Socioeconomic and geographic variations in antenatal care coverage in Angola: further analysis of the 2015 demographic and health survey
- Shibre, Gebretsadik, Zegeye, Betregiorgis, Idriss-Wheeler, Dina, Ahinkorah, Bright Opoku, Oladimeji, Olanrewaju, Yaya, Sanni
- Authors: Shibre, Gebretsadik , Zegeye, Betregiorgis , Idriss-Wheeler, Dina , Ahinkorah, Bright Opoku , Oladimeji, Olanrewaju , Yaya, Sanni
- Date: 2023
- Subjects: Prenatal care , Mothers -- Mortality , Health surveys
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/11260/4489 , vital:44125 , https://doi.org/10.1186/s12889-020-09320-1
- Description: In African countries, including Angola, antenatal care (ANC) coverage is suboptimal and maternal mortality is still high due to pregnancy and childbirth-related complications. There is evidence of disparities in the uptake of ANC services, however, little is known about both the socio-economic and geographic-based disparity in the use of ANC services in Angola. The aim of this study was to assess the extent of socio-economic, urban-rural and subnational inequality in ANC coverage in Angola. We analyzed data from the 2015 Angola Demographic and Health Survey (ADHS) using the World Health Organization (WHO) Health Equity Assessment Toolkit (HEAT) software. The analysis consisted of disaggregated ANC coverage rates using four equity stratifiers (economic status, education, residence, and region) and four summary measures (Difference, Population Attributable Risk, Ratio and Population Attributable Fraction). To measure statistical significance, an uncertainty interval (UI) of 95% was constructed around point estimates. The study showed both absolute and relative inequalities in coverage of ANC services in Angola. More specifically, inequality favored women who were rich (D = 54.2, 95% UI; 49.59, 58.70, PAF = 43.5, 95% UI; 40.12, 46.92), educated (PAR = 19.9, 95% UI; 18.14, 21.64, R = 2.14, 95% UI; 1.96, 2.32), living in regions such as Luanda (D = 51.7, 95% UI; 43.56, 59.85, R = 2.64, 95% UI; 2.01, 3.26) and residing in urban dwellings (PAF = 20, 95% UI; 17.70, 22.38, PAR = 12.3, 95% UI; 10.88, 13.75). The uptake of ANC services were lower among poor, uneducated, and rural residents as well as women from the Cuanza Sul region. Government policy makers must consider vulnerable subpopulations when designing needed interventions to improve ANC coverage in Angola to achieve the 2030 Sustainable Development Goal of reducing global maternal mortality ratio to 70 deaths per 100,000 live births.
- Full Text:
- Date Issued: 2023
- Authors: Shibre, Gebretsadik , Zegeye, Betregiorgis , Idriss-Wheeler, Dina , Ahinkorah, Bright Opoku , Oladimeji, Olanrewaju , Yaya, Sanni
- Date: 2023
- Subjects: Prenatal care , Mothers -- Mortality , Health surveys
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/11260/4489 , vital:44125 , https://doi.org/10.1186/s12889-020-09320-1
- Description: In African countries, including Angola, antenatal care (ANC) coverage is suboptimal and maternal mortality is still high due to pregnancy and childbirth-related complications. There is evidence of disparities in the uptake of ANC services, however, little is known about both the socio-economic and geographic-based disparity in the use of ANC services in Angola. The aim of this study was to assess the extent of socio-economic, urban-rural and subnational inequality in ANC coverage in Angola. We analyzed data from the 2015 Angola Demographic and Health Survey (ADHS) using the World Health Organization (WHO) Health Equity Assessment Toolkit (HEAT) software. The analysis consisted of disaggregated ANC coverage rates using four equity stratifiers (economic status, education, residence, and region) and four summary measures (Difference, Population Attributable Risk, Ratio and Population Attributable Fraction). To measure statistical significance, an uncertainty interval (UI) of 95% was constructed around point estimates. The study showed both absolute and relative inequalities in coverage of ANC services in Angola. More specifically, inequality favored women who were rich (D = 54.2, 95% UI; 49.59, 58.70, PAF = 43.5, 95% UI; 40.12, 46.92), educated (PAR = 19.9, 95% UI; 18.14, 21.64, R = 2.14, 95% UI; 1.96, 2.32), living in regions such as Luanda (D = 51.7, 95% UI; 43.56, 59.85, R = 2.64, 95% UI; 2.01, 3.26) and residing in urban dwellings (PAF = 20, 95% UI; 17.70, 22.38, PAR = 12.3, 95% UI; 10.88, 13.75). The uptake of ANC services were lower among poor, uneducated, and rural residents as well as women from the Cuanza Sul region. Government policy makers must consider vulnerable subpopulations when designing needed interventions to improve ANC coverage in Angola to achieve the 2030 Sustainable Development Goal of reducing global maternal mortality ratio to 70 deaths per 100,000 live births.
