scholarly journals Determinants of full childhood immunization among children aged 12–23 months in sub-Saharan Africa: a multilevel analysis using Demographic and Health Survey Data

2021 ◽  
Vol 49 (1) ◽  
Author(s):  
Setegn Muche Fenta ◽  
Hailegebrael Birhan Biresaw ◽  
Kenaw Derebe Fentaw ◽  
Shewayiref Geremew Gebremichael
Keyword(s):  
Logistic Regression ◽  
Regression Model ◽  
Health Facility ◽  
Health Survey ◽  
Logistic Regression Model ◽  
Immunization Coverage ◽  
Demographic And Health Survey ◽  
Sub Saharan Africa ◽  
Childhood Immunization ◽  
Sub Saharan

Abstract Background Sub-Saharan Africa is one of the highest under-five mortality and low childhood immunization region in the world. Children in Sub-Saharan Africa are 15 times more likely to die than children from high-income countries. In sub-Saharan Africa, more than half of under-five deaths are preventable through immunization. Therefore, this study aimed to identify the determinant factors of full childhood immunization among children aged 12–23 months in sub-Saharan Africa. Methods Data for the study was drawn from the Demographic and Health Survey of nine sub-Saharan African countries. A total of 21,448 children were included. The two-level mixed-effects logistic regression model was used to identify the individual and community-level factors associated with full childhood immunization Result The prevalence of full childhood immunization coverage in sub-Saharan Africa countries was 59.40% (95% CI: 58.70, 60.02). The multilevel logistic regression model revealed that secondary and above maternal education (AOR = 1.38; 95% CI: 1.25, 1.53), health facility delivery (AOR = 1.51; 95% CI: 1.41, 1.63), fathers secondary education and above (AOR = 1.28, 95% CI: 1.11, 1.48), four and above ANC visits (AOR = 2.01; 95% CI: 1.17, 2.30), PNC visit(AOR = 1.55; 95% CI: 1.46, 1.65), rich wealth index (AOR = 1.26; 95% CI: 1.18, 1.40), media exposure (AOR = 1.11; 95% CI: 1.04, 1.18), and distance to health facility is not a big problem (AOR = 1.42; 95% CI: 1.28, 1.47) were significantly associated with full childhood immunization. Conclusion The full childhood immunization coverage in sub-Saharan Africa was poor with high inequalities. There is a significant variation between SSA countries in full childhood immunization. Therefore, public health programs targeting uneducated mothers and fathers, rural mothers, poor households, and those who have not used maternal health care services to promote full childhood immunization to improve child health. By enhancing institutional delivery, antenatal care visits and maternal tetanus immunization, the government and other stakeholders should work properly to increase child immunization coverage. Furthermore, policies and programs aimed at addressing cluster variations in childhood immunization need to be formulated and their implementation must be strongly pursued.

scholarly journals Timely initiation of antenatal care and its associated factors among pregnant women in sub-Saharan Africa: A multicountry analysis of Demographic and Health Surveys

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262411
Author(s):  
Adugnaw Zeleke Alem ◽  
Yigizie Yeshaw ◽  
Alemneh Mekuriaw Liyew ◽  
Getayeneh Antehunegn Tesema ◽  
Tesfa Sewunet Alamneh ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Antenatal Care ◽  
Regression Model ◽  
Health Facility ◽  
Associated Factors ◽  
Logistic Regression Model ◽  
Sub Saharan Africa ◽  
Timely Initiation ◽  
Sub Saharan ◽  
Ssa Countries

