Women’s reproductive health decision-making: A multi-country analysis of demographic and health surveys in sub-Saharan Africa

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.

Download Full-text

Prevalence and determinants of unintended pregnancy in sub-Saharan Africa: A multi-country analysis of demographic and health surveys

PLoS ONE ◽

10.1371/journal.pone.0220970 ◽

2019 ◽

Vol 14 (8) ◽

pp. e0220970 ◽

Cited By ~ 18

Author(s):

Edward Kwabena Ameyaw ◽

Eugene Budu ◽

Francis Sambah ◽

Linus Baatiema ◽

Francis Appiah ◽

...

Keyword(s):

Unintended Pregnancy ◽

Health Surveys ◽

Sub Saharan Africa ◽

Demographic And Health Surveys ◽

Country Analysis ◽

Sub Saharan

Download Full-text

Effect of sexual violence on planned, mistimed and unwanted pregnancies among women of reproductive age in sub-Saharan Africa: A multi-country analysis of Demographic and Health Surveys

SSM - Population Health ◽

10.1016/j.ssmph.2020.100601 ◽

2020 ◽

Vol 11 ◽

pp. 100601 ◽

Cited By ~ 1

Author(s):

Bright Opoku Ahinkorah ◽

Abdul-Aziz Seidu ◽

Francis Appiah ◽

Joseph Kojo Oduro ◽

Francis Sambah ◽

...

Keyword(s):

Sexual Violence ◽

Health Surveys ◽

Reproductive Age ◽

Sub Saharan Africa ◽

Demographic And Health Surveys ◽

Women Of Reproductive Age ◽

Unwanted Pregnancies ◽

Country Analysis ◽

Sub Saharan

Download Full-text

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

10.21203/rs.2.22504/v3 ◽

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.

Download Full-text

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

10.21203/rs.2.22504/v2 ◽

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.

Download Full-text