Prevalence of low birth weight and its associated factor at birth in Sub-Saharan Africa: A generalized linear mixed model

Background Low birth weight (LBW) is one of the major determinants of perinatal survival, infant morbidity, and mortality, as well as the risk of developmental disabilities and illnesses in future lives. Though studies were conducted to assess the magnitude and associated factors of low birth weight, most of the studies were at a single center and little information on the regional level. Hence, this study assessed the prevalence and associated factors of low birth weight in Sub-Saharan countries. Method This study was based on secondary data sources from 35 Sub-Saharan countries’ Demography and Health Survey (DHS). For this study, we used the Kids Record (KR file) data set. In the KR file, all under-five children who were born in the last five years preceding the survey in the selected enumeration area who had birth weight data were included for the study. To identify determinants of low birth weight multivariable mixed-effect logistic regression model fitted. Adjusted Odds Ratios (AOR) with a 95% Confidence Interval (CI) and p-value ≤0.05 in the multivariable model were used to declare significant factors associated with low birth weight at birth. Result The pooled prevalence of newborn babies’ low birth weight measured at birth in Sub-Saharan Africa was 9.76% with (95% CI: 9.63% to 9.89%). Female child, women not participated in healthcare decision making, and wider birth intervals, divorced/ separated women, and twin pregnancies associated with increased occurrences of low birth weight, while some level of woman and husband education, antenatal care visits, older maternal age, and multiparity associated with reduced occurrence low birth weight. Conclusion This study revealed that the magnitude of low birth weight was high in sub-Saharan Africa countries. Therefore, the finding suggests that more emphasis is important for women with a lack of support, multiples, and healthcare decision-making problems.

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OP109 The Need For Building Pharmacists’ Health Technology Assessment Capacity; The Nigerian Scenario

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462319001521 ◽

2019 ◽

Vol 35 (S1) ◽

pp. 26-26

Author(s):

Otuto Amarauche Chukwu ◽

Chizaram Chukwu

Keyword(s):

Decision Making ◽

Health Technology Assessment ◽

Technology Assessment ◽

Health Technology ◽

Developed Countries ◽

Sub Saharan Africa ◽

Health Coverage ◽

Healthcare Decision ◽

Healthcare Decision Making ◽

Sub Saharan

IntroductionThe role of Health technology assessment (HTA) as a systematic approach in the evaluation of health interventions and technologies is becoming increasingly important as the quest for attaining universal health coverage globally continues to increase. Some developed countries in Europe and the Americas now apply HTA extensively in healthcare policy decisions, however, developing regions and countries like sub-Saharan Africa and Nigeria respectively, seem not to be making significant progress in this area. Given that evidence suggests that Nigeria and indeed several countries in sub-Saharan Africa are performing poorly on most healthcare indices as the region continues to be ravaged by predictable and avoidable epidemics and disease outbreaks, the need to build HTA capacity has never been more paramount.MethodsA review of HTA capability in Nigeria was done. Pharmacists in Nigeria's Capital were randomly sampled. Semi-structured questionnaires were administered. Descriptive statistics were used in data analysis. P values less than 0.05 were considered to be significant.ResultsIn Nigeria, there is no institution tasked with undertaking HTA and there seems to be limited knowledge, capacity and awareness on the issue. Pharmacists, being the most accessible healthcare professionals according to evidence, are a key group that could play an active role in HTA and its implementation in developing countries like Nigeria. However, out of 322 pharmacists randomly sampled, 93 percent were not aware of HTA and its application in healthcare decision-making.ConclusionsThere is no paucity of healthcare programs and plans in Nigeria but they seem to fail due to lack of evidence-based assessment, decision-making and implementation. Hence, there is an increasing need to raise awareness on the importance of HTA in healthcare decision-making; strengthen HTA capacity by developing and sustaining institutional capacity and adequate human resource for HTA; and creating regional annexes of HTA organizations in Africa.

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PP129 The Need For Building Pharmacists HTA Capacity; The Nigerian Scenario

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462318002659 ◽

2018 ◽

Vol 34 (S1) ◽

pp. 116-117

Author(s):

Otuto Amarauche Chukwu

Keyword(s):