Background Timely initiation of antenatal care (ANC) is an important component of ANC services that improve the health of the mother and the newborn. Mothers who begin attending ANC in a timely manner, can fully benefit from preventive and curative services. However, evidence in sub-Saharan Africa (sSA) indicated that the majority of pregnant mothers did not start their first visit timely. As our search concerned, there is no study that incorporates a large number of sub-Saharan Africa countries. Thus, the objective of this study was to assess the prevalence of timely initiation of ANC and its associated factors in 36 sSA countries. Methods The Demographic and Health Survey (DHS) of 36 sSA countries were used for the analysis. The total weighted sample of 233,349 women aged 15–49 years who gave birth in the five years preceding the survey and who had ANC visit for their last child were included. A multi-level logistic regression model was used to examine the individual and community-level factors that influence the timely initiation of ANC. Results were presented using adjusted odds ratio (AOR) with 95% confidence interval (CI). Results In this study, overall timely initiation of ANC visit was 38.0% (95% CI: 37.8–38.2), ranging from 14.5% in Mozambique to 68.6% in Liberia. In the final multilevel logistic regression model:- women with secondary education (AOR = 1.08; 95% CI: 1.06, 1.11), higher education (AOR = 1.43; 95% CI: 1.36, 1.51), women aged 25–34 years (AOR = 1.20; 95% CI: 1.17, 1.23), ≥35 years (AOR = 1.30; 95% CI: 1.26, 1.35), women from richest household (AOR = 1.19; 95% CI: 1.14, 1.22), women perceiving distance from the health facility as not a big problem (AOR = 1.05; 95%CI: 1.03, 1.07), women exposed to media (AOR = 1.29; 95%CI: 1.26, 1.32), women living in communities with medium percentage of literacy (AOR = 1.51; 95%CI: 1.40, 1.63), and women living in communities with high percentage of literacy (AOR = 1.56; 95%CI: 1.38, 1.76) were more likely to initiate ANC timely. However, women who wanted their pregnancy later (AOR = 0.84; 95%CI: 0.82, 0.86), wanted no more pregnancy (AOR = 0.80; 95%CI: 0.77, 0.83), and women residing in the rural area (AOR = 0.90; 95%CI: 0.87, 0.92) were less likely to initiate ANC timely. Conclusion Even though the WHO recommends all women initiate ANC within 12 weeks of gestation, sSA recorded a low overall prevalence of timely initiation of ANC. Maternal education, pregnancy intention, residence, age, wealth status, media exposure, distance from health facility, and community-level literacy were significantly associated with timely initiation of ANC. Therefore, intervention efforts should focus on the identified factors in order to improve timely initiation of ANC in sSA. This can be done through the providing information and education to the community on the timing and importance of attending antenatal care and family planning to prevent unwanted pregnancy, especially in rural settings.

scholarly journals HIV and cardiovascular disease in sub-Saharan Africa: Demographic and Health Survey data for 4 countries

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Leonard E. Egede ◽  
Rebekah J. Walker ◽  
Patricia Monroe ◽  
Joni S. Williams ◽  
Jennifer A. Campbell ◽  
...  
Keyword(s):  
South Africa ◽  
Cardiovascular Disease ◽  
Health Survey ◽  
Survey Design ◽  
Logistic Models ◽  
Population Data ◽  
Demographic And Health Survey ◽  
Sub Saharan Africa ◽  
Sub Saharan ◽  
The Relationship

Abstract Background Investigate the relationship between two common cardiovascular diseases and HIV in adults living in sub-Saharan Africa using population data provided through the Demographic and Health Survey. Methods Data for four sub-Saharan countries were used. All adults asked questions regarding diagnosis of HIV, diabetes, and hypertension were included in the sample totaling 5356 in Lesotho, 3294 in Namibia, 9917 in Senegal, and 1051 in South Africa. Logistic models were run for each country separately, with self-reported diabetes as the first outcome and self-reported hypertension as the second outcome and HIV status as the primary independent variable. Models were adjusted for age, gender, rural/urban residence and BMI. Complex survey design allowed weighting to the population. Results Prevalence of self-reported diabetes ranged from 3.8% in Namibia to 0.5% in Senegal. Prevalence of self-reported hypertension ranged from 22.9% in Namibia to 0.6% in Senegal. In unadjusted models, individuals with HIV in Lesotho were 2 times more likely to have self-reported diabetes (OR = 2.01, 95% CI 1.08–3.73), however the relationship lost significance after adjustment. Individuals with HIV were less likely to have self-reported diabetes after adjustment in Namibia (OR = 0.29, 95% CI 0.12–0.72) and less likely to have self-reported hypertension after adjustment in Lesotho (OR = 0.63, 95% CI 0.47–0.83). Relationships were not significant for Senegal or South Africa. Discussion HIV did not serve as a risk factor for self-reported cardiovascular disease in sub-Saharan Africa during the years included in this study. However, given the growing prevalence of diabetes and hypertension in the region, and the high prevalence of undiagnosed cardiovascular disease, it will be important to continue to track and monitor cardiovascular disease at the population level and in individuals with and without HIV. Conclusions The odds of self-reported diabetes in individuals with HIV was high in Lesotho and low in Namibia, while the odds of self-reported hypertension in individuals with HIV was low across all 4 countries included in this study. Programs are needed to target individuals that need to manage multiple diseases at once and should consider increasing access to cardiovascular disease management programs for older adults, individuals with high BMI, women, and those living in urban settings.

scholarly journals HIV knowledge and associated factors among young Ethiopians: application of multilevel order logistic regression using the 2016 EDHS

