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0000-0002-8694-6125
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Publisher: BMJ
Date: 05-2021
DOI: 10.1136/BMJOPEN-2020-045992
Abstract: The objective of the study was to examine the association between maternal healthcare utilisation and complete childhood vaccination in sub-Saharan Africa. Our study was a cross-sectional study that used pooled data from 29 countries in sub-Saharan Africa. A total of 60 964 mothers of children aged 11–23 months were included in the study. The main outcome variable was complete childhood vaccination. The explanatory variables were number of antenatal care (ANC) visits, assistance during delivery and postnatal care (PNC). The average prevalence of complete childhood vaccination was 85.6%, ranging from 67.0% in Ethiopia to 98.5% in Namibia. Our adjusted model, children whose mothers had a maximum of three ANC visits were 56% less likely to have complete vaccination, compared with those who had at least four ANC visits (adjusted OR (aOR)=0.44, 95% CI 0.42 to 0.46). Children whose mothers were assisted by traditional birth attendant/other (aOR=0.43, 95% CI 0.41 to 0.56) had lower odds of complete vaccination. The odds of complete vaccination were lower among children whose mothers did not attend PNC clinics (aOR=0.26, 95% CI 0.24 to 0.29) as against those whose mothers attended. The study found significant variations in complete childhood vaccination across countries in sub-Saharan Africa. Maternal healthcare utilisation (ANC visits, skilled birth delivery, PNC attendance) had significant association with complete childhood vaccination. These findings suggest that programmes, interventions and strategies aimed at improving vaccination should incorporate interventions that can enhance maternal healthcare utilisation. Such interventions can include education and sensitisation, reducing cost of maternal healthcare and encouraging male involvement in maternal healthcare service utilisation.
Publisher: Cambridge University Press (CUP)
Date: 08-06-2021
DOI: 10.1017/S0021932021000237
Abstract: People living with undiagnosed HIV are big contributors to the transmission of the virus. Although measures have been made to scale up HIV prevention and voluntary counselling and testing in sub-Saharan Africa, testing coverage remains low in many sub-Saharan African countries, including Mozambique and Kenya, where most people live with HIV/AIDS. Studies have shown that, in most countries in sub-Saharan Africa, men are less likely to test for HIV compared with women. This study examined the relationship between comprehensive HIV/AIDS knowledge and HIV testing among men in Kenya and Mozambique. Data were from the men’s re-code file of the Demographic and Health Surveys of Mozambique and Kenya. Binary logistic regression models were generated and the results presented as crude odds ratios (cOR) and adjusted odds ratios (aOR). The prevalences of HIV testing in Kenya and Mozambique were 80.1% and 46.7%, respectively. Men in Mozambique who had comprehensive HIV/AIDS knowledge (aOR=1.26, CI: 1.07–1.47) were more likely to test for HIV compared with their counterparts who had no comprehensive HIV/AIDS knowledge. In Kenya, men who had comprehensive HIV/AIDS knowledge (aOR=1.23, CI: 1.09–1.39) were more likely to test for HIV compared with their counterparts who had no comprehensive HIV/AIDS knowledge. This study found a statistically strong significant association between comprehensive HIV/AIDS knowledge and HIV testing among men in Kenya and Mozambique. To improve HIV testing rate among men, it is important that interventions are geared towards improving men’s comprehensive HIV/AIDS knowledge, perhaps by expanding HIV/AIDS education programmes and c aigns. This could improve HIV testing rates and ensure the realization of the global HIV/AIDS target of 95-95-95 by the year 2030.
