African Countries Research Articles

Educational Inequality and Its Political and Economic Consequences: A Case Study of Nigeria and Kenya

Two of the most populous and economically varied countries in Africa, Nigeria and Kenya, continue to face significant obstacles to their development: educational inequality. The article examines the various facets of educational inequality in different nations, emphasizing the effects on the political and economic spheres. Differences in educational accessibility and quality between rural and urban regions, as well as between the north and the south, have contributed to social discontent, political disenfranchisement, and economic stagnation in Nigeria. In a similar vein, while there has been improvement in Kenya regarding educational access, notable inequalities still exist, especially in disadvantaged areas, which fuels political polarization and increases the economic divide. This article highlights effective solutions meant to solve these issues while examining the effects of unequal educational resource distribution on political polarization, economic development, and national stability. This study offers important insights into the larger consequences of educational disparity for sustainable development in sub-Saharan Africa by contrasting the educational systems of Nigeria and Kenya.

A Review of Sanitation Options and Programming in Ghana, West Africa

This review examines Ghana’s progress in sanitation. These efforts include the containment, transport, treatment, and disposal or reuse of human waste. This research specifically examined the current sanitation processes and programming efforts within Ghana, West Africa. Some reports indicate that Ghana is the second dirtiest country in Africa and the seventh dirtiest country in the world. A review of the current water, sanitation, and hygiene (WASH) options within the country indicates that significant efforts need to be undertaken. There are multiple toilet options and current practices within the country for the disposal of excrement. Unfortunately, the municipal sewer systems and wastewater treatment facilities within the country are either broken down or severely inadequate compared to their surrounding population. Current WASH programming, extension efforts, and key factors affecting the uptake of sanitation investment are reviewed. The price point where consumers would utilize sanitation products and services was analyzed, as well as the cost-to-benefit ratio of specific technologies for community members. This review demonstrated that initiatives should be undertaken to provide more sanitation professionals, renovate and expand urban municipal sewerage systems, and provide basic access to rural community areas. It was recommended that future programming, extension, and policy efforts be intentional and include relevant stakeholders and community members to provide a greater opportunity for establishing successful and substantial efforts.

Early inflammation as a footprint of increased mortality risk in infants living with HIV from three African countries

In this work our aim was to identify early biomarkers in plasma samples associated with mortality in children with perinatal HIV treated early in life, to potentially inform early intervention targeting this vulnerable group. 20/215 children (9.3%) with perinatal HIV, enrolled within 3 months of age died prematurely within the first year of the study, despite early ART initiation. Using a propensity score, we selected 40 alive study participants having similar clinical and virological records compared to the deceased group. 13 HIV unexposed (HU) healthy children were additionally used as controls. Baseline plasma samples were analyzed using a targeted proteomic approach, and to assess pathogen-associated and damage-associated molecular patterns (PAMPs, DAMPs) levels. Data from deceased participants were compared to both control groups, with multivariate logistic regression models used to evaluate the association between mortality and plasma proteins. We developed a machine learning model to predict mortality risk, finding that IL-6 and CXCL11 not only were higher in deceased children than Matched-children with HIV (p < 0.001 and p = 0.0034) but also predictive of mortality (accuracy of 77%); levels of PAMPs were higher in deceased children (p = 0.0016). Thus, measuring early inflammatory biomarkers, particularly IL-6, could help mortality risk prediction and potentially guide targeted interventions.

