Household Head Research Articles

Indoor residual spraying uptake and its effect on malaria morbidity in Ngoma district, Eastern province of Rwanda, 2018–2021

BackgroundIndoor residual spraying (IRS) has been implemented in Rwanda in districts with high malaria transmission, including Ngoma District. The first IRS campaign (IRS-1) was conducted in March 2019, ahead of the peak malaria season, followed by a second campaign (IRS-2) in August 2020, targeting 89,331 structures. This study assessed factors influencing IRS uptake and evaluated the impact of IRS interventions on malaria morbidity in Ngoma District, Eastern Province, Rwanda.MethodsA household survey employing multistage cluster sampling design was conducted in May 2021 to randomly select households. A structured questionnaire was administered to the head of household or a designated representative. Logistic regression, adjusted for the complex survey design and weighted for sampling, was used to identify factors associated with IRS uptake. Additionally, secondary data on malaria cases registered in the Rwanda Health Management Information System (RHMIS) from January 2015 to December 2022 were analyzed using interrupted time series analysis to evaluate the effect of IRS on malaria morbidity.ResultsA total of 636 households participated in the survey. Households headed by self-employed individuals (aOR = 0.07; 95% CI 0.01–0.55) and unemployed individuals (aOR = 0.18; 95% CI 0.03–0.99) were less likely to take up IRS compared to those headed by farmers. Households receiving IRS information through media channels (aOR = 0.01; 95% CI 0.00–0.17) were less likely to participate compared to those informed by community health workers. From the RHMIS data, 919,843 malaria cases were identified from January 2015 to December 2022. Interrupted time series analysis revealed that the baseline number of adjusted malaria cases was approximately 16,920. The first IRS intervention in March 2019 resulted in a significant reduction of 14,380 cases (p < 0.001), while the second intervention in August 2020 led to a reduction of 2495 cases, though this was not statistically significant (p = 0.098).ConclusionThis study demonstrates the effectiveness of IRS in reducing malaria incidence in Ngoma District and highlights the role of socioeconomic factors and sources of information in influencing IRS uptake. To maximize the impact of IRS and ensure equitable benefits, targeted strategies, enhanced IRS education, and integrated malaria control approaches, including the use of bed nets, are crucial.

Education of household head and maternal healthcare utilization: the case of Bangladesh

BackgroundThe high maternal mortality ratio in South Asian countries could be attributed to poor maternal healthcare (MHC) utilization. Here household heads (HHs) are the main decision-makers of the households and thus can be key stakeholders in women’s MHC uptake. We aim to investigate the role of HHs’ education in MHC utilization and explore the educational status of male adolescents who will eventually replace today’s HHs in the future.MethodWe investigated antenatal care (ANC), and institutional delivery as two MHC during pregnancy and childbirth using the Bangladesh Multiple Indicator Cluster Survey 2019. Due to the stratified cluster sampling nature of the BMICS 2019, we estimated odds ratios from mixed-effect multiple logistic regression considering women nested within clusters and estimated marginal effects to conclude. Using the Bangladesh Adolescent Health and Wellbeing Survey 2019–20, we estimated region-specific school dropout rates and identified the reasons for and timing of dropout among male adolescents.ResultsThe odds of ANC uptake and institutional delivery decreased by lower levels of HHs’ education. Marginal effects of HHs’ education on institutional delivery across comparable levels of ANC uptake show that less educated HHs diminish the full potential of ANC uptake in facilitating institutional delivery. The heaviest burden (~ 70%) of less educated (up to primary level) HHs was in the northeastern region. The highest rate of school dropout (40%) was also in the northeastern region. Around 60% of dropouts left school before or just after completing primary level. The primary reasons for dropout were lack of interest and financial constraints.ConclusionIntegrating HHs into MHC programs can be the immediate call for action while averting male adolescents’ school dropouts can be the long-term strategy.

