scholarly journals Under-5 mortality in sub-Saharan Africa: is maternal age at first childbirth below 20 years a risk factor?

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e049337
Author(s):  
Bright Opoku Ahinkorah
Keyword(s):  
Adolescent Mothers ◽  
Informal Education ◽  
Maternal Age ◽  
Economic Status ◽  
Public Health Education ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Cross Sectional ◽  
Sub Saharan ◽  
Children Under 5

ObjectivesThis study aimed at examining the association between young maternal age at first childbirth and under-5 mortality in sub-Saharan Africa (SSA).Design and settingThis cross-sectional study pooled nationally-representative data from the most recent Demographic and Health Surveys conducted in 30 countries in SSA from 2010 to 2019.Participants116 379 mothers of children under 5.ResultsThe prevalence of adolescent childbirth and death in children under 5 in SSA were 57.36% (95% CI 53.73% to 60.99%) and 4.10% (95% CI 3.65% to 4.54%), respectively. Children born to mothers whose first childbirth occurred at <20 years were 11% more likely to die before the age of 5 compared with those whose mothers’ first childbirth occurred at age ≥20 years (adjusted odds ratio (aOR) 1.11; 95% CI 1.05 to 1.18). In terms of the covariates, the likelihood of under-5 mortality was higher among children born to single (aOR 1.54; 95% CI 1.41 to 1.67) and cohabiting mothers (aOR 1.10; 95% CI 1.01 to 1.21) compared with married mothers. Children born to mothers who were obese were more likely to die before the age of 5 compared with those born to mothers with normal body weight (aOR 1.17; 95% CI 1.09 to 1.26). The odds of under-5 mortality were higher among children whose weight at birth was <2500 g compared with those whose weight was ≥2500 g at birth (aOR 1.83; 95% CI 1.64 to 2.03).ConclusionsThe findings call for the need to enhance policies aimed at reducing under-5 mortality in SSA by reducing adolescent pregnancy and childbirth through family planning, comprehensive sexuality education, and the elimination of child marriage. Again, Since under-5 mortality among adolescent mothers is linked with their poor socio-economic status, there is the need for government and non-governmental organisations in SSA to introduce poverty alleviation programmes and improve access to both formal and informal education as a way of enhancing the socioeconomic status of adolescent mothers. Public health education, through continuous advocacy programmes should be done to encourage adolescent mothers to access antenatal care and health facility deliveries as a way of enhancing the survival status of their children. These interventions should be implemented, taking into consideration other characteristics of mothers such marital status and BMI and child’s characteristics such as child’s weight, which were found to be associated with high under-5 mortality.

scholarly journals Maternal age at first childbirth and under-five morbidity in sub-Saharan Africa: analysis of cross-sectional data of 32 countries

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Bright Opoku Ahinkorah
Keyword(s):  
Maternal Age ◽  
Cross Sectional Study ◽  
Sub Saharan Africa ◽  
Outcome Variable ◽  
Demographic And Health Surveys ◽  
Odds Ratios ◽  
Cross Sectional ◽  
Children Under Five ◽  
Under Five ◽  
Sub Saharan

Abstract Background The prevalence of childhood morbidity remains high in low-and middle-income countries, including sub-Saharan Africa (SSA). In this study, the association between maternal age at first childbirth and under-five morbidity in SSA was examined. Methods This was a cross-sectional study involving nationally-representative data from the most recent Demographic and Health Surveys conducted in 32 countries in SSA from 2010 to 2019. A sample size of 311,603 mothers of children under-five was considered. The outcome variable for this study was under-five morbidity. This variable was derived from the experience of fever, cough, and diarrhoea among children under-five. Both multilevel and binary logistic regression models were used to test the hypothesis that adolescent childbirth is associated with under-five morbidity. The results were presented as crude odds ratios (cORs) and adjusted odds ratios (aORs), with 95 % confidence intervals (CIs). Results Children born to mothers whose first childbirth occurred at < 20 years were 16 % times more likely to suffer from under-five morbidity, compared to those whose mothers’ first childbirth occurred at age ≥ 20 years [cOR = 1.16; CI = 1.13–1.19], and this persisted but with reduced odds after controlling for covariates [aOR = 1.10; CI = 1.07–1.12]. At the country level, children born to mothers whose first childbirth occurred at < 20 years were more likely to suffer from under-five morbidity, compared to those whose mothers’ first childbirth occurred at age ≥ 20 years in Angola, Burundi, Congo DR, Guinea, Kenya, and Uganda. Conclusions In this study, an association between adolescent childbirth and morbidity in children under five in SSA has been established. The study concludes that under-five morbidity is higher among children born to mothers whose first childbirth occurred before 20 years compared to those whose mothers’ first childbirth occurred at 20 years and above. The findings indicate that in order to reduce under-five morbidity, there is the need to deal with adolescent childbearing through cultural and social change, coupled with engagement of adolescents and stakeholders in adolescent sexual and reproductive health programmes.

