Multilevel Logistic Regression Analysis Research Articles

What Predicts Within-Participant Replication of Relative Efficiency in Single-Case Comparisons? A Logistic Regression Analysis

Single-case comparative studies could help identify efficient instructional procedures for individuals with disabilities. However, previous literature reported inconsistent efficiency results if multiple comparisons were conducted, indicating that within-participant replication was uncommon. In this review, we examined single-case comparative studies with multiple within-participant comparisons and identified the arrangements that may be related to within-participant replication. We performed a multilevel mixed-effects logistic regression analysis to assess the association between different arrangements and consistent efficiency results between the comparisons. We found that some arrangements, such as random assignment of targets and a combination of random assignment and equating procedure, appear more predictive of within-participant replication.

Prevalence and associated factors of active trachoma among 1-9 years of age children in Andabet district, northwest Ethiopia, 2023: A multi-level mixed-effect analysis.

Trachoma is the chief cause of preventable blindness worldwide and has been earmarked for elimination as a public health problem by 2030. Despite the five-year Surgery, Antibiotics, Facial cleanliness, and Environmental improvement (SAFE)-based interventions in the Andabet district, the prevalence of trachomatous follicular (TF) was 37%. With such a high prevalence of TF, the determinant factors were not revealed. Besides, there were no reports on the overall prevalence of active trachoma (i.e.TF and or trachomatous intense (TI)). To determine the prevalence and associated factors of active trachoma among 1-9 years of age children in the Andabet district. A community-based cross-sectional study was conducted among children aged under nine years from March 1-30, 2023 in Andabet district, Northwest Ethiopia. Multi-stage systematic random sampling was employed to reach 540 children. A multilevel mixed-effect logistic regression analysis was employed to assess factors associated with active trachoma. We fitted both random effect and fixed effect analysis. Finally, variables with p<0.05 in the multivariable multilevel analysis were claimed to be significantly associated with active trachoma. In this study, the overall prevalence of active trachoma was 35.37% (95% CI: 31.32%, 39.41%). The prevalence of TF and TI was 31.3% and 4.07% respectively. In the multilevel logistic regression analysis ocular discharge, fly-eye contact, latrine utilization, and source of water were significantly associated with the prevalence of active trachoma. In this study, the prevalence of active trachoma was much higher than the World Health Organization (WHO) threshold prevalence. Ocular discharge, fly-eye contact, latrine utilization, and source of water were independent determinants of active trachoma among children (1-9 years). Therefore, paying special attention to these high-risk groups could decrease the prevalence of a neglected hyperendemic disease, active trachoma.

Sexual lives of reproductive-aged people with disabilities in Central Sidama National Regional State, Ethiopia: a mixed-methods study

BackgroundSexuality is an important part of human life; people with disabilities have the same sexual desires as people without disabilities. However, the status of the sexual lives of reproductive-aged people with disabilities is unfolded in Ethiopia. Therefore, this study was aimed to assess sexual lives and its associated factors among reproductive-aged people with disabilities in central Sidama National Regional State, Ethiopia.MethodsA mixed-methods study was conducted among randomly selected 685 reproductive-age people with disabilities and fifteen (15) in-depth interviews among individuals who have sexual practice experience from June 20 to July 15, 2022. The quantitative data were collected through face-to-face interviewing techniques using a structured and semi-structured questionnaire. A multilevel logistic regression analysis model was employed to analyze the data. The adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to report the measures of associations. The qualitative data were managed and analyzed using the phenomenological research analysis approach.ResultsIn this study, 59.9% (95% CI: 56.1, 63.5) of the people with disabilities have practiced sexual intercourse. Of these, 30.8% (95% CI: 27.4, 34.4) were males and 29.1% (95% CI: 25.7, 32.6) were females with disabilities. Being female (AOR = 2.81; 95% CI: 1.70, 4.62), having an occupation (AOR = 7.55; 95% CI: 4.03, 14.1), having a disability and being in a wheelchair (AOR = 0.27; 95% CI: 0.09, 0.82), having a good self-perception (AOR = 0.46; 95% CI: 0.28, 0.77), and having a rich economic status (AOR = 2.05; 95% CI: 1.08, 3.89) were factors associated with the sexual practice. The qualitative findings revealed that having sexuality information (training) is the facilitator, and community discrimination and low economic income are the barriers to sexual practice.ConclusionSexual practice among people with disabilities is low in the Dale and Wonsho districts and Yirgalem city administration. Socio-demographic and economic factors and sexuality training are the associated factors. Therefore, creating job opportunities and economic empowerment, providing sexuality training, and creating community awareness are crucial to improving the sexual practice of reproductive-age people with disabilities.

