scholarly journals Predictors of Teenage Pregnancy in Zambia Between 2007-2018

Author(s):  
Claire H. Packer ◽  
Nelly-Claire Muntalima ◽  
Ana Langer ◽  
Michael T. Mbizvo

Abstract Background: In Zambia, 29% of adolescents aged 10-19 have begun childbearing. Early childbearing has been shown to have detrimental social and medical outcomes. As far as we are aware, there has been no study in Zambia that has investigated the drivers of teenage pregnancies over a 10-year period. Using DHS data, we sought to determine predictors of teenage pregnancies among teenagers in Zambia between the years of 2007 and 2018. Methods: We analyzed survey data of 11,194 adolescents from the 2007, 2014 and 2018 Demographic and Health Surveys (DHS), which are nationally representative. Analyses were conducted with Stata/SE software and we examined rates of teenage pregnancy based on multiple predictors of interest. Chi-square tests and multivariable logistic regression models were employed for statistical comparison using a p-value of 0.05 to indicate statistical significance. Results:After exclusions, 11,194 adolescents under the age of 19 were included in our analysis, with a 29% prevalence of teenage pregnancy. Teenagers were more likely to become pregnant if they were married, had younger sexual debut, had less education, were illiterate, lived in rural areas, or were of the poorest wealth index than if they were not. Among adolescents with teenage pregnancies, utilization of sexual and reproductive health services among teen mothers significantly increased between 2007 and 2018. On multivariate analysis, teenage pregnancy was found to be significantly different given predictors when compared to the reference group, with significant effect modification due to marital status. Conclusion: Our study identified significant demographic, intrapersonal, and socioeconomic factors that have impacted rates of teenage pregnancy in Zambia over the past 10 years. Understanding these drivers can inform programmatic interventions targeting reduction of teenage pregnancies.

Author(s):  
Ching Yuen Luk

This chapter examines the causes and consequences of teenage pregnancy in China and how to prevent teenage pregnancy using a human rights-based approach. It shows that teenage pregnancy is caused by social and cultural factors, including adolescents' more open attitude towards sex, the lack of formal and comprehensive sex education at schools, parents failing to be prominent socializing agents of sexuality for their children, and the problem of “left-behind” children in rural areas. Teenage pregnancy adversely affects adolescents, their babies, and their family in different ways. In order to solve the problem of teenage pregnancy, this study suggests the adoption of a human rights-based approach to teenage pregnancy prevention by recognizing adolescents' right to sexual and reproductive information and education, their right to sexual and reproductive health services, and their right to participate.


2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Lauren Blacker ◽  
Shari Krishnaratne

Abstract Objectives Childhood vaccines and biannual vitamin A delivery by health systems are key to child health; suboptimal administration may be a result of inadequate coverage or access to health systems. There have been national programs set in Ethiopia, such as the health sector development program, to improve child health. Therefore, we sought to describe trends in infant vaccines and vitamin A in urban and rural settings in Ethiopia. We hypothesized there would be an increase over time in infants (1) receiving all basic vaccines and (2) vitamin A in the past 6 months. We also hypothesized (3) coverage would be higher in urban settings. Methods We used four nationally representative Demographic and Health Surveys (DHS) from Ethiopia between 2000 and 2016. The analysis comprised 11,621 infants 6–23 months old. Logistic regression models using a forward-stepwise approach were created to test these 3 hypotheses, controlling for wealth, age, sex of infant, and mother's highest education level. Interaction terms were fitted between survey year and education level, setting and education level, and setting and wealth index quintile, and tested using the Wald test. Results (1) The percentage of infants having received all basic vaccines increased from 11.1% in 2000 to 31.0% in 2016; the odds of having received these vaccines increased over time also. (2) This is not true for vitamin A, where there was no pattern in the odds of having received vitamin A between survey years. (3) Rural infants were 40% less likely to have received all basic vaccines, compared to urban infants (adjusted odds ratio (AOR): 0.60; 95% CI: 0.43, 0.83), and there was no evidence of an association between setting and receiving vitamin A (AOR: 0.81; 95% CI: 0.61, 1.09). There was strong evidence for interaction between setting and mother's highest education level, setting and wealth index quintile, and survey year and education level (all P < 0.01). Conclusions These results suggest that (1) while there has been improvement in infants receiving basic vaccines, (2) progress may be slowing slightly in vitamin A coverage and (3)there is a need to improve coverage of basic vaccines for infants in rural areas. Strengthening of and improved access to health services should remain a priority to ensure proper distribution of vaccines and vitamin A in Ethiopia. Funding Sources N/A. Supporting Tables, Images and/or Graphs


BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e018468 ◽  
Author(s):  
Muhammad Abdul Baker Chowdhury ◽  
Md Mohiuddin Adnan ◽  
Md Zakiul Hassan

ObjectiveTo determine the trends, prevalence and risk factors of overweight and obesity among Bangladeshi women of reproductive age from 1999 to 2014.DesignWe analysed nationally representative data from the 1999, 2004, 2007, 2011 and 2014 cross-sectional Bangladesh Demographic and Health Surveys.SettingBangladesh.ParticipantsWomen aged 15–49 years.Primary outcomeOverweight/obesity.ResultsA total of 58 192 women were included in the analysis. The prevalence of overweight and obesity among women of reproductive age increased significantly from 7.53% (95% CI 6.83 to 8.29) and 1.82% (95% CI 1.48 to 2.24) in 1999 to 28.37% (95% CI 27.49 to 29.28) and 10.77% (95% CI 10.22 to 11.35) in 2014, respectively. Age, education, wealth index, watching television and contraceptive use were associated with overweight and obesity in both urban and rural areas.ConclusionsOverweight and obesity prevalence increased significantly among Bangladeshi women of reproductive age between 1999 and 2014. Development of effective low-cost strategies to address the increasing burden of obesity should be a high priority.


Author(s):  
Betregiorgis Zegeye ◽  
Gebretsadik Shibre ◽  
Dina Idriss-Wheeler ◽  
Sanni Yaya

Abstract Background The decrease in the magnitude of stunting over the past 20 years has been slow in Ethiopia. To date, in Ethiopia, the trends in and extent of inequality in stunting have not been investigated using methods suitably developed for disparity studies. This paper investigated both the extent and overtime dynamics of stunting inequality in Ethiopia over the last 17 years. Methods Using the World Health Organization’s Health Equity Assessment Toolkit software, data from the Ethiopia Demographic and Health surveys (EDHS) were analyzed between 2000 and 2016. The inequality analysis consisted of disaggregated rates of stunting using five equity stratifiers (economic status, education, residence, region and sex) and four summary measures (Difference, Population Attributable risk, Ratio and Absolute Concentration Index). A 95% uncertainty interval was constructed around point estimates to measure statistical significance. Results The study showed that both absolute and relative inequalities in stunting exist in all the studied years in Ethiopia. The inequality disfavors children of mothers who are poor, uneducated and living in rural areas and specific regions such as Amhara. The pro-rich (R = 1.2; 1.1, 1.3 in 2000 to R = 1.7; 1.4, 2 in 2016) and pro-educated (R = 1.6; 95%UI = 1.3, 1.9 in 2000 and R = 2.3; 95%UI = 1.5, 3 in 2011) inequalities slightly increased with time. Male children bear a disproportionately higher burden of stunting, and the disparity increased between the first and the last time points (PAR = −1.5 95%UI = −2.5, −0.6 in 2000 and PAR = −2.9 95%UI = −3.9, −1.9) based on complex measures but remained constant with simple measures (R = 1; 95%UI = 0.9, 1.1 in 2000 and R = 1.1 95%UI = 1, 1.2 in 2016). Similarly, both the sub-national regional and residence-related stunting disparities generally widened over time according to some of the inequality measures. Conclusions Stunting appeared to be highly prevalent among certain sub-groups (i.e. poor, uneducated and living in rural regions). The subpopulations experiencing excessively high stunting prevalence should be the focus of policy makers’ attention as they work to achieve the WHO 40% reduction in stunting target by 2025 and the UN Agenda 2030 for Sustainable Development Goals.


