scholarly journals Geographical and socioeconomic inequalities in the utilization of maternal healthcare services in Nigeria: 2003–2017

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Chijioke Okoli ◽  
Mohammad Hajizadeh ◽  
Mohammad Mafizur Rahman ◽  
Rasheda Khanam
Keyword(s):  
Low Income ◽  
Rural Areas ◽  
Healthcare Services ◽  
Socioeconomic Inequalities ◽  
Low Income Countries ◽  
Theil Index ◽  
Maternal Healthcare ◽  
North East ◽  
Birth Attendance ◽  
Urban And Rural Areas

Abstract Background Maternal mortality has remained a challenge in many low-income countries, especially in Africa and in Nigeria in particular. This study examines the geographical and socioeconomic inequalities in maternal healthcare utilization in Nigeria over the period between 2003 and 2017. Methods The study used four rounds of Nigeria Demographic Health Surveys (DHS, 2003, 2008, 2013, and 2018) for women aged 15–49 years old. The rate ratios and differences (RR and RD) were used to measure differences between urban and rural areas in terms of the utilization of the three maternal healthcare services including antenatal care (ANC), facility-based delivery (FBD), and skilled-birth attendance (SBA). The Theil index (T), between-group variance (BGV) were used to measure relative and absolute inequalities in the utilization of maternal healthcare across the six geopolitical zones in Nigeria. The relative and absolute concentration index (RC and AC) were used to measure education-and wealth-related inequalities in the utilization of maternal healthcare services. Results The RD shows that the gap in the utilization of FBD between urban and rural areas significantly increased by 0.3% per year over the study period. The Theil index suggests a decline in relative inequalities in ANC and FBD across the six geopolitical zones by 7, and 1.8% per year, respectively. The BGV results do not suggest any changes in absolute inequalities in ANC, FBD, and SBA utilization across the geopolitical zones over time. The results of the RC and the AC suggest a persistently higher concentration of maternal healthcare use among well-educated and wealthier mothers in Nigeria over the study period. Conclusion We found that the utilization of maternal healthcare is lower among poorer and less-educated women, as well as those living in rural areas and North West and North East geopolitical zones. Thus, the focus should be on implementing strategies that increase the uptake of maternal healthcare services among these groups.

Biosecurity of Poultry Worker Related to Avian Influenza in Bangladesh

2014 ◽  
Vol 3 (4) ◽  
pp. 267
Author(s):  
Swapan Kumar Roy ◽  
Quazi Zahangir Hossain
Keyword(s):  
Avian Influenza ◽  
Low Income ◽  
Rural Areas ◽  
Cross Sectional Study ◽  
Low Income Countries ◽  
Work Place ◽  
Cross Sectional ◽  
Change Behavior ◽  
Poultry Workers ◽  
Urban And Rural Areas

Research on biosecurity of poultry workers of Live Bird Market (LBM) in urban and rural areas related to highly pathogenic avian influenza (AI) was undertaken during March-June, 2014 at Keshabpur upazila (22°48´-22°57´N latitude and 89°06´-89°22´E longitude), Jessore, Bangladesh. A non-randomized (purposive) sampling method was applied and a descriptive type of cross sectional study was performed among 72 workers, dividing them into two groups as 36 urban and 36 rural poultry workers of LBM through split-halves variation technique. They were interviewed confidentially in their work place using a structured pretested questionnaire. Among respondents 53%, 75%, 45%, 81%, and 56% of urban and 50%, 42%, 50%, 89%, and 36% of rural residence had attended up to primary school, knowledge about AI through media like TV and radio, used proper personal protective equipment as mask and gloves, washed their hands and equipment after finishing work and cleaned stalls/cages daily and mostly they used water as a cleaning material, respectively. In urban (14%) and rural (36%) workers used the same vehicle to transport poultry and humans. A combined effort is required to enhance knowledge and change behavior among those most at risk in low-income countries and precautions necessary to avoid spreading the virus among poultry and humans.

scholarly journals Biosecurity of Poultry Worker Related to Avian Influenza in Bangladesh

2014 ◽  
Vol 3 (4) ◽  
pp. 267
Author(s):  
Swapan Kumar Roy ◽  
Quazi Zahangir Hossain
Keyword(s):  
Avian Influenza ◽  
Low Income ◽  
Rural Areas ◽  
Cross Sectional Study ◽  
Low Income Countries ◽  
Work Place ◽  
Cross Sectional ◽  
Change Behavior ◽  
Poultry Workers ◽  
Urban And Rural Areas

