scholarly journals Socioeconomic inequality and determinants of postnatal home visits made by public health midwives: An analysis of the Sri Lanka Demographic and Health Survey

PLoS ONE ◽  
2019 ◽  
Vol 14 (4) ◽  
pp. e0215816 ◽  
Author(s):  
Dhammika Deepani Siriwardhana ◽  
Arunasalam Pathmeswaran ◽  
Ananda Rajitha Wickremasinghe
Anemia ◽  
2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Taddese Alemu ◽  
Melaku Umeta

Anemia is a major public health problem worldwide. In Ethiopia, a nationally representative and consistent evidence is lacking on the prevalence and determinants during pregnancy. We conducted an in-depth analysis of demographic and health survey for the year 2011 which is a representative data collected from all regions in Ethiopia. Considering maternal anemia as an outcome variable, predicting variables from sociodemographic, household, and reproductive/obstetric characteristics were identified for analyses. Logistic regression model was applied to identify predictors atP<0.05. The prevalence of anemia among pregnant women was 23%. Maternal age, region, pregnancy trimester, number of under five children, previous history of abortion (termination of pregnancy), breastfeeding practices, and number of antenatal care visits were key independent predictors of anemia during pregnancy. In conclusion, the level of anemia during pregnancy is a moderate public health problem in Ethiopia. Yet, special preventive measures should be undertaken for pregnant women who are older in age and having too many under five children and previous history of abortion. Further evidence is expected to be generated concerning why pregnant mothers from the eastern part of the country and those with better access to radio disproportionately develop anemia more than their counterparts.


2020 ◽  
Author(s):  
Sashimali Wickramasinghe ◽  
Nalika Gunawardena ◽  
Dhanusha Punyadasa ◽  
Shanthi Gunawardena ◽  
Champika Wickramasinghe ◽  
...  

Abstract Background Unintentional injuries among adolescents is a major public health problem the world over. A great majority of the annual deaths among adolescents is due to unintentional injuries; it is also the leading cause of death among adolescents in the world. The aim of this study was to estimate the incidence of injuries and their associated factors among school going adolescents aged 13-17 years using data from the most recent Global School-Based Health Survey (GSHS) conducted in Sri Lanka. Methods A cross-sectional survey was conducted using a self-administered questionnaire, among 3,262 adolescents attending government schools. The sample was selected through a two-staged cluster sampling technique. In the first stage, 40 schools were selected using probabilities proportional to school enrollment size, from all schools in the country that have classes in grades 8-12 . Then, from the selected schools, classes were selected using systematic equal probability sampling with a random start. The weighted prevalence was calculated, and logistic regression analysis was conducted in order to determine the correlates. Results During the 12 months before the survey, 35.8% (95% CI-30.7 - 41.1) of the students reported being seriously injured one or more times. The injuries were more common among males, but were equally common among the two different age groups (13-15 age group vs 16-17 age group). The most common type of injury was cut or stab wounds (5.5%), followed by broken bones/dislocated joints (5.3%). Multivariable analysis revealed that only a few factors were associated with injury, such as being of the male sex, being bullied, being physically attacked, and/or being in a physical fight. Conclusion This study demonstrated that the prevalence of serious unintentional injuries among school going adolescents is a major public health problem in Sri Lanka. This timely and comprehensive survey would help policy makers and researchers identify the unmet needs related to adolescent injuries. Furthermore, evidence generated form the study should be given due consideration when designing school-based interventions to prevent adolescent injuries.


Author(s):  
Abdollah ALMASIAN KIA ◽  
Sahar GOODARZI ◽  
Heshmatollah ASADI ◽  
Ardeshir KHOSRAVI ◽  
Aziz REZAPOUR

Background: Nutritional status at the early stages of children’s lives is essential for growth and development not only in infancy but also in adult life. This study aimed to measure the inequality in malnutrition among under-five children in Iran and explore the impact of socioeconomic factors on this inequality using a regression-based decomposition approach. Methods: Data were extracted from Iran's Multiple-Indicator Demographic and Health Survey 2010. The concentration index of stunting, underweight, and wasting were applied in order to measure the magnitude of socioeconomic inequality in child malnutrition. Moreover, the concentration indices were decomposed to understand the contribution of socioeconomic variables in childhood malnutrition inequality. Results: The obtained concentration indices of stunting, underweight, and wasting were respectively -0.177, -0.092, and -0.031. Socioeconomic inequality in stunting and underweight was statistically significant, however this socioeconomic gradient was not observed in wasting. More than 50% of the inequality in stunting and about 63% of the inequality in underweight were influenced by socioeconomic status. Furthermore, maternal education was associated with 19% and 22% of inequality in stunting and underweight respectively. Conclusion: The average reduction of malnutrition indices at the national level hides the burden of malnutrition among children in poor families. If government and policymakers seek to solve this problem, they have to take direct and targeted actions to eliminate the existing inequalities in the socioeconomic determinants associated with malnutrition.  