Individual- and institution-level predictors of the turnover intention of medical staff among rural primary medical institutions in Xinjiang Production and Construction Corps, China: a cross-sectional multi-level analysis.

Primary medical staff (PMS) are the guardians of population health. However, their loss further worsens the shortage and uneven distribution of human health resources, which should be addressed immediately. This study aimed to investigate the current status of turnover intention of rural PMS in Xinjiang Production and Construction Corps (XPCC) in China and its influencing factors atthe individual and institutional levels to provide reliable baseline data for intervention strategies to protect valuable rural PMS. Participants were recruited from rural public health institutions of the XPCC using a cross-sectional multistage sampling process. Data on participants' turnover intention and individual- and institution-level indicators were obtained through standardized electronic questionnaires and statistical reports of regional health administrative departments. The key factors influencing PMS turnover intention were identified us ingunivariateandmulti-level logistic regression analysis. Overall, 20.5% (447/2182) of participants reported turnover intention. Univariate analysis showed that the occurrence of turnover intention was significantly influenced by marriage, education, age, year of working, monthly income, human resource management practices (HRMP), job satisfaction, per capita served population (PCSP) and number of beds (p < 0.05). Multi-level logistic regression analysis showed that bachelor's degree or above and intermediate professional title were closely related to the occurrence of turnover intention (p < 0.05), age 41-50 years old and above, high human resource management practice, and high job satisfaction effectively reduced the odds (p < 0.05). The odds of turnover intention increased by 37% (p < 0.10) for PMS in institutions with PCSP more than 250 people. In contrast, the odds of turnover intention decreased to 68% (p < 0.05) for PMS in institutions with more than 50 beds. Government-run primary medical institutions face the risk of PMS turnover intention. From a personal perspective, the high-risk population fortheturnover intention was mainly the PMS with bachelor's degrees or above and intermediate professional titles. The low-risk population was the PMS with aged over 40 years, a higher evaluation of human resource management practice, and job satisfaction. From the perspective of primary medical institutions, larger institutions can reduce the turnover intention of individuals, whereas the size of the service population has the opposite effect.

Individual, Community, and Health Facility Predictors of Postnatal Care Utilization in Rural Tanzania: A Multilevel Analysis.

Postnatal care (PNC) is an underused service in the continuum of care for mothers and infants in sub-Saharan Africa. There is little evidence on health facility characteristics that influence PNC utilization. Understanding PNC use in the context of individual, community, and health facility characteristics may help in the development of programs for increased use. We analyzed data from 4,353 women with recent births in Kigoma Region, Tanzania, and their use of PNC (defined as at least 1 checkup in a health facility in the region within 42 days of delivery). We used a mixed-effects multilevel logistic regression analysis to explain PNC use while accounting for household, individual, and community characteristics from a regionwide population-based reproductive health survey and for distance to and adequacy of proximal health facilities from a health facility assessment. PNC utilization rate was low (15.9%). Women had significantly greater odds of PNC if they had a high level of decision-making autonomy (adjusted odds ratio [aOR]: 1.56; 95% confidence interval [CI]=1.11, 2.17); had a companion at birth (aOR: 1.57; 95% CI=1.19, 2.07); had cesarean delivery (aOR: 2.27; 95% CI=1.47, 3.48); resided in Kasulu district (aOR: 3.28; 95% CI=1.94, 5.52); or resided in a community that had at least 1 adequate health facility within 5 km (aOR: 2.15; 95% CI=1.06, 3.88). Women's decision-making autonomy and presence of companionship at birth, as well as proximity to a health facility with adequate infrastructure, equipment, and workforce, were associated with increased PNC use. More efforts toward advocating for the health benefits of PNC using multiple channels and increasing quality of care in health facilities, including companionship at birth, can increase utilization rates.

