Behavior In sub-Saharan Africa Research Articles

Influence of socio-contextual factors on the link between traditional and new media use, and young people’s sexual risk behaviour in Sub-Saharan Africa: a secondary data analysis

BackgroundTraditional and new media use links to young people’s sexual risk behaviour. The social contexts of young people’s daily lives that influence media use and sexual risk behaviour are often investigated as independent causal mechanisms. We examined the link between media use and young people’s sexual risk behaviour, considering the intersecting socio-contextual factors in Sub-Saharan Africa.MethodsAge-adjusted bivariate logistic regression models tested the association between traditional media (TV, radio, and newspapers), and new media (mobile phone and online) use and sexual risk behaviour using the Demographic and Health Surveys from six Sub-Saharan African countries among unmarried sexually active youths, aged 15–24 years. Multivariate logistic regression models ascertained the media sources that had an additional influence on young people’s sexual risk behaviour, after accounting for socio-contextual factors, and knowledge about HIV and other sexually transmitted infections.ResultsSocio-contextual factors attenuated the association between media use and young people’s sexual risk behaviour in many countries. However, those who did not have access to new and traditional media were more likely to use unreliable contraceptive methods or not use contraception. Adolescents in Nigeria who did not own phones were 89% more likely to use unreliable contraceptive methods or not use any methods [(AOR = 1.89 (1.40–2.56), p < .001)], those in Angola who did not read newspapers had higher odds of not using contraception or used unreliable methods [(aOR = 1.65 (1.26–2.15), p < .001)]. Young people in Angola (aOR = 0.68 (0.56–0.83), p < .001), Cameroon [(aOR = 0.66 (0.51–0.84), p < .001)], Nigeria [(aOR = 0.72 (0.56–0.93), p = .01)], and South Africa [(aOR = 0.69 (0.49–0.98), p = .03)] who did not own phones were less likely to have 2 or more sexual partners compared to those who owned phones. Lack of internet access in Mali was associated with lower odds of having 2 or more sexual partners (aOR = 0.45 (0.29–0.70), p < .001). Traditional media use was significantly associated with transactional sex in many countries.ConclusionsMedia use is linked to sexual risk behaviour among young people in Sub-Saharan Africa. Socioeconomic inequalities, levels of globalization, as well as rural–urban disparities in access to media, underscore the need to deliver tailored and targeted sexual risk reduction interventions to young people using both traditional and new media.

"My Mother Persuaded Me to Have More Children", Understanding the Influence of Social Network on Fertility Behavior in Sub-Saharan Africa.

Introduction: Despite the adoption of an antenatal demographic transition model in sub-Saharan Africa, population growth continues to soar in the region. The reasons for population growth are nebulous and should be approached from different perspectives. Inadequate attention has been paid to how social pressures shape reproductive behavior. Thus, this study examines the association between social networks and fertility behavior in sub-Saharan Africa. Methods: This study used a cross-sectional design that employed a qualitative method to conduct 28 in-depth interviews among married women. Data was collected in 2023. Thematic analyses were utilized to interpret the results. Results: Parental pressure, the desire for more children, the desire for male children, values placed on children, norms, and pronatalist culture were associated with high fertility in sub-Saharan Africa. Conclusions: Thus, there is a need for more awareness of family planning and contraceptive use in order to reduce fertility in sub-Saharan Africa.

Influence of type of violence on women's help-seeking behaviour: Evidence from 10 countries in sub-Saharan Africa.

