Female Household Research Articles

The level of wasting and associated factors among children aged 6-59 months in sub-Saharan African countries: multilevel ordinal logistic regression analysis.

Despite various interventions to combat child malnutrition in sub-Saharan Africa, wasting remains a critical public health concern for children aged 6-59 months. Wasting is a significant predictor of child survival and development, with a heightened risk of mortality among children. However, there is a lack of recent comprehensive data on the prevalence, severity level, and factors contributing to wasting in this age group. To identify the severity levels of wasting and its individual and community-level factors contributing to wasting among children aged 6-59 months in Sub-Saharan African countries. This research utilized Demographic and Health Survey data from 34 Sub-Saharan African countries, spanning the period from 2007 to 2022. The study included a weighted sample of 180,317 6-59-month-old children. We employed a multilevel proportional odds model to identify factors predicting the severity of wasting. Adjusted odds ratios and 95% confidence intervals were reported to demonstrate significant relationships (p < 0.05) in the final model. In Sub-Saharan Africa, 7.09% of children aged 6-59 months experience wasting (95% CI: 6.97, 7.20%). Among these children, the prevalence of moderate wasting is 4.97% (95% CI: 4.90, 5.10%), while severe wasting affects 2.12% (95% CI: 2.0, 2.20%). Factors such as term/post-term babies, wealth, frequency of feeding, improved toilet facilities, water sources, employed and educated mothers, rural residence, high community maternal education, and community media exposure are strongly associated with a lower chance of experiencing severe form of wasting. Conversely, birth order, family size, breastfeeding, diarrhea, cough, and fever, high community poverty, female household heads, and all Sub-Saharan Africa regions are linked to higher levels of wasting. The study findings underscore the persistent challenge of wasting among Sub-Saharan Africa's children, with 7.09% affected, of which 4.97% experience moderate wasting and 2.12% severe wasting. The identified predictors of wasting highlight the complex interplay of socio-economic, environmental, and health-related determinants. To address this issue improve access to healthcare and nutrition services, enhance sanitation infrastructure, promote women's empowerment, and implement community-based education programs. Additionally, prioritize early detection through routine screening and strengthen health systems' capacity to provide timely interventions.

Food Security Status of Female-Headed Households in Ethiopia

Abstract This article aims to explore the food security status of female-headed households and its determinant factors in Sidama Regional State, Ethiopia. To that end, the article used both quantitative and qualitative research approaches, as well as multistage sampling techniques and blending both descriptive and econometric statistics during data analysis. The findings depicted that 40.97% of female-head households were food secure, 15.97% of female headed households were mildly food insecure, 18.75% were highly food insecure, and 24.31% were severely food insecure. The study also involves demographic, socioeconomic, and institutional factors that had a substantial impact on food security in female-headed households in the study area. Finally, the study advised that rural female-headed families receive special care and support in order to improve their livelihoods and food security status, and that livestock holding and cultivated land size play an important role in boosting food security.

Antenatal care component utilization and associated factors among pregnant women in Ethiopia: Multilevel analysis of Ethiopian Mini Demographic and Health survey 2019.