Publisher: Public Library of Science (PLoS)
Date: 23-07-2020
Publisher: Springer Science and Business Media LLC
Date: 23-07-2020
DOI: 10.1186/S12914-020-00240-0
Abstract: Female genital mutilation/cutting (FGM/C) has been recognized as a gross violation of human rights of girls and women. This is well established in numerous international legal instruments. It forms part of the initiation ceremony that confers womanhood in Sierra Leone. Girls and women who are subjected to this practice are considered to be ready for marriage by their parents and communities and are rewarded with celebrations, gifts, and public recognition. Following this, we examined the relationship between education and women’s FGM/C intention for their daughters in Sierra Leone. We used cross-sectional data from the women’s file of the 2013 Sierra Leone Demographic and Health Survey (SLDHS) to explore the influence of education on FGM/C intention among women in the reproductive age (15–49). A s le of 6543 women were included in the study. Our analysis involved descriptive computation of education and FGM/C intention. This was followed by a two-level multilevel analysis. Fixed effect results were reported as Odds Ratios and Adjusted Odds Ratios with their respective credible intervals (CrIs) whilst results of the random effects were presented as variance partition coefficients and median odds ratios. Our findings showed that women who had no formal education were more likely to intend to circumcise their daughters [aOR = 4.3, CrI = 2.4–8.0]. Among the covariates, women aged 20–24 [aOR = 2.3, CrI = 1.5–3.4] were more likely to intend to circumcise their daughters compared to women between 45 and 49 years old. Poorest women were more likely to report intention of circumcising their daughters in the future compared with the richest [aOR = 2.1, CrI = 1.3–3.2]. We noted that, 63.3% of FGM/C intention in Sierra Leone is attributable to contextual factors. FGM/C intention is more common among women with no education, younger women as well as women in the lowest wealth category. We recommend segmented female-child educational and pro-poor policies that target uneducated women in Sierra Leone. The study further suggests that interventions to end FGM/C need to focus on broader contextual and social norms in Sierra Leone.
Publisher: Springer Science and Business Media LLC
Date: 02-01-2021
DOI: 10.1186/S12978-020-01057-9
Abstract: Understanding women’s desire to have more children is critical for planning towards future reproductive health behaviour. We examined the association between socio-economic and demographic factors and fertility preferences among women of reproductive age in Ghana. This study used data from the 2014 Ghana Demographic and Health Survey. The s le consisted of 5389 women of reproductive age. We fitted Binary logistic regression models to assess the association between socio-economic status and fertility preferences, whiles controlling for demographic factors. The results were presented as crude odds ratios (cORs) and adjusted odds ratios (aORs) together with their corresponding 95% confidence intervals. Approximately 60% of women of reproductive age in Ghana desired for more children. Women with no formal education were more likely to desire for more children compared to those with higher level of education (aOR = 2.16, 95% CI 1.29–3.48). The odds of desire for more children was higher among women who lived in rural areas compared to those who lived in urban areas (aOR = 1.24, 95% CI 1.01–1.53). With region, women who lived in the Northern region were more likely to desire for more children compared to those who lived in the Ashanti region (aOR = 4.03, 95% CI 2.69–6.04). Similarly, women who belonged to other ethnic groups were more likely to desire for more children compared to Akans (aOR = 1.78, 95% CI 1.35–2.35). The desire for more children was higher among women with 0–3 births compared to those with four or more births (aOR = 7.15, 95% CI 5.97–8.58). In terms of religion, Muslim women were more likely to desire for more children compared to Christians (aOR = 1.87, 95% CI 1.49–2.34). This study concludes that women in high-socio economic status are less likely to desire more children. On the other hand, women in the Northern, Upper East and those belonging to the Islamic religious sect tend to desire more children. To aid in fertility control programmes designing and strengthening of existing ones, these factors ought to be critically considered.
Publisher: Springer Science and Business Media LLC
Date: 28-12-2022
DOI: 10.1186/S12978-022-01534-3
Abstract: Utilization of contraceptives remains low in several countries in sub-Saharan Africa despite evidence of its benefits. Several factors are associated with contraceptive use. However, little is known about the association between women’s decision-making capacity and the utilization of contraceptives in Mali. This study sought to determine the association between women’s household decision-making power and contraceptive use in Mali. This study involved a cross-sectional analysis of data from the 2018 Mali Demographic and Health Survey. A total of 7893 married women were included in the final analysis. A binary logistic regression analysis was conducted with statistical significance set at p 0.05. Contraceptive use among married women in Mali was 17.1%. The odds of using contraceptives were higher among women with joint decision-making with their husbands on how to spend respondent’s earnings [aOR = 1.79 95% CI = 1.12, 2.85], joint decision-making with their husbands on what to do with their husband’s earnings [aOR = 1.43 95% CI = 1.12, 1.83], and joint decision-making with their husbands on large household purchases [aOR = 1.32 95% CI = 1.10, 1.59]. Deciding alone on a visit to family or relatives was associated with lower odds of contraceptive use [aOR = 0.72 95% CI = 0.58, 0.89]. The study has revealed that joint household decision-making is positively associated with contraceptive use. Therefore, to achieve the Sustainable Development Goal 3, the ministry for the advancement of women, children and families and related stakeholders should unearth strategies to empower women in joint decision-making and encourage men’s involvement in contraceptive decision-making.