- Full Text:
- Date Issued: 2023
Health facility delivery and early initiation of breastfeeding: Cross-sectional survey of 11 sub-Saharan African countries
- Ameyaw, Edward K, Adde, Kenneth S, Paintsil, Jones A, Dickson, Kwamena S, Oladimeji, Olanrewaju, Yaya, Sanni
- Authors: Ameyaw, Edward K , Adde, Kenneth S , Paintsil, Jones A , Dickson, Kwamena S , Oladimeji, Olanrewaju , Yaya, Sanni
- Date: 2023/05
- Subjects: Early initiation of breastfeeding , Newborn , Neonatal health , Global health , sub-Saharan Africa
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13253 , vital:78414 , DOI: https://doi.org/10.1002/hsr2.1263
- Description: Background and Aims: Early initiation of breastfeeding (EIB) remains one of the promising interventions for preventing neonatal and child deaths. EIB is positively associated with healthcare delivery or childbirth. Meanwhile, no study in sub‐ Saharan Africa (SSA) appears to have investigated the relationship between health facility delivery and EIB; thus, we assessed the correlation between health facility delivery and EIB. Methods: We used data from the Demographic and Health Survey (DHS) of 64,506 women from 11 SSA countries. The outcome variable was whether the respondent had early breastfeeding or not. Two logistic regression models were used in the inferential analysis. With a 95% confidence interval (CI), the adjusted odds ratios (aORs) for each variable were calculated. The data set was stored, managed, and analyzed using Stata version 13. Results: The overall percentage of women who initiated early breastfeeding was 59.22%. Rwanda recorded the highest percentage of early initiation of breastfeeding (86.34%), while Gambia recorded the lowest (39.44%). The adjusted model revealed a significant association between health facility delivery and EIB (aOR = 1.80, CI = 1.73–1.87). Compared with urban women, rural women had higher likelihood of initiating early breastfeeding (aOR = 1.22, CI = 1.16–1.27). Women with a primary education (aOR = 1.26, CI = 1.20–1.32), secondary education (aOR = 1.12, CI = 1.06–1.17), and higher (aOR = 1.13, CI = 1.02–1.25), all had higher odds of initiating early breastfeeding. Women with the richest wealth status had the highest odds of initiating early breastfeeding as compared to the poorest women (aOR = 1.33, CI = 1.23–1.43). Conclusion: Based on our findings, we strongly advocate for the integration of EIB policies and initiatives with healthcare delivery advocacy. Integration of these efforts can result in drastic reduction in infant and child mortality. Essentially, Gambia and other countries with a lower proclivity for EIB must reconsider their current breastfeeding interventions and conduct the necessary reviews and modifications that can lead to an increase in EIB.
- Full Text:
- Date Issued: 2023/05
- Authors: Ameyaw, Edward K , Adde, Kenneth S , Paintsil, Jones A , Dickson, Kwamena S , Oladimeji, Olanrewaju , Yaya, Sanni
- Date: 2023/05
- Subjects: Early initiation of breastfeeding , Newborn , Neonatal health , Global health , sub-Saharan Africa
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13253 , vital:78414 , DOI: https://doi.org/10.1002/hsr2.1263
- Description: Background and Aims: Early initiation of breastfeeding (EIB) remains one of the promising interventions for preventing neonatal and child deaths. EIB is positively associated with healthcare delivery or childbirth. Meanwhile, no study in sub‐ Saharan Africa (SSA) appears to have investigated the relationship between health facility delivery and EIB; thus, we assessed the correlation between health facility delivery and EIB. Methods: We used data from the Demographic and Health Survey (DHS) of 64,506 women from 11 SSA countries. The outcome variable was whether the respondent had early breastfeeding or not. Two logistic regression models were used in the inferential analysis. With a 95% confidence interval (CI), the adjusted odds ratios (aORs) for each variable were calculated. The data set was stored, managed, and analyzed using Stata version 13. Results: The overall percentage of women who initiated early breastfeeding was 59.22%. Rwanda recorded the highest percentage of early initiation of breastfeeding (86.34%), while Gambia recorded the lowest (39.44%). The adjusted model revealed a significant association between health facility delivery and EIB (aOR = 1.80, CI = 1.73–1.87). Compared with urban women, rural women had higher likelihood of initiating early breastfeeding (aOR = 1.22, CI = 1.16–1.27). Women with a primary education (aOR = 1.26, CI = 1.20–1.32), secondary education (aOR = 1.12, CI = 1.06–1.17), and higher (aOR = 1.13, CI = 1.02–1.25), all had higher odds of initiating early breastfeeding. Women with the richest wealth status had the highest odds of initiating early breastfeeding as compared to the poorest women (aOR = 1.33, CI = 1.23–1.43). Conclusion: Based on our findings, we strongly advocate for the integration of EIB policies and initiatives with healthcare delivery advocacy. Integration of these efforts can result in drastic reduction in infant and child mortality. Essentially, Gambia and other countries with a lower proclivity for EIB must reconsider their current breastfeeding interventions and conduct the necessary reviews and modifications that can lead to an increase in EIB.
