scholarly journals Temporal relationship between Women’s empowerment and utilization of antenatal care services: lessons from four National Surveys in sub-Saharan Africa

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yusuf Olushola Kareem ◽  
Imran Oludare Morhason-Bello ◽  
Funmilola M. OlaOlorun ◽  
Sanni Yaya
Keyword(s):  
Maternal Health ◽  
Antenatal Care ◽  
Women's Empowerment ◽  
First Trimester ◽  
Sub Saharan Africa ◽  
Women’S Empowerment ◽  
Antenatal Visit ◽  
Women Empowerment ◽  
Maternal Health Outcomes ◽  
Sub Saharan

Abstract Background In November 2016, the WHO four-visit focused antenatal care (FANC) model adopted in sub-Saharan Africa (SSA) was reverted to eight contacts or more as a response to reducing the global perinatal and maternal deaths and in achieving the sustainable development goal (SDG) 3. Women’s empowerment, which connote the social standing, position and the ability of women to make life decisions and choices has been associated with the maternal health seeking behaviour and outcomes. This study examined the association between women’s empowerment and the WHO ANC model of eight visits or more, and early first antenatal visit among pregnant women. In addition, we explored the association between women’s empowerment and the WHO FANC model to allow for comparison for countries that have not adopted the recent WHO ANC model. Methods The most recent (2018) Demographic and Health Survey (DHS) datasets conducted in SSA were used for analyses. We used all available indicators of women’s empowerment captured in the DHS. The 30 variables on women’s empowerment were classified into eight components using exploratory factor analysis. We fitted separate ordinal logistic regression to assess association between antenatal care utilization (number of visits and time of first antenatal visit) and women empowerment factors while adjusting for other covariates. Analysis was performed with STATA 15.0 and adjusted for complex survey design, p-value< 0.05 were used for interpretation of results. Results The proportion of women who attended eight or more ANC visits were 1.4, 2.7 and 3.5% in Zambia, Guinea and Mali, respectively. Zambia had the lowest prevalence of 8 or more ANC visits also had the highest prevalence of at least 4 visits (63.8%) and early first ANC visit (38.2%), while Nigeria with the highest prevalence of women with at least 8 visits (17.7%) had the lowest prevalence (17.6%) of women that attended ANC visit in their first trimester. Women’s empowerment was associated with more ANC visits and attending first ANC visit in the first trimester. However, these association with the women empowerment components varied significantly across the four SSA countries. Conclusion This study highlights the significant impact of women’s empowerment as a key factor for improving maternal health outcomes in SSA. It is imperative that government and development partners invest more on empowerment of women as part of strategic intervention to improve maternal health outcomes.

scholarly journals Women’s Empowerment and HIV Testing Uptake: A Meta-analysis of Demographic and Health Surveys from 33 Sub-Saharan African Countries

2020 ◽  
Vol 9 (3) ◽  
pp. 274-286
Author(s):  
Sanni Yaya ◽  
Gebretsadik Shibre ◽  
Dina Idriss-Wheeler ◽  
Olalekan A Uthman
Keyword(s):  
Global Health ◽  
Hiv Testing ◽  
Women's Empowerment ◽  
Sub Saharan Africa ◽  
Wife Beating ◽  
Women’S Empowerment ◽  
Demographic And Health Surveys ◽  
Women Empowerment ◽  
Testing Uptake ◽  
Sub Saharan

Background: There is a growing body of evidence suggesting that women’s empowerment can help achieve better health behaviours and outcomes. However, few have looked at the impact of women’s empowerment on HIV testing in Sub-Saharan Africa (SSA). This study investigated the association between women’s empowerment and HIV testing among women in 33 countries across SSA. Methods: Cross-sectional data from the most recent Demographic and Health Surveys (2005-2018) of 33 countries in SSA were used. Confounder adjusted logistic regression analysis was completed separately for each of the 33 DHS datasets to produce the adjusted Odds Ratio (OR) for the association between women empowerment and HIV testing. The regression analysis strictly accounted for the three design elements (weight, cluster and strata) to produce an estimate representative of the respective countries. Finally, an Individual Participant Data (IPD) meta-analysis approach was used to statistically pool the effect of women empowerment on HIV testing. Results: There was a wide variation in the percentage of women who were empowered among the countries studied, with only a few countries such as South Africa, Angola and Ghana having a high prevalence of negative attitudes toward wife beating. HIV testing was higher in Angola, Lesotho, Uganda and South Africa. While participation in one or two of the three decisions had been marginally associated with lower odds of HIV testing across the SSA regions (0.89; 95%CI: 0.83, 0.97); the corresponding prediction interval crossed the null. Being involved in the three decisions (0.92; 95%CI: 0.84, 1.00) and disagreement to wife-beating (0.99; 95%CI: 0.94, 1.05) had no statistical relationship with HIV testing uptake. Conclusion and Global Health Implications: The two indirect indicators of women empowerment could not predict HIV testing uptake. Further studies are recommended to establish the nature of the relationship between HIV testing and women’s empowerment that is measured through standard tools. Key words: • HIV/AIDS prevention • Women • Empowerment • Gender equality • Global health • Sub-Saharan Africa   Copyright © 2020 Yaya 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.

