)), were divorced (AOR=6.16; 95% CI (3.976-9.541)), who had no access to media (AOR = 0.69; 95 CI %: (0.540-0.870)), who had no comprehensive HIV knowledge (AOR = 0.68; 65% CI: (0.530-0.861)) and having one or more sexual partners (AOR=2.48; 95% CI:(1.350-4.551)) were significantly associated with ever been tested for HIV.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Abdul-Aziz Seidu

Abstract Background Safe disposal of children’s faeces has always been one of the main challenges to good hygiene in Ghana. Although it has been proven that children’s faeces are more likely to spread diseases than adults’ faeces, people usually mistake them for harmlessness. This study, therefore, sought to determine the prevalence and factors associated with safe disposal of children’s faeces in Ghana. Methods Data from the 2014 Ghana Demographic and Health Survey was used for the analysis. A sample size of 2228 mother-child pairs were used for the study. The outcome variable was disposal of children stools. Both bivariate and multivariable logistic regression analyses were performed to identify the factors with safe child stool disposal. Results The prevalence of safe child stool disposal in Ghana was 24.5%. Women in the middle [Adjusted odds ratio (AOR) = 4.62; Confidence Interval (CI) = 3.00–7.10], Coastal Zone [AOR = 4.52; CI = 2.82–7.22], mothers whose children were aged 12–17 [AOR = 1.56; CI = 1.15–2.13] and 18–23 months [AOR = 1.75; CI = 1.29–2.39], and mothers whose household had improved type of toilet facility [AOR = 2.04; CI = 1.53–2.73] had higher odds of practicing safe children’s faeces disposal. However, women from households with access to improved source of drinking water [AOR = 0.62; CI = 0.45–2.7] had lower odds of practicing safe children’s faeces disposal. Conclusion Approximately only about 25 out of 100 women practice safe disposal of their children’s faeces in Ghana. The age of the child, ecological zone, the type of toilet facilities, and the type of drinking water source are associated with the disposal of child faeces. These findings have proven that only improved sanitation (i.e. drinking water and toilet facilities) are not enough for women to safely dispose of their children’s faeces. Therefore, in addition to provision of toilet facilities especially in the northern zone of Ghana, there is also the need to motivate and educate mothers on safe disposal of children’s stools especially those with children below 12 months. More so, mothers without access to improved toilet facility should also be educated on the appropriate ways to bury their children’s stools safely.


2021 ◽  
Vol 11 (2) ◽  
pp. 20 ◽  
Author(s):  
Bright Opoku Ahinkorah ◽  
Richard Gyan Aboagye ◽  
Francis Arthur-Holmes ◽  
Abdul-Aziz Seidu ◽  
James Boadu Frimpong ◽  
...  

(1) Background: Psychological problems of adolescents have become a global health and safety concern. Empirical evidence has shown that adolescents experience diverse mental health conditions (e.g., anxiety, depression, and emotional disorders). However, research on anxiety-induced sleep disturbance among in-school adolescents has received less attention, particularly in low- and middle-income countries. This study’s central focus was to examine factors associated with t anxiety-induced sleep disturbance among in-school adolescents in Ghana. (2) Methods: Analysis was performed using the 2012 Global School-based Health Survey (GSHS). A sample of 1342 in-school adolescents was included in the analysis. The outcome variable was anxiety-induced sleep disturbance reported during the past 12 months. Frequencies, percentages, chi-square, and multivariable logistic regression analyses were conducted. Results from the multivariable logistic regression analysis were presented as crude and adjusted odds ratios at 95% confidence intervals (CIs) and with a statistical significance declared at p < 0.05. (3) Results: Adolescents who went hungry were more likely to report anxiety-induced sleep disturbance compared to their counterparts who did not report hunger (aOR = 1.68, CI = 1.10, 2.57). The odds of anxiety-induced sleep disturbance were higher among adolescents who felt lonely compared to those that never felt lonely (aOR = 2.82, CI = 1.98, 4.01). Adolescents who had sustained injury were more likely to have anxiety-induced sleep disturbance (aOR = 1.49, CI = 1.03, 2.14) compared to those who had no injury. Compared to adolescents who never had suicidal ideations, those who reported experiencing suicidal ideations had higher odds of anxiety-induced sleep disturbance (aOR = 1.68, CI = 1.05, 2.71). (4) Conclusions: Anxiety-induced sleep disturbance among in-school adolescents were significantly influenced by the psychosocial determinants such as hunger, loneliness, injury, and suicidal ideation in this study. The findings can help design appropriate interventions through effective strategies (e.g., early school-based screening, cognitive-behavioral therapy, face-face counseling services) to reduce psychosocial problems among in-school adolescents in Ghana.


