scholarly journals Women’s healthcare decision-making capacity and HIV testing in sub-Saharan Africa: a multi-country analysis of demographic and health surveys

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Abdul-Aziz Seidu ◽  
Joseph Kojo Oduro ◽  
Bright Opoku Ahinkorah ◽  
Eugene Budu ◽  
Francis Appiah ◽  
...  
Keyword(s):  
Decision Making ◽  
Hiv Testing ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Healthcare Decision ◽  
African Countries ◽  
Healthcare Decision Making ◽  
Decision Making Capacity ◽  
Testing Uptake ◽  
Sub Saharan

Abstract Background Global commitment to stop Human Immunodeficiency Virus (HIV) and ensure access to HIV treatment calls for women empowerment, as these efforts play major roles in mother-to-child transmission. We examined the association between women’s healthcare decision-making capacity and uptake of HIV testing in sub-Saharan Africa. Methods We used data from the current Demographic and Health Surveys (DHS) of 28 countries in sub-Saharan Africa, conducted between January 1, 2010 and December 31, 2018. At the descriptive level, we calculated the prevalence of HIV testing in each of the countries. This was followed by the distribution of HIV testing across the socio-demographic characteristics of women. Finally, we used binary logistic regression assess the likelihood of HIV testing uptake by women’s health care decision-making capacity and socio-demographic characteristics. The results were presented as Crude Odds Ratios (COR) and Adjusted Odds Ratios (AOR) with their corresponding 95% confidence intervals signifying precision. Statistical significance was set at p-value < 0.05. Results We found that prevalence of HIV testing uptake in the 28 sub-Saharan African countries was 64.4%, with Congo DR having the least (20.2%) and the highest occurred in Rwanda (97.4%). Women who took healthcare decisions alone [COR = 3.183, CI = 2.880–3.519] or with their partners [COR = 2.577, CI = 2.335–2.844] were more likely to test for HIV, compared to those whose healthcare decisions were taken by others, and this persisted after controlling for significant covariates: [AOR = 1.507, CI = 1.321–1.720] and [AOR = 1.518, CI = 1.334–1.728] respectively. Conclusion Sub-Saharan African countries intending to improve HIV testing need to incorporate women’s healthcare decision-making capacity strategies. These strategies can include education and counselling. This is essential because our study indicates that the capacity of women to make healthcare decisions has an association with decision to test for their HIV status.

scholarly journals Women’s healthcare decision-making capacity and HIV testing in sub-Saharan Africa: a multi-country analysis of demographic and health surveys

2020 ◽  
Author(s):  
Abdul-Aziz Seidu ◽  
Joseph Kojo Oduro ◽  
Bright Opoku Ahinkorah ◽  
Eugene Budu ◽  
Francis Appiah ◽  
...  
Keyword(s):  
Decision Making ◽  
Hiv Testing ◽  
Health Surveys ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Healthcare Decision ◽  
Healthcare Decision Making ◽  
Decision Making Capacity ◽  
Sub Saharan ◽  
Ssa Countries

Abstract Background Global commitment to stop Human Immunodeficiency Virus (HIV) and ensure access to HIV treatment calls for women empowerment, as these efforts play major roles in mother-to-child transmission. We explored the association between women’s healthcare decision-making capacity and HIV testing in sub-Saharan Africa (SSA). Methods We used data from the current Demographic and Health Surveys (DHS) conducted between January 1, 2010 and December 31, 2018 in 28 countries in SSA. At the descriptive level, we calculated the prevalence of HIV testing in each of the countries. This was followed by the distribution of HIV testing across the socio-demographic characteristics of women. Finally, we used binary logistic regression to explore the likelihood of HIV testing by women’s health care decision-making capacity and socio-demographic characteristics. The results were presented as Crude Odds Ratios (COR) and Adjusted Odds Ratios (AOR) with their corresponding 95% confidence intervals signifying precision. Statistical significance was set at p-value <0.05. Results We found that prevalence of HIV testing in the 28 SSA countries was 64.4%, with Congo DR having the least (20.2%) and the highest occurred in Rwanda (97.4%). Women who took healthcare decisions alone [COR=3.183, CI=2.880-3.519] or with their partners [COR=2.577, CI=2.335-2.844] were more likely to test for HIV, compared to those whose healthcare decisions were taken by others, and this persisted after controlling for significant covariates: [AOR=1.507, CI=1.321-1.720] and [AOR=1.518, CI=1.334-1.728] respectively. Conclusion SSA countries intending to improve HIV testing need to incorporate women’s healthcare decision-making capacity strategies. These strategies can include education and counselling. This is essential because our study indicates that the capacity of women to make healthcare decisions has an association with their decision to test for their HIV status.

