Role of Maternal Education and Vaccination Coverage: Evidence From Pakistan Demographic and Health Survey

2019 ◽  
Vol 31 (8) ◽  
pp. 679-688 ◽  
Author(s):  
Atta Muhammad Asif ◽  
Muhammad Akbar ◽  
Muhammad Ramzan Tahir ◽  
Irshad Ahmad Arshad

The aim of this study was to examine the impact of maternal education on child immunization uptake in Pakistan, both at individual and community levels. Pakistan Demographic and Health Survey data were used for analysis. Multilevel logistic regression was used to access the individual- and community-level factors associated with childhood immunization coverage. Out of 6765 children 2659 (39.3%) were fully immunized. Parents education, access to media, and wealth status have positive while ethnicity and working status of mother have a negative impact on the immunization uptake. In the community with a high percentage of educated mothers, the odds of immunized children were high (odds ratio = 1.43, 95% confidence interval = 1.14-1.80) as compared with communities with lower percentage of educated mothers. Moreover, significant variation was found in the likelihood of full immunization across communities. Both community- and individual-level factors have substantial impact on children immunization status. There is a need of improvement in maternal education, poverty alleviation, and removal of rural-urban disparities.

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.  


2021 ◽  
Vol 49 (1) ◽  
Author(s):  
Setegn Muche Fenta ◽  
Hailegebrael Birhan Biresaw ◽  
Kenaw Derebe Fentaw ◽  
Shewayiref Geremew Gebremichael

Abstract Background Sub-Saharan Africa is one of the highest under-five mortality and low childhood immunization region in the world. Children in Sub-Saharan Africa are 15 times more likely to die than children from high-income countries. In sub-Saharan Africa, more than half of under-five deaths are preventable through immunization. Therefore, this study aimed to identify the determinant factors of full childhood immunization among children aged 12–23 months in sub-Saharan Africa. Methods Data for the study was drawn from the Demographic and Health Survey of nine sub-Saharan African countries. A total of 21,448 children were included. The two-level mixed-effects logistic regression model was used to identify the individual and community-level factors associated with full childhood immunization Result The prevalence of full childhood immunization coverage in sub-Saharan Africa countries was 59.40% (95% CI: 58.70, 60.02). The multilevel logistic regression model revealed that secondary and above maternal education (AOR = 1.38; 95% CI: 1.25, 1.53), health facility delivery (AOR = 1.51; 95% CI: 1.41, 1.63), fathers secondary education and above (AOR = 1.28, 95% CI: 1.11, 1.48), four and above ANC visits (AOR = 2.01; 95% CI: 1.17, 2.30), PNC visit(AOR = 1.55; 95% CI: 1.46, 1.65), rich wealth index (AOR = 1.26; 95% CI: 1.18, 1.40), media exposure (AOR = 1.11; 95% CI: 1.04, 1.18), and distance to health facility is not a big problem (AOR = 1.42; 95% CI: 1.28, 1.47) were significantly associated with full childhood immunization. Conclusion The full childhood immunization coverage in sub-Saharan Africa was poor with high inequalities. There is a significant variation between SSA countries in full childhood immunization. Therefore, public health programs targeting uneducated mothers and fathers, rural mothers, poor households, and those who have not used maternal health care services to promote full childhood immunization to improve child health. By enhancing institutional delivery, antenatal care visits and maternal tetanus immunization, the government and other stakeholders should work properly to increase child immunization coverage. Furthermore, policies and programs aimed at addressing cluster variations in childhood immunization need to be formulated and their implementation must be strongly pursued.


Author(s):  
Albert Apotele Nyaaba ◽  
Augustine Tanle ◽  
Louis Kobina Kobina ◽  
Matthew Ayamga

