An Empirical Analysis of the Socioeconomic and Demographic characteristics influencing Birth Certification in Nigeria

Abstract Introduction: Equity in the access and use of health services is critical if countries are to make progress towards universal health coverage and address the systematic exclusion of the most vulnerable groups. The purpose of this study was to test the feasibility of existing wealth measurement tools and functional disability questions to assess if the Co-ordinated Approach To Community Health programme implemented by Sightsavers was successful in reaching the poorest population and people living with disabilities in Kasungu district, Malawi. Methods: Between April and September 2017, data on socio-economic status, household characteristics and functional disability were collected from patients attending at eye camps in Kasungu district, Malawi. Using asset-based tools to measure household wealth (EquityTool© and Simple Poverty Scorecard©) and the Washington Group Short Set of Questions, individuals were categorised by wealth quintiles, poverty status, and functional disability status and then compared to relevant representative national household surveys. A follow-up household survey was conducted to check the validity of self-reported household characteristics at eye camps. Results: A total of 1,358 individuals participated in the study. The study shows that self-reported data on household characteristics and assets are reliable and can be collected in clinical settings (instead of relying on direct observations of assets). Individuals attending outreach camps were poorer in terms of relative wealth and absolute poverty rates compared to the rest of the population in Kasungu. It was estimated that 9% of the participants belonged to the poorest quintile compared to 4% for the population in Kasungu (DHS 2015-2016). The ultra-poverty rate was also lower among respondents (13%) compared to 15% for Kasungu district (IHS 2017). The functional disability rate was 27.5% for study participants, and statistically higher than the general population (5.6%, SENTIF 2017). Conclusions: Our study shows that existing tools can be reliably used, and combined, if based on recent population data, to assess equity of access to health services for vulnerable groups of the population. The findings suggest that the programme was successful in reaching the poorest people of the Kasungu district population as well as those with disabilities through outreach camps. However, it is essential to use sub-national data (district or regional level) from recent surveys for the purpose of benchmarking in order to produce accurate results.

Download Full-text

Assessing and decomposing inequality of opportunity in access to child health and nutrition in sub-Saharan Africa: evidence from three countries with low human development index

International Journal for Equity in Health ◽

10.1186/s12939-020-01258-5 ◽

2020 ◽

Vol 19 (1) ◽

Author(s):

Yacobou Sanoussi ◽

Bright Opoku Ahinkorah ◽

Aduragbemi Banke-Thomas ◽

Sanni Yaya

Keyword(s):

Sub Saharan Africa ◽

Inequality Of Opportunity ◽

Access To Health Services ◽

Children Under Five ◽

Under Five ◽

Guinea Bissau ◽

Health And Nutrition ◽

Access To Health ◽

Sub Saharan ◽

Favorable Group

Abstract Background Inequality of opportunity in health and nutrition is a major public health issue in the developing regions. This study analyzed the patterns and extent of inequality of opportunity in health and nutrition among children under-five across three countries sub-Saharan Africa with low Human development index (HDI). Methods We used data from the Multiple Indicator Cluster Survey of the Democratic Republic of Congo (20,792 households, 21,756 women aged 15 to 49 and 21,456 children under five), Guinea Bissau (6601 households, 10,234 women aged 15–49 and 7573 children under five) and Mali (11,830 households, 18,409 women in 15–49 years and 16,468 children under five) to compute the human opportunity index (HOI) and the dissimilarity index (D-index). Secondly, the Shapley decomposition method was used to estimate the relative contribution of circumstances that are beyond the control of children under-five and affecting their development outcomes in later life stages. Results The study revealed that children belonging to the most favorable group had higher access rates for immunization (93.64%) and water and sanitation facilities (73.59%) in Guinea Bissau. In Congo DR, the access rate was high for immunization (93.9%) for children in the most favorable group. In Mali, access rates stood at 6.56% for children in the most favorable group. In Guinea Bissau, the inequality of opportunity was important in access to health services before and after delivery (43.85%). In Congo DR, the inequality of opportunity was only high for the immunization composite indicator (83.79%) while in Mali, inequality of opportunity was higher for access to health services before and after delivery (41.67%). Conclusion The results show that there are efforts in some places to promote access to health and nutrition services in order to make access equal without distinction linked to the socio-economic and demographic characteristics in which the children live. However, the inequalities of opportunity observed between the children of the most favorable group and those of the least favorable group, remain in general at significant levels and call on government of these countries to implement policies taking them into account.