scholarly journals Women’s healthcare decision-making capacity and HIV testing in sub-Saharan Africa: a multi-country analysis of demographic and health surveys

2020 ◽  
Author(s):  
Abdul-Aziz Seidu ◽  
Joseph Kojo Oduro ◽  
Bright Opoku Ahinkorah ◽  
Eugene Budu ◽  
Francis Appiah ◽  
...  
Keyword(s):  
Decision Making ◽  
Hiv Testing ◽  
Health Surveys ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Healthcare Decision ◽  
Healthcare Decision Making ◽  
Decision Making Capacity ◽  
Sub Saharan ◽  
Ssa Countries

Abstract Background Global commitment to stop Human Immunodeficiency Virus (HIV) and ensure access to HIV treatment calls for women empowerment as these efforts play major roles in mother-to-child transmission. We explored the association between women’s healthcare decision-making capacity and HIV testing in sub-Saharan Africa (SSA). Methods We used data from the current Demographic and Health Surveys (DHS) conducted between January 1, 2010 and December 31, 2018 in 28 countries in SSA. At the descriptive level, we calculated the prevalence of HIV testing in each of the countries. This was followed by the distribution of HIV testing across the socio-demographic characteristics of women. Finally, we used binary logistic regression to explore the likelihood of HIV testing by women’s health care decision-making capacity and socio-demographic characteristics. The results were presented as Crude Odds Ratios (COR) and Adjusted Odds Ratios(AOR) with their corresponding 95% confidence intervals signifying precision. Statistical significance was set at p-value <0.05. Results We found that prevalence of HIV testing in the 28 SSA countries was 64.4%, with Congo DR having the least (20.2%) and the highest occurred in Rwanda (97.4%). Women who took healthcare-decisions alone [COR=3.183, CI=2.880-3.519] or with their partners [COR=2.577, CI=2.335-2.844] were more likely to test for HIV compared to those whose healthcare-decisions were taken by others and this persisted after controlling for significant covariates [AOR=1.507, CI=1.321-1.720] and [AOR=1.518, CI=1.334-1.728], respectively. Conclusion SSA countries intending to improve HIV testing need to incorporate women’s healthcare decision-making capacity strategies. These strategies can include education and counselling. This is essential because our study indicates that the capacity of women to make healthcare decisions has an association with their decision to test for their HIV status.

scholarly journals Women’s decision-making capacity and HIV testing in sub-Saharan Africa: A multi-country analysis of Demographic and Health Surveys

2020 ◽  
Author(s):  
Abdul-Aziz Seidu ◽  
Joseph Kojo Oduro ◽  
Bright Opoku Ahinkorah ◽  
Eugene Budu ◽  
Francis Appiah ◽  
...  
Keyword(s):  
Decision Making ◽  
Hiv Testing ◽  
Health Surveys ◽  
Demographic Characteristics ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Odds Ratios ◽  
Decision Making Capacity ◽  
Sub Saharan ◽  
Ssa Countries

Abstract IntroductionGlobal commitment to stop HIV and ensure access to HIV treatment call for women empowering as these efforts play a major role in mother to child transmission. We explored the association between women decision-making capacity and HIV testing in sub-Saharan Africa (SSA). Materials and methodsWe used data from current Demographic and Health Surveys (DHS) conducted between January 1, 2010 and December 31, 2016 in 30 countries within SSA. At the descriptive level, we calculated the prevalence of women who had undergone HIV testing and decision-making capacity in each of the countries as well as prevalence of HIV testing across their socio-demographic characteristics. We used Binary Logistic Regression to explore the likelihood of HIV testing by decision-making capacity and socio-demographic characteristics at 5% margin of error. The results were presented as Crude Odds Ratios (CORs) and Adjusted Odds Ratios (AORs). ResultsWe found that overall, 10.0% of women had decision-making with Nigeria (4.5%) and Zimbabwe (21.3%) recording the least and the highest respectively. In terms of HIV testing, the prevalence of HIV testing in the 30 SSA countries was 64.4%, with Guinea (12.8%) having the least. The highest occurred in Lesotho (99%) and Rwanda (99%). Women who had capacity to make decisions had higher likelihood of HIV testing [AOR=1.04, CI=1.02–1.09]. Women from Rwanda had the highest likelihood of HIV testing [AOR=53.92, CI=41.31–70.37] with women from Guinea having the least likelihood [AOR=0.10, CI=0.08–0.11]. Other determinants to HIV testing were level of education, wealth status, believing that a healthy-looking person can have HIV, watching television almost every day, age and place of residence.Conclusion SSA countries intending to improve HIV testing need to incorporate women decision-making capacity strategies in terms of education and counselling into the available policies. This is essential because our study indicates that as women are able to make decisions in their households, the possibility for them to test for their HIV status increases.