Maternal and neonatal health are among the top prioritised agendas of global health care with due emphasis given to developing countries, where the burden is profound. Antenatal care accompanied by its recommended components is highly beneficial for both maternal health and birth outcome. The objective of this study was to identify the proportion of pregnant women who received adequate Antenatal care components and associated factors among Ethiopian women. We used a nation-wide data from Mini Ethiopian Demographic and Health Survey (MEDHS) of 2019. All women of age 15-49 and who had at least one ANC visit, who were either permanent residents of the selected households or visitors who slept in the household the night before the survey, were eligible to be interviewed. Since we utilised multilevel logistic regression model, the STATA output had two components, the fixed effect and the random effect. In our model, the fixed effect part was displayed by odds ratio while the random effect was addressed by variance and intra-cluster correlation (ICC). From the total women with at least one antenatal care (ANC) visit 55.41% (95% CI 53.60%, 57.20%) of them received adequate components of the care. In the final model after adjusting for the cluster and individual level variables, attending primary (AOR = 1.45; 95% CI: 1.15 to 1.84), secondary (AOR = 2.21; 95% CI: 1.51 to 3.24) and higher education (AOR = 2.42; 95% CI: 1.38 to 4.26) were significantly associated with higher odds of receiving adequate components of ANC. Similarly, wealth index of middle (AOR = 1.51; 95% CI: 1.06, 2.14), richer (AOR = 1.92; 95% CI: 1.32, 2.80), and richest (AOR = 3.86; 95% CI: 2.35, 6.33) compared to poorest index and having two or more ANC visits were significantly associated with receiving adequate components of ANC. On the other hand, being from Oromia region, from female headed household and protestant religion were negatively associated with receiving adequate components of ANC. The proportion of women who received adequate ANC component was much lower compared to the universal recommendation for every woman on ANC visit. Educational status, wealth index, number of ANC visit, region of residence and type of health facility were significantly associated with the odds of receiving adequate components of ANC. The government should pay attention to those without any formal education, encouraging pregnant women to receive the optimum number of ANC visits, and devising techniques to address those in poorest wealth index so that the proportion of adequate components of ANC will be increased.

SPATIAL MODELING OF POVERTY IN BENGKULU PROVINCE WITH MIXED GEOGRAPHICALLY WEIGHTED REGRESSION

The percentage of poor people in Bengkulu Province is high from year to year. The poverty rate in Bengkulu Province also tends to fluctuate. If there is a decrease in the poverty rate, the decrease is relatively small. Poverty in the regions of Bengkulu Province also varies from district to district, subdistrict, and village to village, because poverty data is spatial data that varies regionally. The diversity of poverty data in Bengkulu Province is influenced by spatial effects, namely spatial dependency and spatial heterogeneity. Spatial dependency occurs due to spatial error correlation in cross section data, while spatial heterogeneity occurs due to random area effects, which is the difference between one region and another. Therefore, classical methods are not qualified enough to analyze the resulting diversity. This research will model the poverty of each district/city in Bengkulu Province using Mixed Geographically Weighted Regression (MGWR), because this method is quite complex in modeling data that contains spatial heterogeneity and variations in geospatial data. This modeling aims to identify and analyze poverty indicators in Bengkulu Province spatially, namely based on poverty data in each district/city in Bengkulu Province. The results showed that by using the MGWR method, the variables that locally influence the percentage of extreme poor people in each district/city in Bengkulu Province are Female Household Head Gender and not having a waterheater . Meanwhile, the variable that has a global effect on the percentage of the extreme poor in each district/city in Bengkulu Province is not having a flat screen television ().

Adolescent pregnancy persists in Nigeria: Does household heads' age matter?

About 700,000 pregnant youths die each year in developing countries. To determine whether the persistent adolescent pregnancy in Nigeria between 2013 and 2018 was influenced by proximal factors, particularly household head age, we carried out a cross-sectional study on adolescent girls that participated in the 2018 Nigeria Demographic and Health Survey (NDHS). Age of first birth, residence type, age, and gender of household heads was collected using a 2018 standardized NDHS. Multiple logistic regression was performed to test for associations. We analyzed 8,448 adolescents who had experienced pregnancy during the study period. The results demonstrated that girls with male household heads aged 45 and older have lower odds of adolescent pregnancy (OR = 0.619; 95% CI = 0.447, 0.856; p = 0.004 compared to those with female household heads in the same age group. Girls with male household heads in three younger age groups have higher odds of adolescent pregnancy than those with female household heads in the corresponding age group (15-24: OR = 1.719, 95% CI = 1.042, 2.835, p = 0.034; 25-34: OR = 4.790, 95% CI = 1.986, 11.551, p < 0.001; 35-44: OR = 2.080, 95% CI = 1.302, 3.323, p = 0.002). Girls with household heads aged in the 15-24 and 25-34 groups had higher odds of adolescent pregnancy compared to those with household heads aged 45 and older. Higher odds of adolescent pregnancy in Nigeria were found among girls with household heads aged in the 15-24 and 25-34 groups compared to those with household heads aged 45 and older. Although girls with younger male household heads are at an increased risk nationally, those living in the rural areas with younger household heads are at an even higher risk for adolescent pregnancy. Therefore, levels of socioecological model must be considered in planning for effective interventions.

