scholarly journals Individual and community level factors associated with use of iodized salt in sub-Saharan Africa: A multilevel analysis of demographic health surveys

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0251854
Author(s):  
Yigizie Yeshaw ◽  
Alemneh Mekuriaw Liyew ◽  
Achamyeleh Birhanu Teshale ◽  
Tesfa Sewunet Alamneh ◽  
Misganaw Gebrie Worku ◽  
...  
Keyword(s):  
Community Education ◽  
Media Exposure ◽  
Wealth Index ◽  
Education Level ◽  
Iodized Salt ◽  
Community Level ◽  
Sub Saharan Africa ◽  
Poverty Level ◽  
Community Media ◽  
Sub Saharan

Introduction Iodine deficiency disorder a common problem in sub-Saharan Africa (SSA). It affects not only the health of the affected individual but also the economic development of the country. However, to the best of our knowledge, there is a scarcity in literature about the associated factors of iodized salt utilization in sub-Saharan Africa. Therefore, this study aimed to identify both individual and community level determinants of iodized salt utilization in sub-Saharan Africa. Methods This study used the appended datasets of the most recent demographic and health survey from 31 sub-Saharan countries. A total weighted sample of 391,463 households was included in the study. Both bivariable and multivariable multilevel logistic regression were done to determine the associated factors of iodized salt utilization in SSA. P value ≤ 0.05 was used to declare statistically significant variables. Results Those households with primary (AOR  =  1.53, 95% CI  =  1.50–1.57), secondary (AOR  = 1.81, 95% CI  =  1.76–1.86) and higher education level (AOR  =  2.28, 95% CI  =  2.17–2.40) had higher odds of iodized salt utilization. Households with middle (AOR  =  1.05, 95% CI  =  1.02–1.08), richer (AOR  = 1.13, 95% CI  =  1.09–1.17) and richest wealth index (AOR  =  1.23, 95% CI  =  1.18–1.28) also had an increased chance of using iodized salt. Households from high community media exposure (AOR  =  2.07, 95% CI  =  1.71–2.51), high community education level (AOR  =  3.78, 95% CI  =  3.14–4.56), and low community poverty level (AOR = 1.29, CI  =  1.07–1.56) had higher odds of using salt containing iodine. Conclusion Both individual and community level factors were found to be associated with use of salt containing iodine in sub-Saharan Africa. Education level, media exposure, community poverty level, wealth index, community education, and community media exposure were found to be associated with use of salt containing iodine in SSA. Therefore, to improve the use of iodized salt in the region, there is a need to increase access to media sources and develop the socioeconomic status of the community.

scholarly journals Spatial distribution and determinants of household iodized salt utilization in Ethiopia: a spatial and multilevel analysis of Ethiopian demographic and Health survey

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Yigizie Yeshaw ◽  
Adugnaw Zeleke Alem ◽  
Getayeneh Antehunegn Tesema ◽  
Achamyeleh Birhanu Teshale ◽  
Alemneh Mekuriaw Liyew ◽  
...  
Keyword(s):  
Spatial Distribution ◽  
Health Survey ◽  
Odds Ratio ◽  
Media Exposure ◽  
Education Level ◽  
Demographic And Health Survey ◽  
Iodized Salt ◽  
Community Level ◽  
Cold Spot ◽  
Community Media

Abstract Background Iodine deficiency disorder is a significant public health problem, affecting both developed and developing nations worldwide. It is associated with poor body growth and irreversible mental retardation. However, little is known about the spatial distribution and determinants of household iodized salt utilization in Ethiopia. Therefore, this study aimed to explore the spatial distribution and determinants of iodized salt utilization at national level. Methods Ethiopian Demographic and Health Survey 2016 data was used to investigate the spatial distribution and determinants of household iodized salt utilization in Ethiopia. ArcGIS 10.6 and SaTScan™ version 9.6 software were used to explore the spatial distribution and detect significant clusters, respectively. The odds ratio with its 95% confidence interval (CI) was determined for potential determinants included in the multivariable multilevel logistic regression model. Results Household iodized salt utilization was spatially clustered in Ethiopia (Moran’s Index = 0.076, p-value = 0.01). The significant hotspot areas with high iodized salt utilization were located in Benishangul, Amhara, Gambella, Tigray and Northwest Oromia regions. Significant cold spot areas (areas with low iodized salt utilization) were found in Somali, and East Afar regions. Those households with higher education level ((Adjusted Odds Ratio [AOR] =1.49, 95% CI =1.14–1.93), high community level education (AOR = 1.51, 95% CI = 1.03–2.20), middle wealth index (AOR = 1.31, 95% CI = 1.04–1.65) and high community media exposure (AOR = 1.52, 95% CI = 1.07–2.17) had higher odds of iodized salt utilization. Conclusions Household iodized salt utilization had significant spatial variation across the country. Both household and community level variables were found to be associated with household iodized salt utilization in Ethiopia. Therefore, increasing the education level, wealth status and community media exposure is recommended to improve iodized salt utilization in a country. A targeted intervention is also needed for those regions with low household iodized salt utilization.