Intimate partner violence (IPV) is a major public health concern that mostly impacts women's health and social well-being. This study explored how the various types of IPV (physical, sexual, and emotional) including women's experience of childhood violence influence their help-seeking behavior in sub-Saharan Africa (SSA). We analyzed data from the most recent Demographic and Health Surveys (DHS), carried out between 2018 and 2021. The outcome variable was help-seeking behavior. Descriptive and inferential analyses were carried out. The descriptive analysis looked at the bivariate analysis between the country and outcome variables. Using a binary logistic regression model, a multivariate analysis was utilized to determine the association between the outcome variable and the explanatory variables. Binary logistic regression modelling was used based on the dichotomous nature of the outcome variable. The results were sample-weighted to account for any under- or over-sampling in the sample. The proportion of women who sought help for intimate partner violence was 36.1 percent. This ranged from 19.2 percent in Mali to 49.6 percent in Rwanda. Women who experienced violence in childhood (OR = 0.75, CI = 0.69, 0.82) have a lower likelihood of seeking help compared to those who did not experience violence in their childhood. Women who had experienced emotional violence (OR = 1.94, CI = 1.80, 2.08), and physical violence (OR = 1.37, CI = 1.26, 1.48) have a higher likelihood of seeking help compared to those who have not. Women with secondary educational levels (aOR = 1.13, CI = = 1.02, 1.24) have a higher likelihood of seeking help compared to those with no education. Cohabiting women have a higher likelihood (aOR = 1.22, CI = 1.10, 1.35) of seeking help compared to married women. The study highlights the importance of early identification of IPV and fit-for-purpose interventions to demystify IPV normalization to enhance women's willingness to seek help. The study's findings suggest that education is crucial for increasing women's awareness of the legalities surrounding IPV and available structures and institutions for seeking help.

The Influence of Social Media on Consumer Behavior in Sub-Saharan Africa: An Empirical Evidence from Ghana

Social media network platforms have been widely accepted in Africa. Many policymakers argue that social media is a retarding factor of development dynamics of countries. Countries have developed ambiguous security reasons to ban and suppress social media accessibility. This paper seeks to examine how social media gears and steers the transactional behavior of consumers. Social media has a unique influence on the various stages of commodity transactions and the decision-making process. The prompt aim of the study is to explore the influence of social media on the purchase and interactive decisions of Ghanaian consumers. The study uses quantitative data analysis method to analyze survey data to achieve the objectives of this study. Overall, social media has a significant influence on consumer behavior in Ghana, particularly higher in the areas of information and commodity search as well as post-purchase decisions than in real-time purchase decisions.

Perinatal suicidal behavior in sub-Saharan Africa: A study protocol for a systematic review with meta-analysis.

Perinatal mental illnesses are predominant during gestation and continue for a year after delivery. According to the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10), suicide is classified as a direct cause of death among the maternal population. The occurrence of suicidal behavior among perinatal women was considered the main contributor to the burden of the disorder. Hence, the current study will develop a protocol for a systematic review as well as a meta-analysis on estimating the prevalence and determinants of perinatal suicidal behavior in Sub-Saharan African countries. PubMed/MEDLINE, Scopus, EMBASE, PsycINFO, and the Web of Science electronic databases will be searched for studies reporting primary data. The second search strategy will be done with Google Scholar, using a combination of the medical subject headings and keywords as the search terms. The studies will be classified into included, excluded, and undecided categories. The studies will be judged based on the eligibility criteria. Heterogeneity will be checked by using the I2 test (Cochran Q test) at a p-value of 0.05 and assuming that the I2 value is > 50%. Publication bias will be checked using a funnel plot, Beg's rank, and Eggers linear statistical tests. A subgroup analysis and sensitivity test will be carried out. The risk of bias will be assessed using the Joanna Briggs Institute (JBI), and the quantitative analysis will determine whether or not to proceed based on the results. This protocol's comprehensive review is expected to generate sufficient evidence on the prevalence of suicidal behavior and its determinants among women during the perinatal period in Sub-Saharan African countries over the last two decades. Hence, this protocol will be imperative to collect and combine empirical data on suicidal behavior during the perinatal period, and doing so will help to provide essential implications or better evidence to plan different kinds of interventions considering determinants expected to impact the burden of suicidal behavior during the perinatal period. PROSPERO (CRD42022331544).

Risky Sexual Behaviour among HIV-Infected Adults in Sub-Saharan Africa: A Systematic Review and Meta-Analysis.