scholarly journals Time trends in socio-economic inequalities in HIV testing: insights from population-based surveys in 16 sub-Saharan African countries

2019 ◽  
Author(s):  
Pearl Anne Ante-Testard ◽  
Tarik Benmarhnia ◽  
Anne Bekelynck ◽  
Rachel Baggaley ◽  
Eric Ouattara ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Time Trends ◽  
Population Based ◽  
Sub Saharan Africa ◽  
Absolute Difference ◽  
Demographic And Health Surveys ◽  
African Countries ◽  
Testing Uptake ◽  
Sub Saharan ◽  
Economic Inequalities

SummaryBackgroundOverall increase in the uptake of HIV testing in the past decades may hide discrepancies across socio-economic groups. We used population-based surveys conducted in sub-Saharan Africa to quantify socio-economic inequalities in recent HIV testing uptake, together with their trends over the two past decades.MethodsWe analyzed the data from Demographic and Health Surveys in sub-Saharan African countries where at least one survey was conducted before and after 2008. Country- and gender-specific proportions of recent (<12 month) HIV testing were assessed across wealth and education groups, and inequalities were quantified using the relative and slope indices of inequalities. Time trends in inequalities were assessed and results were pooled across countries using random-effect meta-analyses.FindingsWe analyzed data from 32 surveys conducted between 2003 and 2016 in 16 countries among 537,784 participants. In pre-2008 surveys, women reported higher HIV testing uptake than men in 8 out of 16 countries, and in 15 out of 16 countries in post-2008 surveys. After 2008, the wealthiest women were on average 2.77 (95% CI 1.42-5.40) times more likely to report recent testing than the poorest; and 3.55 (1.85-6.81) times in men. The averaged absolute difference in recent testing between the richest and poorest was 11.1 (4.6-17.5) percentage points in women and 15.1 (9.6-20.6) in men. Over time, relative inequalities in recent HIV testing decreased in both genders, while absolute inequalities plateaued in women and increased in men.InterpretationsThe overall increase in HIV testing uptake that was stimulated by the impetus to scale up HIV treatment in sub-Saharan Africa led to a decrease in relative inequalities, while absolute inequalities persisted. Within most countries, large inequalities still remained, both in absolute and relative scales, especially in West and Central Africa. A greater focus should be put on equity in monitoring HIV testing programs.A French version of this article is available in the Appendices [Une version française de cet article est disponible en appendice].FundingINSERM-ANRS (France Recherche Nord & Sud Sida-HIV Hépatites), grant number ANRS-12377.

OP109 The Need For Building Pharmacists’ Health Technology Assessment Capacity; The Nigerian Scenario

2019 ◽  
Vol 35 (S1) ◽  
pp. 26-26
Author(s):  
Otuto Amarauche Chukwu ◽  
Chizaram Chukwu
Keyword(s):  
Decision Making ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Health Technology ◽  
Developed Countries ◽  
Sub Saharan Africa ◽  
Health Coverage ◽  
Healthcare Decision ◽  
Healthcare Decision Making ◽  
Sub Saharan

IntroductionThe role of Health technology assessment (HTA) as a systematic approach in the evaluation of health interventions and technologies is becoming increasingly important as the quest for attaining universal health coverage globally continues to increase. Some developed countries in Europe and the Americas now apply HTA extensively in healthcare policy decisions, however, developing regions and countries like sub-Saharan Africa and Nigeria respectively, seem not to be making significant progress in this area. Given that evidence suggests that Nigeria and indeed several countries in sub-Saharan Africa are performing poorly on most healthcare indices as the region continues to be ravaged by predictable and avoidable epidemics and disease outbreaks, the need to build HTA capacity has never been more paramount.MethodsA review of HTA capability in Nigeria was done. Pharmacists in Nigeria's Capital were randomly sampled. Semi-structured questionnaires were administered. Descriptive statistics were used in data analysis. P values less than 0.05 were considered to be significant.ResultsIn Nigeria, there is no institution tasked with undertaking HTA and there seems to be limited knowledge, capacity and awareness on the issue. Pharmacists, being the most accessible healthcare professionals according to evidence, are a key group that could play an active role in HTA and its implementation in developing countries like Nigeria. However, out of 322 pharmacists randomly sampled, 93 percent were not aware of HTA and its application in healthcare decision-making.ConclusionsThere is no paucity of healthcare programs and plans in Nigeria but they seem to fail due to lack of evidence-based assessment, decision-making and implementation. Hence, there is an increasing need to raise awareness on the importance of HTA in healthcare decision-making; strengthen HTA capacity by developing and sustaining institutional capacity and adequate human resource for HTA; and creating regional annexes of HTA organizations in Africa.