Spatial Distribution and Determinants of Household Iodized Salt Utilization in Ethiopia: A Spatial and Multilevel Analysis of Ethiopian Demographic and Health Survey

2020 ◽  
Author(s):  
Yigizie Yeshaw ◽  
Adugnaw Zeleke Alem ◽  
Getayeneh Antehunegn Tesema ◽  
Achamyeleh Birhanu Teshale ◽  
Alemneh Mekuriaw Liyew ◽  
...  
Keyword(s):  
Higher Education ◽  
Spatial Distribution ◽  
Health Survey ◽  
Odds Ratio ◽  
Media Exposure ◽  
Wealth Index ◽  
Education Level ◽  
Iodized Salt ◽  
P Value ◽  
Community Media

Abstract Background: Iodine deficiency disorder is a significant public health problem, affecting both developed and developing nations worldwide. It is associated with poor body growth and irreversible mental retardation. However, little is known about the spatial distribution and determinants of household iodized salt utilization in Ethiopia. Therefore, this study aimed to explore the spatial distribution and determinants of iodized salt utilization at national level. Methods : Ethiopian Demographic and Health Survey 2016 data was used to investigate the spatial distribution and determinants of household iodized salt utilization in Ethiopia. ArcGIS 10.6 and SaTScan™ version 9.6 software were used to explore the spatial distribution and detect significant clusters, respectively. We used STATA version 14 software to analyze the determinants of household iodized salt utilization. The odds ratio with its 95% confidence interval (CI) was determined for potential determinants included in the multivariable multilevel logistic regression model and the corresponding p-value ≤ 0.05 was employed to declare the statistically significant variables. Results : Household iodized salt utilization was spatially clustered in Ethiopia (Moran’s Index = 0.076, p-value= 0.01). The significant hotspot areas with high iodized salt utilization were located in Benishangul, Amhara, Gambella, Tigray and Northwest Oromia regions. Those households with higher education level ((Adjusted Odds Ratio [AOR] =1.49, 95% CI =1.14-1.93), high community level education (AOR=1.51, 95% CI=1.03-2.20), middle wealth index (AOR=1.31, 95% CI=1.04-1.65) and high community media exposure (AOR=1.52, 95% CI=1.07-2.17) had higher odds of iodized salt utilization. Conclusions : Household iodized salt utilization had significant spatial variation across the country . The significant hotspot areas with high iodized salt utilization were located in Benishangul, Amhara, Gambella, Tigray and Northwest Oromia regions. Households with higher education level, high community level education and high community media exposure and middle wealth index had higher odds of iodized salt utilization. Increasing education level, wealth status and community media exposure is recommended to increase iodized salt utilization. A targeted intervention is also needed for those regions with low household iodized salt utilization.

scholarly journals Multilevel analysis of unhealthy bodyweight among women in Malawi: Does urbanisation matter?