Molecular transmission clusters in newly HIV-1 diagnosed migrants in Portugal from 2014 to 2019

Abstract Background Portugal has an important HIV burden with a total of 804 diagnosed cases in 2022. Migrants remain a significant source of HIV infections, with 45% of newly reported cases. We aimed to evaluate the characteristics of HIV-1 molecular transmission clusters (MTCs) among migrants followed in Portugal, diagnosed between 2014 and 2019. Methods 265 migrants, newly HIV-1 diagnosed were included in the BESTHOPE project with clinical, socio-behavioral and genomic data. Pol nucleotide-based phylogenetic analyses were used to infer HIV-1 MTC. Those were constructed using ClusterPickerGUI_1.2.3 considering SH-aLRT higher than 90 of branch support and a pairwise genetic distance of ≤ 4.5. Logistic regression analyses were used to examine the relationship between the sociodemographic and clinical data associated with HIV-1 clustering. Results 66.8% of the migrants included in the study were males with a median age at diagnosis of 36.0 years old (IQR:29-45). Most migrants were from African countries (50.6%) followed by Brazil (39.6%). Sixty-eight (33%) of the migrants were included in clusters. Being in cluster was significantly associated with region of origin, with individuals from South America more likely to be in cluster (OR = 14.85, 95%CI:1.52-144.79), compared to individuals from Africa; with transmission route, with men who have sex with men (MSM) more likely to be in cluster (OR = 23.52, 95%CI:2.35-235.10), compared to the heterosexuals and with subtype, with subtypes B less likely to be in cluster (OR = 0,017, 95%CI:0,001-0,254) compared with subtype non-B. Conclusions Migrants HIV transmission clusters in Portugal are associated with specific health determinants, such as region of origin, transmission route and subtype. Targeted prevention health strategies are needed to mitigate transmission of HIV within this population. Funded by FCT to GHTM - UID/04413/2020 and LA-REAL - LA/P/0117/2020; BESTHOPE (HIVERA:249697); and MARVEL (PTDC/SAU-PUB/4018/2021). Key messages • HIV transmission clusters in migrant are associated with their region of origin, transmission route and subtype. • Targeted prevention health strategies are needed for the migrant population.

Malnutrition in Guinea-Bissau: a country wide representative cross-sectional study

Abstract Background According to the WHO, malnutrition refers to deficiency, excess, or imbalance in a person’s intake of energy and/or nutrients. Children under five are especially vulnerable to malnutrition. The problem is widespread, but it is particularly prevalent in West African countries, where a prevalence of 30% stunting, 6.7% wasting and 2.4% overweight was described in 2022. In this study, we aimed to evaluate malnutrition in Guinea-Bissau (GB), a low-income country in West Africa. Methods We conducted a cross-sectional study between May and June 2023 on a representative sample of 1608 children aged 6 to 59 months, who had access to health care in all 11 regions of GB. Nutritional status was assessed by evaluating weight for height/length, weight for age, height/length for age, and hemoglobin concentration was determined using a portable hemoglobin analyzer. Furthermore, semi-structured questionnaires were applied to children’s parents, including questions on sociodemographic and behavioral factors, such as ethnicity, parental literacy, health care, and dietary patterns. Results 802 boys and 806 girls were included in the study, with a mean age of 26 months. Malnutrition rates were comparable to those described in other West African countries. We found wasting rates of 8,3%, stunting rates of 24,3%, low weight rates of 17,4%, and overweight rates of 2,4% among children under five. Importantly, 55.9% of the children had anemia: 23.6% had mild anemia, 31.1% had moderate anemia, and 1.2% had severe anemia. Statistical analyses are underway to investigate factors associated with malnutrition. Conclusions An important challenge in global health is combating malnutrition in all its forms. The identified prevalence of malnutrition in GB is high and emphasizes the importance of developing strategies and policies with local authorities so that the Sustainable Development Goals and Global Goals of Nutrition can be achieved and health outcomes improved. Key messages • Collaboration essential: researchers, policymakers, healthcare, and local authorities must unite for targeted malnutrition interventions. • Sustainable development in GB hinges on addressing malnutrition among its children through concerted efforts.