- Full Text:
- Date Issued: 2023/05
Prevalence and factors associated with HIV treatment non-adherence among people living with HIV in three regions of Cameroon: A cross-sectional study
- Buh, Amos, Deonandan, Raywat, Gomes, James, Krentel, Alison, Oladimeji, Olanrewaju, Yaya, Sanni
- Authors: Buh, Amos , Deonandan, Raywat , Gomes, James , Krentel, Alison , Oladimeji, Olanrewaju , Yaya, Sanni
- Date: 2023/04
- Subjects: hiv treatment , non-adherence , young people
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13281 , vital:78419 , DOI: https://doi.org/10.1371/journal.pone.0283991
- Description: Background: In Cameroon, HIV care decentralization is enforced as a national policy, but follow-up of people living with HIV (PLWH) is provider-driven, with little patient education and limited patient participation in clinical surveillance. These types of services can result in low antiretroviral therapy (ART) adherence. The objective of this study was to assess the prevalence and predictors of ART non-adherence among PLWH in Cameroon. Methods: A cross-sectional descriptive study of PLWH in HIV treatment centres in Cameroon was conducted. Only PLWH, receiving treatment in a treatment centre within the country, who had been on treatment for at least six months and who were at least 21 years old were included in the study. Individuals were interviewed about their demographics and ART experiences. Data were collected using a structured interviewer-administered questionnaire and analyzed using STATA version 14...
- Full Text:
- Date Issued: 2023/04
- Authors: Buh, Amos , Deonandan, Raywat , Gomes, James , Krentel, Alison , Oladimeji, Olanrewaju , Yaya, Sanni
- Date: 2023/04
- Subjects: hiv treatment , non-adherence , young people
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13281 , vital:78419 , DOI: https://doi.org/10.1371/journal.pone.0283991
- Description: Background: In Cameroon, HIV care decentralization is enforced as a national policy, but follow-up of people living with HIV (PLWH) is provider-driven, with little patient education and limited patient participation in clinical surveillance. These types of services can result in low antiretroviral therapy (ART) adherence. The objective of this study was to assess the prevalence and predictors of ART non-adherence among PLWH in Cameroon. Methods: A cross-sectional descriptive study of PLWH in HIV treatment centres in Cameroon was conducted. Only PLWH, receiving treatment in a treatment centre within the country, who had been on treatment for at least six months and who were at least 21 years old were included in the study. Individuals were interviewed about their demographics and ART experiences. Data were collected using a structured interviewer-administered questionnaire and analyzed using STATA version 14...
