scholarly journals Household Cooking Fuel Type and Child Anaemia in Sub-saharan Africa: Insights From Demographic and Health Surveys

2020 ◽  
Author(s):  
Iddrisu Amadu ◽  
Abdul-Aziz Seidu ◽  
Abdul-Rahaman Afitiri ◽  
Bright Opoku Ahinkorah
Keyword(s):  
Drinking Water ◽  
Maternal Education ◽  
Household Head ◽  
Childhood Mortality ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Fuel Type ◽  
Cooking Fuel ◽  
Cooking Fuels ◽  
Sub Saharan

Abstract Background Childhood anaemia is one of the major public health concerns in low and middle-income countries, contributing substantially to childhood mortality and morbidity. This study, therefore, sought to investigate the association between household cooking fuel type, and the joint impact of household cooking fuel type and urbanicity on anaemia among children under the age of 5 in sub-Saharan Africa. Methods We analysed cross-sectional data of 95,056 children under the age of 5 from 29 sub-Saharan African countries. Bivariate and multivariate analyses were performed using chi-square test of independence and negative log-log regression respectively at p < 0.05. Results were presented as Adjusted Odds Ratios for the negative log-log regression analysis. Results The percentage of children who had anaemia was 57%. Children from rural households that depend on unclean cooking fuels were more likely to be anaemic [AOR = 1.042; 95% CI = 1.010–1.074] compared to children from urban households using unclean cooking fuel. We also found that children in female headed households [AOR = 1.047; CI = 1.019–1.076], children in large households [AOR = 1.066; CI = 1.021–1.113]; those in households with improved source of drinking water [AOR = 1.035; CI = 1.006–1.065] had higher odds of suffering from anaemia. However, children with normal weight [AOR = 0.946;CI = 0.916–0.976], children aged 4 [AOR = 0.900; CI = 0.868–0.934], children whose mothers are aged 45–49 [AOR = 0.866; CI = 0.778–0.963] and those aged 30–34 [AOR = 0.868; CI = 0.815–0.925], children whose mothers had tertiary level of education [AOR = 0.865; CI = 0.809–0.925], children in rich households [AOR = 0.935; CI = 0.904–0.968] and those in households with improved type of toilet facility [AOR = 0.955; CI = 0.929–0.981] had lower odds of being anaemic. Conclusion Our study established an association between the joint effect of type of household cooking fuel and urbanicity and anaemia among children under the age of 5 in SSA. Childs’ birthweight, current age, maternal age, sex of household head, age of household head, maternal education, wealth status, size of household, type of source of drinking water and country of residence are associated with childhood anaemia. It is therefore critical to promote the usage of clean cooking fuels among households and women in rural areas. This could be done by governments in various countries subsidising the cost of liquefied petroleum gases and cylinders. Stakeholders that seek to improve maternal and child health should also take these associated factors into consideration.

scholarly journals Prevalence and Factors Associated with the Triple Burden of Malnutrition among Mother-Child Pairs in Sub-Saharan Africa

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 2050
Author(s):  
Bright Opoku Ahinkorah ◽  
Iddrisu Amadu ◽  
Abdul-Aziz Seidu ◽  
Joshua Okyere ◽  
Eric Duku ◽  
...  
Keyword(s):  
Maternal Education ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Micronutrient Deficiencies ◽  
Cross Sectional Survey ◽  
Cooking Fuel ◽  
Factors Associated ◽  
Western Africa ◽  
Sub Saharan ◽  
Size At Birth