Decision Making ◽

Disease Outbreaks ◽

Active Role ◽

Developed Countries ◽

Sub Saharan Africa ◽

Health Coverage ◽

Healthcare Decision ◽

Developing Regions ◽

Healthcare Decision Making ◽

Sub Saharan

Introduction:The role of Health technology assessment (HTA) as a systematic approach in the evaluation of health interventions and technologies is becoming increasingly important as the quest for attaining universal health coverage globally continues to increase. Some developed countries in Europe and the Americas now apply HTA extensively in healthcare policy decisions, however, developing regions and countries like sub-Saharan Africa and Nigeria respectively, seem not to be making significant progress in this area. Given that evidence suggests that Nigeria and indeed several countries in sub-Saharan Africa are performing poorly on most healthcare indices as the region continues to be ravaged by predictable and avoidable epidemics and disease outbreaks, the need to build HTA capacity has never been more paramount.Methods:A review of HTA capability in Nigeria was done. Pharmacists in Nigeria's Capital were randomly sampled. Semi-structured questionnaires were administered. Descriptive statistics was used in data analysis. P values less than 0.05 were considered to be significant.Results:In Nigeria, there is no institution tasked with undertaking HTA and there seems to be limited knowledge, capacity and awareness on the issue. Pharmacists, being the most accessible healthcare professionals according to evidence, are a key group that could play an active role in HTA and its implementation in developing countries like Nigeria. However, out of 322 pharmacists randomly sampled, ninty-three percent were not aware of HTA and its application in healthcare decision-making.Conclusions:There is no paucity of healthcare programs and plans in Nigeria but they seem to fail due to lack of evidence-based assessment, decision-making and implementation. Hence, there is increasing need to raise awareness on the importance of HTA in healthcare decision-making; strengthen HTA capacity by developing and sustaining institutional capacity and adequate human resource for HTA; and creating regional annexes of HTA organizations in Africa.

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

BMC Public Health ◽

10.1186/s12889-020-09660-y ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Abdul-Aziz Seidu ◽

Joseph Kojo Oduro ◽

Bright Opoku Ahinkorah ◽

Eugene Budu ◽

Francis Appiah ◽

...

Keyword(s):

Decision Making ◽

Hiv Testing ◽

Sub Saharan Africa ◽

Demographic And Health Surveys ◽

Healthcare Decision ◽

African Countries ◽

Healthcare Decision Making ◽

Decision Making Capacity ◽

Testing Uptake ◽

Sub Saharan

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 examined the association between women’s healthcare decision-making capacity and uptake of HIV testing in sub-Saharan Africa. Methods We used data from the current Demographic and Health Surveys (DHS) of 28 countries in sub-Saharan Africa, conducted between January 1, 2010 and December 31, 2018. 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 assess the likelihood of HIV testing uptake 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 uptake in the 28 sub-Saharan African 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 Sub-Saharan African 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 decision to test for their HIV status.

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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.

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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.

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Protocol for a scoping review of neonatal emollient therapy and massage practices throughout sub-Saharan Africa

Gates Open Research ◽

10.12688/gatesopenres.13359.1 ◽

2021 ◽

Vol 5 ◽

pp. 142

Author(s):

Keona J.H. Blanks ◽

Milton W. Musaba ◽

Lily Ren ◽

Kathy Burgoine ◽

David Mukunya ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Scoping Review ◽

Very Low Birth Weight ◽

Skin Care ◽

Sub Saharan Africa ◽

Skin Barrier Function ◽

Neonatal Skin ◽

Care Practices ◽

Sub Saharan

Background: Serious infections and other complications from very low birth weight and prematurity are the leading causes of death for neonates worldwide. Infections partly result from the compromised skin barrier function in preterm neonates. Optimal skin care practices for neonates, especially in settings with limited access to adequate hygienic conditions, hold potential to reduce infection and avoid these preventable preterm neonatal deaths. The purpose of this protocol is to support a scoping review of neonatal skin care, emollient therapy and massage practices throughout sub-Saharan Africa. Protocol: The proposed review will follow a methodological framework consisting of the following five steps: (i) identifying the research question, (ii) identifying relevant studies, (iii) selection of eligible studies, (iv) charting the data, and (v) collating and summarizing the results. In addition, we will reflect on the implications of the findings for the feasibility and design of randomized controlled trials to examine the impact of emollient therapy on survival, growth, infection and neurodevelopment of very low birth weight infants in sub-Saharan Africa. We will search domestic and international databases for literature published in English between January 1, 2000, and July 12, 2021. Articles will be chosen based on standardized inclusion criteria. The primary criteria for inclusion will be a report on skin care practices administered to neonates in Africa. Conclusions: Documentation of common neonatal skin care practices throughout Africa has the potential to highlight opportunities for skin care intervention and future research on neonatal skin care practices in sub-Saharan Africa, and support the development of future emollient intervention trials for preterm and low birthweight neonates in low- and middle-income countries.