Who brings emissions home? Comparing female and male breadwinner households by matching techniques

This paper tests the hypothesis that female and male breadwinner household present significant differences in the greenhouse gases (GHG) emissions patterns induced by consumption. We investigate this issue by studying a sample of consumption basket of Spanish households for 2008, 2014, and 2018, linking consumption levels with emissions by means of input-output analysis. Once a vector of GHG emissions have been calculated for each household sampled, we apply the Propensity Score Matching estimator to analyze the mean difference between households with female and male breadwinners, finding a significant negative effect of having female breadwinner households on the GHG emissions patterns derived by household energy consumption, mainly due to the larger use of private transport by male breadwinner households. These results contribute to the growing demand for studies linking environment and gender and to expose the role of women in sustainable energy production and consumption. Therefore, policies that encourage the inclusion of women in different economic activities are also likely to have climate related benefits.

Gendered flood risk perception and mental health of urban households in Ghana: Insights from the Oforikrom municipality

It is important to understand gendered impacts of flood risks on mental health in developing countries. This study examines the gender-differentiated impacts of flood risk on the mental health of households in Ghana. Utilizing a mixed-methods approach, we collected data through questionnaire survey and in-depth interviews. Descriptive statistics and Student's t-test were used to analyze the data. The study revealed that both male and female headed households in the communities had experienced floods and associated impacts. However, flood risk perceptions of households were gender differentiated. The independent samples t-test result shows that the difference between male and female households' perceived mental health impacts of flooding are not significantly different. The impacts, include increased stress, anxiety, depression, and post-traumatic stress symptoms. Additionally, the results show divergent coping strategies, with male headed households preferring temporal relocation and female headed households seeking support from family and friends. Further distinctions emerged in adaptation strategies, as male headed households constructed floodwalls, while female headed households opted for desilting drainage systems. The findings have theoretical and practical implications for flood risk management in urban Ghana and other developing countries, especially in sub-Saharan Africa.

Does Women’s Empowerment Matter for Household Food Security? Evidence From Northern Ghana

The study seeks to analyze the effect of women’s empowerment on household food security in northern Ghana. Employing Random Effect and Generalized Estimating Equations on the two rounds of Feed the Future dataset, 2012 and 2015, the study measured women empowerment as the comparative years of schooling and decision making by women. Multivariate Decomposition was used to explain whether variations in food insecurity between gendered household types are due to differences in explained and/or unexplained variations. The study showed significant differences in food insecurity levels between male and female headed households. The finding revealed that improving women decision making at the household level will reduce food insecurity by 45%. The study therefore recommends that Ministry of Gender, Children and Social protection should educate male partners on the need for women’s decision making and also ensure the establishment of social groups for women.

Pathways and policy options for food and nutrition gaps in arid agricultural farming systems in the Tigray Region, north Ethiopia

