scholarly journals Two decades of regional trends in vaccination completion and coverage among children aged 12-23 months: an analysis of the Uganda Demographic Health Survey data from 1995 to 2016

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Gerald Okello ◽  
Jonathan Izudi ◽  
Immaculate Ampeire ◽  
Frehd Nghania ◽  
Carine Dochez ◽  
...  
Keyword(s):  
Child Health ◽  
Health Survey ◽  
Maternal Education ◽  
Statistical Significance ◽  
Public Health Intervention ◽  
Household Wealth ◽  
Childhood Vaccination ◽  
Demographic Health Survey ◽  
Health Card ◽  
Vaccination Completion

Abstract Background Childhood vaccination is an important public health intervention but there is limited information on coverage, trends, and determinants of vaccination completion in Uganda at the regional level. We examined trends in regional vaccination coverage and established the determinants of vaccination completion among children aged 12-23 months in Uganda. Methods We analyzed data from the women’s questionnaire for the 1995-2016 Uganda Demographic Health Survey (UDHS). Vaccine completion was defined as having received a dose of Bacillus-Calmette Guerin (BCG) vaccine; three doses of diphtheria, pertussis, and tetanus (DPT) vaccine; three doses of oral polio vaccine (OPV) (excluding OPV given at birth); and one dose of measles vaccine. We performed Chi-square tests to compare vaccination completion by socio-demographic factors stratified by 10 sub-regions: Eastern, East Central, Central 1, Central 2, Kampala, Karamoja, North, Western, West Nile, and Southwest. We performed logistic regression analysis for each of the regions to identify factors associated with vaccination completion at 5% level of statistical significance. Results Overall vaccination completion was 48.6% (95%CI, 47.2, 50.1) and ranged from 17.3% in Central 1 to 65.9% in Southwest. Vaccination completion rates declined significantly by 10.4% (95% confidence interval (CI), − 16.1, − 4.6) between 1995 and 2000, and increased significantly by 10.0% (95% CI, 4.6, 15.4) between 2000 and 2006, and by 5.4% (95% CI, 0.2, 10.6) between 2006 and 2011. Maternal education (secondary or higher level), receipt of tetanus toxoid (TT) during pregnancy, and possession of a child health card were associated with vaccination completion across all the sub-regions. Other factors like place of residence, religious affiliation, household wealth, maternal age, childbirth order, size of child at birth, and place of delivery were associated with vaccination completion but differed between the 10 sub-regions. Conclusion Besides considerable regional variations, the vaccination completion rate among children aged 12-23 months in Uganda remains suboptimal despite the availability of vaccines. Maternal education, receipt of TT, and possession of a child health card are associated with a higher likelihood of vaccination completion among children aged 12-23 months in all the regions of Uganda. Interventions to improve the utilization of vaccination services in Uganda should consider these factors.

scholarly journals Childhood vaccination coverage and equity impact in Ethiopia by socioeconomic, geographic, maternal and child characteristics

2020 ◽  
Author(s):  
Anne Geweniger ◽  
Kaja M. Abbas
Keyword(s):  
Vaccination Coverage ◽  
Health Survey ◽  
Maternal Education ◽  
National Level ◽  
Household Head ◽  
Household Wealth ◽  
Demographic And Health Survey ◽  
Childhood Vaccination ◽  
Child Characteristics ◽  
Single Vaccination

AbstractBackgroundEthiopia is a priority country of Gavi, the Vaccine Alliance to improve vaccination coverage and equitable uptake. The Ethiopian National Expanded Programme on Immunisation (EPI) and the Global Vaccine Action Plan set coverage goals of 90% at national level and 80% at district level by 2020. This study aims to analyse basic vaccination coverage among children in Ethiopia and to estimate the equity impact by socioeconomic, geographic, maternal and child characteristics based on data from the Ethiopia Demographic and Health Survey 2016.MethodsBasic vaccination coverage (1-dose BCG, 3-doses DPT-HepB-Hib, 3-doses polio, 1-dose measles vaccine) of 2,004 children aged 12-23 months was analysed. Mean coverage was disaggregated by socioeconomic (household wealth, religion, ethnicity), geographic (area of residence, region), maternal (maternal age at birth, maternal education, maternal marital status, sex of household head) and child (sex of child, birth order) characteristics. Concentration indices assessed wealth and education-related inequalities. Multiple logistic regression estimated associations between basic vaccination coverage and socioeconomic, maternal and child characteristics.ResultsNational coverage for basic vaccinations was 39.7% in 2016. Single vaccination coverage ranged between between 53.2% (DTP3) and 69.2% (BCG). Wealth and maternal education related inequities were present for all vaccines. Children from richer households, urban regions, primary maternal education and male headed households were associated with higher vaccination coverage. The Ethiopia Mini Demographic and Health Survey 2019 reports national coverage for basic vaccinations at 43.3% with single vaccination coverage ranging between 57.8% (measles) and 74.2% (BCG).ConclusionsVaccination coverage has improved from 2016 to 2019, but remains below the coverage goals of the EPI. Low vaccination coverage is associated with poorer households, rural regions of Afar and Somali, no maternal education and female headed households. Targeted approaches are necessary to improve vaccination coverage among these population subgroups and equitable uptake of vaccines in Ethiopia.