Background and Objectives: This study aims to investigate the strength of the association between socio-economic, maternal and environmental determinants and under-five mortality in Ghana. Methods: We utilized data from the 2014 Ghana Demographic and Health Survey, a population-based cross-sectional study, which included 4151 children born alive to women aged 15-49 years. The primary outcome variable was under-five mortality. Descriptive statistics and multivariate logistic regression were applied to assess the relationship and relative association of the independent variables with the outcome variable. Results: Children of women with secondary education and above and women within the middle wealth status were 0.593 and 0.886 less likely to experience under five deaths compared to women with no education and women of low wealth status (OR=0.593; 95% CI 1.690 to 2.063; p< 0.01) (OR =0.886; 95% CI 1.48 to 1.63; p<0.01). Women who had their first birth at age 20-29 years were 0.764 less likely to experience under-five deaths compared to those aged 15-19 years (OR= 0.764; 95% CI 0.994 to 1.191; p<0.01). Children born in households with pit toilets were more likely (OR= 1.51; 95% CI 1.20 to 2.30; p<0.01) to die before age five compared to children born in households with flushed toilet. Women who used bore hole /well water were more likely (OR= 1.686; 95% CI 2.94 to 3.01; p< 0.05) to experience under-five deaths compared to women who used piped water. Conclusion and Implications for Translation: This study identified the determinants that significantly predicted under-five deaths and the magnitude of the influence on under-five deaths in Ghana. It accentuates the need for increased maternal education, delayed child bearing, provision of improved drinking water and toilet facilities to reduce under-five deaths in Ghana. Key words: • Socio-economic • Maternal health • Child health • Environmental factors • Under-five mortality • Ghana • Demographic and Health Survey • DHS   Copyright © 2020 Nyaaba, et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in this journal, is properly cited.


2021 ◽  
Author(s):  
Bright Nkhoma ◽  
Wingston Felix Ng'ambi ◽  
Peter J. Chipimo ◽  
Mowa Zambwe

ABSTRACT: OBJECTIVE: The study aimed at identifying socioeconomic and environmental factors that were associated with stunting among children aged 0 to 59 months in Zambia. BACKGROUND: Hitherto, stunting continues to be a Public Health problem worldwide. A child is stunted if his or her height is less than negative two standard deviations below the World Health Organization (WHO) standard. The study aimed to explore determinants of stunting in Zambia among children (< 5 years of age) using the Zambia Demographic and Health Survey (ZDHS) 2018 to 2019 database. METHODS: A total of 7, 045 Zambian children with complete anthropometric measurements and aged 0 to 59 months were included in the study. Nutritional status was evaluated using anthropometric; height for age, as a proxy measure of stunting. Univariate and multivariate binary logistic regression were used to examine the association between stunting and selected environmental, maternal sociodemographic and child level variables. RESULTS: A total of 2, 479 children under the age of five found to be stunted representing a prevalence of 34.9%. Stunting was higher among male children as compared to female children (38.5% vs 31.3% respectively). Additional analysis revealed that children from households whose source of drinking water was improved (34%) were less likely to be stunted compared to children from households whose source of drinking water was non-improved (40%). Stunting was statistically significantly associated with sex and age of a child; birth size; breastfeeding; residence; maternal education; wealth index; twin births and the birth interval among siblings. Children born to mothers whose previous birth interval is less than 24 months (aOR= 1.34 95%CI: 1.13-1.58; p<0.001), children from lower index households (aOR= 1.65 95%CI: 1.32-2.08; p<0.001), twin births (aOR=2.65 95%CI: 1.61-4.36; p<0.001), children whose mothers had primary education (aOR=1.16 95%CI 1.00-1.35; p=0.046), children coming from households whose source of drinking water was non-improved (aOR= 1.30 95%CI: 1.09-1.5: p=0.003), child not breastfed (aOR= 1.20 95%CI: 1.04-1.38; p=0.015) were more likely to be stunted. CONCLUSION: The study established that the major predictors of stunting among children under 5 years old in Zambia were sex and age of the child; birth weight; maternal education; wealth status; source of drinking water; twin births, breastfeeding, residence and the birth interval among siblings. Therefore, to reduce the burden of stunting interventions that can address these factors are required such as community based education and targeted nutritional interventions. Keywords: Children, Stunting, Zambia Demographic and Health Survey


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mesfin Wudu Kassaw ◽  
Ayele Mamo Abebe ◽  
Biruk Beletew Abate ◽  
Seteamlak Adane Masresha ◽  
Ayelign Mengesha Kassie ◽  
...  