Download Full-text

Health services, intersectoriality and social control: a comparative study on a conditional income transfer program

Global Health Promotion ◽

10.1177/1757975921996150 ◽

2021 ◽

pp. 175797592199615

Author(s):

José Anael Neves ◽

Lia Thieme Oikawa Zangirolani ◽

Maria Angélica Tavares de Medeiros

Keyword(s):

Health Services ◽

Social Control ◽

Multiple Correspondence Analysis ◽

Conditional Cash Transfer ◽

Cash Transfer ◽

Southeastern Brazil ◽

P Value ◽

Transfer Program ◽

Access To Health Services ◽

Access To Health

The Bolsa Família Program (BFP) is one of the largest conditional cash transfer programs in the world, providing cash transfers and intersectoral actions. The aim of this study was to compare whether there is a difference in access to health services, intersectoral actions and social control, between families entitled or not, to the BFP. A cross-sectional study was carried out. A representative sample of a peripheral, socioeconomically vulnerable population from a large urban center in southeastern Brazil was calculated, totaling 380 families. Chi-square or Fisher’s exact tests and multiple correspondence analysis were used to compare groups. Families entitled to the BFP had worse living conditions in general and greater access to health services, such as: medical care ( p-value 0.009), community healthcare agent ( p-value 0.001) and home visits ( p-value 0.041). Being entitled or not affected the variability in the pattern of access to services by 31%; low access to intersectoral actions was identified in both groups; social control was incipient. There was an adequate focus on the program; greater access to health services was related to compliance with conditionalities; low access to intersectoral actions can restrict the interruption of the cycle of intergenerational transmission of poverty.

Download Full-text

An Empirical Analysis of the Socioeconomic and Demographic characteristics influencing Birth Certification in Nigeria

10.21203/rs.3.rs-18158/v3 ◽

2020 ◽

Author(s):

Uchechi Shirley Anaduaka

Keyword(s):

Health Care ◽

Access To Health Care ◽

Birth Certificate ◽

Demographic Factors ◽

Ordinary Least Squares ◽

Skilled Attendant ◽

Children Under Five ◽

Under Five ◽

Factors Associated ◽

Socioeconomic And Demographic Factors

Abstract Background: Promoting birth certification is instrumental to achieving target 16.9 of the Sustainable Development Goals: legal identity for all by 2030. However, limited research has investigated the determinants of birth certification of children in the sub-Saharan African context. This study analyzes the socioeconomic and demographic factors associated with the birth certification of children under-five years in Nigeria. Methods: The study employed three rounds of the Nigerian Demographic and Health Survey involving 79487 children (0-4 years) in Nigeria. Birth certification was defined as whether a parent/caregiver had a child’s birth certificate at the time of the interview. Ordinary least squares and multilevel logistic regression models established the relationships between the socioeconomic and demographic factors and birth certification. Results: Children under-five years who had a skilled attendant at birth, at least one vaccination, and maternal access to prenatal visits had about 25.6%, 60.5% and 35.0% higher odds of having their births certified. Children born to more educated mothers and fathers had 1.023 and 1.012 times the odds of birth certification. Children from average and rich households also had 13.2% and 34.2% higher odds of birth certification, respectively. Conversely, child age, higher birth order, longer birth intervals, polygyny, having at least two dead siblings, father being employed in a low skilled job, living far from a registration center and in a poor community are risk factors for birth certification. Maternal age at birth and paternal has non-linear, albeit weak effects on birth certification. Being large at birth, bank account ownership were also significant predictors of birth certification. Mixed effects were noted for religion, ethnicity and region. Finally, no significant effects were noted for gender, maternal occupation and rural residence. Conclusions: The findings identify several socioeconomic and demographic factors associated with birth certification suggesting possible risks with improving birth certification in Nigeria. Access to health care and higher socioeconomic backgrounds are significant protectors of and distance to registration centers as obstacles to birth certification for children in Nigeria. Public policy strategies should encourage the use of health care services and also increase the number of registration centers in Nigeria.

Download Full-text

The intersection of developmental vulnerability and socioeconomic disadvantage on access to health care for preschool aged children: evidence for the inverse-care law

10.21203/rs.2.10731/v1 ◽

2019 ◽

Author(s):

Sue Woolfenden ◽

Claire Galea ◽

Hannah Badland ◽

Hayley Smithers-Sheedy ◽

Katrina Williams ◽

...