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0249289
Author(s):  
Rotimi Felix Afolabi ◽  
Martin Enock Palamuleni
Keyword(s):  
Higher Education ◽  
Weight Status ◽  
Community Education ◽  
Community Level ◽  
Sub Saharan Africa ◽  
Health Concern ◽  
Outcome Variable ◽  
Education Attainment ◽  
Poverty Level ◽  
Urban Residence

Background Underweight and overweight constitute unhealthy bodyweight and their coexistence is symptomatic of the dual burden of malnutrition (DBM) of high public health concern in many sub-Saharan Africa countries. Little is known about DBM and its correlates in Malawi, a country undergoing urbanisation. The study examined net effects of urban residence on unhealthy weights amidst individual- and community-level factors among women in Malawi. Methods Data on 7231 women aged 15–49 years nested within 850 communities extracted from 2015–16 Malawi Demographic and Health Survey were analysed. Women’s weight status measured by body mass index, operationally categorised as underweight, normal and overweight, was the outcome variable while urban-rural residence was the main explanatory variable. Multilevel multinomial logistic regression analysis was employed at 5% significant level; the relative-risk ratio (RR) and its 95% confidence interval (CI) were presented. Results Urban residents had a significantly higher prevalence of overweight than rural (36.4% vs. 17.2%; p< 0.001) but a -non-significant lower prevalence of underweight (6.2% vs. 7.4%; p = 0.423). Having adjusted for both individual- and community-level covariates, compared to rural, living in urban (aRR = 1.25; CI: 1.02–1.53) accounted for about 25% higher risk of being overweight relative to normal weight. Higher education attainment, being married and belonging to Chewa, Lomwe or Mang’anja ethnic group significantly reduced the risk of being underweight but heightened the risk of being overweight. Being older and living in wealthier households respectively accounted for about 3- and 2-times higher likelihood of being overweight, while breastfeeding (aRR = 0.65; CI: 0.55–0.76) was protective against overweight. Living in communities with higher poverty and higher education levels reduced and increased the risk of being overweight, respectively. Evidence of community’s variability in unhealthy weights was observed in that 11.1% and 3.0% respectively of the variance in the likelihood of being overweight and underweight occurred across communities. Conclusions The study demonstrated association between urban residence and women overweight. Other important associated factors of overweight included breastfeeding, community education- and poverty-level, while education attainment, marital status and ethnicity were associated with the dual unhealthy weight. Thus, both individual- and community-level characteristics are important considerations for policy makers in designing interventions to address DBM in Malawi.

scholarly journals Risk factor of neonatal mortality in Ethiopia: multilevel analysis of 2016 Demographic and Health Survey

2021 ◽  
Vol 49 (1) ◽  
Author(s):  
Setegn Muche Fenta ◽  
Hailegebrael Birhan Biresaw ◽  
Kenaw Derebe Fentaw
Keyword(s):  
Neonatal Mortality ◽  
Health Survey ◽  
Wealth Index ◽  
Demographic And Health Survey ◽  
Community Level ◽  
Sub Saharan Africa ◽  
Multiple Birth ◽  
African Countries ◽  
Sub Saharan ◽  
Newborn Children

Abstract Background In sub-Saharan African countries, neonatal mortality rates remain unacceptably high. Ethiopia is one of the countries in Sub-Saharan Africa with the highest death rates of newborn children. Therefore, this study aimed to identify the risk factors associated with neonatal mortality in Ethiopia at the individual and community level. Methods The 2016 Ethiopian Demographic and Health Survey data was accessed and used for the analysis. A total of 2449 newborn children were included in the analysis. The multilevel logistic regression model was used to identify the significant factor of neonatal mortality. Adjusted odds ratio with a 95% confidence interval and p-value < 0.05 in the multilevel model was reported. Results A total of 2449 newborn children were included in this study. Multiple birth type (AOR = 3.18; 95% CI 2.78, 3.63), birth order of ≥ 5 (AOR = 2.15; 95% CI 1.75, 2.64), pre-term birth (AOR = 5.97; 95% CI 4.96, 7.20), no antenatal care (ANC) visit during pregnancy (AOR = 2.33; 95% CI 2.09, 2.61), not received TT injection during pregnancy (AOR = 2.28; 95% CI 1.92, 2.71), delivered at home (AOR = 1.99; 95% CI 1.48, 2.69), less than 24 months of preceding birth interval (AOR = 1.51; 95% CI 1.35,1.68), smaller birth size (AOR = 1.58; 95% CI 1.46, 1.71), never breastfeeding (AOR = 2.43; 95% CI 2.17, 2.72), poor wealth index (AOR = 1.29; 95% CI 1.17,1.41), non-educated mothers (AOR = 1.58; 95% CI 1.46, 1.71), non-educated fathers (AOR = 1.32; 95% CI 1.12, 1.54), rural residence (AOR = 2.71; 95% CI 2.23, 3.29), unprotected water source (AOR = 1.35; 95% CI 1.16, 1.58), and have no latrine facility (AOR = 1.78; 95% CI 1.50, 2.12) were associated with a higher risk of neonatal mortality. Neonates living in Amhara, Oromia, Somali, Harari, and Dire Dawa had a higher risk of neonatal mortality compared to Tigray. Moreover, the random effects result showed that about 85.57% of the variation in neonatal mortality was explained by individual- and community-level factors. Conclusions The findings suggest that attention be paid to education-based programs for mothers that would highlight the benefits of delivery care services, such as ANC visits, TT injections, and facility births. Meanwhile, public health initiatives should focus on expanding access to quality sanitation facilities, especially for latrines and drinking water that could improve neonatal health at the community-level as a whole.