The Role of Community Social Capital and Collective Action in the Development of Sustainable Tourism

ABSTRACTBangelan Tourism Village in Indonesia holds significant potential as a tourist destination that delivers both economic and social benefits to the local community. This study focuses on the role of social capital as a key factor in the success of sustainable tourism development. The theoretical framework of this research centres on social capital, which includes trust, social networks and norms as essential elements that facilitate collective action between communities and the government to achieve sustainable tourism. Social capital, in its connection to sustainable tourism, enables coordination and collaboration among local stakeholders to pursue common goals. Uniquely, this study demonstrates that community‐driven collective action, supported by social capital, is more effective than government‐initiated programmes in advancing sustainable tourism in rural Indonesia, filling a gap in the existing literature. Data were collected via questionnaires from 261 heads of households in Bangelan Tourism Village and analysed using the structural equation modelling (SEM) partial least square (PLS) method. The results indicate that social capital, represented by trust, social networks and norms, has a strong positive influence on collective action. In turn, collective action has an even stronger impact on achieving sustainable tourism. The practical implications underscore the importance of strengthening social capital to promote active community participation in tourism management, through strategies such as community training and policies that foster mutual cooperation. This research provides a significant contribution to the literature on the relationship between social capital, collective action and sustainable tourism development, offering valuable insights for policymakers seeking to strengthen social capital in support of sustainable rural tourism.

Factors associated with time to first birth interval among ever married Bangladeshi women: A comparative analysis on Cox-PH model and parametric models.

The fertility rate of a married woman can be measured by the length of the first birth interval (FBI). This length is influenced by some significant factors. Better knowledge about the factors affecting the birth interval can help in controlling population growth and fertility progress. The main focus of this study was to compare the performance of Cox-Proportional Hazard (Cox-PH) and the parametric Accelerated Failure Time (AFT) model in assessing the impact of significant factors affecting the time to FBI of ever-married Bangladeshi women. Information of 14941 women having at least one birth was included in this study from the most recent nationally representative data 2017-18 Bangladesh Demographic and Health Survey (BDHS). We used the Cox-PH model and AFT model under various parametric forms of survival time distributions (Weibull, Exponential, and Log-normal distribution) to measure the effect of factors influencing FBI. And then, a respective Akaike information criterion (AIC) was calculated for selecting the best-fitted model. According to the AIC and BIC values, the log-normal model fitted better than other AFT models. Based on the log-normal model, women's age and age at first marriage, maternal and paternal education, contraceptive use status, used anything to avoid pregnancy, sex of household head, and spousal age difference had a significant association with FBI of ever married Bangladeshi women. The parametric AFT model (log-normal distribution) was a better fitted model in evaluating the covariates associated with FBI of ever-married Bangladeshi Women. Higher education, the right age at marriage, and proper knowledge about family planning (i.e., contraception use) should be ensured for every married person to control the gap of the first birth.

Knowledge, Attitude, and Practices Regarding the Prevention and Control of Malaria in KhyberPakhtunkhwa: An Observational Study

ABSTRACT Background: This Knowledge, Attitudes, and Practices (KAP) study aims to assess local awareness andpreventive behaviors concerning malaria in high-risk areas like Karak District. By evaluating understandingtransmission, symptom recognition, and treatment-seeking behaviors, the study seeks to inform and enhancemalaria control strategies as malaria is one of the most serious global public health challenges, contributingsignificantly to illness and mortality. The insights gained will aid in developing targeted interventions andimproving the effectiveness of malaria control programs. Objective. To assess knowledge, attitude, and practices regarding the prevention and control of malaria inlocal population of District Karak. Methods:This cross-sectionalstudywas conductedinTehsilTakht-e-Nasrati,Karakdistrict,KhyberPakhtunkhwa(KPK), using convenience sampling to survey 372 household heads. Data was collected through structuredinterviews, and only respondents who understood Urdu or Pashto were included. Descriptive statistics andFisher's exact tests were used for analysis, with a significance level of p ≤0.05. SPSS version 19 was utilizedfor analysis. Results: The study found that individuals aged 26-35 years were most affected by malaria. Additionally,72.31% of participants were employed and awareness and preventive practicesshowed that 56.45% of participantsdeemed avoiding outdoor sleeping important, 43.28% advocated for insecticide use and mosquito control,and 42.20% used protective measures, with 42.47% employing bed nets or indoor spraying. Conclusions. The study reveals a solid understanding of malaria prevention among the population yetemphasizes the need for improved implementation of protective measures and targeted government actionsto enhance malaria control.