Relationship between depressive symptoms and anemia among the middle-aged and elderly: a cohort study over 4-year period

BackgroundThe association between anemia and depression has been demonstrated in previous studies, but it's still unclear whether depressive symptoms as a hazard factor for anemia. The findings of a large-scale cross-sectional and longitudinal examination of such an association of among the middle-aged and elderly individuals in China were presented in our study.MethodsThe data from China Health and Retirement Longitudinal Study in 2011 and 2015 were evaluated. 10,179 and 5,887 participants were included in cross-sectional and longitudinal study, respectively. According to the World Health Organization, hemoglobin concentrations below 13 g/dL for males and 12 g/dL for females are considered anemia. The research population was separated into two groups based on scores of the 10-item short form of the Center for Epidemiologic Studies Depression Scale (CES-D-10): the group with depressed symptoms had a score of more than 10 points, and the group with depressive disorder had a score of more than 20 points. Multilevel logistic regression analyses were conducted to explore the relationship between anemia and varying degrees of depressive symptoms, utilizing three models based on adjusting for different types of covariates.ResultsIn our cross-sectional investigation, depression disorders were more likely to link to the occurrence of anemia (OR, 1.34; 95% CI, 1.02–1.77; P = 0.035). Additionally, there seems a linear connection between depression questionnaire scores and hemoglobin concentrations (r = - 0.053, P < 0.001). Depressive symptom was significantly associated with anemia over 4 years of follow-up, and the more intense the depressive symptoms, the greater the danger of anemia (depressive symptoms group: OR, 1.27; 95% CI, 1.02–1.57, P = 0.032; depressive disorder group: OR, 1.59; 95% CI, 1.12–2.25, P = 0.010).ConclusionsOur findings suggest that depression symptoms seem related to anemia in the middle-aged and elderly in China cross-sectionally and longitudinally, and that the risk of anemia increases with the severity of depressive symptoms.

Prevalence and correlates associated with early childbearing among teenage girls in Ethiopia: A multilevel analysis.

Teenage childbearing remains a significant global health concern, and in nations with limited resources, it is the major cause of newborn and maternal deaths. Early teenage childbearing is still Ethiopia's public health issue. Therefore, the goal of this study was to identify the prevalence and correlates of influencing early childbearing among teenage girls across Ethiopia. We conducted a secondary analysis of cross-sectional data from the 2016 Ethiopian Demographic and Health Survey. A multistage stratified cluster sampling strategy based on the community was used to include the 3,498 participants in total. To determine the significantly correlated factors that influence adolescent pregnancy, a multilevel binary logistic regression analysis was used. The factors that have a significant association with early childbearing were identified using the Adjusted Odds Ratio (AOR) and 95% Confidence Interval (CI). This study demonstrated that 10.3% of teens across the country had children at an early age. The odds of early childbearing among teenage girls increased with first marriages occurring before the age of 18, non-formal education, being from a lower- or middle-class family, not using contraceptives, following Muslim or other religious beliefs, and being aware of the fertile window. Teenagers who had exposure to the media, however, had a reduced chance of becoming pregnant early. The study indicates that early teenage childbearing is still Ethiopia's most significant public health problem. Therefore, the Ethiopian government should ban early marriage while also taking steps to reduce the risk through formal education, improved access to reproductive health education, and contraception, particularly for adolescent girls from low-income families and, by educating religious institutions about pregnancy dangers.

Trust, Interaction with Neighbors, and Vaccination during the COVID-19 Pandemic: A Cross-Sectional Analysis of Chinese Data.

The COVID-19 pandemic significantly impacted public health and quality of life, leading to government recommendations for vaccination. Using cross-sectional data from a nationwide population-based survey conducted in China (N = 6860), this study aimed to examine the associations between individual vaccine uptake and general trust in others, trust in government, and interaction with neighbors. We conducted a multilevel logistic regression analysis to examine the relevance of these factors at the individual and community levels. Among young adults, higher levels of general trust at both levels were positively associated with vaccination, with odds ratios (OR) of 1.35 (95% confidence interval [CI]: 1.07, 1.70) and 1.58 (95% CI: 1.14, 2.18), respectively. We also found a positive association between vaccination and community-level interaction with neighbors, with ORs of 1.55 (95% CI: 1.11, 2.17). In contrast, among older individuals, vaccination was positively associated only with individual-level interaction with neighbors, with an OR of 1.55 (95% CI: 1.15, 2.08). The results indicated that vaccine uptake was associated with an individual's views of society and the social environment of the community, with substantial variations between the young and the old. Our findings emphasize the significance of public health measures to strengthen neighborhood interactions among older adults.