Obesities ◽  
2021 ◽  
Vol 1 (2) ◽  
pp. 113-135
Author(s):  
Kritika Rana ◽  
Puspa Ghimire ◽  
Romila Chimoriya ◽  
Ritesh Chimoriya

This study aimed to examine the trends in the prevalence of overweight and obesity and to determine the associated socioeconomic and household environmental factors among women in Nepal. Using nationally representative data from the 1996, 2001, 2006, 2011, and 2016 cross-sectional Nepal Demographic and Health Surveys (NDHSs) (n = 33,507), the prevalence of overweight–obesity (body mass index (BMI) ≥ 25 kg/m2) and obesity (BMI ≥ 30 kg/m2) among women aged 15–49 years were examined. From the latest NDHS 2016, non-pregnant women with recorded anthropometric measurements (n = 6165) were included in the final analyses. Multivariate logistic regression models were used to determine the socioeconomic and household environmental factors associated with BMI ≥ 25 and BMI ≥ 30. Between 1996 and 2016, the prevalence of overweight–obesity increased from 1.8% to 19.7%, while the prevalence of obesity increased from 0.2% to 4.1%. Age, marital status, wealth index, province of residence, type of cooking fuel, and household possessions—refrigerator and bicycle were significantly associated with having overweight–obesity and obesity. Similarly, educational status, religion, type of toilet facility, and household possessions—television and mobile phone were significantly associated with having overweight–obesity. Given the alarming increase in the prevalence of overweight and obesity among Nepalese women, there is an urgent need for interventions addressing these critical socioeconomic and household environmental factors.


PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0254774
Author(s):  
Abdul-Aziz Seidu ◽  
Bright Opoku Ahinkorah ◽  
Kwaku Kissah-Korsah ◽  
Ebenezer Agbaglo ◽  
Louis Kobina Dadzie ◽  
...  

Background Over the years, sanitation programs over the world have focused more on household sanitation, with limited attention towards the disposal of children’s stools. This lack of attention could be due to the misconception that children’s stools are harmless. The current study examined the individual and contextual predictors of safe disposal of children’s faeces among women in sub-Saharan Africa (SSA). Methods The study used secondary data involving 128,096 mother-child pairs of under-five children from the current Demographic and Health Surveys (DHS) in 15 sub-Saharan African countries from 2015 to 2018. Multilevel logistic analysis was used to assess the individual and contextual factors associated with the practice of safe disposal of children’s faeces. We presented the results as adjusted odds ratios (aOR) at a statistical significance of p< 0.05. Results The results show that 58.73% (57.79–59.68) of childbearing women in the 15 countries in SSA included in our study safely disposed off their children’s stools. This varied from as high as 85.90% (84.57–87.14) in Rwanda to as low as 26.38% (24.01–28.91) in Chad. At the individual level, the practice of safe disposal of children’s stools was more likely to occur among children aged 1, compared to those aged 0 [aOR = 1.74; 95% CI: 1.68–1.80] and those with diarrhoea compared to those without diarrhoea [aOR = 1.17, 95% CI: 1.13–1.21]. Mothers with primary level of education [aOR = 1.42, 95% CI: 1.30–1.5], those aged 35–39 [aOR = 1.20, 95% CI: 1.12–1.28], and those exposed to radio [aOR = 1.23, 95% CI: 1.20–1.27] were more likely to practice safe disposal of children’s stools. Conversely, the odds of safe disposal of children’s stool were lower among mothers who were married [aOR = 0.74, 95% CI: 0.69–0.80] and those who belonged to the Traditional African Religion [aOR = 0.64, 95% CI: 0.51–0.80]. With the contextual factors, women with improved water [aOR = 1.13, 95% CI: 1.10–1.16] and improved toilet facility [aOR = 5.75 95% CI: 5.55–5.95] had higher odds of safe disposal of children’s stool. On the other hand, mothers who lived in households with 5 or more children [aOR = 0.89, 95% CI: 0.86–0.93], those in rural areas [aOR = 0.86, 95% CI: 0.82–0.89], and those who lived in Central Africa [aOR = 0.19, 95% CI: 0.18–0.21] were less likely to practice safe disposal of children’s stools. Conclusion The findings indicate that between- and within-country contextual variations and commonalities need to be acknowledged in designing interventions to enhance safe disposal of children’s faeces. Audio-visual education on safe faecal disposal among rural women and large households can help enhance safe disposal. In light of the strong association between safe stool disposal and improved latrine use in SSA, governments need to develop feasible and cost-effective strategies to increase the number of households with access to improved toilet facilities.