Implementing Project Monitoring and Evaluation Plan with Beneficiaries for Improving Performance: Evidence from Tanzania Conditional Cash Transfer

The study assessed the influence of households’ involvement in the implementation of the Monitoring and Evaluation (M&amp;E) plan on the performance of the Tanzania Conditional Cash Transfer Project (CCTP). The study used the mixed method whereby the sample size was 400 heads of households while purposive sampling enabled to obtain 8 Village Committees and 8 Monitoring Officers. Quantitative data was analysed using Pearson’s correlation and regression model while qualitative data was analysed using content analysis. The study established a significant influence between households’ involvement in the implementation of the M&amp;E plan (t= 8.472, p-value =.000) on the performance of the Tanzania CCTP. It was recommended therefore that the Tanzania CCTP M&amp;E policy should be reviewed to ensure it is vital for households’ involvement in the M&amp;E cycle. The research recommended further study on the organizational practice and level of use of M&amp;E information for further improving performance.

Effect of small-scale irrigation on rural household agricultural income in Demba-Gofa District, Southern Ethiopia

Even though small-scale irrigation (SSI) is a practical solution to address issues like poverty, food insecurity, and low farm production, its promise is often overlooked in Ethiopia. In the Demba Gofa District of southern Ethiopia, many rural households continued to rely primarily on rain-fed agriculture despite the possibility of irrigation. Therefore, the purpose of this study was to determine the factors that influence the adoption of SSI in Demba Gofa and its effect on farm income. A cross-sectional explanatory research design with a mixed-methods approach was employed on a total of 369 households selected through a multistage sampling procedure. An econometric data analysis using the propensity score matching model was employed to evaluate the effect of small-scale participation on households' farm income. The analysis revealed that the gender of the household head, cultivated land area, market accessibility, livestock ownership, and credit service accessibility positively affect irrigation adoption. Households' irrigation adoption was negatively and significantly associated with the age of the household head and the distance of the farm from the irrigation site. Furthermore, households that did not adopt small-scale irrigation schemes lost 4831.77 ETB in farm revenue compared to those that did. Thus, the study advises the government to support the establishment of adequate, long canals and government-guaranteed credit services for smallholder farmers in order to boost household income and, consequently, food security. Agricultural agents ought to conduct routine evaluations of the canals' operation and offer farmers training to enhance their skills in the sustainable use of irrigation systems.

Assessment of sustainable development models for rural watershed areas with a focus on environmental components

&lt;p&gt;From the point of view of the systemic approach in sustainable rural development programs, all components should be considered concerning each other, but one of the most important components is the environmental index in development programs. Considering that the lack of attention to the environmental components in the development plans of many projects has failed and many challenges have been created in the environmental components. The current research aims to evaluate the role of environmental components in the sustainable development of rural areas. For this purpose, a questionnaire was compiled and using Cochran’s formula, a sample size of 100 copies of the questionnaire was completed from household heads, and in addition, 20 copies of the questionnaire were completed to survey the relevant officials. SPSS software was used to classify and analyze data and information, and the AHP model was used to examine the relationship between variables and prioritize them. The studied area was located in the north of Tehran-Mashhad asphalt road and about 50 km east of Garmsar city. The results of the study indicate that there is a significant relationship between the environmental components and the sustainable development of the rural areas of the studied area, which requires the special attention of the officials in this sector. It has the most importance in this region. At the end, suggestions for better planning and sustainable development are given.&lt;/p&gt;

Assessing the Impact of Women’s Empowerment on their Nutritional Status in Bangladesh: A Multilevel Logistic Regression Analysis