Research on biosecurity of poultry workers of Live Bird Market (LBM) in urban and rural areas related to highly pathogenic avian influenza (AI) was undertaken during March-June, 2014 at Keshabpur upazila (22°48´-22°57´N latitude and 89°06´-89°22´E longitude), Jessore, Bangladesh. A non-randomized (purposive) sampling method was applied and a descriptive type of cross sectional study was performed among 72 workers, dividing them into two groups as 36 urban and 36 rural poultry workers of LBM through split-halves variation technique. They were interviewed confidentially in their work place using a structured pretested questionnaire. Among respondents 53%, 75%, 45%, 81%, and 56% of urban and 50%, 42%, 50%, 89%, and 36% of rural residence had attended up to primary school, knowledge about AI through media like TV and radio, used proper personal protective equipment as mask and gloves, washed their hands and equipment after finishing work and cleaned stalls/cages daily and mostly they used water as a cleaning material, respectively. In urban (14%) and rural (36%) workers used the same vehicle to transport poultry and humans. A combined effort is required to enhance knowledge and change behavior among those most at risk in low-income countries and precautions necessary to avoid spreading the virus among poultry and humans.

scholarly journals Decomposing the urban–rural inequalities in the utilisation of maternal health care services: evidence from 27 selected countries in Sub-Saharan Africa

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Oduse Samuel ◽  
Temesgen Zewotir ◽  
Delia North
Keyword(s):  
Maternal Health ◽  
Rural Areas ◽  
Health Care Services ◽  
Healthcare Services ◽  
Sub Saharan Africa ◽  
Maternal Healthcare ◽  
Care Services ◽  
Urban Rural ◽  
Sub Saharan ◽  
Urban And Rural Areas

Abstract Background There has been a substantial improvement in reducing maternal mortality in the Sub-Saharan African region. The vast rural-urban gap in maternal health outcomes, however, is obscured by this average achievement. This study attempts to measure the contribution of identified risk factors to describe the average rural-urban difference in the use of antenatal care, health facilities for delivery, and health professional assistance at delivery. Method To achieve this objective, we used descriptive analysis and Fairlie non-linear decomposition method to quantify covariates’ contribution in explaining the urban–rural difference in maternal healthcare services utilisation. Result The study’s finding shows much difference between urban and rural areas in the use of maternal healthcare services. Socio-economic factors such as household wealth index, exposure to media, and educational level of women and their husbands/partners contributed the most in explaining the gap between urban and rural areas in healthcare services utilisation. Conclusions Interventions to bridge the gap between urban and rural areas in maternal healthcare services utilisation in Sub-Saharan Africa should be centred towards socio-economic empowerment. Government can enforce targeted awareness campaigns to encourage women in rural communities in Sub-Sharan Africa to take the opportunity and use the available maternal health care services to be at par with their counterparts in urban areas.

scholarly journals Health insurance coverage and maternal healthcare services utilization in Jordan: evidence from the 2017–18 Jordan demographic and health survey

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Petula Fernandes ◽  
Emmanuel Kolawole Odusina ◽  
Bright Opoku Ahinkorah ◽  
Komlan Kota ◽  
Sanni Yaya
Keyword(s):  
Health Insurance ◽  
Antenatal Care ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Healthcare Services ◽  
Skilled Birth Attendance ◽  
Reproductive Age ◽  
Maternal Healthcare ◽  
Services Utilization ◽  
Birth Attendance

Abstract Background Despite the relationship between health insurance coverage and maternal healthcare services utilization, previous studies in Jordan on the use of maternal healthcare services have mainly focused on patterns and determinants of maternal healthcare services utilization in Jordan. Therefore, this study investigated the relationship between health insurance coverage and maternal healthcare services utilization in Jordan. Methods This study used secondary data published in 2017-18 Jordan Demographic and Health Survey on 4656 women of reproductive age (15–49 years). The independent variable was health insurance coverage and the outcome variable was maternal healthcare services utilization, measured through timing of first antenatal visit, four or more antenatal care visits, and skilled birth attendance. The data were analyzed using descriptive statistics and binary logistic regression. Results Out of the total number of women who participated in the study, 38.2% were not covered by health insurance. With maternal healthcare utilization, 12.5%, 23.2%, and 10.1% respectively, failed to make early first antenatal care visit, complete four or more antenatal care visits and have their delivery attended by a skilled worker. After controlling for the socio-demographic factors, health insurance coverage was associated with increased odds of early timing of first antenatal care visits and completion of four or more antenatal care visits (aOR = 1.33, p < 0.05, aOR = 1.25, p < 0.01, respectively). However, women who were covered by health insurance were less likely to use skilled birth attendance during delivery (aOR = 0.72 p < 0.001). Conclusions Jordanian women with health insurance coverage were more likely to have early first antenatal care visits and complete four or more antenatal care visits. However, they were less likely to have their delivery attended by a skilled professional. This study provides evidence that health insurance coverage has contributed to increased maternal healthcare services utilization, only in terms of number and timing of antenatal care visits in Jordan. It is recommended that policy makers in Jordan should strengthen the coverage of health insurance in the country, especially among women of reproductive age in order to enhance the use of maternal healthcare services in the country.