Keyword(s):

Health Services ◽

Access To Health Care ◽

Parental Education ◽

Service Use ◽

Socioeconomic Disadvantage ◽

Access To Health Services ◽

Health Services Use ◽

Cross Sectional ◽

Inverse Care Law ◽

Access To Health

Abstract Aim. Children who are developmentally vulnerable have greater health needs. Socioeconomic disadvantage not only increases this risk of developmental vulnerability but can be associated with less access to health services. Our aim was to compare health services use in children aged 4-5 years in Australia with and without developmentally vulnerability and consider the intersection of socioeconomic disadvantage on this relationship. Method. Cross sectional data were collected from Wave 3 of the Longitudinal Study of Australian Children birth cohort when the children were aged 4-5 years. A composite variable for developmental vulnerability was designed by combining those children who were in the lowest 15% in the physical, socioemotional and/or learning outcome indices. Children were then subgrouped according to developmental vulnerability and disadvantage based on socioeconomic position (SEP) quintile (derived from parental education, occupation, household income). We defined SEP 1 the lowest quintile as ‘disadvantaged’ and SEP quintiles 2-5 as ‘not disadvantaged’. Multivariate regression was used to examine the intersection between health service use and developmental vulnerability and disadvantage using these composite variables. Results The total number of children with information on developmental vulnerability in Wave 3 was 3967 (90% of the sample). A total of 1292 (32.6%) children were classified as developmentally vulnerable. 30.6% of children who were developmentally vulnerable came from families who were disadvantaged. Overall children who were developmentally vulnerable were reported to use more specialist/hospital health services than those who were not developmentally vulnerable (10-25 % vs 5-16%). Children who were developmentally vulnerable and not disadvantaged were 1.4-2.0 times more likely to have reported using a GP, paediatrician, other specialist, and Emergency Department compared with children who were developmentally vulnerable and disadvantaged. Conclusion Preschool children who are developmentally vulnerable have a higher reported use of specialist and hospital services compared with those who are not developmentally vulnerable. There is evidence of an inverse care law; those who were not disadvantaged with and without developmental vulnerability are more likely to use health services compared with their counterparts who were disadvantaged.

Download Full-text

Faktor Penentu Stunting: Analisis Komparasi Masa Millenium Development Goals (MDGs) dan Sustainable Development Goals (SDGs) di Indonesia

Jurnal Ilmiah Universitas Batanghari Jambi ◽

10.33087/jiubj.v21i3.1726 ◽

2021 ◽

Vol 21 (3) ◽

pp. 1338

Author(s):

Sri Widari ◽

Nasri Bachtiar ◽

Elvina Primayesa

Keyword(s):

Birth Weight ◽

Parental Education ◽

Secondary Data ◽

Clean Water ◽

Access To Health Services ◽

Under Five ◽

Nutritional Problem ◽

Access To Health ◽

Before And After ◽

Development Goals

This study aims to analyze, before and after the SDGs agenda in Indonesia, the determinants of stunting through household characteristics, mother characteristics and child characteristics. Stunting is a condition in which, due to direct and indirect causes, toddlers fail to thrive or are too short compared to children of their age and is a nutritional problem that is the government's focus. Nationally, at the end of the Millennium Development Goals (MDGs) in 2015, the prevalence rate of stunting in Indonesia was 36.4 percent and 30.8 percent in 2018. This figure is still above the RPJMN target for 2019, namely 28% stunting and the WHO stipulation, namely 20% stunting prevalence in 2025 and 0% stunting prevalence in 2030 according to the SDGs target. Access to clean water, access to sanitation, access to health services, national health insurance, housing, underweight mothers, mothers with parental education, birth weight and premature births were the variables studied in this study. This research uses secondary data, processed with logistic regression, from Riskesdas in 2013 and 2018. Results showed that under-five birth weight, underweight mothers, shelter, access to sanitation, access to clean water and preterm birth had a significant (significant) association with the incidence of under-five stunting.

