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 Constructing a measure of health literacy in Sub-Saharan African countries

2019 ◽  
Vol 35 (5) ◽  
pp. 907-915
Author(s):  
Heather F McClintock ◽  
Julia M Alber ◽  
Sarah J Schrauben ◽  
Carmella M Mazzola ◽  
Douglas J Wiebe
Keyword(s):  
Health Literacy ◽  
Demographic Characteristics ◽  
Sub Saharan Africa ◽  
National Study ◽  
African Countries ◽  
Good Internal Consistency ◽  
Sub Saharan ◽  
Definition Of ◽  
The Relationship ◽  
High Health Literacy

Abstract We sought to develop and evaluate a health literacy measure in a multi-national study and to examine demographic characteristics associated with health literacy. Data were obtained from Demographic Health Surveys conducted between 2006–15 in 14 countries in Sub-Saharan Africa. Surveys were the same in all countries but translated to local languages as appropriate. We identified eight questions that corresponded to the National Academy of Medicine (NAM) definition of health literacy. Factor analysis was used to extract one measure of health literacy. Logistic regression was employed to examine the relationship between demographic characteristics and health literacy. A total of 224 751 individuals between the ages of 15 and 49 years were included. The derived health literacy measure demonstrated good internal consistency (Cronbach’s α = 0.72) and good content validity. The prevalence of high health literacy overall was 35.77%; females 34.08% and males 39.17%; less than or equal to primary education 8.93%, some secondary education 69.40% and ≥complete secondary 84.35%. High health literacy varied across nations, from 8.51% in Niger to 63.89% in Namibia. This is the first known study to evaluate a measure of health literacy relying on the NAM definition utilizing a large sample from 14 countries in Sub-Saharan Africa. Our study derived a robust indicator of NAM-defined health literacy. This indicator could be used to examine determinants and outcomes of health literacy in additional countries.

scholarly journals Social Reintegration and Rehabilitation of Obstetric Fistula Patients Before and After Repair in Sub-Saharan Africa: A Systematic Review

2018 ◽  
Vol 13 (2) ◽  
pp. 5-14
Author(s):  
Atuhaire Shallon ◽  
Oladosu A. Ojengbede ◽  
John Francis Mugisha ◽  
Akin-Tunde A. Odukogbe
Keyword(s):  
Systematic Review ◽  
Obstetric Fistula ◽  
Relevant Literature ◽  
Sub Saharan Africa ◽  
Vaginal Fistula ◽  
African Countries ◽  
Social Reintegration ◽  
Open Access Journals ◽  
Before And After ◽  
Sub Saharan

Aims: Social reintegration and rehabilitation of obstetric fistula patients before and after repair enhance their overall status, which may be unattainable even with a successful repair. Nonetheless, there is little traceable documentation about it even with supportive programs and projects, the thrust of this study. Methods: This is a systematic review involving a search of relevant literature from PubMed, Google scholar, PsychINFO, African Journals Online, Australian Journals Online, and open access journals of international organizations such as WHO, UNFPA, USAID, Engender Health, Fistula Foundation and Fistula Care Plus published between 1978 to date. Of the 46 articles identified, 25 were suitable for achievement of this study’s purpose. Results:Sub-Saharan African countries have recognized the overall burden of obstetric fistula and have devised strategies for its holistic management. Most countries have National Obstetric Fistula Strategic Frameworks which emphasize multi-sectoral and multidisciplinary approaches other than medical paradigms. Social reintegration and rehabilitation have been done through the identification of individual patient’s need/s. Projects and programs aiming to combat obstetric fistula and restore patients’ self-worth and dignity are: Lamaneh Suisse, and Delta Survie in Mali, Dimol in Niger,  Medecins Sans Frontieres (MSF) in Burundi, FORWARD in Nigeria and Sierra Leone, Handicap International in Benin Republic, Women For Africa in Ghana and Liberia, TERREWODE and CoRSU both in Uganda, Hamlin Fistula Ethiopia in Ethiopia, and others which cut across the region. Conclusions: Effective social reintegration and rehabilitation strategies are still inadequate in Sub-Saharan Africa due to lack of political commitment and inadequate outreach programs. Keywords: obstetric fistula, recto-vaginal fistula, rehabilitation, social reintegration, vesico-vaginal fistula.

scholarly journals Correlates of the double burden of malnutrition among women: an analysis of cross sectional survey data from sub-Saharan Africa

