scholarly journals Determinants of Access to Health Care Among Women in East African Countries: A Multilevel Analysis of Recent Demographic and Health Surveys from 2008 to 2017

2020 ◽  
Vol Volume 13 ◽  
pp. 1803-1813
Author(s):  
Amare Minyihun ◽  
Zemenu Tadesse Tessema
Keyword(s):  
Health Care ◽  
Multilevel Analysis ◽  
Health Surveys ◽  
Access To Health Care ◽  
Demographic And Health Surveys ◽  
East African ◽  
African Countries ◽  
Access To Health

Using survey data: towards valid estimates of poverty in the South

2019 ◽  
pp. 79-90
Author(s):  
Roy Carr-Hill
Keyword(s):  
Developing Countries ◽  
Survey Data ◽  
Health Surveys ◽  
Urban Slums ◽  
Demographic And Health Surveys ◽  
Household Surveys ◽  
Death Registration ◽  
East African ◽  
African Countries ◽  
The World

It is important to be cautious about making inferences from survey data. This chapter focuses on one very important but unexamined problem, that of the undercount of the poorest in the world. This arises both by design (excluding the homeless, those in institutions and nomadic populations) and in practice (those in fragile households, urban slums, insecure areas and servants/slaves in rich households). In developing countries, it is difficult to make inter-censal estimates because essential data like birth and death registration are not systematically collected. Donors have therefore promoted the use of international standardized household surveys. A possible alternative is Citizen surveys initiated by an Indian NGO (Pratham). Comparisons are made between citizen surveys and contemporaneous Demographic and Health Surveys in three East African countries

scholarly journals Complete basic childhood vaccination and associated factors among children aged 12–23 months in East Africa: a multilevel analysis of recent demographic and health surveys

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Getayeneh Antehunegn Tesema ◽  
Zemenu Tadesse Tessema ◽  
Koku Sisay Tamirat ◽  
Achamyeleh Birhanu Teshale
Keyword(s):  
East Africa ◽  
Multilevel Analysis ◽  
Birth Interval ◽  
Associated Factors ◽  
Wealth Index ◽  
Childhood Vaccination ◽  
Demographic And Health Surveys ◽  
East African ◽  
African Countries ◽  
Vaccine Preventable Diseases