Women’s empowerment is one of the ten ‘special initiatives’ of Bangladesh government. According to the Global Gender Gap Report 2022, Bangladesh ranks as the most gender-equal nation in South Asia. Understanding how Bangladeshi women are empowering themselves and its impact on their nutritional status is crucial, as the Sustainable Development Goals (SDGs) include both gender equality and women's health. This study aims to investigate women’s empowerment in Bangladesh and its impacts on their nutritional status. A total number of 14,862 samples were extracted from Bangladesh Demographic and Health Survey (BDHS) 2017-18 for this study. Women’s empowerment was measured using three indicators; (i) women’s participation to make decision on their healthcare, (ii) women’s participation to purchase households goods and (iii) person who usually decides to visit family and friends. The composite index of these three indicators was used as outcome variable for further statistical analysis. The study revealed that 79.0%, 76.1% and 78.4% women participated to make decision on their healthcare, purchasing household goods and visit to relatives and friends respectively, resulting in 63.7% women being classified as empowered in Bangladesh. Predictors of women’s empowerment included: living location (division), type of residence, place of delivery, sex of household head, wealth index, respondents’ age, education, occupation, having bank account, total ever born children and decision in using contraception, and beating by husband. After controlling the effect of other factors, it was shown that empowered women were more likely to become over nourished than unempowered women. The study also found that a strikingly large proportion of women in Bangladesh remained unempowered. Some modifiable factors were found as predictors of women empowerment. Additionally, unempowered women were more likely to be undernourished. International Journal of Statistical Sciences, Vol. 24(2), November, 2024, pp 19-34

Exploring the determinants of dietary nutrients intake among the rural households: a cross-sectional study in Jhargram district of West Bengal, India

In India, nutritional public health problems such as macronutrient malnutrition and diet-related non-communicable diseases are still persistent. Dietary assessment among the population is essential to understand the adequate consumption of nutrients in maintaining a balanced diet and most importantly to accomplish the Sustainable Development Goal-2, ‘End hunger, achieve food security and improved nutrition’, by 2030. Hence, an attempt was made in this paper to examine the nutrient consumption and compare it with the Recommended Dietary Allowances (RDAs)-given by Indian Council of Medical Research(ICMR)-2020 and also to assess the determinants of adequate intake of calorie and Protein among the rural households in Jhargram district of West Bengal, India. The study used primary data from a sample of 200 households collected during April–May, 2017. The daily intake of calorie and protein were calculated by following the RDAs by ICMR-2020 conversion table. Bivariate and multivariate logistic regression models were employed. Results found that the consumption of adequate calorie and protein intake was 30% and 40% respectively. Logistic regression found that age, gender of the household head, social category, size of household, major source of income, access to market, access to credit, type of house, monthly per-capita consumer expenditure and farm size were significantly associated with the consumption of calorie and protein. The study concludes the need to address the importance of socio-economic disparities in nutrient intake and accessibility of credit facilities to rural households. There is also a need for targeted interventions among female-headed households to foster balanced nutrition and avert malnutrition.

Social transfers and poverty alleviation in Taiwan from 2000 to 2020

AbstractThis study explored the effectiveness of government social transfers in alleviating poverty and investigated the profile and reduction of income poverty in Taiwan before and after these transfers by using the Foster–Greer–Thorbecke (FGT) class of poverty measures. Data were obtained from the 2000–2020 Survey of Family Income and Expenditure. Significant progress was made in reducing poverty over the study period. The three FGT poverty measures before and after transfers peaked in 2009 and 2010, respectively, during the global financial crisis. The findings also suggested that poverty varied considerably across the subgroups. Poverty was more prevalent in female‐headed and older adult‐headed households than in male‐headed and younger adult‐headed households before and after transfers. However, the degree of poverty reduction was greater in female‐headed and older adult–headed households, and these households made greater contributions to overall poverty over time. In addition, heterogeneity was identified among the household types, and grandparent, couple, and single‐person households were identified as the most disadvantaged groups. The high number of means‐tested programs suggests piecemeal welfare benefits in Taiwan. The people living in poverty in our study relied considerably on various social transfers. Accordingly, integrated and universal welfare programs should become a key focus of policy.