2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 310-310
Author(s):  
Galya Bigman ◽  
Sally Adebamowo ◽  
Clement Adebamowo

Abstract Objectives To examine the association between dietary intake of beans and breast cancer in Nigerian women. Methods Overall 630 newly diagnosed patients with primary invasive breast cancer were age-matched (±5 years) with 630 controls from the Nigerian Integrative Epidemiology of Breast Cancer (NIBBLE) Study from 01/2014 to 07/2016. Dietary intakes were collected using a food frequency questionnaire (FFQ) to derive daily intake of beans. The daily bean intakes included intakes of beans alone, bean porridge, bean cake (akara), bean pudding (moinmoin), beans and corn (adalu) and bean soup (gbegiri). We categorized the daily bean intake into low, medium and high equally based on the distribution. Additional covariates included occupation, education, wealth index, contraceptive use, menopause status, number of pregnancies, breastfeeding,  Body Mass Index, Waist to Hip Ratio and physical activity. Conditional logistic regression models were utilized to estimate the crude and adjusted Odds Ratio (OR) of total beans intake per day and breast cancer. Results The mean (SD) age of the cases was 42.5 (10.1) and controls was 41.5 (9.2) years. Among controls, almost 36% consume a high intake of total bean compared to 30% among cases, whereas among the cases 37.3% consumed the low intake of total bean compared to 31.6% among controls. In the multivariable, we found a significant association between total beans intakes and breast cancer (OR = 0.85; 95% CI: 0.74–0.97, p-value = 0.02). Comparing the highest category (approximately two portions or more a day) with the lowest category (less than one portion a day), the adjusted OR was 0.72 (95% CI: 0.52–0.98, p-value for trend = 0.04). Conclusions We found a significant association between high intakes of beans and reduce risks for breast cancer. Future studies are needed to evaluate the causality of this relationship and the specific component of beans that is responsible for this reduction. Funding Sources National Human Genome Research Institute of the National Institutes of Health's African Collaborative Center for Microbiome and Genomics Research grant, Award Number U54HG006947; the Fogarty International Center of the National Institutes of Health's Training Program in Nigeria for Non-communicable Diseases Research (TRAPING NCD), Award Number D43TW009106, the Maryland Department of Health's Cigarette Restitution Fund Program.


2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Setognal Birara Aychiluhm ◽  
Kusse Urmale Mare ◽  
Mequannet Sharew Melaku ◽  
Abay Woday Tadesse

Background. Studies conducted to date in Ethiopia did not explore the spatial distribution, individual-level, and community-level factors affecting women’s nonautonomy on decision to use contraceptives. Hence, this study aimed to assess the spatial distribution of women’s nonautonomy on decision regarding contraceptive utilization and its determinants in Ethiopia. Methods. Data were accessed from the Demographic Health Survey program official database website (https://dhsprogram.com). A weighted sample of 3,668 married reproductive-age women currently using contraceptives was included in this analysis. Bayesian multilevel logistic regression models were fitted to identify the determinants of women’s nonautonomy on contraceptive utilization. Adjusted odds ratio with 95% credible interval was used to select variables that have a significant effect on nonautonomy on contraceptive utilization. Results. A high proportion of women with nonautonomy on decision regarding contraceptive utilization was found in northern parts of Southern Nations, Nationalities, and People’s Region, Southern parts of Oromia, and Benishangul-Gumuz regions of the country. Overall, 2876 (78.40% (95% CI: 77.0%, 79.7%)) women were nonautonomous on decision regarding contraceptive utilization. In the final model, age from 35–49 (AOR (95% CI) = 0.63 (0.54, 0.72)), living in the richer households (AOR (95% CI) = 0.12 (0.03, 0.26)), being married at 18 years or above (AOR (95% CI) = 0.33 (0.19, 0.57)), and residing in an rural areas (AOR (95% CI) = 1.34 (1.01, 1.71)) and metropolitan regions (AOR (95% CI) = 0.71(0.54, 0.91)) were associated with women’s nonautonomy on decision regarding contraceptive utilization. Conclusions. In Ethiopia, the spatial distribution of women’s nonautonomy on decision about contraceptive utilization was nonrandom. More than three-fourths of married reproductive-age women in Ethiopia are nonautonomous on decision regarding contraceptive utilization. Region, residence, current age, age at marriage, and wealth index were statistically associated with women’s nonautonomy on decision regarding contraceptive utilization.