Despite concerns about the coexistence of overnutrition, undernutrition and micronutrient deficiencies, which is compositely referred to as the triple burden of malnutrition (TBM), little is known about the phenomenon in sub-Saharan Africa (SSA). We, therefore, aimed to examine the prevalence and investigate the factors associated with TBM in SSA. This study uses cross-sectional survey data collected through the Demographic and Health Surveys (DHS) Program from 2010 to 2019. Data from 32 countries in SSA were used for the analysis. The prevalence of TBM were presented in tables and maps using percentages. The predictors of TBM were examined by fitting a negative log-log regression to the data. The results were then presented using adjusted odds ratios (aORs) at 95% Confidence Intervals (CIs). Out of the 169,394 children, 734 (1%) suffered from TBM. The highest proportion of children with TBM in the four geographic regions in SSA was found in western Africa (0.75%) and the lowest in central Africa (0.21%). Children aged 1 [aOR = 1.283; 95% CI = 1.215–1.355] and those aged 2 [aOR = 1.133; 95% CI = 1.067–1.204] were more likely to experience TBM compared to those aged 0. TBM was less likely to occur among female children compared to males [aOR = 0.859; 95% CI = 0.824–0.896]. Children whose perceived size at birth was average [aOR = 1.133; 95% CI = 1.076–1.193] and smaller than average [aOR = 1.278; 95% CI = 1.204–1.356] were more likely to suffer from TBM compared to those who were larger than average at birth. Children born to mothers with primary [aOR = 0.922; 95% CI = 0.865–0.984] and secondary [aOR = 0.829; 95% CI = 0.777–0.885] education were less likely to suffer from TBM compared to those born to mothers with no formal education. Children born to mothers who attended antenatal care (ANC) had lower odds of experiencing TBM compared to those born to mothers who did not attend ANC [aOR = 0.969; 95% CI = 0.887–0.998]. Children born to mothers who use clean household cooking fuel were less likely to experience TBM compared to children born to mothers who use unclean household cooking fuel [aOR = 0.724; 95% CI = 0.612–0.857]. Essentially, higher maternal education, ANC attendance and use of clean cooking fuel were protective factors against TBM, whereas higher child age, low size at birth and being a male child increased the risk of TBM. Given the regional variations in the prevalence and risk of TBM, region-specific interventions must be initiated to ensure the likelihood of those interventions being successful at reducing the risk of TBM. Countries in Western Africa in particular would have to strengthen their current policies and programmes on malnutrition to enhance their attainment of the SDGs.

The paradox of water accessibility: understanding the temporal and spatial dimensions of access to improved water sources in Rwanda

2015 ◽  
Vol 5 (4) ◽  
pp. 553-564 ◽  
Author(s):  
Lydia Osei ◽  
Jonathan Amoyaw ◽  
Godfred Odei Boateng ◽  
Sheila Boamah ◽  
Isaac Luginaah
Keyword(s):  
Drinking Water ◽  
Water Sources ◽  
Regional Disparities ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Logistic Regression Models ◽  
The People ◽  
Spatial Dimensions ◽  
Sub Saharan ◽  
Over Time

According to the United Nations, the world has met the Millennium Development Goal target of halving the proportion of people without access to safe drinking water. However, global figures mask massive disparities between regions and countries, and within countries. For instance, only 64% of the people in sub-Saharan Africa have access to improved water sources. Over 40% of all people globally who lack access to drinking water live in sub-Saharan Africa. Rwanda is used as a case in point in this study. Despite the abundance of water resources in the country, access to improved water sources is limited. Using the Rwandan Demographic and Health Surveys (2000–2010), we examined regional disparities in access to improved water sources. Results from logistic regression models show that overall, access to improved water has declined between 2000 and 2010; except in the western region, where access to water marginally improved. Educated individuals, wealthier and urban dwellers were more likely to have access to improved water sources over time compared to their uneducated, poor and rural counterparts. The persistence of regional disparities in access to improved water over time suggests the need for policy to address insufficient investments in water infrastructure in Rwanda.

scholarly journals Hospital delivery and neonatal mortality in 37 countries in sub-Saharan Africa and South Asia: An ecological study

PLoS Medicine ◽  
2021 ◽  
Vol 18 (12) ◽  
pp. e1003843
Author(s):  
Anna D. Gage ◽  
Günther Fink ◽  
John E. Ataguba ◽  
Margaret E. Kruk
Keyword(s):  
South Asia ◽  
Neonatal Mortality ◽  
Ecological Study ◽  
Maternal Education ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Cross Sectional ◽  
Hospital Delivery ◽  
Sub Saharan ◽  
Facility Births