Download Full-text

An Empirical Analysis of the Socioeconomic and Demographic characteristics influencing Birth Certification in Nigeria

10.21203/rs.3.rs-18158/v2 ◽

2020 ◽

Author(s):

Uchechi Shirley Anaduaka

Keyword(s):

Health Care ◽

Access To Health Care ◽

Birth Certificate ◽

Demographic Factors ◽

Ordinary Least Squares ◽

Skilled Attendant ◽

Children Under Five ◽

Under Five ◽

Factors Associated ◽

Socioeconomic And Demographic Factors

Abstract Background: Promoting birth certification is instrumental to achieving target 16.9 of the Sustainable Development Goals: legal identity for all by 2030. However, limited research has investigated the determinants of birth certification of children in the sub-Saharan African context. This study analyzes the socioeconomic and demographic factors associated with the birth certification of children under-five years in Nigeria. Methods: The study employed three rounds of the Nigerian Demographic and Health Survey involving 79487 children (0-4 years) in Nigeria. Birth certification was defined as whether a parent/caregiver had a child’s birth certificate at the time of the interview. Ordinary least squares and multilevel logistic regression models established the relationships between the socioeconomic and demographic factors and birth certification. Results: Children under-five years who had a skilled attendant at birth, at least one vaccination, and maternal access to prenatal visits had about 25.6%, 60.5% and 35.0% higher odds of having their births certified. Children born to more educated mothers and fathers had 1.023 and 1.012 times the odds of birth certification. Children from average and rich households also had 13.2% and 34.2% higher odds of birth certification, respectively. Conversely, child age, higher birth order, longer birth intervals, polygyny, having at least two dead siblings, father being employed in a low skilled job, living far from a registration center and in a poor community are risk factors for birth certification. Maternal age at birth and paternal has non-linear, albeit weak effects on birth certification. Being large at birth, bank account ownership were also significant predictors of birth certification. Mixed effects were noted for religion, ethnicity and region. Finally, no significant effects were noted for gender, maternal occupation and rural residence. Conclusions: The findings identify several socioeconomic and demographic factors associated with birth certification suggesting possible risks with improving birth certification in Nigeria. Access to health care and higher socioeconomic backgrounds are significant protectors of and distance to registration centers as obstacles to birth certification for children in Nigeria. Public policy strategies should encourage the use of health care services and also increase the number of registration centers in Nigeria.

Download Full-text

Listening to Caregivers: Narratives of Health Seeking for Children Under Five with Pneumonia and Diarrhea: Insights from the NIGRAAN Trial in Pakistan

10.21203/rs.3.rs-104407/v1 ◽

2020 ◽

Author(s):

Maryam Huda ◽

Leah Shipton ◽

Wafa Aftab ◽

Kausar S Khan ◽

Maria Giulia Marini ◽

...

Keyword(s):

Health Services ◽

Health Providers ◽

Process Of Care ◽

Access To Health Services ◽

Health Seeking ◽

Joint Family ◽

Children Under Five ◽

Under Five ◽

Care Giving ◽

Health Seeking Behaviors

Abstract Background Access to health services is an important way to reduce child mortality and is influenced by health-seeking behaviors of caregivers. There are numerous contextual factors that affect health-seeking behaviors, such as distance to health services, transportation, treatment cost, caregiver access to household finances, perceived quality of available health providers, availability and comprehension of health information, social and religious norms (including gender-based mobility), and perceived severity of illness. Objective The objective of this study (embedded in a larger trial called Nigraan) was to gather caregiver narratives in order to develop a comprehensive understanding of the context and process of care giving for children under five with pneumonia and diarrhea, in order to highlight the complexities and dynamics of health seeking in rural Sindh, Pakistan. Methods This study used a narrative interview approach gathering information in the form of stories from care givers of children under five with pneumonia and diarrhea. Twenty caregivers from 11 households participated in this exercise. All data collection was conducted privately in participants’ homes.Results The role of joint family households is integral in health seeking for pneumonia and diarrhea in children under five. Elders and female relatives, especially the child’s paternal grandmother, are an important and trusted source of knowledge regarding child sickness in the household. Furthermore, practice of home remedies is inherited from mother-in-law and older sisters-in-law in the household, and oftentimes their recommendations are taken as authority. Caregivers were generally dissatisfied with doctors in public sector who provide free consultation and associated higher quality care with private doctors who charge more and had shorter waiting times. Joint family households were generally observed to increase the support available to address the financial and practical considerations of health seeking and implementing treatment plans for pneumonia and diarrhea. Conclusions Policy and research on community-based health programs and interventions would be more comprehensive if a health education intervention considered the context of decision making and social influences at the household level rather than focusing on individual caregivers.

Download Full-text