Assessment of Human Capital and Social Development in Ibipolo Community, Port Harcourt

Urbanization and industrialization have led to rural-urban migration of workers, especially the low income earners. By their influx, shanty towns develop, where the conditions are perplexed with poor road networks, lack of good drinking water and inadequate sanitary conditions. These conditions have caused decrease in the level of human capital and social development of many communities. This study is a sociological analysis of urban problems, focusing on the socio-economic and social amenities as they affect human capital and social development of residents of Ibipolo. The paper adopts a qualitative and ex-post-facto design approach. The population of the study consisted of 70 household heads. Instrument for the study was a questionnaire. Findings indicated higher number of informal workers as residents; lower level education population and high rates of capital crimes. Basic social amenities as public water supply, health care facilities, and schools are non-existent. Unsanitary conditions in the community typify prevalence of health challenges. It is recommended that, government adopt a more equitable distribution of social infrastructures in order to improving the physical quality of life of citizens. Update the national habitat policy to accommodate the low-income earners. Increase human capital and social development opportunities for the citizens.

Associations between sociodemographic exposures, growth and development during infancy with development at the age of eight years among children: Analysis of a maternal education trial in rural Uganda.

Links between early life exposures and child development later in life are not sufficiently explored in low- and middle-income countries. We studied associations between sociodemographic variables, growth and development at six to eight months with developmental outcomes at eight years. We used data from a maternal education trial which included 511 mother-infant pairs at children's age of six to eight months (baseline). In this follow-up study, data from 361 mother-child pairs were available. Questionnaires were used to collect sociodemographic variables. Growth (anthropometry) was measured by study personnel and converted to z-scores according to the World Health Organization (WHO) growth reference. Child development (cognitive, motor and language) at baseline was assessed using Bayley Scales of Infant and Todler Development, third edition (BSID-III). Development at eight years was measured using two neuropsychological tools: Kaufman Assessment Battery for Children Second Edition (KABC-II) and Test of Variables of Attention (TOVA). Higher weight-for-age z-scores (adjusted odds ratio (aOR) = 0.74; 95% confidence interval (CI) = 0.53, 0.98; P = 0.04), better maternal education (aOR = 0.86; 95% CI = 0.78, 0.96; P = 0.03). and better household head education (aOR = 0.86; 95% CI = 0.78, 0.96; P = 0.03) at six to eight months of age were associated with lower odds of scoring below average on KABC-II categorical scores at eight years of age. Motor composite scores and maternal parity at six to eight months of age were positively associated with auditory and visual TOVA scores (all P-values <0.05) at eight years. Cognitive composite scores at six to eight months of age were positively associated with visual TOVA scores (P < 0.05). In contrast, weight-for-length z-scores and household head age were negatively associated with both auditory and visual TOVA scores (P < 0.05). Being a female child was associated with lower auditory and visual TOVA scores (P < 0.05). At six to eight months of age, growth and development, gender, maternal education and parity, and household head age and education were associated with child development at eight years. Interventions emphasising improved growth and development in infancy, as well as parental educational attainment, may improve long-term developmental outcomes.

Social Economic Analysis of Financial Inclusion and Poverty in Indonesia

This article analyzes the impact of financial inclusion on poverty in Indonesia using data from the 2020 National Socioeconomic Survey (Susenas), with household heads as the sample. The study posits the hypothesis that financial inclusion significantly contributes to poverty reduction. The analytical method applied is the probit logit model, considering that the dependent variable is binary. The results indicate that financial inclusion has a negative and significant effect on poverty, with a probability of 0.000 at a 5% significance level. This suggests that increasing financial inclusion can reduce the risk of poverty by up to 8.2%. These findings underscore the importance of access to and use of financial services for households in the effort to alleviate poverty. Therefore, policies are needed to support the enhancement of financial inclusion through the expansion of access to financial services, improvement of financial literacy, adjustment of financial products and services, and cross-sector coordination among the government, private sector, and financial institutions.

Environmental and socio-economic determinants of fecal sludge emptying in Sub-Saharan Africa: A cross-sectional mixed-methods study in Abidjan, Côte d'Ivoire.