Background Widespread increases in facility delivery have not substantially reduced neonatal mortality in sub-Saharan Africa and South Asia over the past 2 decades. This may be due to poor quality care available in widely used primary care clinics. In this study, we examine the association between hospital delivery and neonatal mortality. Methods and findings We used an ecological study design to assess cross-sectional associations between the share of hospital delivery and neonatal mortality across country regions. Data were from the Demographic and Health Surveys from 2009 to 2018, covering 682,239 births across all regions. We assess the association between the share of facility births in a region that occurred in hospitals (versus lower-level clinics) and early (0 to 7 days) neonatal mortality per 1,000 births, controlling for potential confounders including the share of facility births, small at birth, maternal age, maternal education, urbanicity, antenatal care visits, income, region, and survey year. We examined changes in this association in different contexts of country income, global region, and urbanicity using interaction models. Across the 1,143 regions from 37 countries in sub-Saharan Africa and South Asia, 42%, 29%, and 28% of births took place in a hospital, clinic, and at home, respectively. A 10-percentage point higher share of facility deliveries occurring in hospitals was associated with 1.2 per 1,000 fewer deaths (p-value < 0.01; 95% CI: 0.82 to 1.60), relative to mean mortality of 22. Associations were strongest in South Asian countries, middle-income countries, and urban regions. The study’s limitations include the inability to control for all confounding factors given the ecological and cross-sectional design and potential misclassification of facility levels in our data. Conclusions Regions with more hospital deliveries than clinic deliveries have reduced neonatal mortality. Increasing delivery in hospitals while improving quality across the health system may help to reduce high neonatal mortality.

scholarly journals Diarrhea and associated factors among under five children in sub-Saharan Africa: Evidence from demographic and health surveys of 34 sub-Saharan countries

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257522
Author(s):  
Getu Debalkie Demissie ◽  
Yigizie Yeshaw ◽  
Wallelign Aleminew ◽  
Yonas Akalu
Keyword(s):  
Associated Factors ◽  
Maternal Education ◽  
Wealth Index ◽  
Water Source ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
African Countries ◽  
Under Five ◽  
Under Five Children ◽  
Sub Saharan

Introduction Diarrhea is responsible for the death of more than 90% of under-five children in low and lower-middle income countries. Regionally, South Asia and sub-Saharan Africa accounted for 88% of deaths with the same age group. Therefore, the aim of this study was to determine the prevalence and associated factors of diarrhea among children under-five years in sub-Saharan Africa. Methods The appended, most recent demographic and health survey datasets of 34 sub-Saharan African countries were used to determine the prevalence and associated factors of diarrhea among under-five children in the region. A total weighted sample of 330,866 under-five children were included in the study. Both bivariable and multivariable multilevel logistic regression were done to determine the associated factors of diarrhea among under five children in sub-Saharan Africa. The Odds Ratio (OR) with a 95% Confidence Interval (CI) was calculated for those potential factors included in the final model. Result The overall prevalence of diarrhea in this study was 15.3% (95% CI: 15.1–15.4). Those children of mothers aged 15–24 (AOR = 1.26; 95% CI: 1.23, 1.30) and 25–34 years (AOR = 1.15; 95%CI: 1.12, 1.18), those children of mothers with no education (AOR = 1.69; 95%CI: 1.57–1.82), primary education (AOR = 1.73; 95%CI: 1.61–1.86) and secondary education (AOR = 1.49; 95%CI: 1.38–1.59) had higher odds of having diarrhea. Those children from poorest (AOR = 1.14; 95%CI: 1.10, 1.19), poorer (AOR = 1.12; 95%CI: 1.08–1.17), middle (AOR = 1.06; 95%CI: 1.02, 1.10), and richer (AOR = 1.14; 95%CI: 1.04–1.12) households had higher chance of having diarrhea compared to their counterparts. Conclusion This study found that the prevalence of childhood diarrhea morbidity in sub-Saharan Africa was high. Maternal age, wealth index, maternal education, maternal occupation, age of child, time of initiation of breast feeding and time to get water source were significantly associated with diarrhea. Therefore, intervention through health education and health promotion for mothers/caretakers who are poor, less educated, and young should be designed to prevent diarrhea in the region.

scholarly journals Safer sex negotiation and parity among women in sub-Saharan Africa

2022 ◽  
pp. 1-13
Author(s):  
Collins Adu ◽  
James Boadu Frimpong ◽  
Aliu Mohammed ◽  
Justice Kanor Tetteh ◽  
Eugene Budu ◽  
...  
Keyword(s):  
Safer Sex ◽  
Household Head ◽  
Wealth Quintile ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
African Countries ◽  
High Parity ◽  
Significance Level ◽  
Sub Saharan