Risky sexual behaviour raises serious public health concerns. The pooled prevalence of risky sexual behaviours among adults living with HIV/AIDS in sub-Saharan Africa was unknown. This systematic review determined the pooled prevalence of risky sexual behaviours and associated factors among HIV-infected adults in sub-Saharan Africa. International databases such as PubMed, CINAHL, Google Scholar, and African Journals OnLine were systematically searched to identify articles. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline was used to conduct the review. All necessary data were extracted independently. Heterogeneity and publication bias were assessed by I-squared statistics and Egger's test, respectively. The random-effects meta-analysis model was used to estimate the pooled prevalence. The association between predictors and dependent variable was determined by a pooled odds ratio (OR) with a 95% confidence interval (CI). In this study, 3713 articles were retrieved from various databases, and 22 of them were included. The pooled prevalence of risky sexual behaviour in sub-Saharan Africa was 36.16% (95% CI: 28.36-44.34) with significant heterogeneity among studies (I2 = 98.86%, p < 0.001). Risky sexual behaviour was significantly associated with the nondisclosure of HIV status (AOR = 1.97, 95% CI: 1.18, 2.76) and alcohol consumption (AOR = 2.29, 95% CI: 1.21, 3.36). A significant percentage of participants engaged in risky sexual behaviour. Risky sexual behaviour was associated with failure to disclose HIV status and alcohol consumption. Healthcare professionals should advise HIV-positive patients on risk reduction measures like disclosing their HIV status to their sexual partners and avoiding alcohol use in order to promote consistent condom use. PROSPERO Protocol Registration. The protocol for this systematic review and meta-analysis has been registered (record ID: CRD42020170967, 09/06/2022).

Severity of Lifetime Physical Intimate Partner Violence and Controlling Behavior in Sub-Saharan Africa.

Evidence suggestswomen in sub-Saharan Africa may be more likely to experience intimate partner violence (IPV) than women anywhere else in the world.Data was obtained from women (n = 29,444) who completed the Demographic Health Survey's (DHS) domestic violence module in seven countries in sub-Saharan Africa countries between 2011 and 2015. Women who reported controlling behavior by a spouse/partner were more likely to have experienced less severe lifetime physical violence (adjusted odds ratio (AOR) 3.02, 95% confidence interval (CI) 2.63, 3.47) and severe violence (AOR 4.27, 95% CI 3.32, 5.49). Partner's controlling behavior may increase the likelihood of experiencing both less severe and severe lifetime physical violence.

Older Adults Vastly Overestimate Both HIV Acquisition Risk and HIV Prevalence in Rural South Africa

Perceptions of HIV acquisition risk and prevalence shape sexual behavior in sub-Saharan Africa (SSA). We used data from the Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa baseline survey. Data were collected through home-based interviews of 5059 people ≥ 40 years old. We elicited information on perceived risk of HIV acquisition and HIV prevalence among adults ≥ 15 and ≥ 50 years old. We first describe these perceptions in key subgroups and then compared them to actual estimates for this cohort. We then evaluated the relationship between sociodemographic characteristics and accurate perceptions of prevalence in regression models. Finally, we explored differences in behavioral characteristics among those who overestimated risk compared to those who underestimated or accurately estimated risk. Compared to the actual HIV acquisition risk of < 1%, respondents vastly overestimated this risk: 35% (95% CI: 32–37) and 34% (95% CI: 32–36) for men and women, respectively. Respondents overestimated HIV prevalence at 53% (95% CI: 52–53) for those ≥ 15 years old and 48% (95% CI: 48–49) for those ≥ 50 years old. True values were less than half of these estimates. There were few significant associations between demographic characteristics and accuracy. Finally, high overestimators of HIV prevalence tested themselves less for HIV compared to mild overestimators and accurate reporters. More than 30 years into the HIV epidemic, older people in a community with hyperendemic HIV in SSA vastly overestimate both HIV acquisition risk and prevalence. These misperceptions may lead to fatalism and reduced motivation for prevention efforts, possibly explaining the continued high HIV incidence in this community.