Food and nutrition security is a major global challenge especially indeveloping countries.Agriculture is main means of livelihoods and hunger is drastically increasing from time to time especially due to effects of climate change, conflict and other manmade and natural calamities in these countries. Similarly, the Tigray Region is one of the Ethiopia's most food and nutrition insecure regions with agriculture serving as the main source of income and employment. This study was therefore conducted to fill the gap in understanding the socioeconomic situation, bio-physical environment, institutional setting and policy landscape by analysing the existing circumstances in Tigray Region. This research employed quantitative data sets collected from 300 randomely selected Productive Saftey Net Program (PSNP) beneficiarieries and Non-PSNP households using probability proportional to size. The Household Dietary Diversity Score (HDDS) used as a proxy measure to nutrition security as our data is 24 h recall and food gap months as proxy to food security. Besides, Principal Component Analysis (PCA) method is used to construct household asset index. The results of the study revealed that there are clear and significant differences of the PSNP and Non-PSNP households, and gender in land holding (p<0.01%), asset ownership(p<0.01%), food gap months(p<0.01%), dietary diversity(p<0.01%), exposure to hazards and risks, copping strategies, yield, access to agricultural extension services, access to improved varieties (varietal diversification). The male headed households, and Non-PSNP households are better off than the female headed and PSNP households' counterparts. Thus, provision of practical training, conducting farmer's participatory research, field days, promoting and creating access to farmers' preferred high yielding improved varieties and management practices available in the research and extension consortium, support in research and development that develops and disseminate appropriate technologies to help farmers to lower their food gap months is highly important. In addition, sustainable intensification, off-farm employment alternatives, and engaging in agribusiness activities that create resilient livelihood options to those resource poor farm households, strengthening the formal and informal seed system would help to reduce food gap months, improve HDDS, build resilience of the food and nutrition insecure households. Therefore, customized extension services and packages are important for addressing the food and nutrition security gaps by setting goal, outcome and output indicators for future interventions in the research and development arena in filling food gap months, dietary diversity and household asset building through collaboration among relevant stakeholders in the food system.

Estimating the Size of Populations at High Risk of Malaria in 2 Operational Districts in Cambodia: Household-Based Survey.

Cambodia is targeting the elimination of malaria by 2025. The last remaining pockets of malaria in Cambodia are concentrated among populations exposed to forested areas, but the size of these populations is not well understood. To plan for the procurement and distribution of vector-control tools, chemoprophylaxis, and other commodities for malaria prevention and surveillance, robust estimates of the population at greatest risk are required. This study aims to estimate the number of forest-exposed individuals residing in Cambodia's highest-burden operational districts (ODs) in 2 provinces with active malaria transmission. In April 2023, a multistage, in-person survey was conducted among residents in the 2 ODs in Cambodia with the highest malaria burden: Sen Monorom in Mondulkiri province and Phnom Srouch in Kampong Speu province. In each OD, 10 villages were randomly selected, and 35 households were randomly selected from each village. To estimate the number of individuals at high risk of malaria-defined as residing within 1 km of a forest or traveling at least once per week to the forest-respondents were asked about the distance from their household to the nearest forested area, and their travel patterns to forested areas. To account for mobility (ie, to avoid double-counting), respondents also provided information on overnight stays at other households in the selected villages in the past month. In the 4 selected villages in Sen Monorom OD where Project BITE forest packs (an intervention in the larger research program) had been distributed prior to the survey, respondents were also asked questions to determine if they had received such a pack, to develop smaller scale "multiplier method" estimates of at-risk individuals in each of those villages. In Sen Monorom, 138 households and 872 individuals were enrolled in the survey, and in Phnom Srouch, 163 households and 844 individuals were enrolled. The estimated percentage of female householders was 49.7% (852/1716) across both ODs; the median age was 22 (IQR 12-37) years in Sen Monorom and 24.5 (IQR 16.0-40.5) years in Phnom Srouch (total age range 3-86). Based on mobility-adjusted survey estimates alone, 32% (280/706; 95% CI 19.9-47.2) of residents in Sen Monorom (an estimated 12,133-20,135 individuals) and 36% (68/198; 95% CI 24.5-45.5) of residents in Phnom Srouch (an estimated 1717-2203 individuals), met risk criteria for forest exposure. Between 125 and 186 individuals were estimated to be at risk in each of the 4 villages where the multiplier method could be applied. This study provides estimates of the number of individuals potentially at high risk for malaria infection due to forest exposure in 2 ODs in Cambodia. These estimates can support planning for malaria control and elimination efforts. The straightforward methods of household surveys and multipliers should be feasible for many national malaria control programs.