Child marriage and its association with partner controlling behaviour against adolescent girls and young women in sub-Saharan Africa

BackgroundChild marriage and partner controlling behaviours are culturally seated phenomena in sub-Saharan Africa (SSA). Child marriage refers to any legal or customary union involving a boy or girl below the age of 18. Partner controlling behaviour on the other hand refers to a situation where a sexual partner consistently tries to control their spouse’s behaviours, movements, and social contacts with other people. This study examined the association between child marriage and partner controlling behaviour among adolescent girls and young women (AGYW) in SSA.MethodsWe extracted data from the most recent Demographic and Health Surveys of 26 countries in SSA. Countries whose surveys were conducted from 2010 to 2020 were included in the study. A total of 26,970 AGYW (15–24 years) were included in the study. We used a multilevel mixed-effect binary logistic regression analysis to examine the association between child marriage and partner controlling behaviour.ResultsThe average prevalence of child marriage was 55.40% (95% CI: 48.83–61.97). This proportion ranged from 19.62% (95% CI: 16.71–22.53) in South Africa to 85.10% (95% CI: 83.14–87.06) in Chad. The proportion of AGYW who had experienced partner controlling behaviour was 68.36% (95% CI: 64.40–72.33), and this ranged from 38.40% (95% CI: 35.55–41.25) in Burundi to 88.18% (95% CI: 83.80–92.56) in Gabon. AGYW who married as child brides were more likely [aOR = 1.31; 95% CI = 1.21, 1.43] to experience partner controlling behaviour compared to those who did not marry as child brides. AGYW in Western [aOR = 1.51; 95% CI = 1.33, 1.71] and Eastern [aOR = 1.31; 95% CI = 1.13, 1.50] part of SSA were more likely to experience partner controlling behaviour compared to those in Central Africa.ConclusionsOur study has shown that there is a significant association between child marriage and the likelihood of experiencing partner controlling behaviour in SSA. Effective policies and interventions are, therefore, needed to prevent child marriage and raise AGYW’s awareness of its implication on victims of partner controlling behaviours.

Factors Associated with Children’s Physical Activity During Youth Soccer Practices

ABSTRACT Purpose: To identify practice and social contextual factors that associate with physical activity (PA) levels of children during their participation in a youth soccer program. Methods: Twenty-seven youth soccer teams serving children ages 6–11 years participated. Research staff directly observed and recorded PA intensity and practice and social contextual factors using momentary time-sampling procedures. Each team was observed for 1 practice, during which approximately 6 children were each observed for twenty 30-s observation blocks (10-s observation, 20-s recording). In total, children were observed for 3,102 intervals. Multilevel logistic regression analyses were conducted to describe associations between PA intensity and practice and social contexts. Interaction terms were introduced into the models to determine if the associations differed across girls-only, boys-only, and coed teams. Results: A total of 158 children were observed across the 27 teams. Children were more likely to engage in moderate or vigorous PA while performing fitness (Odds Ratio [OR], 9.9, 95% CI = 5.34–18.04), game (OR, 4.0, 95% CI = 2.88–5.66), warm-up (OR, 2.8, 95% CI = 1.85–4.11), and drill (OR, 1.9, 95% CI = 1.41–2.67) activities compared to tactic/instructional activities. The associations between PA intensity levels and practice and social contexts did not differ across girls-only, boys-only, and coed teams. Conclusions: Fitness activities and full-team game play were associated with higher PA intensity levels during children’s participation in youth soccer practices. Youth sport practice protocols can be modified to increase children’s physical activity.

Determinants of birth registration in sub-Saharan Africa: evidence from demographic and health surveys.

Birth registration is a crucial aspect of ensuring that children have access to their rights and benefits, including health care, education, and citizenship. In sub-Saharan Africa (SSA), birth registration rates remain low, with millions of children going unregistered each year. Understanding the predictors of birth registration among children in this sub-region is important for developing targeted interventions to improve registration rates. The study examines the predictors of birth registration among children in SSA. We performed a cross-sectional analysis of secondary data pooled from the Demographic and Health Survey of 17 countries conducted from 2015 to 2021. A weighted sample of 162,500 children was included in the final analysis. We summarized the proportion of birth registration among children in SSA using a forest plot. We utilized a multilevel binary logistic regression analysis to examine the predictors of birth registration. The results were presented using adjusted odds ratios (aOR) with 95% confidence intervals (CIs). We found that 48.32% [48.15-48.49] of births in SSA were registered. The lowest and highest prevalence of birth registration were found in Ethiopia (2.70 [2.38-3.02]) and Sierra Leone (92.93 [92.36-93.50]), respectively. Increasing child's age was found to be significantly associated with a higher likelihood of birth registrations, with those aged 4 years [aOR = 1.55; CI = 1.49, 1.62] having the highest odds of birth registration compared to those aged below 1 year. Children born to mothers with primary [aOR = 1.17; CI = 1.11, 1.24], secondary [aOR = 1.44; CI = 1.34, 1.54], and higher education [aOR = 1.71; CI = 1.48, 1.99] were more likely to be registered than those born to mothers who had no formal education. Also, children born in health facilities were more likely to be registered [aOR = 1.60; CI = 1.48, 1.74] than those born at home. The odds of birth registration were significantly higher among children whose mothers received assistance during delivery [aOR = 1.88; CI = 1.72, 2.04], those in the richest wealth index [aOR = 3.91; CI = 3.54, 4.33], and those in rural areas [aOR = 1.92; CI = 1.76, 2.10]. There is low childbirth registration coverage in SSA. The predictors of this phenomenon are the child's age, maternal level of education, wealth index, place of residence, sub-region, maternal age, place of delivery, assistance during delivery, marital status, and sex of household head. Interventions and policies developed to improve childbirth registration coverage in SSA should prioritize mothers with no formal education, those who deliver at home, those with low socioeconomic status, those living in female headed household, and adolescent mothers.