Author(s):  
Abdul-Aziz Seidu ◽  
Ebenezer Agbaglo ◽  
Louis Kobina Dadzie ◽  
Bright Opoku Ahinkorah ◽  
Edward Kwabena Ameyaw ◽  
...  

Abstract Background This study sought to assess the individual and contextual factors associated with barriers to accessing healthcare among women in Papua New Guinea. Methods The study was conducted among 14 653 women aged 15–49 y using data from the 2016–2018 Papua New Guinea Demographic and Health Survey. The outcome variable was barriers to accessing healthcare. Descriptive and multilevel logistic regression analyses were conducted. Statistical significance was declared at P &lt; 0.05. Results Women aged 15–19 y were more likely to experience at least one barrier compared with those aged 40–49 y (adjusted OR [AOR]=1.48; 95% CI 1.18 to 1.86). Women with secondary/higher education (AOR=0.68; 95% CI 0.57 to 0.81), women in the richest wealth quintile (AOR=0.36; 95% CI 0.28 to 0.46) and those in the least disadvantaged socioeconomic status (AOR=0.46; 95% CI 0.33 to 0.64) had lower odds of having challenges with at least one barrier to healthcare. However, living in rural areas increased the odds of facing at least one barrier to healthcare (AOR=1.87; 95% CI 1.27 to 2.77). Conclusions This study has demonstrated that both individual and contextual factors are associated with barriers to healthcare accessibility among women in Papua New Guinea. To enhance the achievement of the Sustainable Development Goals 3.1, 3.7 and 3.8, it is critical to deem these factors necessary and reinforce prevailing policies to tackle barriers to accessing healthcare among women in Papua New Guinea.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Teshome Kabeta Dadi ◽  
Merga Belina Feyasa ◽  
Mamo Nigatu Gebre

Abstract Background Human Immunodeficiency virus continues to be a major global health problem infecting 75 million and killing 32 million people since the beginning of the epidemic. It badly hit Sub Saharan Africa than any country in the world and youths are sharing the greatest burden. The study aims to assess the level of HIV-knowledge and its determinants among Ethiopian youths using the 2016 Ethiopia Demographic and Health Survey data. Methods A nationally representative 2016 Ethiopian Demographic and Health Survey data were used. A total of 10,903 youths comprising 6401 females and 4502 males were included in the study. Descriptive statistics and multilevel order logistic regression were used and confidence interval was used to declare statistical significance in the final model. Results The mean age and SD of youths included in this study was 19.10 (±2.82). Among Ethiopian youths, 20.92% (95% CI: 18.91, 23.09%) had low knowledge of HIV whereas, 48.76% (95% CI: 47.12, 50.41%) and 30.31% (95% CI: 28.51, 32.18%) of them had moderate and comprehensive HIV knowledge respectively. Being male, access to TV and radio, ever tested for HIV/AIDS, owning a mobile telephone, and attending primary school and above compared to non-attendants were associated with having higher HIV knowledge. But, dwelling in rural Ethiopia, being in the Protestant and Muslim religious groups as compared to those of Orthodox followers and being in married groups were associated with having lower HIV knowledge. Approximately, 12% of the variation in knowledge of HIV was due to regions. Conclusion Only one-third of Ethiopian youths have deep insight into the disease, whereas, nearly one-fifth of them have lower HIV-knowledge. There is a significant disparity in HIV-related knowledge among Ethiopian youths living in different regions. Rural residents, less educated, female, and married youths have less knowledge of HIV as compared to their counterparts. Youths who do not have a mobile phone, who lack health insurance coverage, and who have limited access to media have less knowledge about HIV. Therefore, the due focus should be given to the aforementioned factors to minimize the disparities between regions and to enhance Ethiopian youths’ HIV-knowledge.


2020 ◽  
Vol 48 (1) ◽  
Author(s):  
Zemenu Tadesse Tessema ◽  
Tadele Amare Zeleke