Intimate partner violence severity and controlling behavior in Sub-Saharan Africa

Intimate partner violence severity and controlling behavior in Sub-Saharan Africa

Turkey’s Foreign Aid to Africa: An Analysis of the Post-July 15 Era

ABSTRACT The volume of Turkish aid and its geographic coverage have undergone a process of change following the Arab Uprisings and the foiled coup d’état of July 15. This article primarily addresses the latter event, as with the former’s influence foreign aid relations became more tight-knit with Turkey’s immediate neighbours yet fell apart in areas such as sub-Saharan Africa. Considering the period between 2013 and 2018, this paper seeks the key determinants behind Turkish foreign aid behaviour in sub-Saharan Africa by asking whether the (non)existence of Gülenist schools in recipient states exerted agency in the disbursement of Turkey’s aid flow. Based on bilateral foreign aid disbursement and the Turkish Maarif Foundation’s educational landscape in sub-Saharan Africa, this paper has found that although the recipient state’s cooperation with Turkey on the matter of Gülenist schools is a variable of moderate importance in gauging the volume of Turkish aid, there is no monolithic Turkish foreign aid orientation towards the countries collaborating with Turkish authorities to transfer the management of these schools and those that do not. This orientation has been firmly motivated by humanitarianism and has thus assured continuity in the context of humanitarian aid following July 15.

Assessing SMEs tax non-compliance behaviour in Sub-Saharan Africa (SSA): An insight from Nigeria

The existing studies on determinants of small and medium enterprises (SMEs) tax compliance behaviour in Sub-Saharan Africa have been criticised on account of limited study scope which compromises g...

Africa’s heterogeneous middle class: A 10-city study of consumer lifestyle indicators

Income and living standards measures have long been used in market research and marketing in Africa. This study examined a set of lifestyle indicators (both belongings and behaviors) to determine their success in profiling middle-class consumers in sub-Saharan Africa. The African middle class exhibits robust growth and the definition of the lifestyle of these consumers is a major topic for debate between researchers and marketing organizations. Existing absolute monetary definitions do not adequately provide insights into the true nature of middle-class consumer behavior in sub-Saharan Africa. Similarly, current living standards measures are very focused on capturing consumer durables but do not consider other daily lifestyle factors. By analyzing six key lifestyle indicators (housing, income and expenditure, education, employment, mobile and internet penetration, and health care), middle-class lifestyle was assessed in 10 cities across sub-Saharan Africa. The research used a multi-method approach by designing a structured questionnaire that was completed by a probability sample of 6,465 participants from the sample cities. The study found large lifestyle differences between cities and that no single lifestyle indicator could be applied to all middle-class consumers across the cities. The implications of these findings relate directly to understanding broad middle-class consumer behavior. Specifically, international businesses targeting middle-class growth in Africa must consider both the similarities and differences between countries when proposing strategies to successfully engage middle-class consumers in sub-Saharan Africa.

Descriptive analysis of men’s sexual behaviour in sub-Saharan Africa: Simplicity-parsimony approach

The interconnection between men’s sexual behaviour as a contributor to burden of reproductive and sexual health diseases in sub-Saharan Africa are often presented with complex and sophisticated statistical analyses with little or no comprehension among the affected population that are mostly with little or no statistical literacy and education. The study adopted simplicity-parsimony idea as amalgam of simplicity and parsimony theories in analysing the trends and patterns of men’s sexual behaviour in Ethiopia, Nigeria and Zambia, the three countries selected from Eastern, Western and Southern parts of sub-Saharan Africa. Demographic Health Survey male-recode datasets (2000–2014) were used. Simple descriptive statistical techniques at univariate and bivariate levels were conducted. The results highlighted that men’s sexual behaviour are not the same in these regions. The men median sexual debut is 18 (Nigeria and Ethiopia) but 16 in Zambia. The median age at first cohabitation differs: 22 in Zambia and Ethiopia but higher in Nigeria. From 2000/2004 to 2010/2014, cohabitation practice reduced in Ethiopia across all ages but increased among men aged 25–29 (Zambia: 14.7–15.0%, Nigeria: 13.3–13.9%). There were declined in union-turnover in Ethiopia (−8.8%), Nigeria (−11.4%) and Zambia (−9.3%) including condom use; but non-spousal sex increased. The study concludes that the increase in non-spousal sex, non-condom use could have implications for STIs/HIV spread and zero-AIDS deaths agenda in the region. The authors suggest that policy decision-takers focus on non-spousal sex, non-use of condom, and union-turnover as crucial factors in the fight against STIs/HIV in sub-Saharan Africa.