scholarly journals Characteristics of patients with acute heart failure in North Central Nigeria

2021 ◽  
Vol 9 (3) ◽  
pp. 221-235
Author(s):  
J.A. Ogunmodede ◽  
P.M. Kolo ◽  
M.O. Bojuwoye ◽  
B.F. Dele-Ojo ◽  
A.J. Ogunmodede ◽  
...  
Keyword(s):  
Heart Failure ◽  
New York ◽  
Heart Association ◽  
Public Health Education ◽  
Sub Saharan Africa ◽  
Aetiological Factor ◽  
Cross Sectional ◽  
Early Presentation ◽  
North Central ◽  
Sub Saharan

Objectives: Heart failure (HF) is an important cause of hospital admission in Nigeria. HF is increasingly prevalent because the population is aging and HF epidemiology is changing. We aimed at profiling the socio-demographic, clinical and echocardiographic (Echo)  characteristics of patients admitted for acute HF. This is one of the largest cohorts of HF patients profiled in Nigeria so far. Methods: Cross sectional design. Socio-demographic, clinical and Echo data were collected from 455 patients admitted for AHF at University of Ilorin Teaching Hospital, North central, Nigeria. Results: Mean age of patients was 58.9± 15.7years, (men were older than women, P= 0.006). 265(58.2%) were males, most patients were aged >60 years, 4.8% had pre-existing Type2 Diabetes mellitus. 53.2% of patients presented in New York Heart Association Stages III and IV. Median duration of admission was 11days (IQR, 6-17), intrahospital mortality- 11.6%. Hypertension was the commonest aetiological factor (62.4%), followed by dilated cardiomyopathy 17.6%, rheumatic heart disease (6.6%), Peripartum cardiomyopathy (5.3%), and others. Conclusion: AHF patients in our study are older than those in previous studies in Nigeria and sub-Saharan Africa. Hypertension is main driver of AHF, and patients largely present with clinically advanced disease necessitating stronger public health education about risk factors and early presentation.  

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.

scholarly journals Trends and inequalities in the nutritional status of adolescent girls and adult women in sub-Saharan Africa since 2000: a cross-sectional series study

2020 ◽  
Vol 5 (10) ◽  
pp. e002948
Author(s):  
Safia S Jiwani ◽  
Giovanna Gatica-Domínguez ◽  
Inacio Crochemore-Silva ◽  
Abdoulaye Maïga ◽  
Shelley Walton ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Adolescent Girls ◽  
Overweight And Obesity ◽  
Rate Of Change ◽  
Capital City ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Adult Women ◽  
Cross Sectional ◽  
Sub Saharan

IntroductionEvidence on the rate at which the double burden of malnutrition unfolds is limited. We quantified trends and inequalities in the nutritional status of adolescent girls and adult women in sub-Saharan Africa.MethodsWe analysed 102 Demographic and Health Surveys between 1993 and 2017 from 35 countries. We assessed regional trends through cross-sectional series analyses and ran multilevel linear regression models to estimate the average annual rate of change (AARC) in the prevalence of underweight, anaemia, anaemia during pregnancy, overweight and obesity among women by their age, residence, wealth and education levels. We quantified current absolute inequalities in these indicators and wealth-inequality trends.ResultsThere was a modest decline in underweight prevalence (AARC=−0.14 percentage points (pp), 95% CI −0.17 to -0.11). Anaemia declined fastest among adult women and the richest pregnant women with an AARC of −0.67 pp (95% CI −1.06 to -0.28) and −0.97 pp (95% CI −1.60 to -0.34), respectively, although it affects all women with no marked disparities. Overweight is increasing rapidly among adult women and women with no education. Capital city residents had a threefold more rapid rise in obesity (AARC=0.47 pp, 95% CI 0.39, 0.55), compared with their rural counterparts. Absolute inequalities suggest that Ethiopia and South Africa have the largest gap in underweight (15.4 pp) and obesity (28.5 pp) respectively, between adult and adolescent women. Regional wealth inequalities in obesity are widening by 0.34 pp annually.ConclusionUnderweight persists, while overweight and obesity are rising among adult women, the rich and capital city residents. Adolescent girls do not present adverse nutritional outcomes except anaemia, remaining high among all women. Multifaceted responses with an equity lens are needed to ensure no woman is left behind.