- Full Text:
- Date Issued: 2023/04
Exploring health insurance and knowledge of the ovulatory cycle: evidence from Demographic and Health Surveys of 29 countries in Sub-Saharan Africa
- Zegeye, Betregiorgis, Idriss-Wheeler, Dina, Yaya, Sanni
- Authors: Zegeye, Betregiorgis , Idriss-Wheeler, Dina , Yaya, Sanni
- Date: 2023/09
- Subjects: health insurance , ovulactory cycle , Sub-Saharan Africa
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13311 , vital:78423 , DOI: https://doi.org/10.1186/s12978-023-01675-z
- Description: Background Unplanned pregnancy continues to be a major public health concern in Sub-Saharan Africa (SSA). Understanding the ovulatory cycle can help women avoid unplanned pregnancy. Though a wide range of factors for ovulatory cycle knowledge in SSA countries has not been well assessed, the infuence of health insurance on ovu‑ latory cycle knowledge is largely unknown. As a result, we set out to investigate the relationship between health insurance enrollment and knowledge of the ovulatory cycle among women of childbearing age. This study aims to investigate the relationship between health insurance enrollment and knowledge of the ovulatory cycle among women of childbearing age in sub-Saharan Africa (SSA). Methods Demographic and Health Surveys (DHSs) data from 29 SSA countries were analyzed. The association between health insurance and ovulatory cycle knowledge was investigated using bivariate and multivariate multi‑ level logistic regression models among 372,692 women of reproductive age (15–49). The fndings were presented as adjusted odds ratios (AOR) with 95% confdence intervals (CI). A p-value of 0.05 was considered statistically signifcant. Results The pooled result shows that the prevalence of knowledge of ovulatory cycle in the studied 29 SSA countries was 25.5% (95% CI; 24.4%-26.6%). Findings suggest higher odds of ovulatory cycle knowledge among women cov‑ ered by health insurance (AOR=1.27, 95% CI; 1.02–1.57), with higher education (higher-AOR=2.83, 95% CI; 1.95– 4.09), from the richest wealth quintile (richest-AOR=1.39, 95% CI; 1.04–1.87), and from female headed households (AOR=1.16, 95% CI; 1.01–1.33) compared to women who had no formal education, were from the poorest wealth quintile and belonged to male headed households, respectively. We found lower odds of ovulatory cycle knowledge among women who had 2–4 parity history (AOR=0.80, 95% CI; 0.65–0.99) compared to those with history of one parity. Conclusions The fndings indicate that the knowledge of the ovulatory cycle is lacking in SSA. Improving health insurance enrollment should be considered to increase ovulatory cycle knowledge as an approach to reduce the region’s unplanned pregnancy rate. Strategies for improving opportunities that contribute to women’s empower‑ ment and autonomy as well as sexual and reproductive health approaches targeting women who are in poorest quin‑ tiles, not formally educated, belonging to male headed households, and having high parity should be considered.
- Full Text:
- Date Issued: 2023/09
- Authors: Zegeye, Betregiorgis , Idriss-Wheeler, Dina , Yaya, Sanni
- Date: 2023/09
- Subjects: health insurance , ovulactory cycle , Sub-Saharan Africa
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13311 , vital:78423 , DOI: https://doi.org/10.1186/s12978-023-01675-z
- Description: Background Unplanned pregnancy continues to be a major public health concern in Sub-Saharan Africa (SSA). Understanding the ovulatory cycle can help women avoid unplanned pregnancy. Though a wide range of factors for ovulatory cycle knowledge in SSA countries has not been well assessed, the infuence of health insurance on ovu‑ latory cycle knowledge is largely unknown. As a result, we set out to investigate the relationship between health insurance enrollment and knowledge of the ovulatory cycle among women of childbearing age. This study aims to investigate the relationship between health insurance enrollment and knowledge of the ovulatory cycle among women of childbearing age in sub-Saharan Africa (SSA). Methods Demographic and Health Surveys (DHSs) data from 29 SSA countries were analyzed. The association between health insurance and ovulatory cycle knowledge was investigated using bivariate and multivariate multi‑ level logistic regression models among 372,692 women of reproductive age (15–49). The fndings were presented as adjusted odds ratios (AOR) with 95% confdence intervals (CI). A p-value of 0.05 was considered statistically signifcant. Results The pooled result shows that the prevalence of knowledge of ovulatory cycle in the studied 29 SSA countries was 25.5% (95% CI; 24.4%-26.6%). Findings suggest higher odds of ovulatory cycle knowledge among women cov‑ ered by health insurance (AOR=1.27, 95% CI; 1.02–1.57), with higher education (higher-AOR=2.83, 95% CI; 1.95– 4.09), from the richest wealth quintile (richest-AOR=1.39, 95% CI; 1.04–1.87), and from female headed households (AOR=1.16, 95% CI; 1.01–1.33) compared to women who had no formal education, were from the poorest wealth quintile and belonged to male headed households, respectively. We found lower odds of ovulatory cycle knowledge among women who had 2–4 parity history (AOR=0.80, 95% CI; 0.65–0.99) compared to those with history of one parity. Conclusions The fndings indicate that the knowledge of the ovulatory cycle is lacking in SSA. Improving health insurance enrollment should be considered to increase ovulatory cycle knowledge as an approach to reduce the region’s unplanned pregnancy rate. Strategies for improving opportunities that contribute to women’s empower‑ ment and autonomy as well as sexual and reproductive health approaches targeting women who are in poorest quin‑ tiles, not formally educated, belonging to male headed households, and having high parity should be considered.
- Full Text:
- Date Issued: 2023/09
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