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e029545 ◽  
Author(s):  
Dickson Abanimi Amugsi ◽  
Zacharie Tsala Dimbuene ◽  
Catherine Kyobutungi
Keyword(s):  
Household Wealth ◽  
Normal Weight ◽  
Overweight And Obesity ◽  
Sub Saharan Africa ◽  
Outcome Variable ◽  
Demographic And Health Surveys ◽  
African Countries ◽  
Double Burden ◽  
Double Burden Of Malnutrition ◽  
Sub Saharan

ObjectiveTo investigate the correlates of the double burden of malnutrition (DBM) among women in five sub-Saharan African countries.DesignSecondary analysis of Demographic and Health Surveys (DHS). The outcome variable was body mass index (BMI), a measure of DBM. The BMI was classified into underweight (BMI <18.50 kg/m2), normal weight (18.50–24.99 kg/m2), overweight (25.0–29.9 kg/m2) and obesity (≥30.0 kg/m2).SettingsGhana, Nigeria, Kenya, Mozambique and Democratic Republic of Congo (DRC).SubjectsWomen aged 15–49 years (n=64698).ResultsCompared with normal weight women, number of years of formal education was associated with the likelihood of being overweight and obese in Ghana, Mozambique and Nigeria, while associated with the likelihood of being underweight in Kenya and Nigeria. Older age was associated with the likelihood of being underweight, overweight and obese in all countries. Positive associations were also observed between living in better-off households and overweight and obesity, while a negative association was observed for underweight. Breastfeeding was associated with less likelihood of underweight in DRC and Nigeria, obesity in DRC and Ghana, overweight in Kenya and overweight and obesity in Mozambique and Nigeria relative to normal weight.ConclusionsOur analysis reveals that in all the countries, women who are breastfeeding are less likely to be underweight, overweight and obese. Education, age and household wealth index tend to associate with a higher likelihood of DBM among women. Interventions to address DBM should take into account the variations in the effects of these correlates.

scholarly journals Condom Use for Preventing STI/HIV and Unintended Pregnancy Among Young Men in Sub-Saharan Africa

2008 ◽  
Vol 3 (1) ◽  
pp. 60-78 ◽  
Author(s):  
Akinrinola Bankole ◽  
Susheela Singh ◽  
Rubina Hussain ◽  
Gabrielle Oestreicher
Keyword(s):  
Condom Use ◽  
Unplanned Pregnancy ◽  
Young Men ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Sexually Active ◽  
African Countries ◽  
Sexually Transmitted ◽  
Union Status ◽  
Sub Saharan

The condom is the only known method that provides simultaneous protection against unplanned pregnancy and some sexually transmitted infections (STIs), including HIV, among sexually active people. Using data from the Demographic and Health Surveys from 18 Sub-Saharan African countries, this study examined condom use and reasons for using the method at last intercourse among sexually active young men aged 15 to 29. Most young men were aware of the condom (73%-98%), but its use at last intercourse was quite variable, ranging from 6% in Madagascar to 74% in Namibia. In 10 countries, more young men reportedly used condoms for preventing STIs alone than they did for preventing pregnancy alone. In 6 countries, at least one third of the users used the method for both purposes. Use of the condom at last intercourse was associated with union status, education, residence, and exposure to television in at least two thirds of the countries.

scholarly journals Geographic coverage of demographic surveillance systems for characterising the drivers of childhood mortality in sub-Saharan Africa

2018 ◽  
Vol 3 (2) ◽  
pp. e000611 ◽  
Author(s):  
C Edson Utazi ◽  
Sujit K Sahu ◽  
Peter M Atkinson ◽  
Natalia Tejedor-Garavito ◽  
Christopher T Lloyd ◽  
...  
Keyword(s):  
International Health ◽  
Childhood Mortality ◽  
Sub Saharan Africa ◽  
Surveillance Systems ◽  
African Countries ◽  
Factors Associated ◽  
Development Goals ◽  
Sub Saharan ◽  
Reduction Of Mortality ◽  
Demographic Surveillance Systems