scholarly journals Birth registration and child undernutrition in sub-Saharan Africa

2015 ◽  
Vol 19 (10) ◽  
pp. 1757-1767 ◽  
Author(s):  
Ornella Comandini ◽  
Stefano Cabras ◽  
Elisabetta Marini
Keyword(s):  
Nutritional Status ◽  
Permutation Test ◽  
Negative Relationship ◽  
Wealth Quintile ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Birth Registration ◽  
African Countries ◽  
Cross Sectional ◽  
Sub Saharan

AbstractObjectiveIn many countries of the world millions of people are not registered at birth. However, in order to assess children’s nutritional status it is necessary to have an exact knowledge of their age. In the present paper we discuss the effects of insufficient or imprecise age data on estimates of undernutrition prevalence.DesignBirth registration rates and levels of stunting, underweight and wasting were retrieved from Multiple Indicator Cluster Surveys and Demographic and Health Surveys of thirty-seven sub-Saharan African countries, considering the subdivision in wealth quintiles. The composition of the cross-sectional sample used for nutritional evaluation was analysed using a permutation test. Logistic regression was applied to analyse the relationship between birth registration and undernutrition. The 95 % probability intervals and Student’s t test were used to evaluate the effect of age bias and error.ResultsHeterogeneous sampling designs were detected among countries, with different percentages of children selected for anthropometry. Further, registered children were slightly more represented within samples used for nutritional analysis than in the total sample. A negative relationship between birth registration and undernutrition was recognized, with registered children showing a better nutritional status than unregistered ones, even within each wealth quintile. The over- or underestimation of undernutrition in the case of systematic over- or underestimation of age, respectively, the latter being more probable, was quantified up to 28 %. Age imprecision was shown to slightly overestimate undernutrition.ConclusionsSelection bias towards registered children and underestimation of children’s age can lead to an underestimation of the prevalence of undernutrition.

scholarly journals Investigation of the Possible Moderators of Alcohol-Related Intimate Partner Violence in Sub-Saharan Africa

2021 ◽  
Vol 4 (2) ◽  
pp. 67-83
Author(s):  
Ekpenyong M.S. ◽  
Tawari E. P.2
Keyword(s):  
Intimate Partner Violence ◽  
Partner Violence ◽  
Meta Analysis ◽  
Intimate Partner ◽  
Sub Saharan Africa ◽  
Public Health Issue ◽  
Demographic And Health Surveys ◽  
African Countries ◽  
Cross Sectional ◽  
Sub Saharan

Alcohol-related intimate partner violence (IPV) is a serious public health issue which has attracted a lot of research and debates. While some studies have reported the relationship between alcohol and IPV to be linear, others have reported threshold effects. While some studies have found the link to be strong, others have reported it to be weak or to show no association. The aim of this study was to determine the possible moderators on the alcohol-IPV link in sub-Saharan Africa. For the quantitative study, secondary analysis and meta-analysis were used to analyze cross-sectional data from the demographic and health surveys of ten countries in sub-Saharan Africa (Burkina Faso, Ghana, Kenya, Liberia, Malawi, Nigeria, Sao Tome and Principe, Tanzania, Zambia, and Zimbabwe). Logistic regression analysis of possible moderators of the alcohol-IPV link was determined in ten sub-Saharan African countries. The nature of moderation was different among countries. The results of this study can be applied in planning country-specific and multi-faceted intervention programmes.

scholarly journals Hospital delivery and neonatal mortality in 37 countries in sub-Saharan Africa and South Asia: An ecological study