scholarly journals Factors associated with decision making power of women to use family planning among married women in sub-Saharan Africa: A multilevel analysis of demographic health surveys

2021 ◽  
Author(s):  
Getu Debalkie Demissie ◽  
Yonas Akalu ◽  
Abebaw Addis Gelagay ◽  
Wallelign Alemnew ◽  
Yigizie Yeshaw
Keyword(s):  
Decision Making ◽  
Family Planning ◽  
Media Exposure ◽  
Wealth Index ◽  
Married Women ◽  
Sub Saharan Africa ◽  
Fertility Preference ◽  
Factors Associated ◽  
Contraceptive Usage ◽  
Sub Saharan

Abstract Background: In sub-Saharan Africa there are several socio-economic and cultural factors which affect women’s ability to make decision regarding their own health including contraceptive usage. The main aim of this study was to determine factors associated with decision making power of women to use family planning in sub-Saharan Africa.Methods: The appended, most recent demographic and health survey datasets of 35 sub-Saharan countries were used. A total weighted sample of 83,882 women were included in the study. Both bivariable and multivariable multilevel logistic regression were done to determine the associated factors of decision making power of women to use family planning in SSA. The Odds Ratio (OR) with a 95% Confidence Interval (CI) was calculated for those potential variables included in the final model. Results: Those married women with primary education (AOR=1.24; CI:1.16,1.32),secondary education (AOR=1.31; CI:1.22,1.41), higher education (AOR=1.36; CI:1.20,1.53),media exposure(AOR=1.08; CI: 1.03, 1.13), currently working (AOR=1.27; CI: 1.20, 1.33), antenatal care visit of 1-3 (AOR=1.12; CI:1.05,1.20) and ≥ 4 ANC visit (AOR=1.14;CI:1.07,1.21), women who were informed about family planning (AOR=1.09; CI: 1.04, 1.15), women who had less than 3 children(AOR=1.12; CI: 1.02, 1.23) and 3-5 children (AOR=1.08; CI: 1.01, 1.16) had higher odds of decision making power to use family planning than their counter parts. Besides, mothers with age of 15-19 (AOR=0.61; CI: 0.52, 0.72), 20-24 (AOR= 0.69; CI: 0.60, 0.79), 25-29 (AOR=0.74; CI: 0.66, 0.84), and 30-34 years (AOR=0.82; CI: 0.73, 0.92) had reduced chance of decision making power of women to use family planning. Conclusion: Age, women’s level of education, occupation of women and their husband, wealth index, media exposure, ANC visit, fertility preference, husband’s desire number of children, region and information about family planning were factors associated with decision making power to use family planning among married women.

Spatial distribution and associated factors of iron supplementation use among pregnant women in Ethiopia; Ethiopian Demographic and Health Survey 2016 data: spatial and multilevel logistic regression analysis

2020 ◽  
Author(s):  
Chilot Desta Agegnehu ◽  
Getayeneh Antehunegn Tesema ◽  
Achamyeleh Birhanu Teshale ◽  
Adugnaw Zeleke Alem ◽  
Yigizie Yeshaw ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Spatial Distribution ◽  
Maternal Health ◽  
Pregnant Women ◽  
Iron Supplementation ◽  
Community Education ◽  
Media Exposure ◽  
Wealth Index ◽  
Maternal Health Services ◽  
Household Wealth