A major focus of international health and development goals is the reduction of mortality rates in children under 5 years of age. Achieving this requires understanding the drivers of mortality and how they vary geographically to facilitate the targeting and prioritisation of appropriate interventions. Much of our knowledge on the causes of, and trends in, childhood mortality come from longitudinal demographic surveillance sites, with a renewed focus recently on the establishment and growth of networks of sites from which standardised outputs can facilitate broader understanding of processes. To ensure that the collective outputs from surveillance sites can be used to derive a comprehensive understanding and monitoring system for driving policy on tackling childhood mortality, confidence is needed that existing and planned networks of sites are providing a reliable and representative picture of the geographical variation in factors associated with mortality. Here, we assembled subnational data on childhood mortality as well as key factors known to be associated with it from household surveys in 27 sub-Saharan African countries. We then mapped the locations of existing longitudinal demographic surveillance sites to assess the extent of current coverage of the range of factors, identifying where gaps exist. The results highlight regions with unique combinations of factors associated with childhood mortality that are poorly represented by the current distribution of sites, such as southern Mali, central Nigeria and southern Zambia. Finally, we determined where the establishment of new surveillance systems could improve coverage.

Ethnic inequality and coups in sub-Saharan Africa

2017 ◽  
Vol 54 (3) ◽  
pp. 382-396 ◽  
Author(s):  
Christian Houle ◽  
Cristina Bodea
Keyword(s):  
Ethnic Group ◽  
Ethnic Groups ◽  
Strong Support ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Ethnic Inequality ◽  
African Countries ◽  
Sub Saharan ◽  
Coups D'etat ◽  
Group Inequality

Does ethnic inequality breed coups? The recent literature on civil war shows both that inequality between ethnic groups induces war and, importantly, that civil wars and coups, although fundamentally different, are related. The literature on coups d’état, however, has yet to theorize and test the effect of ethnic inequality on coups. The link is plausible because many coups are ‘ethnic coups’, which depend on the capacity of plotters to mobilize their co-ethnics. We argue that large income and wealth disparities between ethnic groups accompanied by within-group homogeneity increase the salience of ethnicity and solidify within-group preferences vis-à-vis the preferences of other ethnic groups, increasing the appeal and feasibility of a coup. We use group-level data for 32 sub-Saharan African countries and 141 ethnic groups between 1960 and 2005 and provide the first large-N test to date of the effect of ethnic inequality on coups. Between- and within-group inequality measures are constructed based on survey data from the Afrobarometer and the Demographic and Health Surveys. We find strong support for our hypothesis: between-ethnic-group inequality (BGI) increases the likelihood that an ethnic group stages a coup only when within-ethnic-group inequality (WGI) is low. Coups remain frequent in sub-Saharan Africa and coups are the main threat to democracy in the region, by harming democratic consolidation and economic development, and by provoking further political instability. Our work provides a novel rationale to be concerned about ethnic inequality, showing that when ethnic and income cleavages overlap, destabilizing coups d’état are more likely.

Proximity and Power Factors in Western Coverage of the Sub-Saharan AIDS Crisis

2003 ◽  
Vol 80 (1) ◽  
pp. 145-165 ◽  
Author(s):  
Kristen Alley Swain
Keyword(s):  
New York ◽  
News Coverage ◽  
New York Times ◽  
The United States ◽  
Sub Saharan Africa ◽  
African Countries ◽  
Aids Crisis ◽  
World Report ◽  
Sub Saharan ◽  
The Relationship

This content analysis explores the relationship between proximity/power status factors and news coverage of AIDS in sub-Saharan Africa in the elite press of the United States and Britain. Coverage from six publications— Time, Newsweek, U.S. News & World Report, The Economist, New York Times, and London Times—was compared with reported AIDS incidence in the hardest-hit African countries over two decades. AIDS coverage was related to year of publication, country of origin, and former colony status. Strongest predictors of coverage included military spending, scientific research, GDP, GNP, population, government type, and number of highways. Proximity and power status factors may mediate the flow of capital (information, money, and goods) between dominant and dependent nations.

scholarly journals Birth registration and child undernutrition in sub-Saharan Africa

2015 ◽  
Vol 19 (10) ◽  
pp. 1757-1767 ◽  
Author(s):  
Ornella Comandini ◽  
Stefano Cabras ◽  
Elisabetta Marini
Keyword(s):  
Nutritional Status ◽  
Permutation Test ◽  
Negative Relationship ◽  
Wealth Quintile ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Birth Registration ◽  
African Countries ◽  
Cross Sectional ◽  
Sub Saharan