PLoS Medicine ◽  
2021 ◽  
Vol 18 (12) ◽  
pp. e1003843
Author(s):  
Anna D. Gage ◽  
Günther Fink ◽  
John E. Ataguba ◽  
Margaret E. Kruk
Keyword(s):  
South Asia ◽  
Neonatal Mortality ◽  
Ecological Study ◽  
Maternal Education ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Cross Sectional ◽  
Hospital Delivery ◽  
Sub Saharan ◽  
Facility Births

Background Widespread increases in facility delivery have not substantially reduced neonatal mortality in sub-Saharan Africa and South Asia over the past 2 decades. This may be due to poor quality care available in widely used primary care clinics. In this study, we examine the association between hospital delivery and neonatal mortality. Methods and findings We used an ecological study design to assess cross-sectional associations between the share of hospital delivery and neonatal mortality across country regions. Data were from the Demographic and Health Surveys from 2009 to 2018, covering 682,239 births across all regions. We assess the association between the share of facility births in a region that occurred in hospitals (versus lower-level clinics) and early (0 to 7 days) neonatal mortality per 1,000 births, controlling for potential confounders including the share of facility births, small at birth, maternal age, maternal education, urbanicity, antenatal care visits, income, region, and survey year. We examined changes in this association in different contexts of country income, global region, and urbanicity using interaction models. Across the 1,143 regions from 37 countries in sub-Saharan Africa and South Asia, 42%, 29%, and 28% of births took place in a hospital, clinic, and at home, respectively. A 10-percentage point higher share of facility deliveries occurring in hospitals was associated with 1.2 per 1,000 fewer deaths (p-value < 0.01; 95% CI: 0.82 to 1.60), relative to mean mortality of 22. Associations were strongest in South Asian countries, middle-income countries, and urban regions. The study’s limitations include the inability to control for all confounding factors given the ecological and cross-sectional design and potential misclassification of facility levels in our data. Conclusions Regions with more hospital deliveries than clinic deliveries have reduced neonatal mortality. Increasing delivery in hospitals while improving quality across the health system may help to reduce high neonatal mortality.

scholarly journals Core and optional infant and young child feeding indicators in Sub-Saharan Africa: a cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e023238 ◽  
Author(s):  
Samson Gebremedhin
Keyword(s):  
Young Child ◽  
Dietary Diversity ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Child Feeding ◽  
Cross Sectional ◽  
Young Child Feeding ◽  
Infant And Young Child ◽  
Sub Saharan ◽  
Minimum Dietary Diversity

ObjectiveThe objective of the study is to determine the status of infant and young child feeding (IYCF) in Sub-Saharan Africa (SSA) based on multiple indicators.DesignSecondary data analysis of 32 Demographic and Health Surveys conducted in SSA since 2010.SettingThirty-two countries in SSA.Participants151 575 infants and young children born in the preceding 2 years of the surveys.Indicators determinedEight core and six optional IYCF indicators.ResultsMajority (95.8%) of the children born in the preceding 24 months were ever breastfed, and 50.5% initiated breastfeeding within the first hour of birth. Among infants 0–5 months of age, 72.3% were predominantly breastfed and 41.0% were exclusively breastfed. Continued breastfeeding at 1 year (89.5%) was reasonably high, but only 53.7% continued breastfeeding at 2 years and 60.4% had age-appropriate breastfeeding. About two-thirds (69.3%) of infants 6–8 months of age received solid, semisolid or soft food over the previous day across the countries. Among children 6–23 months of age, 41.9% met the minimum recommended meal frequency, while smaller proportions satisfied the minimum dietary diversity (21.0%) and acceptable diet (9.8%). About one-third (37.6%) of children 6–23 months of age consumed iron-rich or iron-fortified food over the previous day. Among non-breastfed children, only 15.0% received the recommended two or more milk feedings. Thirteen per cent were fed with a bottle with a nipple in the previous day. Country-level estimates for most indicators showed remarkable variations. Yet the minimum dietary diversity and acceptable diet indicators were consistently low.ConclusionMost breastfeeding-related indicators, except exclusive and early initiation of breastfeeding, are in an acceptable level in SSA. However, complementary feeding indicators are generally low.