2018 ◽  
Vol 11 (1) ◽  
pp. 425-437
Author(s):  
Faustin Habyarimana ◽  
Temesgen Zewotir ◽  
Shaun Ramroop

Background:Anemia is an important public health problem affecting all age groups of the population. The objective of this study was to identify the risk factors associated with anemia among women of childbearing age in Rwanda and map their spatial variation.Methods:The 2014/15 Rwanda Demographic and Health survey data was used and the structured logistic regression model was fitted to the data, where fixed effects were modeled parametrically, non-linear effects were modeled non-parametrically using second order random walk priors and spatial effects were modeled using Markov Random field priors.Results:The prevalence of anemia among non-pregnant women of reproductive age was 18.9%. Women from the households which use water from the unprotected well had a higher risk of having anemia than a woman from the household where they use water piped into dwelling or yard. The risk of anemia was higher among underweight women and women living in households without toilet facilities. The anemia was less pronounced among the women using contraception, literate women, women from the households which use a bed net and living in rich households.Conclusion:The findings from this study highlighted the districts with the highest number of anemic women and this can help the policymakers and other public health institutions to design a specific programme targeting these districts in order to improve the health status and living conditions of these women. The findings also suggest an improvement of toilet facilities, bed net use and source of drinking water in affected households.


2021 ◽  
Author(s):  
Damitie Kebede Mengesha

Abstract BackgroundUndernutrition is one of the major public health concerns among infants and young children in the country. Childhood under-nutrition is widespread in low and middle-income countries. This study was initiated to assess the prevalence of under-nutrition and its associated factors among under-five children in Afar Region, Ethiopia. MethodsThe data for this study were extracted from the Ethiopian Demographic and Health Survey (EDHS) 2016. The information collected from 937 children born 5 years before the survey was considered in the analysis. A multivariable binary logistic regression analysis was used at a 5% level of significance to determine the individual- and community-level factors associated with childhood malnutrition.ResultsThe prevalence of stunting, underweight and wasting in Afar region were 41.1%, 36.2% and 17.7%, respectively. About 26.7% of children in Afar region were both stunting and underweight, 12.7% were both underweight and wasting, 7.6% were both stunting and wasting and only 7.0% of children had all the three under-nutrition conditions. Among the factors considered in this study, age of a child in months, anemia level, mothers’ BMI, household wealth index, size of child at birth, number of living children and place of residence were significantly associated with stunting, underweight and wasting in Afar Region. ConclusionsThe prevalence of all stunting, underweight and wasting was relatively high. Undernutrition is one of the major public health concerns among children in Afar Region. The effect of these factors should be considered to develop strategies to reduce under-nutrition in the study area. Thus, intervention should be focused on improving the under-nutrition determinants of the children to improve the child's nutritional status and reduce child morbidity and mortality.


2020 ◽  
Vol 20 (2) ◽  
pp. 715-723
Author(s):  
Garoma Wakjira Basha ◽  
Ashenafi Abate Woya ◽  
Abay Kassa Tekile

Background: The first 28 days of life, the neonatal period, are the most vulnerable time for a child’s survival. Neonatal mortality accounts for about 38% of under-five deaths in low and middle income countries. This study aimed to identify the determinants of neonatal mortality in Ethiopia. Methods: The study used data from the nationally representative 2016 Ethiopia Demographic and Health Survey (EDHS). Once the data were extracted; editing, coding and cleaning were done by using SAS 9.4.Sampling weights was applied to en- sure the representativeness of the sample in this study. Both bivariate and multivariable logistic regression statistical analysis was used to identify determinants of neonatal mortality in Ethiopia. Results: A total of 11,023 weighted live-born neonates born within five years preceding the 2016 EDHS were included this in this study. Multiple logistic regression analysis showed that multiple birth neonates (Adjusted Odds Ratio (AOR)=6.38;95%- Confidence Interval (CI):4.42-9.21), large birth size (AOR=1.35; 95% CI: 0.28-1.62), neonates born to mothers who did not utilize ANC (AOR=1.41; 95% CI: 1.11-1.81), neonates from rural area (AOR=1.88; 95% CI: 1.15-3.05) and neonates born in Harari region (AOR=1.45; 95% CI: 0.61-3.45)had higher odds of neonatal mortality. On the other hand, female neonates (AOR=0.60; 95% CI: 0.47-0.75), neonates born within the interval of more than 36 months of the preceding birth (AOR=0.56; 95% CI: 0.43-0.75), neonates born to fathers with secondary and higher education level (AOR=0.51; 95%CI: 0.22-0.88) had lower odds of neonatal mortality in Ethiopia. Conclusion: To reduce neonatal mortality in Ethiopia, there is a need to implement sex specific public health intervention mainly focusing on male neonate during pregnancy, child birth and postnatal period. A relatively simple and cost-effective public health intervention should be implemented to make sure that all pregnant women are screened for multiple pregnancy and if positive, extra care should be given during pregnancy, child birth and postnatal. Keywords: Neonatal mortality; logistic regression; odds ratio; Ethiopia.