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Women’s Autonomy on Healthcare Decision Making in Sub-Saharan African Countries: A Synthesis

The Anthropologist ◽

10.31901/24566802.2021/43.1-3.2056 ◽

2021 ◽

Vol 43 (1-3) ◽

Author(s):

Nigatu Regassa Geda

Keyword(s):

Decision Making ◽

Well Being ◽

Healthcare Decision ◽

Economic Activities ◽

African Countries ◽

Women’S Autonomy ◽

Women's Autonomy ◽

Healthcare Decision Making ◽

Nationally Representative ◽

Sub Saharan

ABSTRACT Over the last few decades, despite progress made in improving female’s decision-making dependence, the challenges posed by female’s low status in Sub-Saharan African countries (SSA) are still influential research agenda. The aim of this scooping review is to assess the effects of women’s autonomy on healthcare decision-making. The researchers did the study based on 15 articles selected from PubMed and Google Scholar. The selection deliberated only those published in the last 15 years, primarily based on nationally representative findings from Sub-Saharan African countries. The selected studies focused on decision-making autonomy on healthcare parameters. All studies reported significant positive impacts of female’s decision-making autonomy on children’s health, and women’s well-being, such as improved children’s nutrition, maternal and children’s well-being, reduced mortality rate, and health service utilization. However, the impacts were more substantial or visible at the community level than at individual or household levels. The study recommended strengthening womens’ involvement in education, promoting peer education, improving husband-wife communication, promoting rural women’s participation in economic activities, and owning assets. More importantly, any intervention should focus more on community norms than only individual decision-making per se.

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A multi-year analysis of kangaroo mother care outcomes in low birth weight babies at a Nyakahanga Hospital in rural Tanzania

African Health Sciences ◽

10.4314/ahs.v20i1.56 ◽

2020 ◽

Vol 20 (1) ◽

pp. 498-508

Author(s):

Linda A Winkler ◽

Agnes Stypulkowski ◽

Shana Noon ◽

Theophila Babwanga ◽

Jesca Lutahoire

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Rural Areas ◽

Urban Areas ◽

Very Low Birth Weight ◽

Kangaroo Mother Care ◽

Sub Saharan Africa ◽

Low Resource ◽

Popu Lations ◽

Sub Saharan

Background: Kangaroo Mother Care (KMC) requires few specialized resources, reduces mortality, and can be implemented in low resource environments. It is now recommended for implementation around the globe. Objectives: This paper discusses KMC use with low birth weight newborns at a Tanzania hospital providing valuable outcomes assessment of KMC use in rural areas of sub-Saharan Africa. Methods: The research used retrospective records (136 Low Birth Weight (LBW) and 33 Very Low Birth Weight (VLBW) ne- onates) supplemented by observations. Data included weights (longitudinal), survival period, and cause of death if it occurred. This hospital’s KMC use and study data began when the mother-baby dyad was referred, usually birth day. Results: This KMC group demonstrated 70% survival, but 77% of deaths occur within 24 hours. After the first 24 hours, KMC survival rate was 92%. Even VLBW neonates (<1000 g) had 37.5% survival among the KMC program. Prematurity and respi- ratory distress caused nearly half of the deaths, but hypothermia (19% of deaths) and infection were factors also. Conclusion: Our study indicates the value of KMC in rural low resource environments. Results are comparable to KMC pro- grams in urban areas where newborns begin KMC after stabilization and better than outcomes reported for comparable popu- lations not practicing KMC in rural sub-Saharan Africa. Keywords: Kangaroo mother care; low birth weight; neonatal mortality; premature infant.

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Relationship between changing malaria burden and low birth weight in sub-Saharan Africa: A difference-in-differences study via a pair-of-pairs approach

eLife ◽

10.7554/elife.65133 ◽

2021 ◽

Vol 10 ◽

Author(s):