Abstract Background Alcohol is a psychoactive substance that is widely consumed in the world. Alcohol use is one of the world’s leading risk factors for disease and disability. It affects individuals’ physical, mental, economic, and social issues. To our knowledge, there is limited study on alcohol consumption and associated factors. Therefore, this study aimed to determine the prevalence and predictors of alcohol use in Ethiopia by using the 2016 Ethiopian Demographic and Health Survey. Methods This study was based on the most recent Ethiopian Demographic and Health Survey 2016. A total of 12,594 men at the age of 15 to 59 were included in this study. Considering the hierarchical nature of EDHS data, a multilevel logistic regression model was applied. The ICC, MOR, and the LR test were done to assess the presence of a significant clustering effect. Besides, deviance was used for model comparison since the models were nested models. Variables with a p value ≤ 0.2 in the bivariable analysis were considered for the multivariable analysis. In the multilevel logistic regression, the adjusted odds ratio (AOR) with 95% confidence interval (CI) was reported to declare the strength and significance of the association between the dependent variable and independent variables. Results The prevalence of alcohol drinking in this study was 46.64% with a 95% CI of 45.00 to 47.00%. Age groups 30–44 (AOR = 1.30, 95% CI 1.08, 1.56) and 45–59 (AOR = 1.38, 95% CI 1.10, 1.74), Orthodox religion follower (AOR = 0.36, 95% CI 0.24, 0.55), media exposure (AOR = 1.67, 95% CI 1.41, 2.20), khat chewing (AOR = 3.08, 95% CI 2.54, 3.74), smoking (AOR = 2.18, 95% CI 1.71, 2.79), having no occupation (AOR = 0.34, 95% CI 0.22, 0.51), and region were the predictors of alcohol use in Ethiopia. Conclusions Nearly half of the Ethiopian population reported alcohol use at least once in their lifetime. Old age, Orthodox religion followers, media exposure, khat chewing, smoking, and having no occupation were predictors of alcohol use in Ethiopia. Therefore, health education about the risk of alcohol used is highly recommended. In addition, khat chewing and smoking control mechanisms should be designed and given special attention. Advertising alcohol through media is better to be controlled. Job opportunities should also be created for those who have no occupation to mitigate alcohol use in Ethiopia.


2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Linus Baatiema ◽  
Edward Kwabena Ameyaw ◽  
Aliu Moomin ◽  
Mukaila Mumuni Zankawah ◽  
Doris Koramah

Background. Despite the high antenatal care attendance rate in Ghana, skilled birth attendance is relatively low. There is limited evidence on whether antenatal care attendance translates into skilled birth attendance in the Ghanaian research discourse. This study investigates whether antenatal care attendance translates into skilled birth. Methods. We extracted data from the 2014 Ghana Demographic and Health Survey. Data were analysed using descriptive and binary logistic regression analyses at 5% confidence interval. Results. The descriptive findings indicated a vast variation between antenatal care attendance and skilled birth attendance. Skilled birth attendance was consistently low across almost all sociodemographic characteristics as compared to antenatal care attendance. The binary logistic regression analysis however indicated higher inclination toward skilled birth attendance among women who had at least four antenatal care visits [OR=5.87, CI=4.86-7.08]. The category of women noted to have higher tendencies of skilled birth attendance was those with higher/tertiary education [OR=9.13, CI=2.19-37.93], the rich [OR=4.27, CI=3.02-6.06], urban residents [OR=2.35, CI=1.88-2.93], women with maximum of four children [OR=1.36, CI=1.08-1.72], and those using modern contraceptives [OR=1.24, CI=1.03-1.50]. Conclusion. We recommend that interventions to enhance skilled birth attendance must target women who do not achieve at least four antenatal visits, those with low wealth standing, those not using contraceptives, and women without formal education. Again, an in-depth qualitative study is envisaged to deepen the understanding of these dynamics in the rural setting.


Author(s):  
Abdollah ALMASIAN KIA ◽  
Sahar GOODARZI ◽  
Heshmatollah ASADI ◽  
Ardeshir KHOSRAVI ◽  
Aziz REZAPOUR

Background: Nutritional status at the early stages of children’s lives is essential for growth and development not only in infancy but also in adult life. This study aimed to measure the inequality in malnutrition among under-five children in Iran and explore the impact of socioeconomic factors on this inequality using a regression-based decomposition approach. Methods: Data were extracted from Iran's Multiple-Indicator Demographic and Health Survey 2010. The concentration index of stunting, underweight, and wasting were applied in order to measure the magnitude of socioeconomic inequality in child malnutrition. Moreover, the concentration indices were decomposed to understand the contribution of socioeconomic variables in childhood malnutrition inequality. Results: The obtained concentration indices of stunting, underweight, and wasting were respectively -0.177, -0.092, and -0.031. Socioeconomic inequality in stunting and underweight was statistically significant, however this socioeconomic gradient was not observed in wasting. More than 50% of the inequality in stunting and about 63% of the inequality in underweight were influenced by socioeconomic status. Furthermore, maternal education was associated with 19% and 22% of inequality in stunting and underweight respectively. Conclusion: The average reduction of malnutrition indices at the national level hides the burden of malnutrition among children in poor families. If government and policymakers seek to solve this problem, they have to take direct and targeted actions to eliminate the existing inequalities in the socioeconomic determinants associated with malnutrition.  


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