Abstract Background Although the World Health Organization recommends for all pregnant women taking iron tablet should be a routine activity, more than 50% of anemia in pregnant women was occurred due to lack of iron supplementation and remains global public health problem and varies with in country. Lack of iron tablet supplementation during pregnancy leads to maternal anemia, which intern increases the risk of maternal death, obstetric complications, preterm birth and low birth weight. Therefore, studying spatial distribution and determinants of iron supplementation use among pregnant women in Ethiopia is vital to design appropriate maternal health services and preventing the determinants earlier. Method: A stratified two-stage cluster sampling technique was used in the Ethiopian Demographic Health Survey in 2016 data. A total of a weighted sample of 7589 pregnant women were included for analysis. Bernoulli model was used to explore the purely spatial clusters of pregnant women using SaTScan version 9.6 and ArcGIS version10.3.A multi-level logistic regression model was used to identify determinant factors of iron supplementation use among pregnant women. Results Spatial distribution of iron supplementation use among pregnant women was non –random in the country with Moran’s index 0.3 (p < 0.001). The primary cluster was in Southwest Somali and Central part of the Oromia region (LLR = 66.69, P < 0.001). ANC visit (AOR = 3.66, 95%CI: 3.21, 417), community education [AOR = 1.31, 95%CI, 1.07, 1.59), media exposure (AOR = 1.33, 95%CI: 1.15, 1.53), distance to health facility (AOR = 1.32, 95%CI: 1.16, 1.50), region and household wealth index were significantly associated with iron supplementation use among pregnant women in Ethiopia. Conclusion Spatial distribution of Iron supplementation use among pregnant women varies across the country. ANC visit, region, household wealth index, media exposure, distance to the health facility, and community education were significant predictors of iron supplementation use among pregnant women. Therefore, it needs great interventions in the hot spot areas and maternal health services should be delivered in all areas of our country.

Community Education in New HIV Prevention Technologies Research

2009 ◽  
pp. 328-338
Author(s):  
Busi Nkala
Keyword(s):  
Hiv Infection ◽  
Community Involvement ◽  
New Technologies ◽  
Community Education ◽  
Sub Saharan Africa ◽  
Contributing Factors ◽  
Survival Sex ◽  
Sub Saharan ◽  
Living With Hiv ◽  
Health Programmes

An estimated 39.5 million people are living with HIV worldwide. There were 4.3 million new infections in 2006 with 2.8 million (65%) of these occurring in sub-Saharan Africa with important increases in Eastern Europe and Central Asia, where there are some indications that infection rates have risen by more than 50% since 2004. In 2006, 2.9 million people died of AIDS-related illnesses (UNAIDS, 2006). The continued increase in new HIV infection is a call for concern. It is imperative that more innovative ways of combating the infections are found sooner. There is an enormous body of evidence that HIV infection is caused mainly by sexual contact. There is also undisputed evidence that there are other contributing factors such as extreme poverty, survival sex, gender inequality, lack of education, fatalism, religious barriers and others. This chapter seeks to support the need to do more research in finding new technologies and innovative ways of dealing with the spread of HIV. The chapter suggests that the involvement of researched communities be effectively involved. Involving communities in finding solutions will help, in that research protocols and health programmes will take into account the cultural acceptability of the new technologies and systems and ensure that recipients of health services become effective organs of change. The chapter seeks to highlight the fact that, if the recipients are involved in all stages of development of health programmes, including technologies, we may begin to see changes in how new technologies are taken up or may shift toward getting technologies that are acceptable. There are various suggested and implemented ways which aid in achieving the protection for individuals and communities; such as community involvement, community participation and community education (Collins, 2002; Gupta 2002), this chapter will focus on community education and a proposal for a community principle.

scholarly journals The feasibility of community level interventions for pre-eclampsia in South Asia and Sub-Saharan Africa: a mixed-methods design

2016 ◽  
Vol 13 (S1) ◽  
Author(s):  
Asif Raza Khowaja ◽  
◽  
Rahat Najam Qureshi ◽  
Diane Sawchuck ◽  
Olufemi T. Oladapo ◽  
...  
Keyword(s):  
Mixed Methods ◽  
South Asia ◽  
Community Level ◽  
Sub Saharan Africa ◽  
Mixed Methods Design ◽  
Sub Saharan
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