Siyu Heng ◽

Wendy P O'Meara ◽

Ryan A Simmons ◽

Dylan S Small

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Confidence Interval ◽

Malaria Prevalence ◽

Sub Saharan Africa ◽

World Health ◽

Difference In Differences ◽

Malaria Burden ◽

Percentage Points ◽

Sub Saharan

Background:According to the World Health Organization (WHO), in 2018, an estimated 228 million malaria cases occurred worldwide with most cases occurring in sub-Saharan Africa. Scale-up of vector control tools coupled with increased access to diagnosis and effective treatment has resulted in a large decline in malaria prevalence in some areas, but other areas have seen little change. Although interventional studies demonstrate that preventing malaria during pregnancy can reduce the rate of low birth weight (i.e. child’s birth weight <2500 g), it remains unknown whether natural changes in parasite transmission and malaria burden can improve birth outcomes.Methods:We conducted an observational study of the effect of changing malaria burden on low birth weight using data from 18,112 births in 19 countries in sub-Saharan African countries during the years 2000–2015. Specifically, we conducted a difference-in-differences study via a pair-of-pairs matching approach using the fact that some sub-Saharan areas experienced sharp drops in malaria prevalence and some experienced little change.Results:A malaria prevalence decline from a high rate (Plasmodium falciparum parasite rate in children aged 2-up-to-10 (i.e. PfPR2-10) > 0.4) to a low rate (PfPR2-10 < 0.2) is estimated to reduce the rate of low birth weight by 1.48 percentage points (95% confidence interval: 3.70 percentage points reduction, 0.74 percentage points increase), which is a 17% reduction in the low birth weight rate compared to the average (8.6%) in our study population with observed birth weight records (1.48/8.6 ≈ 17%). When focusing on first pregnancies, a decline in malaria prevalence from high to low is estimated to have a greater impact on the low birth weight rate than for all births: 3.73 percentage points (95% confidence interval: 9.11 percentage points reduction, 1.64 percentage points increase).Conclusions:Although the confidence intervals cannot rule out the possibility of no effect at the 95% confidence level, the concurrence between our primary analysis, secondary analyses, and sensitivity analyses, and the magnitude of the effect size, contribute to the weight of the evidence suggesting that declining malaria burden can potentially substantially reduce the low birth weight rate at the community level in sub-Saharan Africa, particularly among firstborns. The novel statistical methodology developed in this article–a pair-of-pairs approach to a difference-in-differences study–could be useful for many settings in which different units are observed at different times.Funding:Ryan A. Simmons is supported by National Center for Advancing Translational Sciences (UL1TR002553). The funder had no role in study design, data collection and interpretation, or the decision to submit the work for publication.

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Determinants of adverse birth outcome in Sub-Saharan Africa: analysis of recent demographic and health surveys

BMC Public Health ◽

10.1186/s12889-021-11113-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Koku Sisay Tamirat ◽

Malede Mequanent Sisay ◽

Getayeneh Antehunegn Tesema ◽

Zemenu Tadesse Tessema

Keyword(s):

Birth Outcomes ◽

Health Surveys ◽

Preterm Births ◽

Sub Saharan Africa ◽

Demographic And Health Surveys ◽

Adverse Birth Outcomes ◽

Healthcare Decision ◽

Healthcare Decision Making ◽

Pooled Prevalence ◽

Sub Saharan

Abstract Background More than 75% of neonatal deaths occurred in the first weeks of life as a result of adverse birth outcomes. Low birth weight, preterm births are associated with a variety of acute and long-term complications. In Sub-Saharan Africa, there is insufficient evidence of adverse birth outcomes. Hence, this study aimed to determine the pooled prevalence and determinants of adverse birth outcomes in Sub-Saharan Africa. Method Data of this study were obtained from a cross-sectional survey of the most recent Demographic and Health Surveys (DHS) of ten Sub-African (SSA) countries. A total of 76,853 children born five years preceding the survey were included in the final analysis. A Generalized Linear Mixed Models (GLMM) were fitted and an adjusted odds ratio (AOR) with a 95% Confidence Interval (CI) was computed to declare statistically significant determinants of adverse birth outcomes. Result The pooled prevalence of adverse birth outcomes were 29.7% (95% CI: 29.4 to 30.03). Female child (AOR = 0.94, 95%CI: 0.91 0.97), women attended secondary level of education (AOR = 0.87, 95%CI: 0.82 0.92), middle (AOR = 0.94,95%CI: 0.90 0.98) and rich socioeconomic status (AOR = 0.94, 95%CI: 0.90 0.99), intimate-partner physical violence (beating) (AOR = 1.18, 95%CI: 1.14 1.22), big problems of long-distance travel (AOR = 1.08, 95%CI: 1.04 1.11), antenatal care follow-ups (AOR = 0.86, 95%CI: 0.83 0.86), multiparty (AOR = 0.88, 95%CI: 0.84 0.91), twin births (AOR = 2.89, 95%CI: 2.67 3.14), and lack of women involvement in healthcare decision-making process (AOR = 1.10, 95%CI: 1.06 1.13) were determinants of adverse birth outcomes. Conclusion This study showed that the magnitude of adverse birth outcomes was high, abnormal baby size and preterm births were the most common adverse birth outcomes. This finding suggests that encouraging antenatal care follow-ups and socio-economic conditions of women are essential. Moreover, special attention should be given to multiple pregnancies, improving healthcare accessibilities to rural areas, and women’s involvement in healthcare decision-making.

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