AbstractObjectiveIn many countries of the world millions of people are not registered at birth. However, in order to assess children’s nutritional status it is necessary to have an exact knowledge of their age. In the present paper we discuss the effects of insufficient or imprecise age data on estimates of undernutrition prevalence.DesignBirth registration rates and levels of stunting, underweight and wasting were retrieved from Multiple Indicator Cluster Surveys and Demographic and Health Surveys of thirty-seven sub-Saharan African countries, considering the subdivision in wealth quintiles. The composition of the cross-sectional sample used for nutritional evaluation was analysed using a permutation test. Logistic regression was applied to analyse the relationship between birth registration and undernutrition. The 95 % probability intervals and Student’s t test were used to evaluate the effect of age bias and error.ResultsHeterogeneous sampling designs were detected among countries, with different percentages of children selected for anthropometry. Further, registered children were slightly more represented within samples used for nutritional analysis than in the total sample. A negative relationship between birth registration and undernutrition was recognized, with registered children showing a better nutritional status than unregistered ones, even within each wealth quintile. The over- or underestimation of undernutrition in the case of systematic over- or underestimation of age, respectively, the latter being more probable, was quantified up to 28 %. Age imprecision was shown to slightly overestimate undernutrition.ConclusionsSelection bias towards registered children and underestimation of children’s age can lead to an underestimation of the prevalence of undernutrition.

scholarly journals Relationship between Public Debt Burden and Health Expenditure in Sub-Saharan African Countries: The Role of Institutional Quality

2020 ◽  
Vol 6 (2) ◽  
Author(s):  
Rusmawati Said ◽  
Abdullahi Sani Morai
Keyword(s):  
Public Debt ◽  
Health Expenditure ◽  
Institutional Quality ◽  
Sub Saharan Africa ◽  
African Countries ◽  
The Public ◽  
Debt Burden ◽  
Sub Saharan ◽  
The Relationship

The historically lower level of public health expenditure of sub-Saharan African (SSA) countries could be partly explained by the mounting debt burden of this region. This consumes a sizable proportion of their domestic resources to debt servicing and potentially decreases their overall budgetary allocations to various sectors in the economy and health expenditure in particular. Using the Generalized Method of Moments (GMM) approach on a sample of 43 sub-Saharan African countries, we examined the relationship between the public debt burden and health expenditure highlighting the role of institutional quality for the period 2000 – 2014. The empirical result confirms that the relationship between public debt burden and health expenditure in sub-Saharan Africa is negative. Interestingly, however, the marginal effect of the relationship between the public debt burden and health expenditure has shown that such a negative relationship turns out to be positive when the quality of the institutions is at maximum. This suggests that the relationship between the public debt burden and health expenditure in sub-Saharan Africa is a function of institutional quality.  Therefore, to minimize the negative impact of public debt on health expenditure in sub-Saharan Africa, governments should take determine stand to minimize its debt accumulation and intensify efforts toward the improvement of institutional quality in the region comprehensively.

scholarly journals Investigation of the Possible Moderators of Alcohol-Related Intimate Partner Violence in Sub-Saharan Africa

2021 ◽  
Vol 4 (2) ◽  
pp. 67-83
Author(s):  
Ekpenyong M.S. ◽  
Tawari E. P.2
Keyword(s):  
Intimate Partner Violence ◽  
Partner Violence ◽  
Meta Analysis ◽  
Intimate Partner ◽  
Sub Saharan Africa ◽  
Public Health Issue ◽  
Demographic And Health Surveys ◽  
African Countries ◽  
Cross Sectional ◽  
Sub Saharan

Alcohol-related intimate partner violence (IPV) is a serious public health issue which has attracted a lot of research and debates. While some studies have reported the relationship between alcohol and IPV to be linear, others have reported threshold effects. While some studies have found the link to be strong, others have reported it to be weak or to show no association. The aim of this study was to determine the possible moderators on the alcohol-IPV link in sub-Saharan Africa. For the quantitative study, secondary analysis and meta-analysis were used to analyze cross-sectional data from the demographic and health surveys of ten countries in sub-Saharan Africa (Burkina Faso, Ghana, Kenya, Liberia, Malawi, Nigeria, Sao Tome and Principe, Tanzania, Zambia, and Zimbabwe). Logistic regression analysis of possible moderators of the alcohol-IPV link was determined in ten sub-Saharan African countries. The nature of moderation was different among countries. The results of this study can be applied in planning country-specific and multi-faceted intervention programmes.

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