Jumia travel in Africa: expanding the boundaries of the online travel agency business model

Purpose This study aims to analyse the business model of Jumia Travel, an innovative online travel agency (OTA) that operates in African markets. Focusing on market conditions and consumer behaviour in sub-Saharan Africa, where barriers to e-commerce are strong and tourism is viewed as a non-essential activity, the study examines the ways in which Jumia Travel carries out its development objectives in Côte d’Ivoire and revamps the OTA business model in relation to market constraints. Design/methodology/approach The study uses a descriptive-qualitative method based on desk research analysis of corporate sources, including websites, annual reports, public interviews of managers and newspaper articles. It also draws on primary sources collected through interviews with the Jumia Travel Côte d’Ivoire country manager. Findings The research shows that the demand- and supply-side constraints of African markets compel Jumia Travel to acquire new skills and competencies to adapt to and capture the Ivorian travel market. In doing so, the company expands the boundaries of the traditional OTA business models found in developed markets, demonstrating the dynamic capabilities that drive OTA business model transformation when deployed in a technologically immature market. Research limitations/implications The Jumia Travel venture provides an insight into the constraints faced by an OTA at the bottom of the pyramid and in emerging markets and shows concretely what skills and competencies are required to overcome them. It is also a new experiment still in the early stages of development, and this limits the proper assessment of sustainability of its business model. Originality/value This study examines a unique experience: an unconventional OTA that concentrates exclusively on domestic and regional markets in sub-Saharan Africa. The business model lens brings into focus the operational limits and innovation opportunities of developing an e-travel business in the fast-growing markets of Africa, characterised by major supply-side constraints, the predominance of low-income consumers and a poorly structured travel industry. In this context, OTAs’ innovation challenge is no longer to disrupt the travel sector in differentiating from competitors, as was the case in the mature markets of the first world but to develop business processes suitable for operating in the constraint-based environment of emerging markets and capturing the rising demand for travel products. This involves co-creating value in linking African hotel providers and clients and increasing economic returns from this value through various business model adaptations designed for and with local consumers and partners.

Safety in stigmatizing? Instrumental stigma beliefs and protective sexual behavior in Sub-Saharan Africa

How are people's expression of HIV stigma beliefs connected to their own personal decisions concerning safe sexual practices? Does this relationship vary across countries and by the national context in which people reside? To answer these questions, we develop and test individual, contextual, and cross-level interactional hypotheses of the impact of instrumental HIV stigma attitudes on several measures of protective sexual behavior. Using Demographic and Health Survey data from 467,656 unpartnered individuals across 34 sub-Saharan African countries, we first find that counterintuitively, conservative HIV stigma attitudes are associated with lower likelihoods of participating in all types of protective sexual behaviors. Second, this negative relationship is most pronounced in the Southern and Eastern regions of Africa, where HIV prevalence is highest. Together, these findings suggest that stigma beliefs can shape private behaviors in counterintuitive yet important ways that have profound implications for current epidemiological and public health approaches to slowing the spread of HIV.