한국의 소비불평등 요인분해에 관한 연구

Purpose: This study examines the determinants of household consumption expenditure and quantifies their contribution to within group inequality by gender of household head in South Korea.&#x0D; Research design, data, and methodology: This study first decomposes total inequality into within and between inequality by gender of household head. It also examines the association between a vector of household demographic and socioeconomic characteristics and household consumption expenditure in an attempt to identify how much inequality can be attributed to each of explanatory factors. This study empirically draws upon the recent national representative dataset, Survey of Household Finance and Living Conditions (SFLC) 2 021 c ollected b y Korea Statistical Office.&#x0D; Results: According to the present study, inequality in 2021 in South Korea was found to be mainly dominated by inequality within population sub groups. Examining the determinants of household consumption inequality, it shows that factors and their conributions are different between male and female headed households. For instance, whilst the type of job occupation of a head appears to have a large impact on inequality within male headed households, it is found to have marginal contribution compared to within female headed households (25.2% vs. 7.4%). In case of household demography, it is observed as the second largest factor increasing within inequality among female headed households (31.2%) whereas its contribution to inequality within inequality among male group was relatively small (18.6%).&#x0D; Implications: Our study suggests that target specific investigation and deep structural understanding need to be made on the different characteristics of within inequality as reflected by the different role of factors and their contributions. Amongst, the different inequality impact of higher education might reflect that the expansion of higher education had a relatively lower impact on the living stand of female group than that of its counterpart, male group. Finally, the discriminatory barriers (e.g. job occupation) against female may reduce within inequality, it could widen total inequality, worsening distribution between male and female groups.

Micro-entrepreneurship, Institutional Environment and the COVID-19 Pandemic: A Comparison of Weaving Clusters in West Bengal, India

This article compares micro-enterprises’ performance and the entrepreneurial ability of weavers as perceived by the weavers themselves under two different institutional environments: one dominated by a cooperative society and the other dominated by private traders. Weavers in the private trader-dominated institutional environment are more likely to introduce new designs, develop new products and usher client satisfaction. However, the determinants of overall entrepreneurial ability reveal that after controlling for several factors, the weavers associated with a cooperative society seem to have significantly higher abilities. Analysing the marginal effects of the institutional environment, it is observed that the perceived quality of handlooms, weaver’s ability to bargain for returns and ability to efficiently manage business finances are much better in the cooperative-dominated cluster as compared to the private trader-dominated cluster. Furthermore, the resilience of enterprises during the COVID-19 pandemic was much higher in the cooperative-dominated business environment. Enterprises using more unpaid female household labour were more resilient than others during the pandemic.

Vulnerability of Female Headed Households

Abstract Research has shown that the vulnerability of female headed households is hugely exacerbated during crises such as wars and conflict. However, little research has uncovered the unique challenges that single women face in accessing humanitarian aid, for themselves and for their dependents, before, during and immediately following a crisis. This article critically examines the challenges that female headed households face in accessing humanitarian aid in crisis settings to provide a clearer and deeper understanding as well as exploration of the risks. This research found that although social and cultural health but also logistical as well as economic challenges limit female headed households’ access to humanitarian aid, female heads of households use their agency to actively respond to these challenges to provide for their dependents during a crisis. Thus, female headed households must be recognized as active agents prior to, during and immediate post conflict situations and must be supported socially, politically and economically, using effective, sustainable and equitable techniques.