The impact of intimate partner violence on adverse birth outcomes in 20 sub-Saharan African countries: propensity score matching analysis

BackgroundIntimate partner violence (IPV) is a significant public health problem, with serious consequences on women's physical, mental, sexual, and reproductive health, as well as birth outcomes. Women who encounter IPV are more likely to experience adverse birth outcomes such as low birth weight, premature delivery, and stillbirth. Although numerous studies are exploring the association between IPV and adverse birth outcomes, they merely used classical models and could not control for potential confounders. The purpose of this study was to ascertain whether there was a causation between IPV and adverse birth outcomes in sub-Saharan Africa (SSA) using a quasi-experimental statistical technique [i.e., propensity score matching (PSM) analysis].MethodThis study used the most recent (2015–22) Demographic and Health Survey (DHS) data from 20 SSA countries. A total weighted sample of 13,727 women was included in this study. IPV (i.e., sexual, physical, emotional, and at least one form of IPV) was the exposure/treatment variable and adverse birth outcomes (preterm delivery, low birth weight, stillbirth, and macrosomia) were the outcome variables of this study. PSM was employed to estimate the impact of IPV on adverse birth outcomes.ResultsThe average treatment effects (ATE) of sexual, physical, emotional, and at least one form of IPV were 0.031, 0.046, 0.084, and 0.025, respectively. Sexual, physical, emotional, and at least one form of IPV increased adverse birth outcomes by 3.1%, 4.6%, 8.4%, and 2.5%, respectively. Findings from the average treatment effect on treated (ATT) showed that women who experienced sexual, physical, emotional, and at least one form of IPV had an increased risk of adverse birth outcomes by 3.6%, 3.7%, 3.3%, and 3.0%, respectively, among treated groups.ConclusionThis study demonstrates a causal relationship between IPV and adverse birth outcomes in SSA countries, indicating a need for programs and effective interventions to mitigate the impact of IPV during pregnancy to reduce related adverse pregnancy outcomes. Furthermore, we suggest further research that investigates the causal effect of IPV on adverse birth outcomes by incorporating additional proximal variables not observed in this study.

The Future Politics of Social Protection in Africa

International organisations and their local allies continue to press for the further expansion of social protection across Africa, often in the face of resistance. The future politics of social protection in Africa will be shaped by endogenous and exogenous changes. Endogenous changes involve feedback effects from the past and continuing expansion of social protection; these can be either positive or negative in terms of further expansion. Exogenous effects result from the changing structural context, including especially population growth, urbanisation, and climate change. As the Covid-19 pandemic and related lockdowns showed, even those exogenous shocks which reveal gaps in current provision need not prompt enduring expansions of social protection. Neither endogenous nor exogenous changes are likely to shift African countries off their current varied pathways; considerable political obstacles to the further expansion of social protection will persist.

HOW DOES TRADE IN DIGITALLY DELIVERED SERVICES AFFECT EMPLOYMENT IN AFRICA?

The rapid advancement of technology and the increasing accessibility of the Internet are driving changes in various economic activities, including international trade. This study explores the relationship between digital trade and employment across 30 African countries from 2009 to 2020, with a particular focus on the role of digitally delivered services as a proxy for digital trade. Utilizing panel data and employing PCSE and IV-2SLS estimation techniques, the findings reveal that while the expansion of digitally delivered services may contribute to a reduction in formal employment, it also fosters growth in the industrial and services sectors, while exerting downward pressure on employment in agriculture. These results are robust and highlight the sector-specific dynamics of digital trade’s impact on labor markets.

Readmission and mortality during the first year after an acute stroke: A prospective cohort study from Cameroon.

