Socioeconomic factors contributing to under-five mortality in sub-Saharan Africa: a decomposition analysis

This chapter provides an overview of the complex interactions between ecological and socioeconomic factors for the development and control of Buruli ulcer in Sub-Saharan Africa. We review key ecological and evolutionary processes driving the environmental persistence and proliferation of Mycobacterium ulcerans, the causative agent, within aquatic environments, as well as transmission processes from these aquatic environments to human populations. We also outline key socioeconomic factors driving the economic and health burden of Buruli ulcer in endemic regions, revealed by reciprocal feedbacks between poverty, disease transmission from exposure aquatic environments and disease progression to severe stages owing to low access to health care. The implications of such insights for disease control, both in terms of limitations of current strategies and directions for the future, are discussed.

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Decomposing the rural–urban gap in factors associated with childhood immunisation in sub-Saharan Africa: evidence from surveys in 23 countries

BMJ Global Health ◽

10.1136/bmjgh-2020-003773 ◽

2021 ◽

Vol 6 (1) ◽

pp. e003773

Author(s):

Edward Kwabena Ameyaw ◽

Yusuf Olushola Kareem ◽

Bright Opoku Ahinkorah ◽

Abdul-Aziz Seidu ◽

Sanni Yaya

Keyword(s):

Decomposition Analysis ◽

Household Wealth ◽

Sub Saharan Africa ◽

Demographic And Health Surveys ◽

Childhood Immunisation ◽

Urban Settings ◽

Factors Associated ◽

Rural And Urban ◽

Full Immunisation ◽

Sub Saharan

BackgroundAbout 31 million children in sub-Saharan Africa (SSA) suffer from immunisation preventable diseases yearly and more than half a million children die because of lack of access to immunisation. Immunisation coverage has stagnated at 72% in SSA over the past 6 years. Due to evidence that full immunisation of children may be determined by place of residence, this study aimed at investigating the rural–urban differential in full childhood immunisation in SSA.MethodsThe data used for this study consisted of 26 241 children pooled from 23 Demographic and Health Surveys conducted between 2010 and 2018 in SSA. We performed a Poisson regression analysis with robust Standard Errors (SEs) to determine the factors associated with full immunisation status for rural and urban children. Likewise, a multivariate decomposition analysis for non-linear response model was used to examine the contribution of the covariates to the observed rural and urban differential in full childhood immunisation. All analyses were performed using Stata software V.15.0 and associations with a p<0.05 were considered statistically significant.ResultsMore than half of children in urban settings were fully immunised (52.8%) while 59.3% of rural residents were not fully immunised. In all, 76.5% of rural–urban variation in full immunisation was attributable to differences in child and maternal characteristics. Household wealth was an important component contributing to the rural–urban gap. Specifically, richest wealth status substantially accounted for immunisation disparity (35.7%). First and sixth birth orders contributed 7.3% and 14.9%, respectively, towards the disparity while 7.9% of the disparity was attributable to distance to health facility.ConclusionThis study has emphasised the rural–urban disparity in childhood immunisation, with children in the urban settings more likely to complete immunisation. Subregional, national and community-level interventions to obviate this disparity should target children in rural settings, those from poor households and women who have difficulties in accessing healthcare facilities due to distance.

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

BMC Pregnancy and Childbirth ◽

10.1186/s12884-020-03531-5 ◽

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.

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Public health and research funding for childhood neurodevelopmental disorders in Sub-Saharan Africa: a time to balance priorities

Healthcare in Low-resource Settings ◽

10.4081/hls.2014.1559 ◽

2014 ◽

Vol 2 (1) ◽

Cited By ~ 12

Author(s):

Muideen O. Bakare ◽

Kerim M. Munir ◽

Mashudat A. Bello-Mojeed

Keyword(s):

Public Health ◽

Mental Health ◽

Neurodevelopmental Disorders ◽

Research Funding ◽

Mental Health Problems ◽

Policy Formulation ◽

Sub Saharan Africa ◽

Under Five ◽

Mortality Index ◽

Sub Saharan

Sub-Saharan African (SSA) population consists of about 45% children, while in Europe and North America children population is 10- 15%. Lately, attention has been directed at mitigating childhood infectious and communicable diseases to reduce under-five mortality. As the under-five mortality index in Sub-Saharan Africa has relatively improved over the last two decades, more Sub-Saharan African children are surviving beyond the age of five and, apparently, a sizeable percentage of this population would be living with one or more childhood neurodevelopmental disorders (NDD). The distribution of child mental health service resources across the world is unequal. This manifests in the treatment gap of major childhood onset mental health problems in SSA, with the gap being more pronounced for childhood NDD. It is important to balance the public health focus and research funding priorities in Sub-Saharan Africa. We urgently need to define the burden of childhood NDD in the region for healthcare planning and policy formulation.

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Analysis of HIV/AIDS Epidemic and Socioeconomic Factors in Sub-Saharan Africa

Entropy ◽

10.3390/e22111230 ◽

2020 ◽

Vol 22 (11) ◽

pp. 1230 ◽

Cited By ~ 1

Author(s):

Shuman Sun ◽

Zhiming Li ◽

Huiguo Zhang ◽

Haijun Jiang ◽

Xijian Hu

Keyword(s):

Socioeconomic Factors ◽

Regression Models ◽

Sub Saharan Africa ◽

Likelihood Method ◽

Unknown Parameters ◽

Aids Epidemic ◽

Acquired Immunodeficiency ◽

Sub Saharan ◽

Immunodeficiency Syndrome ◽

Hiv Aids

Sub-Saharan Africa has been the epicenter of the outbreak since the spread of acquired immunodeficiency syndrome (AIDS) began to be prevalent. This article proposes several regression models to investigate the relationships between the HIV/AIDS epidemic and socioeconomic factors (the gross domestic product per capita, and population density) in ten countries of Sub-Saharan Africa, for 2011–2016. The maximum likelihood method was used to estimate the unknown parameters of these models along with the Newton–Raphson procedure and Fisher scoring algorithm. Comparing these regression models, there exist significant spatiotemporal non-stationarity and auto-correlations between the HIV/AIDS epidemic and two socioeconomic factors. Based on the empirical results, we suggest that the geographically and temporally weighted Poisson autoregressive (GTWPAR) model is more suitable than other models, and has the better fitting results.