Do gender disparities in socioeconomic status affect Teff productivity? A comparative analysis in Ethiopia

Ethiopia is one of Africa’s fastest-growing economies, and the recent political and economic reforms recognize the importance of empowering women and increasing their labour force participation. The Federal Democratic Republic of Ethiopia (FDRE) constitution of 1995 recognized women’s right to equality and provides intervened to enable women to compete and participate in all spheres of life and to exercise their rights on equal grounds with men. Gender empowerment and gender equality are given national priority and positioned at the centre of all policy, legal, and institutional frameworks. Research suggests that women remain overrepresented in lower-skilled jobs, while carrying out the bulk of unpaid care work. Women also face multiple forms of deprivation, gender-based discrimination, lack of access to productive resources, intimate partner violence, lack of education and training, and employment. Persistent inequalities in ownership and control over assets, such as land, houses, and oxen negatively affect their productivity and livelihoods. This paper aims at answering the question “Do gender disparities in socioeconomic status affect Teff productivity in Ethiopia?” Using mixed methods, the study conducted a cross-sectional household survey. Purposive sampling was used to select top Teff-producing regions, districts, Kebeles, key informants and FGD participants while a random sampling method was used to select the survey respondents. Results suggest that, although women were fully engaged in Teff production activities, due to a low level of ownership of productive resources such as land, labour, and oxen, there is a statistically significant difference in Teff production between female and male-headed households which needs the attention of the government and stakeholders. The paper contributes to understanding how gender-based disparities in socioeconomic status affect Teff production.

Gender and livelihood assets: Assessing climate change resilience in Phalombe district – Malawi

Access and use of livelihood assets are pertinent to recovery from impacts of climate change for rural households. This study investigated role of livelihood assets to recovery from the impacts of climate change for male and female headed households in Phalombe district in Malawi. Using exploratory sequential mixed methods design, qualitative data was collected using Participant Observation coupled with interviews in two successive phases. Quantitative data was collected using household questionnaire involving 217 households. Results show that erratic rainfall and floods are the main impacts of climate change in the study area. Male headed households have better access to human, financial and natural assets compared to female headed households. There is no significant difference on the recovery period from erratic rainfall for either type of household, but male headed households recover much more quickly from floods than female headed households. Results show that social assets are key to recovery from both erratic rainfall and floods for both male and female headed households. Natural assets contribute to recovery from erratic rainfall for male headed households while human assets are important for female headed households. Human assets are vital for recovery from floods for both male and female headed households while physical assets are important for male headed households. The study shows that enhancing social capital and developing human assets especially for female headed households can significantly contribute towards resilience to the impacts of climate change.

Determinants of Female Labour Force Participation in Pakistan

Women's labour force affects the household economy as well as economic growth. Women's labour force contribution rate is also increasing gradually in Pakistan. We attempted to determine the determinants and impact of women's labour force contribution on households. Time series data were taken from World Bank and WDI from 1981 to 2020. Based on the unit root test the ARDL model was finalized. Akaike Information Criterion (AIC) was used to verify the significance of the estimated ARDL-VECM model. There was a positive and negative association among selected variables. Variables such as female population, ratio of female workers, female headed households and female literacy rate positively and significantly impacted the female labour force participation whereas fertility rate and child mortality rate negatively but significantly determined the participation of females in labour force. Based on findings, government should focus on health and education sectors with special focus on females in order to provide reasonable educational and health facilities in order to support females participation in various economic activities of the country.

National Trends and Prevalence of Atopic Dermatitis and Pandemic-Related Factors among Korean Adults, 2007–2021