This study sought to understand the determinants of household's choices for fecal sludge (FS) emptying to help fighting against unhygienic/unsafe practices and environmental pollution. A cross-sectional mixed study used in the municipality of Yopougon (Abidjan, Côte d'Ivoire), involved surveys (559 household), and 24 semi-structured interviews. Adjusted odds ratios (aORs) from logistic regressions indicated the variables significantly associated with these practices while thematic content analysis helped assessing stakeholders' perceptions. Respondents (47.6%) reported unhygienic/unsafe emptying, mainly direct FS discharge into open drains or the immediate environment via illegal toilets/pits connections (38.1% out of 47.6%). Household heads with a high monthly income (aOR = 0.59; 95% CI 0.35-0.98; p = 0.04), house ownership (aOR = 0.27; 95% CI 0.15-0.47; p < 0.001) and distance to a water body (aOR = 0.03; 95% CI 0.009-0.12; p < 0.001) were the main explanatory variables, significantly reducing the likelihood of unsafe emptying. This likelihood increases when the household is close (≤ 100m) to gully/gutter (aOR = 1.73; 95% CI 0.99-3.03; p = 0.05). Our recommendations for improving sanitation in low-income settings include reducing environmental pollution caused by unhygienic/unsafe emptying practices requires, enhancing and enforcing current regulations and making implementing texts effective, raising public awareness focusing on the benefits associated to hygienic sanitation practices, and subsidizing sanitation interventions for the poor that includes homeowners.

Unimproved source of drinking water and the associated factors: Insights from the 2020 Somalia demographic and health survey.

Access to safe drinking water is a fundamental human right and a critical public health concern, particularly in lower- and middle-income countries with limited infrastructure. Somalia faces significant challenges in providing improved drinking water sources, with a high prevalence of unimproved sources. This study analyzes data from the SHDS 2020 to investigate the prevalence of unimproved drinking water sources and identify associated factors. A cross-sectional study of 32,300 participants was conducted to identify factors associated with using unimproved drinking water sources. Multivariable logistic regression analysis was performed using Stata 16 software. Variables with a p-value < 0.05 in bivariate analysis were included in the multivariate model. Adjusted odds ratios (AOR) and 95% confidence intervals (CI) were used to estimate the association of significant variables with the outcome. Approximately 22.04% (95% CI: 21.5%, 22.4%) of the Somali population utilizes unimproved drinking water sources. Households with a head aged 20 years and above (AOR = 0.88, p = 0.059) were less likely to rely on unimproved sources than households with a head under 20 years. Female household heads (AOR = 1.17, p = 0.000) were more likely to use unimproved sources than male household heads. Unemployed partners (AOR = 1.14, p = 0.000) were more likely to use unimproved sources than employed partners. Rural (AOR = 1.12, p = 0.013) and nomadic (AOR = 0.93, p = 0.175) residents were more likely to use unimproved sources than urban residents. Households in Mudug (AOR = 31.18, p = 0.000), Nugaal (AOR = 4.15, p = 0.000), Bari (AOR = 5.26, p = 0.000), and Sanaag (AOR = 2.52, p = 0.000) regions were less likely to use unimproved sources compared to households in other regions. These findings highlight the urgent need for Somalia to improve its provision of safe and accessible water sources.

Socio-economic determinants of girl’s higher education: empirical insights from the high-mountain Nagar District, Gilgit-Baltistan, Pakistan

ABSTRACT Girls in the high mountainous regions of Pakistan have a comparative disadvantage in terms of getting higher education. By conducting 255 household surveys and employing a binary logistic regression, this study determined socio-economic factors influencing the likelihood of household heads sending their daughters for higher education. The findings indicate that household size, maternal education, and monthly income significantly influence decisions about girls’ higher education. Specifically, daughters of educated mothers are 2.84 times more likely to pursue higher education compared to daughters of illiterate mothers. Additionally, an increase in household monthly income enhances the likelihood of a daughter receiving higher education 14.2 times more than households with stable income. The study recommends raising awareness among mothers about the importance of girls’ education to improve their engagement in educational activities. Additionally, it suggests providing targeted financial support to girls from high-mountain regions to facilitate their access to higher education.

Rising Female‐Headed Households: Shifts in Living Arrangements or Heightened Gender Symmetry?