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Teshome Kabeta Dadi ◽  
Merga Belina Feyasa ◽  
Mamo Nigatu Gebre
Keyword(s):  
Logistic Regression ◽  
Survey Data ◽  
Health Survey ◽  
Statistical Significance ◽  
Insurance Coverage ◽  
Mobile Telephone ◽  
Demographic And Health Survey ◽  
Sub Saharan Africa ◽  
Hiv Knowledge ◽  
Health Survey Data

Abstract Background Human Immunodeficiency virus continues to be a major global health problem infecting 75 million and killing 32 million people since the beginning of the epidemic. It badly hit Sub Saharan Africa than any country in the world and youths are sharing the greatest burden. The study aims to assess the level of HIV-knowledge and its determinants among Ethiopian youths using the 2016 Ethiopia Demographic and Health Survey data. Methods A nationally representative 2016 Ethiopian Demographic and Health Survey data were used. A total of 10,903 youths comprising 6401 females and 4502 males were included in the study. Descriptive statistics and multilevel order logistic regression were used and confidence interval was used to declare statistical significance in the final model. Results The mean age and SD of youths included in this study was 19.10 (±2.82). Among Ethiopian youths, 20.92% (95% CI: 18.91, 23.09%) had low knowledge of HIV whereas, 48.76% (95% CI: 47.12, 50.41%) and 30.31% (95% CI: 28.51, 32.18%) of them had moderate and comprehensive HIV knowledge respectively. Being male, access to TV and radio, ever tested for HIV/AIDS, owning a mobile telephone, and attending primary school and above compared to non-attendants were associated with having higher HIV knowledge. But, dwelling in rural Ethiopia, being in the Protestant and Muslim religious groups as compared to those of Orthodox followers and being in married groups were associated with having lower HIV knowledge. Approximately, 12% of the variation in knowledge of HIV was due to regions. Conclusion Only one-third of Ethiopian youths have deep insight into the disease, whereas, nearly one-fifth of them have lower HIV-knowledge. There is a significant disparity in HIV-related knowledge among Ethiopian youths living in different regions. Rural residents, less educated, female, and married youths have less knowledge of HIV as compared to their counterparts. Youths who do not have a mobile phone, who lack health insurance coverage, and who have limited access to media have less knowledge about HIV. Therefore, the due focus should be given to the aforementioned factors to minimize the disparities between regions and to enhance Ethiopian youths’ HIV-knowledge.

scholarly journals Paid sex among men in sub-Saharan Africa: Analysis of the demographic and health survey

2020 ◽  
Vol 11 ◽  
pp. 100459 ◽  
Author(s):  
Abdul-Aziz Seidu ◽  
Eugene Kofuor Maafo Darteh ◽  
Akwasi Kumi-Kyereme ◽  
Kwamena Sekyi Dickson ◽  
Bright Opoku Ahinkorah
Keyword(s):  
Health Survey ◽  
Demographic And Health Survey ◽  
Sub Saharan Africa ◽  
Sub Saharan

scholarly journals Catastrophic Health Expenditure Before and After of the Implementation of Health Sector Evolution Plan

2020 ◽  
Author(s):  
Razieh Ahmadi ◽  
Milad Shafii ◽  
Hosein Ameri ◽  
Roohollah Askari ◽  
Hossein Fallahzadeh
Keyword(s):  
Logistic Regression ◽  
Regression Model ◽  
Health Survey ◽  
Logistic Regression Model ◽  
Economic Status ◽  
World Health ◽  
World Health Survey ◽  
Face To Face ◽  
Single Visit ◽  
The World

Objective: Methods: The data was collected through face-to-face interview during a single visit. The World Health Survey (WHS) questionnaire was completed by 400 households. The relationships between CHE and variables were examined by the Fisher exact tests, and the impacts of variables on CHE were assessed by logistic regression model. Methods: The data was collected through face-to-face interview during a single visit. The World Health Survey (WHS) questionnaire was completed by 400 households. The relationships between CHE and variables were examined by the Fisher exact tests, and the impacts of variables on CHE were assessed by logistic regression model. Results: The exposure of the households to CHE increased from 8.2% in 2011 to 14.25% in 2020, and percentage of the impoverished households due to health expenditures in 2020 was more than that in 2011(4.3% vs. 7.5%). The economic status, dental services and inpatients services were the key factor determining CHE. The most important determinant affecting the exposure to CHE was dental service utilization in 2011(92.64) and 2020(122.68). Conclusion: The results showed a negative incremental change for the households facing CHE in this period. The dental and inpatients services, as well as the presence of member ≥65 years and economic status were the key determining factors for CHE. The services need to be more widely covered by the basic health insurance and households having members ≥65 years and the poor households should be exempted from paying some of the healthcare expenditures for improving financial protection against CHE.