Introduction: Previous studies have variably reported inconclusive trends in the prevalence of atopic dermatitis (AD) among adults, and there are limited data on the impact of the COVID-19 pandemic. We aimed to investigate the national trends and age-stratified prevalence of AD among adults from 2007 to 2021 in South Korea, focusing mainly on the impact of the COVID-19 pandemic-related factors. Methods: A nationwide cross-sectional study was conducted using the Korea National Health and Nutrition Examination Survey data from 2007 to 2021. Overall and age-stratified prevalence for AD were assessed using weighted beta coefficients or odds ratios. Results: A total of 83,566 adults over 20 years (male, 49.40%) were included. During the observation period, the prevalence of AD was stable in the overall population from 2.61% (95% CI, 2.29–2.93) in 2007–2009 to 2.15% (1.68–2.63) in 2020 and 2.38% (1.81–2.95) in 2021. However, the weighted prevalence of AD in adults aged 40–59 years old decreased during the pre-pandemic era, and the prevalence of AD in adults aged above 60 years significantly decreased during the pandemic, with a significant decline observed after the initial outbreak. From age-stratification analysis, the adults aged 40–59 years showed a significant increase after the pandemic outbreak which was evident in specific variables: individuals with rural residence, lower education, and lower household income quartiles. Adults aged above 60 years showed a significant decrease in the slope after the outbreak, evident in specific variables: individuals of female, rural residence, lower education, and lower household income quartiles. Conclusion: We observed a stable overall prevalence of AD throughout the 15-year observation period. However, the age-stratified analysis suggested significantly different trends according to age-stratified groups and the impact of the COVID-19 pandemic on the prevalence of AD.

Gender relations and decision-making on climate change adaptation in rural East African households: A qualitative systematic review

Background: Climatic changes are threatening rural livelihoods in East Africa. Evidence suggests that climate change adaptation in this context might reproduce inequitable intra-household gender relations and that adaptation may be more effective when women are involved in meaningful ways. Hence, a nuanced understanding of the gendered nature of intra-household adaptation decision-making is essential for gender-responsive research, policy-making and practice. This qualitative systematic review aimed to investigate how gender relations influence decision-making concerning climate change adaptation in rural East African households and how decisions about climate change adaptation influence intra-household gender dynamics, in turn. Applying qualitative meta-synthesis principles, systematic searches were conducted in 8 databases and supplemented with comprehensive hand searches. 3,662 unique hits were screened using predetermined inclusion criteria, leading to a final sample of 21 papers. Relevant findings of these studies were synthesised using inductive thematic coding, memoing and thematic analysis. While men tended to be the primary decision-makers, women exercised some decision-making power in traditionally female domains and in female-headed households. Women’s and men’s roles in intra-household adaptation decision-making appeared to be influenced by a plethora of interconnected factors, including gender norms, gendered divisions of labour and access, ownership and control over resources. Intra-household adaptation seemed to impact the dynamics between male and female household members. The pathways of this influence were complex, and the ultimate outcomes for men and women remained unclear. We discuss our findings with reference to theoretical literature on gender-transformative approaches in development and adaptation and previous research concerning the gendered nature of climate change adaptation in East Africa. We then discuss implications for gender-responsive adaptation interventions.

Complementary feeding practices and associated factors among mothers of children aged 6 to 23 months in Sub-saharan African countries: a multilevel analysis of the recent demographic and health survey