Publisher: Springer Science and Business Media LLC
Date: 12-2020
DOI: 10.1186/S12884-020-03470-1
Abstract: Despite the extensive research on fertility desires among women the world over, there is a relative dearth of literature on the desire for more children in sub-Saharan Africa (SSA). This study, therefore, examined the desire for more children and its predictors among childbearing women in SSA. We pooled data from 32 sub-Saharan African countries’ Demographic and Health Surveys. A total of 232,784 married and cohabiting women with birth history, who had complete information on desire for more children made up the s le for the study. The outcome variable for the study was desire for more children. Multilevel logistic regression analysis was conducted. Results were presented using adjusted odds ratios (aOR), with their corresponding 95% confidence intervals (CI). The overall prevalence of the desire for more children was 64.95%, ranging from 34.9% in South Africa to 89.43% in Niger. Results of the in idual level predictors showed that women aged 45–49 [AOR = 0.04, CI = 0.03–0.05], those with higher education [AOR = 0.80, CI = 0.74–0.87], those whose partners had higher education [AOR = 0.88 CI = 0.83–0.94], women with four or more births [AOR = 0.10, CI = 0.09–0.11], those who were using contraceptives [AOR = 0.68, CI = 0.66–0.70] and those who had four or more living children [AOR = 0.09 CI = 0.07–0.12] were less likely to desire for more children. On the other hand, the odds of desire for more children was high among women who considered six or more children as the ideal number of children [AOR = 16.74, CI = 16.06–17.45] and women who did not take decisions alone [AOR = 1.58, CI = 1.51–1.65]. With the contextual factors, the odds of desire for more children was high among women who lived in rural areas compared to urban areas [AOR = 1.07, CI = 1.04–1.13]. This study found relatively high prevalence of women desiring more children. The factors associated with desire for more children are age, educational level, partners’ education, parity, current contraceptive use, ideal number of children, decision-making capacity, number of living children and place of residence. Specific public health interventions on fertility control and those aiming to design and/or strengthen existing fertility programs in SSA ought to critically consider these factors.
Publisher: Cambridge University Press (CUP)
Date: 19-03-2021
DOI: 10.1017/S0021932021000109
Abstract: Female genital mutilation (FGM) is very pervasive in Africa, with significant regional variations in the prevalence of this traditional practice. This study examined the linkages between FGM and multiple sexual partnership in Mali and Sierra Leone – two African countries with a high prevalence of FGM. Data were from the 2018 Mali and 2013 Sierra Leone Demographic and Health Surveys, and the study s le comprised 4750 women from Mali and 16,614 from Sierra Leone. Multilevel logistic regression was used for the data analysis, with reported adjusted odds ratios (aOR) and associated 95% confidence intervals. In Mali, women who had not undergone FGM were less likely to have multiple sexual partners (aOR=0.60, CI=0.38–0.96) compared with those who had undergone FGM. In Sierra Leone, women who had undergone FGM (aOR=1.15, CI=1.02–1.30) were more likely to have multiple sexual partners compared with those who had not undergone FGM. Age, level of education, wealth quintile, sex of household head, community socioeconomic status, mass media exposure, and community literacy level were found to be associated with the likelihood of multiple sexual partnership among women in Mali and Sierra Leone. Comprehensive, age-group-based risk-reduction strategies, such as abstinence education and decision-making skills (assertiveness) training, are needed to reduce girls’ and young women’s engagement in multiple sexual partnerships. Policy interventions, such as anti-FGM legislation and initiatives like the ‘Schooling for the Female Child’ initiative aimed at reducing social inequality among girls and women, might help decrease FGM and the likelihood of health-compromising behaviours like multiple sexual partnership.
No related grants have been discovered for Ebenezer Kwesi Armah-Ansah.