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MATERNAL HEALTH-SEEKING BEHAVIOUR AND UNDER-FIVE MORTALITY IN ZIMBABWE

Journal of Biosocial Science ◽

10.1017/s0021932016000298 ◽

2016 ◽

Vol 49 (3) ◽

pp. 408-421 ◽

Cited By ~ 1

Author(s):

Nyasha Chadoka-Mutanda ◽

Clifford O. Odimegwu

Keyword(s):

Public Health ◽

Maternal Health ◽

Reproductive Age ◽

Sub Saharan Africa ◽

Health Seeking Behaviour ◽

Health Seeking ◽

Cross Sectional ◽

Under Five ◽

Sub Saharan ◽

Cox Proportional Hazard Regression

SummaryUnder-five mortality remains a major public health challenge in sub-Saharan Africa. Zimbabwe is one of the countries in the region that failed to achieve Millennium Developmental Goal 4 in 2015. The objective of this study was to examine the extent to which maternal health-seeking behaviour prior to and during pregnancy and post-delivery influences the likelihood of under-five mortality among Zimbabwean children. The study was cross-sectional and data were extracted from the 2010/11 Zimbabwe Demographic and Health Survey (ZDHS). The study sample comprised 5155 children who were born five years preceding the 2010/11 ZDHS to a sample of 4128 women of reproductive age (15–49 years). Cox Proportional Hazard regression modelling was used to examine the relationship between maternal health-seeking behaviour and under-five mortality. The results showed that maternal health-seeking behaviour factors are associated with the risk of dying during childhood. Children born to mothers who had ever used contraceptives (HR: 0.38, CI 0.28–0.51) had a lower risk of dying during childhood compared with children born to mothers who had never used any contraceptive method. The risk of under-five mortality among children who had a postnatal check-up within two months after birth (HR: 0.36, CI 0.23–0.56) was lower than that of children who did not receive postnatal care. Small birth size (HR: 1.70, CI 1.20–2.41) and higher birth order (2+) increased the risk of under-five mortality. Good maternal health-seeking behaviour practices at the three critical stages around childbirth have the potential to reduce under-five mortality. Therefore, public health programmes should focus on influencing health-seeking behaviour among women and removing obstacles to effective maternal health-seeking behaviour in Zimbabwe.

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Biological nitrogen fixation and socioeconomic factors for legume production in sub-Saharan Africa: a review

Agronomy for Sustainable Development ◽

10.1051/agro/2010004 ◽

2011 ◽

Vol 31 (1) ◽

pp. 139-154 ◽

Cited By ~ 39

Author(s):

Jonas. N. Chianu ◽

E. M. Nkonya ◽

F. S. Mairura ◽

Justina. N. Chianu ◽

F. K. Akinnifesi

Keyword(s):

Nitrogen Fixation ◽

Socioeconomic Factors ◽

Biological Nitrogen Fixation ◽

Sub Saharan Africa ◽

Sub Saharan ◽

Legume Production ◽

Biological Nitrogen

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A Scoping Review of the Risk Factors Associated with Anaemia among Children Under Five Years in Sub-Saharan African Countries

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17238829 ◽

2020 ◽

Vol 17 (23) ◽

pp. 8829

Author(s):

Phillips Edomwonyi Obasohan ◽

Stephen J. Walters ◽

Richard Jacques ◽

Khaled Khatab

Keyword(s):

Risk Factors ◽

Scoping Review ◽

Household Wealth ◽

Sub Saharan Africa ◽

Cochrane Library ◽

Children Under Five ◽

Contextual Risk ◽

Under Five ◽

Factors Associated ◽

Sub Saharan

Background/Purpose: Globally, anaemia is a severe public health condition affecting over 24% of the world’s population. Children under five years old and pregnant women are the most vulnerable to this disease. This scoping review aimed to evaluate studies that used classical statistical regression methods on nationally representative health survey data to identify the individual socioeconomic, demographic and contextual risk factors associated with developing anaemia among children under five years of age in sub-Saharan Africa (SSA). Methods/Design: The reporting pattern followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. The following databases were searched: MEDLINE, EMBASE (OVID platform), Web of Science, PUBMED, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, Scopus, Cochrane library, African Journal of online (AJOL), Google Scholar and Measure DHS. Results: The review identified 20 relevant studies and the risk factors for anaemia were classified as child-related, parental/household-related and community- or area-related factors. The risk factors for anaemia identified included age, birth order, sex, comorbidities (such as fever, diarrhoea and acute respiratory infection), malnutrition or stunting, maternal education, maternal age, mother’s anaemia status, household wealth and place of residence. Conclusion: The outcome of this review is of significant value for health policy and planners to enable them to make informed decision that will correct any imbalances in anaemia across socioeconomic, demographic and contextual characteristics, with the view of making efficient distributions of health interventions.

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