Abstract Background Complete childhood vaccination remains poor in Sub-Saharan Africa, despite major improvement in childhood vaccination coverage worldwide. Globally, an estimated 2.5 million children die annually from vaccine-preventable diseases. While studies are being conducted in different East African countries, there is limited evidence of complete basic childhood vaccinations and associated factors in East Africa among children aged 12–23 months. Therefore, this study aimed to investigate complete basic childhood vaccinations and associated factors among children aged 12–23 months in East Africa. Methods Based on the Demographic and Health Surveys (DHSs) of 12 East African countries (Burundi, Ethiopia, Comoros, Uganda, Rwanda, Tanzania, Mozambique, Madagascar, Zimbabwe, Kenya, Zambia, and Malawi), secondary data analysis was performed. The study included a total weighted sample of 18,811 children aged 12–23 months. The basic childhood vaccination coverage was presented using a bar graph. Multilevel binary logistic regression analysis was fitted for identifying significantly associated factors because the DHS has a hierarchical nature. The Intra-class Correlation Coefficient (ICC), Median Odds Ratio (MOR), Proportional Change in Variance (PCV), and deviance (−2LLR) were used for checking model fitness, and for model comparison. Variable with p-value ≤0.2 in the bi-variable multilevel analysis were considered for the multivariable analysis. In the multivariable multilevel analysis, the Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) were reported to declare the significance and strength of association with full vaccination. Results Complete basic childhood vaccination in East Africa was 69.21% (95% CI, 69.20, 69.21%). In the multivariable multilevel analysis; Mothers aged 25–34 years (AOR = 1.21, 95% CI: 1.10, 1.32), mothers aged 35 years and above (AOR = 1.50, 95% CI: 1.31, 1.71), maternal primary education (AOR = 1.26, 95% CI: 1.15, 1.38), maternal secondary education and above (AOR = 1.54, 95% CI: 1.36, 1.75), husband primary education (AOR = 1.25, 95% CI: 1.13, 1.39), husband secondary education and above (AOR = 1.24, 95% CI: 1.11, 1.40), media exposure (AOR = 1.23, 95% CI: 1.13, 1.33), birth interval of 24–48 months (AOR = 1.28, 95% CI: 1.15, 1.42), birth interval greater than 48 months (AOR = 1.35, 95% CI: 1.21, 1.50), having 1–3 ANC visit (AOR = 3.24, 95% CI: 2.78, 3.77), four and above ANC visit (AOR = 3.68, 95% CI: 3.17, 4.28), PNC visit (AOR = 1.34, 95% CI: 1.23, 1.47), health facility delivery (AOR = 1.48, 95% CI: 1.35, 1.62), large size at birth 1.09 (AOR = 1.09, 95% CI: 1.01, 1.19), being 4–6 births (AOR = 0.83, 95% CI: 0.75, 0.91), being above the sixth birth (AOR = 0.60, 95% CI: 0.52, 0.70), middle wealth index (AOR = 1.16, 95% CI: 1.06, 1.28), rich wealth index (AOR = 1.20, 95% CI: 1.09, 1.33), community poverty (AOR = 1.21, 95% CI: 1.11, 1.32) and country were significantly associated with complete childhood vaccination. Conclusions In East Africa, full basic childhood vaccine coverage remains a major public health concern with substantial differences across countries. Complete basic childhood vaccination was significantly associated with maternal age, maternal education, husband education, media exposure, preceding birth interval, number of ANC visits, PNC visits, place of delivery, child-size at birth, parity, wealth index, country, and community poverty. Public health interventions should therefore target children born to uneducated mothers and fathers, poor families, and those who have not used maternal health services to enhance full childhood vaccination to reduce the incidence of child mortality from vaccine-preventable diseases.

scholarly journals Determinants of access to health care for depression in 49 countries: A multilevel analysis

2018 ◽  
Vol 234 ◽  
pp. 80-88 ◽  
Author(s):  
Ricardo Araya ◽  
Pedro Zitko ◽  
Niina Markkula ◽  
Dheeraj Rai ◽  
Kelvyn Jones
Keyword(s):  
Health Care ◽  
Multilevel Analysis ◽  
Access To Health Care ◽  
Access To Health

scholarly journals Intersection of Migration and Access to Health Care: Experiences and Perceptions of Female Economic Migrants in Canada

2020 ◽  
Vol 17 (10) ◽  
pp. 3682
Author(s):  
Solina Richter ◽  
Helen Vallianatos ◽  
Jacqueline Green ◽  
Chioma Obuekwe
Keyword(s):  
South Africa ◽  
Health Care ◽  
Access To Care ◽  
Health Care System ◽  
Access To Health Care ◽  
Social Connectedness ◽  
Reproductive Age ◽  
African Countries ◽  
Access To Health ◽  
Care System

More people are migrating than ever before. There are an estimated 1 billion migrants globally—of whom, 258 million are international migrants and 763 million are internal migrants. Almost half of these migrants are women, and most are of reproductive age. Female migration has increased. The socioeconomic contexts of women migrants need investigation to better understand how migration intersects with accessing health care. We employed a focused ethnography design. We recruited 29 women from three African countries: Ghana, Nigeria, and South Africa. We used purposive and convenient sampling techniques and collected data using face-to-face interviews. Interviews were audio-recorded and transcribed verbatim. Data were analyzed with the support of ATLAS.ti 8 Windows (ATLAS.ti Scientific Software Development GmbH), a computer-based qualitative software for data management. We interviewed 10 women from both South Africa and Ghana and nine women from Nigeria. Their ages ranged between 24 and 64 years. The four themes that developed included social connectedness to navigate access to care, the influence of place of origin on access to care, experiences of financial accessibility, and historical and cultural orientation to accessing health care. It was clear that theses factors affected economic migrant women’s access to health care after migration. Canada has a universal health care system but multiple research studies have documented that migrants have significant barriers to accessing health care. Most migrants indeed arrive in Canada from a health care system that is very different than their country of origin. Access to health care is one of the most important social determinants of health.