Abstract Background Globally, 4 million infants die in their first 4weeks of life every year; above 8 million infants died before their first year of birthday, and nearly 10 million children died before their 5th birthday. Majority of the deaths were occurred at home because of not receiving health care. In Ethiopia, 120,000 infants died during their first 4 weeks of life. The aim of this study was to assess maternal knowledge about neonatal danger signs and its associations after they had been thought by health professionals in Ethiopia. Methods This study used the 2016 Ethiopian Demographic and Health Survey data (EDHS) as a data source. The 2016 EDHS data were collected using a two stage sampling method. All the regions were stratified into urban and rural areas. The study sample taken from the 2016 EDHS data and used in this further analysis was 325. A logistic regression model was used to assess the associations with post health education maternal knowledge on neonatal danger signs. Results In this study, mothers who had poor knowledge about neonatal danger signs (NDS) were 69.8 % (227) (95 %CI (64.8, 74.8 %). In the final logistic model, wanted no more child ((AOR = 4.15), (95 %CI = 1.12, 15.41)), female child ((AOR = 0.58), (95 %CI = 0.34, 0.98)), primary level maternal education ((AOR = 0.42), (95 %CI = 0.19, 0.92)), secondary level maternal education ((AOR = 0.37), (95 %CI = 0.16, 0.91)), and average size of child ((AOR = 2.64), (95 %CI = 1.26, 5.53)), and small size child ((AOR = 4.53), (95 %CI = 1.52, 13.51)) associated with post health education maternal knowledge about NDS. Conclusion The mothers’ knowledge about NDS is poor even they were gave a birth in health facilities. Wanting of additional child, child sex, maternal education and size of child were associated with NDS knowledge. This indicates that the mode of health education provided for mother might not be appropriate and needs protocol changes.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Mastewal Arefaynie ◽  
Melaku Yalew ◽  
Yitayish Damtie ◽  
Bereket Kefale

Abstract Background Evidences on determinants of early sexual initiation among female youth is still limited especially; community-level factors are not investigated in Ethiopia. Therefore, the aim of this study was to assess individual and community-level factors associated with early sexual initiation among female youth in Ethiopia. Methods The 2016 Ethiopian Demographic and Health Survey (EDHS) dataset were used and a total of 6143 participants (female youth) were included. Multi-level mixed-effect logistic regression was done to identify individual and community-level factors. Adjusted odds ratio along with 95% confidence interval was used to show the strength and direction of the association. Finally, the level of statistical significance was declared at P value less than 0.05. Results Individual-level factors significantly associated with early sexual initiation among female youth were; age group from 19 to 24 years [AOR = 5.8, 95% CI = (4.6, 7.3)], not attending school [AOR = 14.1, 95% CI = (8.1, 24.7)], ever chewing Chat [AOR = 2.0, 95% CI = (1.3, 3.0)]. From community-level factors: living in Addis Ababa [AOR = 0.3, 95% CI = (0.2, 0.5)], living in Gambella [AOR = 2.7, 95% CI = (1.7, 4.3)] and live in a low proportion of poor communities [AOR = 0.7, 95% CI = (0.5, 0.9)] were significantly associated with early sexual initiation among female youth in Ethiopia. Conclusions Age, low educational status, ever chewing Chat, region and live in a high proportion of poor community had a statistical association with early sexual initiation among female youth in Ethiopia. Improving educational coverage and community-level of wealth status are important intervention areas to delay the age of early sexual initiation.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Eugene Budu

Abstract Background Home births is one of the factors associated with maternal mortality. This study examined the predictors of home births among rural women in Ghana. Methods Data for this study was obtained from the 2014 Demographic and Health Survey (DHS) of Ghana. For the purpose of this study, a sample size of 2,101 women in the rural areas who had given birth within five years prior to the survey and had responses on variables was considered. Data processing, management and analysis were carried out using STATA version 14.0. This study carried out bivariate and multivariate analyses and results were tested at 95% confidence interval. The Adjusted odds ratios were used to present the results and the level of statistical significance was assessed using 95% confidence intervals. Results Home births was found to be high among women who resided in the Northern region compared to those in the Western region [AOR, 1.81 CI = 1.10–2.98]. Similarly, the likelihood of home birth was high among women with four or more births [AOR, 1.46 CI = 1.03–2.05] and Traditionalists [AOR, 2.50 CI = 1.54–4.06]. Conversely, giving birth at home was low among women with higher level of education [AOR = 0.58, CI = 0.43–0.78], those with rich wealth status [AOR = 0.19, CI = 0.10–0.38], those with four or more ANC visits [AOR = 0.11, CI = 0.15–0.23] and those who were covered by NHIS [AOR = 0.58, CI = 0.46–0.72]. Conclusions Over the years, there have been efforts by governments in Ghana to make maternal health services free in the country. However, a substantial proportion of women still undergo home births. To reduce the utilization of home births in Ghana, it is essential that government and non-governmental organisations make the cost of delivery services part of the free maternal health care policy and take into consideration the factors associated with the high rates of home births among rural women in Ghana.