2021 ◽  
Author(s):  
Hawa Kedir ◽  
Godana Arero

Abstract Background: An underweight individual is a somebody whose body weight is considered too low (BMI <18.5) to be healthy. The similar idea applies to lactating mothers. However, little is known about underweight status among lactating women in the study area. The objective of study to assess incidence of underweight and related issues among lactating mothers in Dodota district of Arsi Zone, Oromia, Ethiopia, from February 1-28, 2021.Method: The cross-sectional study design was done on 355 lactating mothers. The starata and simple random sampling technique were used. The structured questionnaire and anthropometric measurements were used. Data were entered and cleaned using Epi info version 7.1 and SPSS version 21 for analysis. Bivariate and multivariate analysis were done. Descriptive statistics wree performed. The crude and adjusted odds ratio along with 95%CI were used to measure the strength of association. The level of statistical significance was declared at a p-value < 0.05. Result: Study revealed (14.1) lactating mother were underweight. Rural areas, (AOR=2.5 [95% CI: (1.061, 6.302), the practice of food taboos (AOR= 2.3, [95% CI: (1.045, 5.084) and income level(AOR= 2.1[95% CI: (1.003, 4. 460) were found to be independent determinants of underweight among lactating mothers in the study area. Conclusions: The prevalence of underweight among lactating mothers was lower.


PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257813
Author(s):  
Abathun Temesgen ◽  
Mesafint Molla Adane ◽  
Amsalu Birara ◽  
Tebkew Shibabaw

Background Open defecation practice problem is rampant in most rural areas of developing countries, including Ethiopia. To combat this problem, the Ethiopian government implemented different sanitation interventions including Community-Led Total Sanitation and Hygiene (CLTSH). The CLTSH approach is mainly aimed to eradicate open defecation practice through mobilizing the community to construct a latrine facility and utilize it. Although this intervention has significantly improved households’ access to a latrine facility, its impact on bringing behavioral change such as avoiding open defecation is not well studied. Objective Our study aimed to assess the prevalence of open defecation among households having their latrine and its determinant factors in rural settings in Northwest Ethiopia. Methods A community-based cross-sectional study was conducted in Machakal district from September 1 to 30, 2019. A total of 472 household heads who had a latrine facility and systematically selected from six rural Kebeles of the district, were involved in the study. The data were collected using a structured questionnaire and observational checklist tools through face-to-face interviews and observation methods. Bivariate and multivariable logistic regression models were run to identify the factors that influence open defecation practice. During the multivariable analysis, statistical significance was declared at the p-value of <0.05 with 95% CI. Results The prevalence of open defecation practice among household heads who had latrine facility was 27.8% (95% CI, [23.1–32.8]). Female gender (AOR = 2.94, 95% CI [1.13–7.68]), not attending of formal education (AOR = 3.10, CI 95% [1.34–7.13]), having >5 family members (AOR = 1.72, CI 95% [1.05–2.80]), presence of under-five child (AOR = 3.64 CI 95% [2.14–6.21]), preferring leaf as anal cleaning material (AOR = 3.18, CI 95% [1.67–6.08]), having unclean latrine (AOR = 2.15, CI 95% [1.34–3.44]), and having latrine that needs maintenance (AOR = 2.50 CI 95% [1.52–4.11]) variables were associated with open defecation practice. Conclusions Among the total respondents, finding more than a quarter of open defecators is concerning for a district that achieved greatly in terms of latrine coverage. This indicates the above-mentioned factors contributed to influence household heads to defecate openly despite having latrines. Therefore, the government and partners need to focus on designing strategies that effectively address determinant factors of open defecation.


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