scholarly journals Trends and determinants of undernutrition among young Kenyan children: Kenya Demographic and Health Survey; 1993, 1998, 2003 and 2008–2009

2012 ◽  
Vol 15 (9) ◽  
pp. 1715-1727 ◽  
Author(s):  
Peninah K Masibo ◽  
Donald Makoka
Keyword(s):  
Health Survey ◽  
Urban Areas ◽  
Child Nutrition ◽  
Maternal Education ◽  
Sampling Technique ◽  
Household Wealth ◽  
Demographic And Health Survey ◽  
Demographic And Health Surveys ◽  
Double Burden ◽  
Percentage Points

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.

scholarly journals Social, economic, health and environmental determinants of child nutritional status in three Central Asian Republics

2009 ◽  
Vol 12 (10) ◽  
pp. 1871-1877 ◽  
Author(s):  
Nolunkcwe J Bomela
Keyword(s):  
Nutritional Status ◽  
Maternal Education ◽  
Social Economic ◽  
Statistical Significance ◽  
Household Wealth ◽  
Binary Logistic Regression Analysis ◽  
Demographic And Health Surveys ◽  
Unexpected Finding ◽  
Economic Health ◽  
Child Nutritional Status

AbstractObjectiveTo investigate the comparative effect of social, economic, health and environmental characteristics on the nutritional status of children aged <3 years in Central Asia.DesignCross-sectional analysis using data from Demographic and Health Surveys.SettingUzbekistan, Kyrgyzstan and Kazakhstan.SubjectsInformation on demographic health was gathered by Macro International Inc., Uzbekistan, Kyrgyzstan and Kazakhstan governments from a random sample of 14 067 households in the three countries. Anthropometric measurements were performed using standardized procedures on all children <3 years of age (n 2358). Only children with plausible Z-scores (n 1989) were selected for subsequent analyses.ResultsThe main results indicated that country of residence, number of people in household, household wealth, birth weight, age of child, knowledge of oral rehydration therapy, maternal education, number of children <5 years of age and source of drinking water were strong predictors of child nutritional status in these countries. Furthermore, chronic malnutrition was most prevalent in all three countries but at varied levels. An unexpected finding was that fully vaccinated children were more likely to be malnourished than children who were partially vaccinated. A further unexpected finding was that breast-feeding especially in children >6 months old had a strong negative association with stunting and underweight.ConclusionsIn summary, the results from both the descriptive and binary logistic regression analysis are similar in terms of the explanatory variables and the statistical significance in the models.

The influence of economic development level, household wealth and maternal education on child health in the developing world

2006 ◽  
Vol 63 (8) ◽  
pp. 2242-2254 ◽  
Author(s):  
Michael H. Boyle ◽  
Yvonne Racine ◽  
Katholiki Georgiades ◽  
Dana Snelling ◽  
Sungjin Hong ◽  
...  
Keyword(s):  
Economic Development ◽  
Child Health ◽  
Maternal Education ◽  
Developing World ◽  
Household Wealth ◽  
Development Level

scholarly journals Women’s empowerment is associated with maternal nutrition and low birth weight: Evidence from Bangladesh Demographic Health Survey

2019 ◽  
Author(s):  
Alamgir Kabir ◽  
Md Mahbubur Rashid ◽  
Kamal Hossain ◽  
Md Arifuzzaman Khan ◽  
Shegufta Shefa Shikder ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Health Survey ◽  
Maternal Nutrition ◽  
Women's Empowerment ◽  
Wealth Quintile ◽  
Household Wealth ◽  
Women’S Empowerment ◽  
Demographic Health Survey ◽  
Maternal Malnutrition