Non-iodized salt consumption among women of reproductive age in sub-Saharan Africa: a population-based study

2020 ◽  
Vol 23 (15) ◽  
pp. 2759-2769
Author(s):  
Djibril M Ba ◽  
Paddy Ssentongo ◽  
Duanping Liao ◽  
Ping Du ◽  
Kristen H Kjerulff
Keyword(s):  
Logistic Regression ◽  
Iodized Salt ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Women Of Reproductive Age ◽  
Cross Sectional ◽  
Factors Associated ◽  
Multivariable Logistic Regression ◽  
Sub Saharan

AbstractObjective:To identify countries in sub-Saharan Africa (SSA) that have not yet achieved at least 90 % universal salt iodization and factors associated with the consumption of non-iodized salt among women of reproductive age.Design:A cross-sectional study using data from Demographic and Health Surveys (DHS). The presence of iodine in household salt (iodized or non-iodized), which was tested during the survey process, was the study outcome. Multivariable logistic regression models were used to determine independent factors associated with the consumption of non-iodized salt among women of reproductive age.Setting:There were eleven countries in SSA that participated in the DHS since 2015 and measured the presence of iodine in household salt.Participants:Women (n 108 318) aged 15–49 years.Results:Countries with the highest rate of non-iodized salt were Senegal (29·5 %) followed by Tanzania (21·3 %), Ethiopia (14·0 %), Malawi (11·6 %) and Angola (10·8 %). The rate of non-iodized salt was less than 1 % in Rwanda (0·3 %), Uganda (0·5 %) and Burundi (0·8 %). Stepwise multivariable logistic regression showed that women were more likely to be using non-iodized salt (adjusted OR; 95 % CI) if they were poor (1·62; 1·48, 1·78), pregnant (1·16; 1·04, 1·29), aged 15–24 years (v. older: 1·14; 1·04, 1·24) and were not literate (1·14; 1·06, 1·23).Conclusions:The use of non-iodized salt varies among SSA countries. The higher level of use of non-iodized salt among poor, young women and pregnant women is particularly concerning.

scholarly journals Ambient Air Pollution and Respiratory Health in Sub-Saharan African Children: A Cross-Sectional Analysis

2021 ◽  
Vol 18 (18) ◽  
pp. 9729
Author(s):  
Yutong Cai ◽  
Harry Gibson ◽  
Rema Ramakrishnan ◽  
Mohammad Mamouei ◽  
Kazem Rahimi
Keyword(s):  
Air Pollution ◽  
Respiratory Health ◽  
Ambient Air ◽  
Household Wealth ◽  
Sub Saharan Africa ◽  
Ambient Air Pollution ◽  
Demographic And Health Surveys ◽  
Acute Lower Respiratory Infection ◽  
Cross Sectional ◽  
Sub Saharan

Ambient air pollution is projected to become a major environmental risk in sub-Saharan Africa (SSA). Research into its health impacts is hindered by limited data. We aimed to investigate the cross-sectional relationship between particulate matter with a diameter ≤ 2.5 μm (PM2.5) and prevalence of cough or acute lower respiratory infection (ALRI) among children under five in SSA. Data were collected from 31 Demographic and Health Surveys (DHS) in 21 SSA countries between 2005–2018. Prior-month average PM2.5 preceding the survey date was assessed based on satellite measurements and a chemical transport model. Cough and ALRI in the past two weeks were derived from questionnaires. Associations were analysed using conditional logistic regression within each survey cluster, adjusting for child’s age, sex, birth size, household wealth, maternal education, maternal age and month of the interview. Survey-specific odds ratios (ORs) were pooled using random-effect meta-analysis. Included were 368,366 and 109,664 children for the analysis of cough and ALRI, respectively. On average, 20.5% children had reported a cough, 6.4% reported ALRI, and 32% of children lived in urban areas. Prior-month average PM2.5 ranged from 8.9 to 64.6 μg/m3. Pooling all surveys, no associations were observed with either outcome in the overall populations. Among countries with medium-to-high Human Development Index, positive associations were observed with both cough (pooled OR: 1.022, 95%CI: 0.982–1.064) and ALRI (pooled OR: 1.018, 95%CI: 0.975–1.064) for 1 μg/m3 higher of PM2.5. This explorative study found no associations between short-term ambient PM2.5 and respiratory health among young SSA children, necessitating future analyses using better-defined exposure and health metrics to study this important link.

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