Abstract Women’s ability to negotiate for safer sex has effects on their sexual and reproductive health. This study investigated the association between safer sex negotiation and parity among women in sub-Saharan Africa. The data were sourced from the Demographic and Health Surveys of 28 sub-Saharan African countries conducted from 2010 to 2019. A total of 215,397 women aged 15–49 were included in the study. Multilevel logistic analysis was conducted to examine the association between safer sex negotiation and parity among women in sub-Saharan Africa. The results were presented as adjusted odds ratios (aOR) and the significance level set at p<0.05. The overall prevalences of safer sex negotiation and high parity among women in sub-Saharan Africa were 82.7% and 52.1%, respectively. The prevalence of high parity ranged from 32.3% in Chad to 72.1% in Lesotho. The lowest prevalence of safer sex negotiation was in Chad (16.8%) while the highest prevalence was recorded in Rwanda (99.7%). Women who had the capacity to negotiate for safer sex were less likely to have high parity compared with those who had no capacity to negotiate for safer sex (aOR = 0.78, CI: 0.75–0.81). Other factors that were associated with high parity were age, educational level, marital status, exposure to media, contraceptive use, religion, wealth quintile, sex of household head, and place of residence. The study identified significant association between safer sex negotiation and high parity among women of reproductive age in sub-Saharan Africa. It is worth noting that women’s ability to negotiate for safer sex could reduce high parity among women in sub-Saharan Africa. Therefore, policies and programmes aimed at birth control or reducing high parity among women could be targeted at improving their capacity to negotiate for safer sex through education.

scholarly journals Assessing sex differentials in under-five mortality in sub-Saharan Africa: A cross-national comparative analysis

2015 ◽  
Vol 41 (3-4) ◽  
pp. 49 ◽  
Author(s):  
Adebiyi Germain Boco
Keyword(s):  
Community Level ◽  
Childhood Mortality ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
African Countries ◽  
Sex Differentials ◽  
Before And After ◽  
Individual Household ◽  
Sub Saharan ◽  
The Relationship

This paper investigates and compares country-specific sex differentials in childhood mortality in thirty sub-Saharan African countries. Data from the demographic and Health Surveys (DHS) were analyzed to assess sex differentials in U5M rates before and after adjustment for individual, household, and community-level factors, using multilevel discrete-time hazard models. The findings show a systematically higher mortality for male children compared to female in all countries except Sierra Leone and Swaziland. The relationship is significant in nineteen of the thirty countries. Across the region, males have 17–54 per cent higher odds of dying before age five. These patterns remained when controls were added for individual and community-level factors, as well as unobserved community-level effects. 

scholarly journals Trends in Household Air Pollution Contributed by the Type of Cooking Fuel Used in Ugandan Households from 2000 to 2016 and Associated Household Factors: An Analysis of Demographic and Health Surveys

2021 ◽  
Author(s):  
Derrick Bary Abila ◽  
Nalunkuma Racheal ◽  
Sulaiman Bugosera Wasukira ◽  
Provia Ainembabazi ◽  
Aggrey Siya ◽  
...  
Keyword(s):  
Air Pollution ◽  
Health Surveys ◽  
Household Head ◽  
Household Air Pollution ◽  
P Value ◽  
Demographic And Health Surveys ◽  
Multivariate Logistic Regression ◽  
Cooking Fuel ◽  
Household Factors ◽  
Cooking Fuels

Abstract Background The type of cooking fuel used in households can expose the members to polluted air which has been shown to have multiple health effects. We describe the trend in household air pollution (HAP) caused by the type of cooking fuel used in Ugandan households from 2001 to 2016 and explore the household factors associated with it. Methods This was a retrospective analysis of four datasets of Ugandan demographic and health surveys (DHS) conducted from 2000/2001 to 2016 with the household as the unit of analysis. We included variables that described the households, the type of cooking fuel, and where the food was cooked. A household was considered to have exposure to HAP if they used cooking fuels like coal, charcoal, wood, straw/shrubs/grass, crops, or animal dung for cooking. Bivariate and multivariate logistic regression was used to determine the association between household characteristics and exposure to household air pollution (HAP) from the most recent DHS of 2016. Results A total of 45,376 households were included in the study. In all the surveys, the majority of the households were rural (74.33–85.11%), were headed by a male (68.98–72.46%), and with their highest educational attainment as incomplete primary education (37.21–42.44%). In all the surveys, the majority of the households used wood as a cooking fuel (71.69–82.08%). Most of the households were exposed to HAP (96.69–99.80%). From the multivariate logistic regression analysis, households with a household head having attained either complete secondary education [Adjusted Odd ratio: 0.13, 95% Confidence interval (0.03–0.58), p-value = 0.008] or higher education [Adjusted Odd ratio: 0.11, 95% Confidence interval (0.03–0.48), p-value = 0.003] were less likely to be exposed to HAP when compared with households with a household head having no education. Conclusions This study revealed that most households in Uganda have exposure to household air pollution caused by the type of cooking fuel used in the household. This underscores the need for innovations in cooking fuels like clean energy stoves that are cost-effective and cause less exposure to household air pollution.

