Adult Female Overweight and Obesity Prevalence in Seven Sub-Saharan African Countries: A Baseline Sub-National Assessment of Indicator 14 Of the Global NCD Monitoring Framework

Introduction: Decreasing overweight and obesity prevalence requires precise data at sub-national levels to monitor progress and initiate interventions. This study aimed to estimate baseline age-standardized overweight prevalence at the lowest administrative units among women, 18 years and older, in seven African countries. The study aims are synonymous with indicator 14 of the global non-communicable disease monitoring framework. Methods: We used the most recent Demographic and Health Survey and administrative boundaries data from the GADM. Three Bayesian hierarchical models were fitted and model selection tests implemented. The age-standardized prevalence of overweight among adult women at national, first and second administrative levels were individually reported in each country in the form of maps and tables. Results: Substantial variation in the age-standardized prevalence of adult female overweight was noted across several second-level administrative units. In numerous locations in Tanzania, Nigeria and Zimbabwe, more than half of the adult female population were overweight and in one location in Tanzania, over 72% of the adult female population were overweight. These estimates were roughly twice the national level overweight prevalence and, in some cases, roughly 10 – 20% greater than the overweight prevalence in first-level administrative units. Conclusion: The observed overweight burden in subnational administrative units suggests the presence of an epidemic tantamount to the situation in more affluent economies. African countries lack the resources to effectively handle the fallout from such epidemic, therefore motivating the need for increased urgency in adopting WHO obesity-related intervention guidelines and implementing more rigorous studies to validate the study findings.

Predictors of Postschool Education/Training and Employment Outcomes for Youth With Disabilities

Youth with disabilities have consistently poor postschool engagement outcomes in employment and postsecondary education and training. At least once every 6 years, states are required to submit a State Performance Plan in which they report performance on the progress of students with disabilities (20 U.S.C. 1416(b)(1)). Indicator 14 requires states to collect postschool outcome data 1 year after students exit high school. The purpose of this exploratory study was to examine the impact of student-, school-, district-level, and combined (student + school + district) factors on engagement outcomes for youth with high incidence disabilities across 3 years. Findings from logistic regression analyses indicate that student-level, district-level, and combined factors were significant in predicting postschool outcomes of employment and postsecondary education.

The Impact of IDEA Indicator 13 Compliance on Postsecondary Outcomes

Since the revision of Individuals With Disabilities Education Act (IDEA) in 2004, experts and service providers have been operating on the untested assumption that State Performance Plan Indicator 13 (transition Individualized Education Program [IEP] compliance) is a precursor to Indicator 14 (student outcomes of engagement in postsecondary education, training, and employment). This study analyzed the relationship between Indicator 13 and Indicator 14 through bivariate linear regression. The sample included student-level secondary transition data from 352 local education agencies (LEAs) in Missouri. A total of 2,123 IEP files were reviewed using a validated checklist for compliance to the IDEA transition requirements, known as Indicator 13. Indicator 14 was measured via survey responses from 4,994 high school graduates with IEPs. Results revealed statistically significant linear relationships between LEAs’ Indicator 13 compliance data and the percentage of graduates with IEPs who completed a semester of college or a career training program. Findings suggest that alternate approaches and indicators may be needed to improve postsecondary outcomes for students with and without IEPs.