scholarly journals Vaccine stockouts and vaccination rate: examination of unique administrative data from Nigeria

2019 ◽  
Vol 12 (3) ◽  
pp. 170-176
Author(s):  
Ryoko Sato
Keyword(s):  
Logistic Regression ◽  
Health Facility ◽  
Administrative Data ◽  
Vaccination Coverage ◽  
Health Survey ◽  
Negative Correlation ◽  
Vaccine Coverage ◽  
Universal Access ◽  
Vaccination Rate ◽  
Demographic And Health Survey

Abstract Background Universal access to vaccines is crucial in protecting the population from deadly diseases. This study presents the prevalence of vaccine stockouts in Nigeria and examines the correlation between the vaccine stockouts and vaccine take-up. Methods We use the unique administrative data of monthly vaccine stockouts at each health facility in Nigeria. To evaluate the correlation between the stockouts and the vaccine take-up, the administrative data were merged with the Nigeria Demographic and Health Survey conducted in 2013. We used logistic regression for the correlational study. Results The prevalence of vaccine stockouts in Nigeria is high: 82.7% between 2012 and 2013. We find a negative correlation between vaccine stockouts and vaccine take-up. However, we observe the differential correlational pattern depending on the regional vaccine coverage, which we consider as the proxy of the level of demand for vaccines. Conclusions We find that, while vaccine stockouts are correlated with the low vaccine take-up on average, this negative correlation between stockouts and vaccination rate is observed only in regions with low demand for vaccines. Reducing vaccine stockouts in regions with the low vaccination coverage might be an effective way to increase the overall vaccination rate.

scholarly journals Neonatal near Miss and Its Predictors among Neonates Delivered at Debretabor General Hospital, Northern Ethiopia; A Retrospective Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Habtamu Abie Tassew ◽  
Fisseha Yetwale Kassie ◽  
Muhabaw Shumye Mihret
Keyword(s):  
Logistic Regression ◽  
Regression Model ◽  
General Hospital ◽  
Neonatal Mortality ◽  
Logistic Regression Model ◽  
Near Miss ◽  
Sub Saharan Africa ◽  
Northern Ethiopia ◽  
Mortality Reduction ◽  
Neonatal Near Miss

Background. In many low-resource countries, the progress of neonatal mortality reduction is very slow. The scenario is notably true in sub-Saharan Africa including Ethiopia. For every neonatal death, there are lots of near missed neonates. Generating evidences on the extent and predictors of neonatal near miss is a key step in neonatal mortality reduction efforts. However, there is limited evidence in this aspect in Ethiopia. Objective. This study is aimed at assessing the proportion of neonatal near miss and associated factors among neonates delivered at Debretabor General Hospital, Northern Ethiopia, 2019. Methods. An institution-based cross-sectional study was conducted on 422 neonates delivered at Debretabor General Hospital from July 1st, 2018, to June 30th, 2019. Both pragmatic and management criteria of definition of neonatal near miss were utilized. A systematic random sampling technique was used to select the cards of the study participants. Data were extracted with structured and pretested checklist, entered in the EpiData, and then exported to SPSS version 20. Both descriptive and analytical procedures have been done. Descriptive statistics such as frequencies and cross tabulations were carried out. The binary logistic regression model was fitted and variables with p value < 0.20 were entered in the multivariable logistic regression model. Both crude and adjusted odds ratios with the corresponding 95% CI were computed. The level of significance has been claimed based on the adjusted odds ratio with 95% CI and its p value of ≤0.05. Results. The proportion of neonates experiencing near miss was obtained to be 32.2% with 95% CI (28, 36). Rural residence (AOR=4.41; 95% CI: 2.57,7.55), incomplete ANC visit (AOR=3.16; 95% CI: 1.90,5.25), primiparous (AOR=2.55; 95% CI: 1.59,4.12), pregnancy-induced hypertension (AOR=3.23; 95% CI: 1.19,8.78), premature rupture of membrane (AOR=4.65; 95% CI: 1.70,12,73), cephalic-pelvic disproportion (AOR=3.05; 95% CI: 1.32,7.01), and antepartum hemorrhage (AOR=4.95; 95% CI: 1.89,12.96) were the independent predictors of neonatal near-miss. Conclusion and Recommendations. The proportion of neonatal near miss was found to be high in the study setting. Most of the determinants of near miss are modifiable obstetric-related factors. Hence, stakeholders need to consider the aforesaid factors while they design interventions.

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