Hospital readmission after discharge for stroke is associated with high morbidity and mortality. There is a paucity of data on the burden of stroke readmission in most sub-Saharan African countries. We aimed to determine the rate, reasons and predictors of hospital readmission and the mortality rate within 12 months of discharge among stroke survivors in Cameroon. This prospective cohort included patients who survived hospitalization for an acute stroke and who were discharged from two referral hospitals in the capital city of Cameroon between January 2013 and December 2013.We performed logistic regression analysis to identify demographic and clinical factors associated with readmission within 1 year of discharge and causes of readmission. Of the 254 consecutive patients admitted for acute stroke, 198 were discharged alive. There were 107 (54%) males, and their mean age (SD) was 61.7 (13.9) years (range: 10 to 95 years). A total of 30 (15.2%) patients were readmitted following discharge from the index admission over a mean follow-up time of 286.9 (127.6) days. Of these, 14 (46.7%) were discharged and 16 (53.3%) died after readmission. Thirty percent (30%) of readmissions occurred within the first month. The most frequent causes of readmissions were infections (30%) and recurrent stroke (26.7%). Factors associated with readmission in bivariate analysis were initial admission temperature > 37.5°C (risk ratio [RR]: 1.3, p = 0.021) and initial admission Glasgow Coma Score < 14 (RR: p = 1.23, p = 0.019). After stratified adjustment for age and sex, temperature > 37.5°C (adjusted RR: 1.3, 95% CI: 1-1.7, p = 0.036) and GCS <14 (adjusted RR: 1.23, 95% CI: 1-1.6, p = 0.041) were associated with readmission. Readmission after discharge for stroke was common with nearly one third occurring within the first month and more than half dying following readmission. The most common causes of readmission were infections and recurrent stroke.

Interrogating the environmental and social correlates of health risk behaviours in West Africa

Abstract Background Despite the high incidences of health risk behaviors (HRBs) in sub-Saharan Africa, studies on the contextual determinants of HRBs across countries are generally lacking, concentrated on isolated countries and often focus solely on specific health behaviors. Thus, this study investigated the environmental and social correlates of HRBs in West Africa. Methods Data was from post-2015 Demographic and Health Surveys in three West African countries of Benin, Mali and Nigeria. A composite outcome variable of health risk behaviors (HRBs) was derived from variables of tobacco smoking, intimate partner violence, overweight/obesity and risky sexual behaviors. The contextual variables were normalized difference vegetation index, precipitation, maximum and minimum temperatures, region of residence and population Density. Data analysis involved descriptive statistics, chi square test, geographical mapping, and multilevel logistic regression. Results The engagement in HRBs varied from 42.65% in Nigeria to 42.88% in Benin and 51.06% in Mali as there are spatial variations in the engagement in HRBs within different regions of these countries. There also existed significant variations in HRBs regarding age, education, employment status, wealth index, household size, place of residence, and region of residence in the three countries. In the contextual models of environmental and social factors, population density significantly increased odds of HRBs in the three countries, maximum temperature significantly increased odds of HRBs in Benin and Mali, while precipitation significantly increased odds of HRBs in Nigeria and Mali. Other factors which significantly increased odds of HRBs across the three countries were increase in age, wealth index, households with 9+ persons, and regions of residence. Conclusions These findings suggest that among other things, changes in lifestyles regarding the different HRBs should be emphasized in specific contextual situations Key messages • There are variations in engagement in health risk behaviours across the countries. • Cliamte variables influence engagement in health risk behaviours.

Effects of importing second-hand clothes on supply chains: insights for Africa’s textiles and apparel industry

ABSTRACT Some African countries import a large number of second-hand clothes. This paper examines how importing second-hand clothes affects Africa’s textile and apparel (TA) supply chain. We find that the availability of second-hand clothes could benefit consumers because it provides a new option to consumers. However, import bans and the importation of second-hand clothes may help or hurt local TA manufacturers and workers’ incomes depending on the cost structures for new and second-hand clothes. Imposing import tariffs restrains the second-hand clothing business, helps local TA manufacturers and improves consumer welfare if the quality of new clothing is competitive. Our findings provide insights into how governments use distribution management to protect local TA manufacturers in Africa. Encouraging agents to sell in the local market is desirable if a government wants to help local manufacturing firms and workers. However, if a government wants to collect more tariffs, not allowing second-hand clothing importers to sell through retailers is wise.