scholarly journals Magnitudes and Determinants of Antenatal Care Utilization among Pregnant Women in East Africa: Evidence from Demographic and Health Surveys (DHS) from 2010 to 2018

2021 ◽  
Author(s):  
Temam Beshir Raru ◽  
Belay Negash ◽  
Biruk Shalmenu ◽  
Addisu Birhanu ◽  
Lemma Demissie ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Antenatal Care ◽  
East Africa ◽  
Health Surveys ◽  
Logistic Regression Model ◽  
Media Exposure ◽  
Wealth Index ◽  
Demographic And Health Surveys ◽  
East African ◽  
African Countries

Abstract Introduction: The use of antenatal care (ANC) plays a major role in minimizing maternal and child mortality through effective and appropriate screening, preventive, or treatment intervention. Despite the fact that almost all of the pregnancy-related mortalities are largely preventable through adequate use of ANC, Sub-Saharan Africa (SSA) particularly East African Countries continues to share the largest share of global maternal, and newborn mortality. Therefore, this study aimed to estimate the overall magnitude and determinants of ANC utilization in the 11 East Africa Countries from 2010 to 2018 using recent Demographic and Health Surveys (DHS)Methods: A secondary data analysis was done based on DHS from 2010 to 2018 in the 11 East African Countries. A total weighted sample of 89,991 women who gave birth in the 5 years preceding each country’s DHS survey were included in this study. Data processing and analysis were performed using STATA 15 software. Multilevel mixed effect logistic regression model was fitted. Model comparison was done based on Akaike and Bayesian Information Criteria (AIC and BIC). Variables with a p-value≤0.05 were declared as significant determinants of ANC utilization.Results: The magnitude of ANC utilization in East African Countries was 53.03% (95% CI: 52.70, 53.35) with the highest ANC utilization in Kenya (57.64%) and the lowest ANC utilization in Comoros (48.99%). In the multivariable multilevel logistic regression model; age 20-24 (Adjusted Odds Ratio (AOR) = 1.25; 95% CI; 1.17-1.34), 25-29 AOR = 1.47; 95% CI; 1.37-1.58), 30-34 (AOR = 1.58; 95% CI; 1.47-1.71), 35-39 (AOR = 1.63; 95% CI; 1.50-1.77), 40-44 (AOR = 1.64; 95% CI; 1.49-1.81), 45-49 (AOR = 1.71; 95% CI; 1.51-1.93), primary education (AOR = 1.24; 95% CI; 1.18-1.31), richest wealth index (AOR = 1.57; 95% CI; 1.47-1.67), being in rural resident (AOR = 0.93; 95% CI; 0.88,0.98), have media exposure (AOR = 1.11; 95% CI; 1.07-1.15), and being a Zimbabwe resident (AOR = 2.87; 95% CI; 2.55-3.23) were among factors that are significantly associated with ANC utilization.Conclusion: ANC utilization was low in the East Africa countries. Age, women education, wealth index, birth order, residence, media exposure and living countries were major determinants of ANC utilization. It would be useful to increase financial support strategies that enables mothers from poor households to use health services will be advantageous. To increase women’s understanding of the significance of ANC utilization, health education targeting mothers with no education is very crucial.