IntroductionMalnutrition is a public health problem in sub-Saharan Africa with an increased morbidity and mortality rate than in other parts of the world. Poor complementary feeding practices are one of the major causes of malnutrition during the first two years of life. Therefore, this study aimed to determine the prevalence and associated factors of appropriate complementary feeding practices among mothers of children aged 6 to 23 months in sub-Saharan African countries.MethodsA multilevel mixed-effect analysis was carried out using recent demographic health survey data from 19 sub-Saharan African countries, which were conducted between 2015 and 2020. A total weighted sample of 60,266 mothers of children aged 6 to 23 months were included in the study. The demographic health survey employs a stratified two-stage sampling technique. Data extracted from the recent DHS data sets were cleaned, recorded, and analyzed using STATA/SE version 14.0 statistical software. Multilevel mixed-effects logistic regression was used to determine the factors associated with complementary feeding practice. Variables with a p-value less than 0.05 and adjusted odds ratio (AOR) with a 95% confidence interval (CI) were reported as statistically significant variables associated with appropriate complementary feeding practices.ResultsThe prevalence of appropriate complementary feeding practices among mothers of children aged 6 to 23 months in sub-Saharan African countries was 13.02% (95% CI: 12.75–13.29%). Maternal educational level [AOR = 0.69, 95% CI (0.64, 0.74)] and [AOR = 0.52, 95% CI (0.47, 0.57)], marital status of the mother [AOR = 0.85, 95% CI (0.74, 0.96)], sex of household head [AOR = 1.78, 95% CI (1.09, 1.27)], total children ever born [AOR = 1.52, 95% CI (1.18, 1.96)], [AOR = 1.43, 95% CI (1.14, 1.81)], and [AOR = 1.31, 95% CI (1.04, 1.64)], media exposure [AOR = 0.74, 95% CI (0.69, 0.79)], ANC visits attended during pregnancy [AOR = 0.73, 95% CI (0.63, 0.80)] and [AOR = 0.67, 95% CI (0.62, 0.74)], place of delivery [AOR = 0.92, 95% CI (0.85, 0.98)], currently breastfeeding [AOR = 1.12, 95% CI (1.01, 1.23)], PNC checkup [AOR = 0.75, 95% CI (0.70, 0.80)], the current age of the child [AOR = 0.26, 95% CI (0.24, 0.28)] and [AOR = 0.14, 95% CI (0.13, 0.16)], birth order [AOR = 1.31, 95% CI (1.09, 1.58)], number of under 5 children in the household [AOR = 0.76, 95% CI (0.59, 0.97)], community illiteracy [AOR = 1.09, 95% CI (1.02, 1.18)], and country category [AOR = 1.62, 95% CI (1.18, 2.22)] were significantly associated with appropriate complementary feeding practices.ConclusionThe prevalence of appropriate complementary feeding practices among mothers of children aged 6 to 23 months in sub-Saharan Africa was relatively low. Higher maternal educational level, female household head, having media exposure, attending more ANC visits, health facility delivery, currently breastfeeding, having PNC follow-up, low community illiteracy, and living in the West Africa region increase the odds of appropriate complementary feeding practices. Women empowerment, increasing maternal health services accessibility, promoting breastfeeding behavior, increasing media exposure of the household, and improving the proportion of health facility delivery are strongly recommended.

Assessment of Urban Health Extension Package Utilization and Healthcare Seeking Behavior Among Model and Non-model Households in Addis Ababa, Ethiopia: A Comparative Community Based Study

BACKGROUND: Ethiopia has been implementing the Urban Health Extension Program (UHEP) at the community level since 2009. The program was a pro-poor and cost-effective approach that aimed to enhance the utilization of urban health extension program packages and empower community healthcare-seeking behavior. This study was conducted to compare the utilization and healthcare-seeking behaviors of urban health extension program packages and the healthcare-seeking behaviors of model and non-model households. METHODS: A community-based comparative cross-sectional study was conducted among 594 female household heads (297 models and 297 non-models) using a structured face-to-face interview. A bivariate and multivariable logistic regression analysis was employed to identify associated factors. A p-value less than 0.05 and an adjusted odds ratio (AOR) with a 95% confidence interval were carried out to identify significant factors. RESULTS: Urban health extension program package utilization was 78% among model and 64.2% among non-model female households. A total of 75.5% of model and 65.2% of non-model female household heads had appropriate healthcare-seeking behavior. Moreover, having information about UHEPs (AOR = 2.35, 95% CI = 1.08 - 3.42), the frequency of home visits by UHEWs (AOR = 2.12, 95% CI = 1.01 - 3.13), knowledge about UHEPs (AOR = 3.14, 95% CI = 2.43 - 4.47), and household graduation status (AOR = 3.052, 95% CI = 2.024 to 5.113) were significantly associated with urban health extension program package utilization and healthcare-seeking behaviors. CONCLUSION: In terms of utilization, the overall urban health extension package favors model female household heads over the non-model female household heads. As a result, raising awareness, frequent home visits, and focusing more on disease prevention and control packages will boost the adoption of urban health extension packages.