Income inequality thresholds that should be avoided for governance to promote economic growth with evidence from Africa

AbstractThis paper examines the role of inequality on the link between governance and economic growth in 44 African countries with data running from 2008 to 2018. Using a system GMM and the generalized least square (GLS) estimators, we establish that the effects of governance on growth are rightly conditioned by inequality. The GMM and GLS estimates portray positive effects of inequality on growth, but only the GMM estimates are significant. For both estimators, the effect of institutions on economic growth is positive and significant. However, inequality retards growth when embedded in selected institutions, which implies a substitution relationship between institutions and inequality on growth. The turning point beyond which inequality begins to contribute negatively to economic growth ranges between 34% and 49% based on the GMM estimates or 40.15% and 44.5% for the GLS analysis depending on the institutional indicator used. Therefore, institutions can only be effective in economic development if income inequality levels of not less than 0.34 and not more than 0.49 are maintained to ensure that inequality does not negate growth. Policy makers of African countries should ensure better income distribution alongside good institutions to achieve sustainable economic growth in the region.

A scoping review of human papillomavirus and cervical cancer knowledge, attitudes, practices, and prevention among female sex workers in Africa

Background Global initiatives have emphasized the elimination of cervical cancer (CC) among female sex workers (FSW) in Africa. Yet screening remains low, and few interventions have been outlined to target this group. This scoping review sought to understand the knowledge, attitudes, and practices (KAP) among FSW in Africa regarding human papillomavirus (HPV) and CC prevention, and to identify the most effective intervention strategies. Methods A systematic literature search was performed in PubMed, Scopus, Web of Science, and African Index Medicus for work published between January 2012 through August 2022. Eligible studies included those relating to HPV and CC prevention among FSW in Africa. Studies were categorized as KAP, intervention, or both. A Logic Model was used to guide content analysis of the interventions, and a thematic analysis of all studies was performed. Results The search resulted in 79 articles of which 11 were included in the study. Six African countries were represented including South Africa, Mozambique, Uganda, Kenya, Ethiopia, and Nigeria. Five of the articles described KAP, while the other six described interventions. The intervention studies were categorized into 3 groups: “screen and treat”, self-collection HPV testing, and a “diagonal intervention” which included a multi-faceted approach. Conclusions Limited literature exists regarding KAP and interventions for HPV and CC prevention among FSW in Africa. While FSW in the literature had a moderate level of knowledge regarding HPV and CC prevention, studies identified a lack of detailed and nuanced knowledge. Successful uptake of screening was seen when services were provided at convenient locations, integrated into routine or HIV care, and recommended by healthcare providers. Future interventions should be context-specific, include improved counselling and education, and be integrated with other services.

China’s International Trade of Parrots from 1981 to 2022 Based on the CITES Trade Database

Parrots are popular with pet consumers and are one of the most traded groups of live birds around the world. China has been considered as an important country in bird trades, but we know little about China’s import and export of parrots. Using the latest data available from the CITES Trade Database, we analyzed China’s import and export of CITES-listed live parrots from 1981–2022 to better understand the patterns and dynamics of these trades. China imported 155,339 parrots of 173 species and exported 608,987 parrots of 42 species during the study period with an annual average of about 18,500 individuals, accounting for c. 5% of the global average number. The most imported parrots to China were Grey Parrot (Psittacus erithacus) and Monk Parakeet (Myiopsitta monachus), while the most exported ones were Fisher’s Lovebirds (Agapornis fischeri), Rosy-faced Lovebirds (Agapornis roseicollis), and Yellow-collared Lovebird (Agapornis personatus). Since the early 21st century, China’s imports of parrots gradually increased, but exports decreased more pronouncedly, making China’s international parrot trade volume declining in the past 20 years. China’s international parrot trade routes also changed over time, with the destination of parrot exports shifting from Europe to Africa and the Arabian region, while more parrots being gradually imported from countries in South America and Africa. The vast majority of parrots exported from China were captive-bred non-native species like Fisher’s Lovebirds, while a substantial proportion of imported parrots were wild-sourced and the proportion has been increasing in the last decade. The fact that China exported much more parrots than imported suggests existence of large-scale parrot farming and domestic parrot trade in China. Attention needs to be paid to monitoring China’s import of increasing proportion of wild-sourced parrots from South America countries and its potential impacts on their wild populations. Close monitoring of and more studies on domestic and illegal parrot trade are essential to fully understand the role China plays in the international trade of parrots.