Complexity ◽  
2019 ◽  
Vol 2019 ◽  
pp. 1-15 ◽  
Author(s):  
Yixin Zhang ◽  
Xifu Wang

Supply risk can have a negative impact on a manufacturer’s performance. Backup sourcing is one of the most commonly used strategies to mitigate the adverse consequences of supply risks. In this paper, we study a procurement strategy with backup sourcing when a manufacturer faces stochastic supply risk and demand. The optimal decisions of the players involved are investigated theoretically using the game theoretic framework, and the impacts of the key parameters, such as wholesale prices and the risk probability, are assessed numerically under supply information symmetry and asymmetry. The results illustrate that the reservation price provided by the backup supplier varies greatly under different information-sharing conditions. Reservation quantity is negatively correlated with the reservation price, which is affected by the risk probability, wholesale prices, and marginal cost of the backup supplier. We also show that given the same wholesale prices, the potential supply risk has a substantial impact on the manufacturer’s expected profit, and the performance of the manufacturer under asymmetrical supply information is not always better than that under symmetrical information. In addition, we also discuss the impact of wholesale prices on reservation price and participants’ profits based on numerical examples. The research enriches the understanding of a procurement strategy under stochastic supply risk, and the conclusions have certain management significance.


2012 ◽  
Vol 15 (9) ◽  
pp. 1715-1727 ◽  
Author(s):  
Peninah K Masibo ◽  
Donald Makoka

AbstractObjectiveTo report on the trends and determinants of undernutrition among children <5 years old in Kenya.DesignData from four nationwide Kenya Demographic and Health Surveys, conducted in 1993, 1998, 2003 and 2008–2009, were analysed. The Demographic and Health Survey utilizes a multistage stratified sampling technique.SettingNationwide covering rural and urban areas in Kenya.SubjectsThe analysis included 4757, 4433, 4892 and 4958 Kenyan children aged <5 years in 1993, 1998, 2003 and 2009–2009, respectively.ResultsThe prevalence of stunting decreased by 4·6 percentage points from 39·9 % in 1993 to 35·3 % in 2008–2009, while underweight decreased by 2·7 percentage points from 18·7 % in 1993 to 16·0 % in 2008–2009. The effects of household wealth, maternal education and current maternal nutritional status on child nutrition outcomes have changed dynamically in more recent years in Kenya. Inadequate hygiene facilities increased the likelihood of chronic undernutrition in at least three of the surveys. Small size of the child at birth, childhood diarrhoea and male gender increased the likelihood of undernutrition in at least three of the surveys. Childhood undernutrition occurred concurrently with maternal overnutrition in some households.ConclusionsThe analysis reveals a slow decline of undernutrition among young children in Kenya over the last three decades. However, stunting and underweight still remain of public health significance. There is evidence of an emerging trend of a malnutrition double burden demonstrated by stunted and underweight children whose mothers are overweight.


2016 ◽  
Vol 29 (1) ◽  
pp. 60-69
Author(s):  
Most. Fatima-Tuz-Zahura ◽  
Khandoker Akib Mohammad ◽  
Wasimul Bari

Log-logistic parametric survival regression model has been used to find out the potential determinants of infant mortality in Bangladesh using the data extracted from Bangladesh Demographic and Health Survey, 2011. First, nonparametric product-limit approach has been used to examine the unadjusted association between infant mortality and covariate of interest. It is found that maternal education, membership of nongovernmental organizations, age of mother at birth, sex of child, size of child at birth, and place of delivery play an important role in reducing the infant mortality, adjusting relevant covariates.


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