scholarly journals A Garden-Based Intervention to Improve Dietary Diversity in Kenyan School Children: Results from a Natural Experiment

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 810-810 ◽  
Author(s):  
Sara Benjamin-Neelon ◽  
Tiange Liu ◽  
Eve S Puffer ◽  
Liz Turner ◽  
Daniel Zaltz ◽  
...  
Keyword(s):  
Low Income ◽  
Rural Areas ◽  
Primary Schools ◽  
Dietary Diversity ◽  
Food Group ◽  
Low Income Countries ◽  
Severe Drought ◽  
School Gardens ◽  
Post Intervention

Abstract Objectives School gardens may improve child diet, but little is known about their effectiveness in rural areas in low-income countries. We evaluated the ability of school gardens to improve child diet in rural Kenya. We hypothesized that children in intervention schools would improve their dietary diversity and specifically their produce intake. Methods An non-government organization installed gardens in 2 primary schools. We selected 2 geographically proximal additional schools as comparisons. We conducted baseline assessments in 2013, prior to garden installation, and follow-up assessments a year later in 2014 in all 4 schools. We measured child dietary intake via a single 24-hour recall. We calculated dietary diversity using the women's dietary diversity score (WDDS) (continuous) and also examined each of the 10 food group components defined as adequate ≥15 g (binary). We conducted marginal linear or logistic regression models using a generalized estimating equation and included an exposure x time interaction to assess differences in outcomes between intervention and comparison schools from baseline to follow up. We controlled for child age, gender, and orphan status. Results We assessed 855 children (n = 438 intervention; n = 417 comparison) at baseline and 688 children (n = 383 intervention; n = 305 comparison) at follow up. Children in intervention schools were 51.8% male, compared to 56.5% in comparison schools. Mean (standard deviation) age was 11.6 (2.1) years in intervention and 11.8 (2.3) years in comparison schools. All children's WDDS worsened post-intervention. In adjusted difference in difference analyses, WDDS did not differ in intervention vs. comparison schools pre- to post-intervention (β 0.04, CI −0.19, 0.27). However, we observed less of a decrease in meeting adequate intake for pulses (OR 2.18, CI 1.18, 4.01) and other fruits (OR 1.55, CI 1.00, 2.40) in intervention versus comparison schools. Conversely, children in comparison schools had less of a decrease in meat, poultry, and fish compared to children in intervention schools (OR 0.67, CI 0.45, 0.99). Conclusions Children's WDDS worsened in all 4 schools, likely due to a severe drought that affected the region in 2014. We observed some differences in intervention vs. comparison children, but cannot attribute these improvements to school gardens. Funding Sources Duke Global Health Institute.

Reducing the distance to walk: establishing a remote maternity facility in Runga, Hoima District, Uganda

2020 ◽  
Vol 14 (2) ◽  
pp. 1-8
Author(s):  
Rhiannon Grindle ◽  
Sofia Giannopoulou ◽  
Harriet Jacobs ◽  
Jerome Barongo ◽  
Alexandra Elspeth Cairns
Keyword(s):  
Antenatal Care ◽  
Maternal Mortality ◽  
Health Facility ◽  
Low Income ◽  
Local Level ◽  
Substantial Reduction ◽  
Care Quality ◽  
Low Income Countries ◽  
Health Seeking ◽  
Birth Attendance

Despite a substantial reduction in global maternal mortality, rates in low-income countries remain unacceptably high. Multiple contributing factors exist, grouped into three delays: health-seeking behaviour; accessibility of care; quality of care. In the Hoima District, rates of health facility delivery and skilled birth attendance remain low and maternal mortality exceeds the national average. Establishing the Midwives At Maternity Azur Clinic (February 2017) has addressed these issues at a local level. Health education and antenatal care are provided at the clinic, encouraging women to seek timely, appropriate intrapartum care. Access from surrounding villages is facilitated by a waiting home and weekly transport for antenatal care, alongside transport to a health facility with a staffed operating theatre, when required. It is run by a resident midwife, with regular training updates, and is stocked with the necessary resources for quality healthcare. Since its advent, village leaders report all-cause burials have reduced from one a day to one a week.