The Impact of Climate Change on Food Security in Selected African Countries

The study investigated the impact of climate change on food security in SANE countries, using yearly time series data from 1990 to 2020. The study used descriptive analysis to summarize the behaviour of the variables, second generation panel unit root to test the stationarity of the variables, the panel co-integration test was carried out using the Westerlund test co-integration technique to test the long-run relationship among the variables and it was discovered that there is a long run relationship among the variables. As a result of this, an augmented mean group (AMG) was used to examine the long-run dynamics of variables. The results of the study revealed that climatic change, namely temperature, has a negative and significant impact on food security in SANE countries, indicating a vulnerability of agricultural production to changing climatic conditions. Thus, the study therefore recommended that countries in the SANE region should prioritize their policy towards adopting a climatic-resilient agricultural practice, and also encourage the use of diversification of agricultural systems such as integrating crops with varying temperature sensitivity and agroforestry practices.

Effect of financial deepening and institutional factors on industrial value added: Evidence from Sub-Saharan Africa

This research evaluates the effect of financial deepening and institutional factors on industrial value. Africa, rich in natural resources, stands poised for resource-based industrialization, yet many nations continue to export raw materials with minimal processing. According to World Bank data, Sub-Saharan African countries have seen a decrease in industrial value added over the years. This decline is partly due to insufficient integration between agriculture and manufacturing. The primary factors in converting raw materials into finished products are labor and capital. While Africa is abundant in intellectual capital, it faces challenges with financial capital. Despite the critical role of financial development in enhancing industrial sectors, institutional factors also play a significant role. This study, which involved 38 Sub-Saharan African nations, analyzes the impact of financial development and institutional factors on industrial value added using multiple linear regression. The findings reveal that both financial development and institutional quality positively influence industrial value added, particularly highlighting the importance of bank capital adequacy, ATM availability, regulatory quality, corruption control, and governance. On the other hand, exchange rates, foreign direct investment, trade openness, and inflation all have a negative impact on industrial value added.

Protecting Water Resources in North African Countries as an Entry Point to Achieve the Sixth Sustainable Development Goal

This article examines the legal framework on water in the Maghreb countries and analyzes if the existing legal framework guarantees the achievement of the sixth Sustainable Development Goal by 2030. One of the most important challenges faced by North African countries is the scarcity of water resources. Water scarcity and difficulty of providing the population with potable water, causes a thirst crisis and disruption of biodiversity, and thus preventing the achievement of sustainable economic and social growth, especially since the communities of this region are known for their intensive agricultural activity. The MENA region is among the most exposed to the negative effects of climate change, as the decrease in rainfall and its temporal and spatial variation leads to frequent floods and multiple droughts. All these pose the problem of dealing with the legal system considering the weak official cooperation between these countries to deal with this reality and find the necessary mechanisms to protect water resources from depletion, face climate change and reduce its effects. This article focuses on the Maghreb countries: Morocco, Algeria, Tunisia and Mauritania. The choice of these countries is motivated by the fact that they share the same climatic characteristics and above all they suffer in the same way from the repercussions of global warming. Water resources in these countries are under increasing pressure amid population and industrial growth, irrigated agriculture, urbanization, tourism, climate change, overexploitation of aquifers and deteriorating water quality. In terms of methodology, the article employs a literature review of studies in this field as well as an analysis of legal texts related to water and the environment in the countries surveyed. This study shows that the Maghreb countries have made considerable efforts at the legal level to guarantee access to water for their citizens, however there are many peculiarities and insufficiencies for which the study presents some recommendations susceptible to help with the attainment of the 6 SDG objective within 2030.

Extended-spectrum beta-lactamase- and carbapenemase-producing Escherichia coli isolates causing hospital- and community-acquired infections in Tunisia (2001-2019): expansion of CTX-M-15-C2 and CTX-M-27-C1 ST131 subclades.