Electoral Behavior in Sub-Saharan Africa: Explanatory Factors and Implications: An Exploratory Study

Electoral Behavior in Sub-Saharan Africa: Explanatory Factors and Implications: An Exploratory Study

Motivational and Parental Mediation Factors Related to Kenyan Adolescents’ Intake of Sexual Radio and TV Content

ABSTRACTResearch on the influence of media on youths’ sexual behavior in sub-Saharan Africa has focused almost entirely on the effects of multimedia health communication campaigns and edutainment programming. Scholarly literature is nearly silent about the influence of the multiple hours that young people in many sub-Saharan nations spend immersed in increasingly sex-heavy entertainment programming. We surveyed a stratified cluster sample of 437 Nairobi public high school students about motivational and parental mediation factors associated with their exposure to sexual radio and TV content. Watching sexual content in the bedroom predicted higher intake of both sexual radio and TV content. Believing that parents were successful in their efforts to limit media use predicted lower intake of both sexual radio and TV content. A friend/companion motive for watching was associated with taking in higher levels of sexual TV content. For day school students, watching sexual content in the sitting room also predicted higher levels of exposure to sexual TV content.

An analysis of calendar data: examining contraceptive use dynamics in Uganda

The analysis of contraceptive calendar data offers a valuable and useful approach to enhancing our understanding of patterns of contraceptive use in the developing world. Effective use of modern contraception is believed to be the surest way to plan for births and avert unwanted fertility. Despite the role that contraception plays in reducing fertility, sexually active women (especially those in sub-Saharan Africa), continue to grapple with unwanted and mistimed pregnancies. In many instances, this results in unsafe induced abortion, with its attendant risks to maternal health. Sub-optimal use of contraception is likely to attenuate fertility transition in the region. Using calendar data from two Demographic and Health Surveys conducted in Uganda, we adopt a longitudinal approach to examine method discontinuation and switching patterns following stopping use of a contraceptive method. Discontinuation of methods was more pronounced among women using the pill and injection. The findings provide a basis for a discussion on the implications of reproductive behaviour in sub-Saharan Africa.

Abstinence Funding Was Not Associated With Reductions In HIV Risk Behavior In Sub-Saharan Africa.

The President's Emergency Plan for AIDS Relief (PEPFAR) has been the largest funder of abstinence and faithfulness programming in sub-Saharan Africa, with a cumulative investment of over US $1.4billion in the period 2004-13. We examined whether PEPFAR funding for abstinence and faithfulness programs, which aimed to reduce the risk of HIV transmission, was associated with a relative change in five outcomes indicative of high-risk sexual behavior: number of sexual partners in the past twelve months for men and for women, age at first sexual intercourse for men and for women, and teenage pregnancies. Using nationally representative surveys from twenty-two sub-Saharan African countries, we compared trends between people living in countries that received PEPFAR abstinence and faithfulness funding and those living in countries that did not in the period 1998-2013. We found no evidence to suggest that PEPFAR funding was associated with population-level reductions in any of the five outcomes. These results suggest that alternative funding priorities for HIV prevention may yield greater health benefits.

An ontology for factors affecting tuberculosis treatment adherence behavior in sub-Saharan Africa.

PurposeAdherence behavior is a complex phenomenon influenced by diverse personal, cultural, and socioeconomic factors that may vary between communities in different regions. Understanding the factors that influence adherence behavior is essential in predicting which individuals and communities are at risk of nonadherence. This is necessary for supporting resource allocation and intervention planning in disease control programs. Currently, there is no known concrete and unambiguous computational representation of factors that influence tuberculosis (TB) treatment adherence behavior that is useful for prediction. This study developed a computer-based conceptual model for capturing and structuring knowledge about the factors that influence TB treatment adherence behavior in sub-Saharan Africa (SSA).MethodsAn extensive review of existing categorization systems in the literature was used to develop a conceptual model that captured scientific knowledge about TB adherence behavior in SSA. The model was formalized as an ontology using the web ontology language. The ontology was then evaluated for its comprehensiveness and applicability in building predictive models.ConclusionThe outcome of the study is a novel ontology-based approach for curating and structuring scientific knowledge of adherence behavior in patients with TB in SSA. The ontology takes an evidence-based approach by explicitly linking factors to published clinical studies. Factors are structured around five dimensions: factor type, type of effect, regional variation, cross-dependencies between factors, and treatment phase. The ontology is flexible and extendable and provides new insights into the nature of and interrelationship between factors that influence TB adherence.