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.

Women’s Autonomy on Healthcare Decision Making in Sub-Saharan African Countries: A Synthesis

2021 ◽  
Vol 43 (1-3) ◽  
Author(s):  
Nigatu Regassa Geda
Keyword(s):  
Decision Making ◽  
Well Being ◽  
Healthcare Decision ◽  
Economic Activities ◽  
African Countries ◽  
Women’S Autonomy ◽  
Women's Autonomy ◽  
Healthcare Decision Making ◽  
Nationally Representative ◽  
Sub Saharan

ABSTRACT Over the last few decades, despite progress made in improving female’s decision-making dependence, the challenges posed by female’s low status in Sub-Saharan African countries (SSA) are still influential research agenda. The aim of this scooping review is to assess the effects of women’s autonomy on healthcare decision-making. The researchers did the study based on 15 articles selected from PubMed and Google Scholar. The selection deliberated only those published in the last 15 years, primarily based on nationally representative findings from Sub-Saharan African countries. The selected studies focused on decision-making autonomy on healthcare parameters. All studies reported significant positive impacts of female’s decision-making autonomy on children’s health, and women’s well-being, such as improved children’s nutrition, maternal and children’s well-being, reduced mortality rate, and health service utilization. However, the impacts were more substantial or visible at the community level than at individual or household levels. The study recommended strengthening womens’ involvement in education, promoting peer education, improving husband-wife communication, promoting rural women’s participation in economic activities, and owning assets. More importantly, any intervention should focus more on community norms than only individual decision-making per se.

PP129 The Need For Building Pharmacists HTA Capacity; The Nigerian Scenario

2018 ◽  
Vol 34 (S1) ◽  
pp. 116-117
Author(s):  
Otuto Amarauche Chukwu
Keyword(s):  
Decision Making ◽  
Disease Outbreaks ◽  
Active Role ◽  
Developed Countries ◽  
Sub Saharan Africa ◽  
Health Coverage ◽  
Healthcare Decision ◽  
Developing Regions ◽  
Healthcare Decision Making ◽  
Sub Saharan

Introduction:The role of Health technology assessment (HTA) as a systematic approach in the evaluation of health interventions and technologies is becoming increasingly important as the quest for attaining universal health coverage globally continues to increase. Some developed countries in Europe and the Americas now apply HTA extensively in healthcare policy decisions, however, developing regions and countries like sub-Saharan Africa and Nigeria respectively, seem not to be making significant progress in this area. Given that evidence suggests that Nigeria and indeed several countries in sub-Saharan Africa are performing poorly on most healthcare indices as the region continues to be ravaged by predictable and avoidable epidemics and disease outbreaks, the need to build HTA capacity has never been more paramount.Methods:A review of HTA capability in Nigeria was done. Pharmacists in Nigeria's Capital were randomly sampled. Semi-structured questionnaires were administered. Descriptive statistics was used in data analysis. P values less than 0.05 were considered to be significant.Results:In Nigeria, there is no institution tasked with undertaking HTA and there seems to be limited knowledge, capacity and awareness on the issue. Pharmacists, being the most accessible healthcare professionals according to evidence, are a key group that could play an active role in HTA and its implementation in developing countries like Nigeria. However, out of 322 pharmacists randomly sampled, ninty-three percent were not aware of HTA and its application in healthcare decision-making.Conclusions:There is no paucity of healthcare programs and plans in Nigeria but they seem to fail due to lack of evidence-based assessment, decision-making and implementation. Hence, there is increasing need to raise awareness on the importance of HTA in healthcare decision-making; strengthen HTA capacity by developing and sustaining institutional capacity and adequate human resource for HTA; and creating regional annexes of HTA organizations in Africa.

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