Do urban areas still have advantages over rural areas in antenatal care discontinuity in Sub-Saharan Africa?

2021 ◽  
Vol 9 (2) ◽  
pp. 27-35
Author(s):  
Franklin Bouba Djourdebbé ◽  
Keyword(s):  
Maternal Health ◽  
Antenatal Care ◽  
Rural Areas ◽  
Urban Areas ◽  
Sub Saharan Africa ◽  
Health Policies ◽  
Antenatal Visit ◽  
Urban Rural ◽  
Health Survey Data ◽  
Sub Saharan

In sub-Saharan Africa, among the small proportion of women who had at least one antenatal visit, many of them no longer return to ensure continuity of antenatal care. This antenatal care discontinuity is a matter of serious concern for maternal health. Using Demographic and Health Survey data collected between 2000 and 2016 in 26 sub-Saharan countries, this study aims to analyse urban/rural differences in antenatal care discontinuity. Although in the majority of countries, urban areas have considerable advantages in terms of antenatal care continuity, there are countries where urban/rural differences are not significant, as well as atypical countries (Rwanda, Gambia and Zambia) where antenatal care discontinuity is higher in urban areas compared to rural areas. This study is a contribution to tackle the complex disparities in the discontinuity of care during pregnancy in maternal health policies in sub-Saharan Africa. Keywords: Maternal health, antenatal care, urban, rural, sub-Saharan Africa.

scholarly journals The impact of antenatal care on under‐five mortality in Ethiopia: a difference‐in‐differences analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Samuel Oduse ◽  
Temesgen Zewotir ◽  
Delia North
Keyword(s):  
Antenatal Care ◽  
Child Survival ◽  
First Trimester ◽  
Sub Saharan Africa ◽  
P Value ◽  
Difference In Differences ◽  
Under Five ◽  
Care Services ◽  
Sub Saharan ◽  
The Impact

Abstract Background Sub-Saharan Africa, as opposed to other regions, has the highest under-five mortality rates yet makes the least improvement in reducing under-five mortality. Despite the decline, Ethiopia is among the top ten countries contributing the most to global under-five mortalities. This article examines the impact of the number of antenatal care and the timing of first antenatal care on child health outcomes. We specifically investigated if the utilization of antenatal care services positively affects the reduction of under-five mortality. Methods We employ a difference-in-differences design with propensity score matching to identify direct causal effects of antenatal care on under-five mortality based on the Ethiopian Demographic Health Survey data of 2011 and 2016. Our sample includes 22 295 women between the ages of 14–49 who had antenatal care visits at different times before delivery. Results The study revealed 1 481 cases of reported under-five mortality. 99.0% of that under-five mortality cases are women who had less than eight antenatal care visits, while only 1% of that is by women who had eight or more antenatal care visits. Antenatal care visit decreases the likelihood of under-five mortality in Ethiopia by 45.2% (CI = 19.2–71.3%, P-value < 0.001) while the timing of first antenatal care within the first trimester decreases the likelihood of under-five mortality by 10% (CI = 5.7–15.6%, P-value < 0.001). Conclusions To achieve a significant reduction in the under-five mortality rate, Intervention programs that encourages more antenatal care visits should be considered. This will improve child survival and help in attaining Sustainable Development Goal targets.

scholarly journals Association between women’s empowerment and infant and child feeding practices in sub-Saharan Africa: an analysis of Demographic and Health Surveys

2015 ◽  
Vol 18 (17) ◽  
pp. 3155-3165 ◽  
Author(s):  
Muzi Na ◽  
Larissa Jennings ◽  
Sameera A Talegawkar ◽  
Saifuddin Ahmed
Keyword(s):  
Sierra Leone ◽  
Dietary Diversity ◽  
Women's Empowerment ◽  
Sub Saharan Africa ◽  
Women’S Empowerment ◽  
Demographic And Health Surveys ◽  
Meal Frequency ◽  
Child Feeding ◽  
Sub Saharan ◽  
Minimum Dietary Diversity