We aimed to investigate the microbiological features of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli (ESBL-EC) and carbapenemase-producing E. coli (CP-EC) causing hospital- and community-acquired infections in Tunisia over the last two decades. The study captured the emergence and expansion of the CTX-M-15-C2 ST131 subclade and successively the CTX-M-27-C1 ST131 subclade, which were responsible for the steady increase in the prevalence of ESBL-EC. However, the incidence of CP-EC remained stable over the study period with a highly diverse content in carbapenemase genes dominated by blaOXA-48-like. This is the first study to provide comprehensive data on the epidemiology of ESBL-EC and CP-EC in a North African country.

How Financial Development Heterogeneity, Macroeconomic Volatility, Domestic Investment, and Digital Economy Are Driving Sustainable Economic Growth in Africa

The roles of finance are well stipulated in the various indicators of the sustainable development goals (SDGS). However, the extant literature still finds conflicting outcomes of the finance-led growth. Hence, this study redirects empirical evidence by unbundling the effects of financial development on sustainable economic growth into aggregated and disaggregated, focusing on seven robust indicators (financial development index, financial institution index, depth, and access, and financial market index, depth, and access) in selected African countries from 1995 to 2021. Similarly, the intervening roles of government expenditure, digital economy, domestic investment, human capital, macroeconomic volatility, and trade openness are evaluated based on advanced estimators. Findings show that the seven indices of financial development drive sustainable economic growth in Africa both in the long and short runs. Similarly, government expenditure, digital economy, and human capital promote sustainable economic growth both in the short- and long-term periods. The driving effects of domestic investment are only noticeable in the long run. Conversely, trade openness and macroeconomic instability are noted to be growth-deterring. Policy insights that support sustainable economic growth in Africa emanate from the outcomes.

Determinants of micronutrient supplementation during pregnancy among women in three sub-Saharan African countries: a multilevel logistic regression model

BackgroundPoor maternal nutrition during pregnancy is a common cause of poor maternal and infant outcomes. Micronutrient deficiencies are common among pregnant women in low- and middle-income countries, including sub-Saharan Africa. Pregnant women are recommended to take micronutrients like iron or folic acid and deworming medication during pregnancy. Therefore, this study was conducted to assess micronutrient intake and its associated factors among pregnant women in three countries using the most recent demographic and health survey.MethodsWe used data from the most recent demographic and health surveys, which were carried out between 2019 and 2022 in three sub-Saharan African countries. The study included a weighted sample of 13,568 reproductive-age women who had given birth within the five years prior to the survey. Utilizing multilevel logistic regression, the factors associated with the dependent variable were identified. Model comparison and fitness were assessed using the deviance (-2LLR), likelihood ratio test, median odds ratio, and intra-class correlation coefficient. Ultimately, factors were deemed statistically significant if they had a p-value less than 0.05.ResultsThe pooled prevalence of micronutrient intake among pregnant women during pregnancy of last birth was 77.56% (95% CI: 76.85%–78.25%). Factors like age [AOR = 1.78; 95% CI (1.14, 2.77)], educational status [AOR = 1.49; 95% CI (1.23, 1.79)], marital status [AOR = 0.66; 95% CI (0.58, 0.75)], working status [AOR = 1.17; 95% CI (1.01, 1.34)], media exposure [AOR = 1.20; 95% CI (1.05, 1.38)], preceding birth interval [AOR = 1.17; 95% CI (1.01, 1.34)], number of ANC visits [AOR = 1.65; 95% CI (1.29, 2.10)], and residence [AOR = 1.19; 95% CI (1.03, 1.37)] were significantly associated with micronutrient intake among pregnant women.ConclusionsMore than three-fourths of the study subjects were micronutrient supplemented during their pregnancy. Improving women's education, disseminating nutrition information through media, providing more attention to young pregnant women who live in rural areas, increasing the number of ANC visits, and women's empowerment are strongly recommended.