scholarly journals 1159Inequities in on-time childhood vaccination: Evidence from sub-Saharan Africa

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Martin Mutua
Keyword(s):  
Rural Communities ◽  
Vaccination Coverage ◽  
Maternal Education ◽  
Household Wealth ◽  
Sub Saharan Africa ◽  
Childhood Vaccination ◽  
Demographic And Health Surveys ◽  
Place Of Residence ◽  
Multiple Indicator ◽  
Sub Saharan

Abstract Introduction Vaccination coverage has improved over the past decade but inequalities persist; the poorest, least educated, and rural communities are left behind. Programming has focused on increasing coverage and reaching the hardest to reach children but vaccination timeliness is equally important as delays leave children vulnerable to infections. This study examines the levels and inequities of on-time vaccination in the sub-Saharan African (SSA) region. Methods: The most recent Demographic and Health Surveys or Multiple Indicator Clusters Surveys since 2000 from SSA were used to assess on-time vaccination and inequalities by household wealth, maternal education, and place of residence. Inequalities were quantified using slope index of inequality and concentration index. Results The analysis included 153,632 children aged 12-36 months from 40 SSA countries. Median on-time vaccination coverage was below 50% in all four sub-regions. Differences in on-time vaccination were observed by place of residence in Southern (20.8 pp, 95%CI (0.8; 40.8)), West (17.5 pp, 95%CI (5.1; 29.9)), and Eastern (20.9 pp, 95%CI (6.5; 35.2)) regions. Wealth-related inequities were observed in Southern (22.6 pp, 95%CI (4.0; 41.2)), West (30.6 pp, 95%CI (19.1; 42.1)), and Eastern (26.1 pp, 95%CI (8.2; 44.0)) regions. Significant education-related differences in on-time vaccination were observed in West (20.7 pp, 95%CI (10.9; 30.5)), and Eastern (21.2 pp, 95%CI (7.0; 35.4)) regions. Conclusions On-time vaccination coverage was low in all sub-regions and nearly all countries. Inequalities in on-time immunization by household wealth, place of residence, and education existed in most countries. Concrete strategies to improve levels of timeliness are needed

scholarly journals Profiling Household Double and Triple Burden of Malnutrition in sub-Saharan Africa: Prevalence and Influencing Household Factors

2021 ◽  
pp. 1-32
Author(s):  
Aaron K. Christian ◽  
Fidelia A. A. Dake
Keyword(s):  
Household Head ◽  
Household Wealth ◽  
Overweight And Obesity ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
Health Concern ◽  
Demographic And Health Surveys ◽  
Wealth Status ◽  
Women And Children ◽  
Sub Saharan

Abstract Objective: Undernutrition and anaemia - the commonest micronutrient deficiency, continue to remain prevalent and persistent in sub-Saharan Africa (SSA) alongside a rising prevalence of overweight and obesity. However, there has been little research on the co-existence of all three conditions in the same household in recent years. This study examines the co-existence and correlates of the different conditions of household burden of malnutrition in the same household across SSA. Setting: The study involved twenty-three countries across SSA who conducted demographic and health surveys between 2008 and 2017. Participants: The analytical sample includes 145,020 households with valid data on the nutritional status of women and children pairs (i.e. women of reproductive age; 15-49 years and children under-five years). Design: Logistic regression analyses were used to determine household correlates of household burden of malnutrition. Results: Anaemia was the most common form of household burden of malnutrition, affecting about 7 out of 10 households. Double and Triple burden of malnutrition though less common, was also found to be present in 8 and 5 percent of the households respectively. The age of the household head, location of the household, access to improved toilet facilities and household wealth status were found to be associated with various conditions of household burden of malnutrition. Conclusions: The findings of this study reveal that, both double and triple burden of malnutrition is of public health concern in SSA, thus nutrition and health interventions in SSA must not be skewed towards addressing undernutrition only, but also address overweight/obesity and anaemia.

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