AbstractObjectiveTo explore the relationship between women’s empowerment and WHO recommended infant and young child feeding (IYCF) practices in sub-Saharan Africa.DesignAnalysis was conducted using data from ten Demographic and Health Surveys between 2010 and 2013. Women’s empowerment was assessed by nine standard items covering three dimensions: economic, socio-familial and legal empowerment. Three core IYCF practices examined were minimum dietary diversity, minimum meal frequency and minimum acceptable diet. Separate multivariable logistic regression models were applied for the IYCF practices on dimensional and overall empowerment in each country.SettingBenin, Burkina Faso, Ethiopia, Mali, Niger, Nigeria, Rwanda, Sierra Leone, Uganda and Zimbabwe.SubjectsYoungest singleton children aged 6–23 months and their mothers (n 15 153).ResultsLess than 35 %, 60 % and 18 % of children 6–23 months of age met the criterion of minimum dietary diversity, minimum meal frequency and minimum acceptable diet, respectively. In general, likelihood of meeting the recommended IYCF criteria was positively associated with the economic dimension of women’s empowerment. Socio-familial empowerment was negatively associated with the three feeding criteria, except in Zimbabwe. The legal dimension of empowerment did not show any clear pattern in the associations. Greater overall empowerment of women was consistently and positively associated with multiple IYCF practices in Mali, Rwanda and Sierra Leone. However, consistent negative relationships were found in Benin and Niger. Null or mixed results were observed in the remaining countries.ConclusionsThe importance of women’s empowerment for IYCF practices needs to be discussed by context and by dimension of empowerment.

scholarly journals THE ROLE OF WOMEN EMPOWERMENT IN AGRICULTURE ON HOUSEHOLD FARM COMMERCIALIZATION OF MAIZE, POTATOES AND BEANS IN NORTHERN PROVINCE OF RWANDA

2021 ◽  
Vol 59 (1) ◽  
Author(s):  
Olive Uwineza ◽  
Job Lagat ◽  
Risper M Berem
Keyword(s):  
Negative Relationship ◽  
Women's Empowerment ◽  
Sub Saharan Africa ◽  
Women’S Empowerment ◽  
Farm Size ◽  
Northern Province ◽  
Sub Saharan ◽  
The Government ◽  
Women's Role ◽  
Agriculture And Food

In Sub-Saharan Africa, agricultural commercialization is a major factor in household food diversification and household income. To move to agricultural transformation, Rwanda has focused on shifting from subsistence-based farming to market-oriented agriculture. Various studies have been conducted on agricultural commercialization, however, women’s role in the commercialization of agriculture has received little attention and none of the studies have associated it with women’s empowerment in agriculture. In Rwanda, women are principal players in agriculture and food security, therefore, it is important to understand the influence of their empowerment in agriculture on its commercialization. To investigate the relationship between women’s empowerment in agriculture and agricultural commercialization, the Women’s Empowerment in Agriculture Index (WEAI) was used to measure women’s empowerment in agriculture. A sample size of 252 households from Musanze and Burera districts in the Northern Province of Rwanda was used. It was obtained using the multistage and random sampling techniques. To analyze data, a fractional regression model was used. The results revealed that farm commercialization in Rwanda was positively and significantly influenced by WEAI score, farm size and the prices of maize, potatoes and beans. On the other hand, the index has a negative relationship with access to extension services. It is recommended that the government should strengthen policies of empowering women in agriculture.

Pregnancy intention and gestational age at first antenatal care visit in Lesotho

2021 ◽  
Vol 15 (1) ◽  
pp. 1-11
Author(s):  
Paul Mkandawire ◽  
Joseph Kangmennaang ◽  
Chad Walker ◽  
Roger Antabe ◽  
Kilian Atuoye ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Gestational Age ◽  
Secondary Data ◽  
Universal Coverage ◽  
Sub Saharan Africa ◽  
World Health ◽  
Antenatal Visit ◽  
Life Saving ◽  
Sub Saharan ◽  
Health Organization

Background/aims With coverage of antenatal care in sub-Saharan Africa approaching a universal level, attention is now turning to maximising the life-saving potential of antenatal care. This study assessed the gestational age at which pregnant mothers make their first antenatal visit in the context of high antenatal coverage in Lesotho. Methods For the purposes of this study, secondary data from the Demographic and Health Survey of 2014 was analysed. These data were collected in 2014, via an interviewer administered questionnaire. Survival analysis was applied to the data, using Stata SE 15 to compute time ratios that estimate time to first antenatal visit in Lesotho. Results Despite near universal coverage, only 24% of mothers start antenatal care before 12 weeks of gestation, as recommended by the World Health Organization. In addition, mothers with unwanted pregnancies are most likely to delay antenatal care until later in gestation, followed by mothers with mistimed pregnancies. Education, but not wealth, correlates with the start of antenatal care. Conclusions Having achieved near universal coverage, emphasising a prompt start and adherence to recommended visits could optimise the life-saving potential of antenatal care in Lesotho.

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