Abstract Background The burden of maternal malnutrition and low birth weight (LBW) incurs enormous economic costs due to their adverse consequences. Women’s empowerment is believed to be one of the key factors for attaining maternal and child health and nutritional goals. Our objective was to investigate the association of women’s empowerment with maternal malnutrition and LBW.Methods We used nationally representative data from the Bangladesh Demographic Health Survey for 2011 and 2014. We analysed 27,357 women and 9,234 mother-child pairs. A women’s empowerment index (WEI) was constructed using principal component analysis. We estimated odds ratios as the measure of association between the WEI and the outcome measures using generalized estimating equations to account for the cluster level correlation.Results The overall prevalence of maternal malnutrition was 20% and LBW was 18%. The WEI was significantly associated with both maternal malnutrition and LBW with a dose-response relationship. The adjusted odds of having a LBW baby was 32% [AOR (95% CI):0.68 (0.57, 0.82)] lower in the highest quartile of the WEI relative to the lowest quartile. Household wealth significantly modified the effect of the WEI on maternal nutrition.; in the highest wealth quintile, the odds of maternal malnutrition was 54% [AOR (95% CI): 0.46 (0.33, 0.64)] lower while in the lowest wealth quintile the odds of malnutrition was only 18% [AOR (95% CI): 0.82 (0.67, 1.00)] lower comparing the highest WEI quartile with the lowest WEI quartile. However, the absolute differences in prevalence of malnutrition between the highest and lowest WEI quartiles were similar across wealth quintiles (6-8%).Conclusions This study used a comprehensive measure of women’s empowerment and provides strong evidence that low levels of women’s empowerment is associated with maternal malnutrition as well as with delivering LBW babies in Bangladesh. Therefore, policies to increase empowerment of women would contribute to improved population health.

scholarly journals SickKids Centre for Global Child Health - Chronic Child Malnutrition Project Placement

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Zahra Hussain
Keyword(s):  
Child Health ◽  
Motor Development ◽  
Maternal Education ◽  
Multivariable Analysis ◽  
Household Wealth ◽  
Acute Malnutrition ◽  
Child Malnutrition ◽  
Global Health Research ◽  
Access To Health Services ◽  
Mortality And Morbidity

I completed a 16-week practicum at the SickKids Centre for Global Child Health where I was a part of the stunting team led by Dr. Nadia Akseer under the research portfolio of Dr. Zulfiqar A. Bhutta. Linear growth stunting, or low height-for-age, is a visible and easily measurable physical manifestation of chronic malnutrition. Children who are stunted have higher rates of mortality and morbidity, as well as experience suboptimal cognitive and motor development. At the time of my placement, one of the team's main projects was a mixed-methods study involving an in-depth evaluation of policies, programs, and factors that have contributed to the decline of under-5 stunting in Ethiopia from 2000-2016. I worked on a variety of components of the manuscript for this study. These included narratives for country demographics, background statistics as well as migration and remittance trends. I also contributed to a literature review on factors that have contributed to a reduction in stunting in Ethiopia in relation to an adapted version of UNICEF's conceptual framework for malnutrition. In addition to the manuscript, I conducted a multivariable analysis of the 2016 determinants of under-5 wasting in Ethiopia. Wasting, or low weight for height, is a form of acute malnutrition and is also a risk factor for mortality. I applied a hierarchical analysis to wasting indicators such as disease, household wealth, maternal education and access to health services. I used Ethiopia's 2016 Demographic and Health Survey data and additional data sources provided through various Ethiopian government ministries. Overall my practicum was a rich interdisciplinary learning experience which allowed me to develop my quantitative and qualitative research skills. I also gained a deeper understanding of global health research processes and the multi-sectoral nature of combating child malnutrition.

scholarly journals Women’s empowerment is associated with maternal nutrition and low birth weight: Evidence from Bangladesh Demographic Health Survey

2019 ◽  
Author(s):  
Alamgir Kabir ◽  
Md Mahbubur Rashid ◽  
Kamal Hossain ◽  
Md Arifuzzaman Khan ◽  
Shegufta Shefa Shikder ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Health Survey ◽  
Maternal Nutrition ◽  
Women's Empowerment ◽  
Wealth Quintile ◽  
Household Wealth ◽  
Women’S Empowerment ◽  
Demographic Health Survey ◽  
Maternal Undernutrition