2015 ◽  
Vol 47 (06) ◽  
pp. 845-852
Author(s):  
GAMINIRATNE WIJESEKERE ◽  
DHARMA ARUNACHALAM

SummaryFertility transition in Sri Lanka began in the mid-1960s and the declining trend continued over the decades. The Demographic and Health Survey (DHS) of 2000 showed the total fertility rate (TFR) reaching 1.9 births per woman, a level below replacement fertility. The next DHS of 2006/7 showed a TFR of 2.3. Some have interpreted this pattern as indicating a reversal of the fertility transition. This paper casts doubts on the below-replacement fertility revealed in the 2000 survey.


BMJ Open ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. e037223
Author(s):  
Gayathri Abeywickrama ◽  
Sabu S Padmadas ◽  
Andrew Hinde

ObjectiveTo investigate social inequalities underlying low birthweight (LBW) outcomes in Sri Lanka.DesignCross-sectional study.SettingThis study used the Sri Lanka Demographic and Health Survey 2016, the first such survey to cover the entire country since the Civil War ended in 2001.ParticipantsBirthweight data extracted from the child health development records available for 7713 babies born between January 2011 and the date of interview in 2016.Outcome measuresThe main outcome variable was birth weight, classified as LBW (≤2500 g) and normal.MethodsWe applied random intercept three-level logistic regression to examine the association between LBW and maternal, socioeconomic and geographic variables. Concentration indices were estimated for different population subgroups.ResultsThe population-level prevalence of LBW was 16.9% but was significantly higher in the estate sector (28.4%) compared with rural (16.6%) and urban (13.6%) areas. Negative concentration indices suggest a relatively higher concentration of LBW in poor households in rural areas and the estate sector. Results from fixed effects logistic regression models confirmed our hypothesis of significantly higher risk of LBW outcomes across poorer households and Indian Tamil communities (AOR 1.70, 95% CI 1.02 to 2.83, p<0.05). Results from random intercept models confirmed there was substantial unobserved variation in LBW outcomes at the mother level. The effect of maternal biological variables was larger than that of socioeconomic factors.ConclusionLBW rates are significantly higher among babies born in poorer households and Indian Tamil communities. The findings highlight the need for nutrition interventions targeting pregnant women of Indian Tamil ethnicity and those living in economically deprived households.


2020 ◽  
Vol 9 ◽  
Author(s):  
Peninah Kinya Masibo ◽  
Felix Humwa ◽  
Teresia Njoki Macharia

Abstract The double burden of overnutrition and undernutrition is rapidly becoming a public health concern in low- and middle-income countries. We explored the occurrence of mother−child pairs of over- and undernutrition and the contributing factors using the 2014 Kenya Demographic and Health Survey data. A weighted sample of 7830 mother−child pairs was analysed. The children's nutritional status was determined using the WHO 2006 reference standards while maternal nutritional status was determined with BMI. Descriptive statistics, bivariate and multivariate logistic regression analysis were conducted. The proportion of overweight and obese mothers was 26 % (18·8 % overweight and 7·2 % obese). The prevalence of child stunting, underweight and wasting was 26·3, 12·8 and 5·1 %, respectively. Out of the overweight/obese mothers (weighted n 2034), 20 % had stunted children, 5·4 % underweight children and 3·1 % wasted children. Overweight/obese mother−stunted child pairs and overweight/obese mother−underweight child pairs were less likely to occur in the rural areas (adjusted OR (aOR) = 0·43; P < 0·01) in comparison with those residing in the urban areas (aOR = 0·54; P = 0·01). Children aged more than 6 months were more likely to be in the double burden dyads compared with children below 6 months of age (P < 0·01). The double burden mother−child dyads were more likely to be observed in wealthier households. Mother−child double burden is a notable public health problem in Kenya. Household wealth and urban residence are determinants of the double burden. There is need for target-specific interventions to simultaneously address child undernutrition and maternal overweight/obesity.


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