Structural Adjustment and Health Policy in Africa

1993 ◽  
Vol 23 (4) ◽  
pp. 717-730 ◽  
Author(s):  
Rene Loewenson
Keyword(s):  
Health Care ◽  
Health Policy ◽  
Human Resource Development ◽  
Access To Health Care ◽  
Structural Adjustment ◽  
Health Sector ◽  
Individual Responsibility ◽  
Policy Framework ◽  
African Countries ◽  
Access To Health

World Bank/International Monetary Fund Structural Adjustment Programs (SAPs) have been introduced in over 40 countries of Africa. This article outlines their economic policy measures and the experience of the countries that have introduced them, in terms of nutrition, health status, and health services. The evidence indicates that SAPs have been associated with increasing food insecurity and undernutrition, rising ill-health, and decreasing access to health care in the two-thirds or more of the population of African countries that already lives below poverty levels. SAPs have also affected health policy, with loss of a proactive health policy framework, a widening gap between the affected communities and policy makers, and the replacement of the underlying principle of equity in and social responsibility for health care by a policy in which health is a marketed commodity and access to health care becomes an individual responsibility. The author argues that there is a deep contradiction between SAPs and policies aimed at building the health of the population. Those in the health sector need to contribute to the development and advocacy of economic policies in which growth is based on human resource development, and to the development of a civic environment in Africa that can ensure the implementation of such policies.

scholarly journals The wealth gradient and the effect of COVID-19 restrictions on income loss, food insecurity and health care access in four sub-Saharan African geographies

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0260823
Author(s):  
Elizabeth Gummerson ◽  
Carolina Cardona ◽  
Philip Anglewicz ◽  
Blake Zachary ◽  
Georges Guiella ◽  
...  
Keyword(s):  
Health Care ◽  
Food Insecurity ◽  
Household Income ◽  
Access To Health Care ◽  
Economic Effects ◽  
African Countries ◽  
Income Loss ◽  
Access To Health ◽  
Nationally Representative ◽  
Representative Samples

Introduction While there has been considerable analysis of the health and economic effects of COVID-19 in the Global North, representative data on the distribution and depth of social and economic impacts in Africa has been more limited. Methods We analyze household data collected prior to the COVID-19 pandemic and during the first wave of COVID in four African countries. We evaluate the short-term changes to household economic status and assess women’s access to health care during the first wave of COVID-19 in nationally representative samples of women aged 15–49 in Kenya and Burkina Faso, and in sub-nationally representative samples of women aged 15–49 in Kinshasa, Democratic Republic of Congo and Lagos, Nigeria. We examine prevalence and distribution of household income loss, food insecurity, and access to health care during the COVID-19 lockdowns across residence and pre-pandemic wealth categories. We then regress pre-pandemic individual and household sociodemographic characteristics on the three outcomes. Results In three out of four samples, over 90% of women reported partial or complete loss of household income since the beginning of the coronavirus restrictions. Prevalence of food insecurity ranged from 17.0% (95% CI 13.6–20.9) to 39.8% (95% CI 36.0–43.7), and the majority of women in food insecure households reported increases in food insecurity during the COVID-19 restriction period. In contrast, we did not find significant barriers to accessing health care during COVID restrictions. Between 78·3% and 94·0% of women who needed health care were able successfully access it. When we examined pre-pandemic sociodemographic correlates of the outcomes, we found that the income shock of COVID-19 was substantial and distributed similarly across wealth groups, but food insecurity was concentrated among poorer households. Contrary to a-priori expectations, we find little evidence of women experiencing barriers to health care, but there is significant need for food support.

Using Technology to Improve Access to Health Care for Culturally and Linguistically Diverse Populations

2012 ◽  
Vol 19 (3) ◽  
pp. 71-76 ◽  
Author(s):  
Pauline A. Mashima
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Access To Health Care ◽  
Underserved Populations ◽  
Linguistically Diverse ◽  
Care Providers ◽  
Department Of Health ◽  
Use Of Technology ◽  
Access To Health ◽  
Improve Access

Important initiatives in health care include (a) improving access to services for disadvantaged populations, (b) providing equal access for individuals with limited or non-English proficiency, and (c) ensuring cultural competence of health-care providers to facilitate effective services for individuals from diverse racial and ethnic backgrounds (U.S. Department of Health and Human Services, Office of Minority Health, 2001). This article provides a brief overview of the use of technology by speech-language pathologists and audiologists to extend their services to underserved populations who live in remote geographic areas, or when cultural and linguistic differences impact service delivery.

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