Abstract Background The burden of maternal undernutrition and low birth weight (LBW) incurs enormous economic costs due to their adverse consequences. Women’s empowerment is believed to be one of the key factors for attaining maternal and child health and nutritional goals. Our objective was to investigate the association of women’s empowerment with maternal undernutrition and LBW. Methods We used nationally representative data from the Bangladesh Demographic Health Survey for 2011 and 2014. We analysed 27,357 women and 9,234 mother-child pairs. A women’s empowerment index (WEI) was constructed using principal component analysis. We estimated odds ratios as the measure of association between the WEI and the outcome measures using generalized estimating equations to account for the cluster level correlation. Results The overall prevalence of maternal undernutrition was 20% and LBW was 18%. The WEI was significantly associated with both maternal undernutrition and LBW with a dose-response relationship. The adjusted odds of having a LBW baby was 32% [AOR (95% CI):0.68 (0.57, 0.82)] lower in the highest quartile of the WEI relative to the lowest quartile. Household wealth significantly modified the effect of the WEI on maternal nutrition.; in the highest wealth quintile, the odds of maternal undernutrition was 54% [AOR (95% CI): 0.46 (0.33, 0.64)] lower while in the lowest wealth quintile the odds of undernutrition was only 18% [AOR (95% CI): 0.82 (0.67, 1.00)] lower comparing the highest WEI quartile with the lowest WEI quartile. However, the absolute differences in prevalence of undernutrition between the highest and lowest WEI quartiles were similar across wealth quintiles (6-8%). Conclusions This study used a comprehensive measure of women’s empowerment and provides strong evidence that low levels of women’s empowerment is associated with maternal undernutrition as well as with delivering LBW babies in Bangladesh. Therefore, policies to increase empowerment of women would contribute to improved public health.

scholarly journals Prevalence of and socioeconomic gradient in low birth weight in Ethiopia: further analysis of the 2016 demographic and health survey data

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Gebretsadik Shibre ◽  
Mulugeta Tamire
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Health Survey ◽  
Socioeconomic Position ◽  
Maternal Education ◽  
Household Wealth ◽  
Demographic And Health Survey ◽  
Multivariable Logistic Regression Model ◽  
Targeted Interventions ◽  
Socioeconomic Gradient

Abstract Background Evidence suggests appearance of socioeconomic gradient in the probability of low birth weight (LBW). Such evidence, however, is scanty in Ethiopia. The study aimed to examine the prevalence of and socioeconomic gradient in LBW in Ethiopia. Method Data for the study were drawn from the Ethiopia Demographic and Health Survey conducted in 2016. The 2016 EDHS is the fourth wave in the series of nationally representative household surveys carried out in the country to deliver up-to-date health and demographic indicators for the Ethiopian population. Women aged 15 to 49 years were the main focus of the survey, with data also gathered from men aged 15 to 59 years and under five children. The study pursued complex sampling strategy to draw samples representative at national as well as at urban and rural levels. The data are available to the public domain and were accessed from the MEASURE DHS following registration. Multivariable logistic regression model and marginal standardization were used to estimate socioeconomic gradient in the probability of LBW. We performed sensitivity analysis to evaluate variation of LBW according to different categories of socioeconomic position. Maternal education and household wealth were used as measures of the socioeconomic position in the study. Results 13.2% (95% confidence interval = 10.73, 15.65) of births were complicated by LBW. The findings showed that socioeconomic gradient was evident between maternal education and LBW; as education increases from no education to secondary education, the probability of occurrence of LBW consistently declined. However, no gradient in LBW was detected for household wealth. Conclusions We have identified education gradient in LBW, with the highest burden of LBW occurring among the non-educated women. To redress the observed education disparity in LBW, targeted interventions need to be implemented with greater emphasis placed on illiterate women.

scholarly journals Maternal factors associated with moderate and severe stunting in Ethiopian children: analysis of some environmental factors based on 2016 demographic health survey

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Nebyu Daniel Amaha ◽  
Berhanu Teshome Woldeamanuel
Keyword(s):  
Environmental Factors ◽  
Antenatal Care ◽  
Health Survey ◽  
Maternal Education ◽  
Predictor Variable ◽  
Demographic Health Survey ◽  
Maternal Height ◽  
Maternal Factors ◽  
Severe Stunting ◽  
Factors Associated