AbstractCensuses and surveys predominantly report men as heads of households or reference persons despite women carrying out most domestic and care work. Recent evidence, however, suggests that an increasing number of households are headed by women. Using data from the newly released CORESIDENCE database, which includes over 770 data points from 156 countries worldwide spanning from 1960 to 2021, this study presents the first global map of female headship, traces its recent evolution, and compares female‐headed households with male‐headed ones based on selected household characteristics. The results confirm the widespread increase in female headship in virtually all world regions. Nevertheless, significant cross‐national differences persist, and changes are not uniform across all regions. Spatial and temporal variations in female headship can be attributed, in part, to structural shifts in living arrangements, specifically the decreased presence of adult men in households. Female headship, however, is rising beyond the structural transformation of households. Women are increasingly likely to head households even in the presence of adult men, particularly their male partners. This might be indicative of normative changes towards gender symmetry. We discuss the potential factors behind these transformations and consider their implications for further research and gender equality.

Determinants of non-testing for HIV among women during antenatal care follow up in sub-saharan Africa: a hierarchical analysis of recent Demographic and Health Survey datasets

IntroductionHIV/AIDS is a global public health concern that is closely related to other sociocultural problems. The prevention of mother to child transmission cascade often begins with and is integrated into antenatal care in order to ensure a high rate of case detection and optimal treatment coverage. Although guidelines suggest that all pregnant women should have HIV testing as part of their regular screening checks during antenatal care, a significant proportion of pregnant women were not tested for HIV during antenatal care follow-up in sub-Saharan Africa. Hence, this study was aimed at assessing the determinants of women not tested for HIV during antenatal care follow-up in sub-Saharan Africa.MethodA cross-sectional study was conducted to assess the determinants of non-testing for HIV among women as part of antenatal care in sub-Saharan Africa, utilizing secondary data from the 2015–2022 Demographic and Health Surveys. The study included a weighted sample of 788,421 women who had antenatal care follow-up during their most recent pregnancy within five years preceding the survey. A multilevel mixed effect logistic regression analysis was employed to identify the determinants of non-testing for HIV among these women. The adjusted odds ratios with 95% confidence intervals were calculated to determine the associations between the outcome and explanatory variables. Statistical significance was determined using a p-value of less than 0.05.ResultThe hierarchical analysis of this study identified several significant factors associated with women not being tested for HIV during antenatal care in sub-Saharan Africa. These factors include young age, low or no education, not being in a union, unemployment, and low household wealth index. Additionally, limited media exposure, stigmatizing attitudes towards people living with HIV, male-headed households, and rural residence were significant at the individual and household levels. At the community level, low media exposure and high illiteracy rates were significant, while at the country level, high fertility rates and low literacy rates were also associated with lower rates of HIV testing during antenatal care.ConclusionThis study identified significant individual, community, and country-level factors associated with women not testing for HIV during antenatal care in sub-Saharan Africa. Key factors include young age, low education, unemployment, not being in a union, low household wealth, limited media exposure, stigmatizing attitudes towards people living with HIV, male household head, rural residence, low community media exposure, high community illiteracy, high fertility rates, and low literacy rates. These findings highlight the need for targeted, context-specific interventions to improve HIV testing rates and enhance maternal and child health outcomes in the region.

Traditional Justice System of the Harijan Community in Rajshahi, Bangladesh

The main objective of this research was to examine the characteristics of the traditional justice delivery system utilized by the Harijan community in Rajshahi, Bangladesh, and to illustrate its status along with the roles of judicial services within this community. The study focused on a Harijan colony in Rajshahi district namely the I.D. (Infectious Disease) Ambagan Harijan Palli. A mixed-method approach was employed, which included a social survey involving 110 heads of households using a semi-structured questionnaire to gather quantitative data. Additionally, qualitative data were collected through 20 in-depth interviews (IDIs), 10 key informant interviews (KIIs), and 1 focus group discussion (FGD). The findings indicated that a significant number of Harijan individuals had never engaged with the court or judiciary system, revealing a biased role of the Panchayat or Samaj in maintaining law and order, as they were unable to safeguard the Harijan community from attacks by influential individuals and outsiders. Nevertheless, the results also indicated that many Harijan people expressed satisfaction with their traditional justice system. Furthermore, the study identified various barriers that hinder access to the formal justice system. These findings are expected to serve as a valuable resource for government officials, NGO leaders, legal practitioners, and development professionals.