The chance of conception during lactation

1977 ◽  
Vol 9 (S4) ◽  
pp. 41-54 ◽  
Author(s):  
Jeroen K. van Ginneken
Keyword(s):  
Menstrual Cycle ◽  
Milk Production ◽  
Breast Feeding ◽  
Low Income ◽  
Rural Areas ◽  
Spacing Effect ◽  
Birth Spacing ◽  
Low Income Countries ◽  
Newborn Child

Many mothers in low-income countries, particularly in rural areas, nurse their children for 1–2 years on the average. The main purpose of this practice is, of course, to provide the newborn child with the nutrition necessary for its survival. Prolonged breast-feeding, however, also has a birth-spacing effect and postpones the next pregnancy by inhibiting ovulation and by delaying resumption of the menstrual cycle. Suckling of the infant is important for this suppression of the menstrual cycle because it leads to the release of prolactin, which not only plays an important role in milk production but also inhibits the release of gonadotrophins which initiate resumption of the menstrual cycle. For further details about these endocrinological aspects of lactation see, for example, Rolland et al. (1975); Thomson, Hytten & Black (1975) and Buchanan (1975).

scholarly journals Epidemiology and associated factors of atopic dermatitis in Malagasy children

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
F. A. Sendrasoa ◽  
I. M. Ranaivo ◽  
N. H. Razanakoto ◽  
M. Andrianarison ◽  
O. Raharolahy ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Low Income ◽  
Rural Areas ◽  
Associated Factors ◽  
Age Of Onset ◽  
Descriptive Study ◽  
History Of ◽  
The Mean ◽  
Urban And Rural Areas ◽  
Duration Of Breastfeeding

Abstract Background Little is known about the epidemiology and associated factors of childhood AD in the markedly different, low-income, tropical environment like Madagascar. Methods We aim to assess the epidemiology and associated factors of AD in individuals fewer than 15 years of age in Antananarivo Madagascar. It was a retrospective and descriptive study over a period of 7 years (2010 to 2016) in children 6 months to 14 years in the Department of Dermatology, Joseph Raseta Befelatanana Antananarivo Madagascar. The diagnosis of AD was based on clinical data. Results The prevalence of AD was 5.6% in children aged 6 months to 14 years. The details of 151 cases of atopic dermatitis were analyzed. The mean age of patients was 4 years. There was a female preponderance (sex ratio: 0.7). A family history of AD was noted in 56 cases (37%). No association between breast-feeding and AD was found. The age of onset of AD was before the age of 3 months in 7.5% and between 6 months to 5 years in 70%. Children born in March (dry season) had the highest risk of AD. Consultations for AD increased during the winter (from July to October; p = 0.005). However, the prevalence of AD was similar in urban and rural areas. Conclusion Weather may have an impact on the prevalence of atopic dermatitis in Madagascar. No significant correlation was found between the duration of breastfeeding and AD, as well as urbanization.

scholarly journals Prevalence and access to care for cardiovascular risk factors in older people in Sierra Leone: a cross-sectional survey

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e038520
Author(s):  
Maria Lisa Odland ◽  
Tahir Bockarie ◽  
Haja Wurie ◽  
Rashid Ansumana ◽  
Joseph Lamin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Access To Care ◽  
Sierra Leone ◽  
Low Income ◽  
Rural Areas ◽  
Urban Areas ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Health System Strengthening ◽  
Low Income Countries

IntroductionPrevalence of cardiovascular disease risk factors (CVDRFs) is increasing, especially in low-income countries. In Sierra Leone, there is limited empirical data on the prevalence of CVDRFs, and there are no previous studies on the access to care for these conditions.MethodsThis study in rural and urban Sierra Leone collected demographic, anthropometric measurements and clinical data from randomly sampled individuals over 40 years old using a household survey. We describe the prevalence of the following risk factors: diabetes, hypertension, dyslipidaemia, overweight or obesity, smoking and having at least one of these risk factors. Cascades of care were constructed for diabetes and hypertension using % of the population with the disease who had previously been tested (‘screened’), knew of their condition (‘diagnosed’), were on treatment (‘treated’) or were controlled to target (‘controlled’). Multivariable regression was used to test associations between prevalence of CVDRFs and progress through the cascade for hypertension with demographic and socioeconomic variables. In those with recognised disease who did not seek care, reasons for not accessing care were recorded.ResultsOf 2071 people, 49.6% (95% CI 49.3% to 50.0%) of the population had hypertension, 3.5% (3.4% to 3.6%) had diabetes, 6.7% (6.5% to 7.0%) had dyslipidaemia, 25.6% (25.4% to 25.9%) smoked and 26.5% (26.3% to 26.8%) were overweight/obese; a total of 77.1% (76.6% to 77.5%) had at least one CVDRF. People in urban areas were more likely to have diabetes and be overweight than those living in rural areas. Moreover, being female, more educated or wealthier increased the risk of having all CVDRFs except for smoking. There is a substantial loss of patients at each step of the care cascade for both diabetes and hypertension, with less than 10% of the total population with the conditions being screened, diagnosed, treated and controlled. The most common reasons for not seeking care were lack of knowledge and cost.ConclusionsIn Sierra Leone, CVDRFs are prevalent and access to care is low. Health system strengthening with a focus on increased access to quality care for CVDRFs is urgently needed.

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