Abstract Background Stunting or chronic undernutrition is a significant public health problem in Ethiopia. In 2019, 37% of Ethiopian children under-5 were stunted. Stunting results from a complex interaction of individual, household and social (environmental) factors. Improving the mother’s overall care is the most important determinant in reducing the stunting levels in developing countries. We aimed to determine the most important maternal factors associated with stunting and quantify their effects. Methods This study used data from the nationally representative 2016 Ethiopian Demographic Health Survey (EDHS). Common maternal factors were first selected and analyzed using Pearson’s chi-square of association followed by multiple logistic regression. To quantify the effect of a unit change of a predictor variable a model for the continuous maternal factors was developed. All analyses were carried out using IBM SPSS© Version 23. Results Higher maternal educational level, better maternal autonomy, average or above maternal height and weight, having at least 4 antenatal care (ANC) clinic visits, and delivering in a health facility were significantly associated with lower severe stunting levels. Unemployed mothers were 23% less likely (p = 0.003) to have a stunted child compared with employed mothers. Mothers delivering at home had 32% higher odds of stunting (p = 0.002). We found that short mothers (< 150 cm) were 2.5 more likely to have stunted children when compared with mothers above 160 cm. Every visit to the ANC clinic reduces stunting odds by 6.8% (p <  0.0001). The odds of stunting were reduced by 7% (p = 0.028) for every grade a girl spent in school. A unit increase in Body Mass Index (BMI) reduced the odds of stunting by 4% (p = 0.014) and every centimeter increase in maternal height reduced the odds of stunting by 0.5% (p = 0.01). Conclusion Maternal education, number of antenatal care visits, and place of delivery appear to be the most important predictors of child stunting in Ethiopia.. Therefore, educating and empowering women, improving access to family planning and ANC services, and addressing maternal malnutrition are important factors that should be included in policies aiming to reduce childhood stunting in Ethiopia.

scholarly journals Prevalence and Risk Factors of Anaemia Among Children Under Five Years in Ghana: Analysis From the Ghana Demographic and Health Survey

2021 ◽  
Author(s):  
Ebenezer Opoku ◽  
Shirley Crankson ◽  
Nana Kwame Anokye
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Health Survey ◽  
Maternal Education ◽  
Tertiary Education ◽  
Household Wealth ◽  
Demographic And Health Survey ◽  
Multivariate Logistic Regression Model ◽  
Children Under Five ◽  
Under Five

Abstract Background: Childhood anaemia remains a public health challenge in developing countries, mostly in children under five years in Sub-Sharan Africa. Anaemia in children is a preventable condition; however, it has serious consequences including growth retardation, low cognitive functioning, poor immune system causing an increased susceptibility to diseases, and death. This study determined the prevalence and associated risk factors of anaemia among children under five years in Ghana. Methods: Data from the most recent Ghana Demographic and Health Survey (DHS-VIII) was analysed in this study. Anaemia was examined as a binary variable- anaemic (coded as 1) and non-anaemic (coded as 0). The explanatory variables included age, child’s malaria vaccination status, mother’s number of antenatal visits and household source of drinking water. Bivariate and multivariate logistic regression model were conducted to identify the risk factors of anaemia in the defined population. Results: 2,434 children aged 6-59 months were included in this analysis. The majority were males (50.5%), aged from 24-42 months (36.1%), and had received malaria vaccine (94.3%). The prevalence of anaemia in the population was 58.35% (95%CI=52.72-63.96). The logistic regression indicated that female children under five years in Ghana are less likely to have anaemia than male children under five years [aOR= 0.74, 95% CI=0.62-0.88, p<0.001]. Also, children with malaria had about two times the odds of anaemia than those without malaria [95% CI = 1.28-1.87, p<0.001]. Further, children whose mothers had received tertiary education were less likely to have anaemia [aOR= 0.60, 95% CI=0.38-0.96, p=0.03] than those whose mothers had no formal education.Conclusion: The prevalence of anaemia is high among children under five years in Ghana, and this prevalence is determined by child’s age and malaria status, maternal education, household wealth index, and place of residence. Consequently, anaemia prevention and management strategies must prioritise these factors to reduce the anaemia prevalence in this population.

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