Utilization and factors associated with health facility delivery among women of reproductive age in rural Ethiopia: Mixed effect logistic regression analysis.

Worldwide over 800 women lose their life each day from complication in pregnancy and child birth. Health facility delivery is one of the key strategies for reducing maternal mortality and for ensuring safe birth. Inequity by urban-rural residence is one of the most pronounced challenges in maternal health service coverage with women living in rural areas at a greater disadvantage than other women. This study aims to assess the magnitude and factors affecting the utilization of health facility delivery for the most recent live birth among women of reproductive age in rural Ethiopia. This is a cross-sectional study based on a data from Ethiopian Mini Demographic and Health Survey 2019 dataset with a total weighted sample of 2900 women of reproductive age group in rural Ethiopia. Data cleaning, coding and labeling were done using STATA version 14 software. Multilevel mixed effect logistic regression model was employed to identify associated factors. Only 44% of reproductive-age women in rural Ethiopia gave their most recent live birth in health institutions. In the multivariable multilevel binary logistic regression analysis; educational status, wealth index, attending 4+ANC, and had ANC from skilled provider were found to be statistically significant factors associated with health facility delivery. In a rural part of Ethiopia, the prevalence of institutional delivery is low. Especial emphasis should be given for mothers with no formal education, and poor household wealth index, Furthermore, implementing public health programs that target to enable women to have more frequent Antenatal Care follow-up from skilled providers may increase the number of health facility deliveries.

Unmet need for contraception among women in Benin: a cross-sectional analysis of the Demographic and Health Survey.

The aim of the current study was to examine the prevalence and predictors of unmet need for contraception among women in sexual unions in Benin. Data for the study was extracted from the recent 2017-2018 Benin Demographic and Health Survey. A weighted sample of 9513 women of reproductive age was included in the study. We used multivariable multilevel binary logistic regression analysis to examine the factors associated with unmet need for contraception. The prevalence of unmet need for contraception was 38.0% (36.7, 39.2). The odds of unmet need for contraception was higher among women with ≥4 births compared with those with no births, and among those who reported that someone else or others usually made decisions regarding their healthcare compared with those who make their own healthcare decisions. Wealth index was associated with a higher likelihood of unmet need for contraception. Also, the region of residence was associated with unmet need for contraception, with the highest odds being among women from the Mono region (adjusted odds ratio [aOR]=2.18, 95% CI 1.33 to 3.58). Our study shows that the unmet need for contraception among women in Benin is relatively high. Our findings call on relevant stakeholders, including government and non-governmental organisations, to enhance women's empowerment as part of interventions that seek to prioritise contraceptive services for women.

Modern contraceptive use and associated factors among reproductive-age women in Ethiopia: multilevel analysis evidence from 2019 Ethiopia mini demographic and health survey

Background Despite the high fertility and population growth rates, the use of modern contraceptives remains low in low- and middle-income countries. Different pocket-sized studies on the use of modern contraceptive methods conducted in various parts of Ethiopia have been extremely varied and ambiguous. Therefore, this study aimed to assess modern contraceptive use and its associated factors in women of reproductive age in Ethiopia. Methods Cross-sectional data from the Ethiopia Interim Demographic Health Survey (EMDHS) 2019 in a stratified, two-stage, and cluster sampling study. Multilevel binary logistic regression analysis was used to fit the associated factors. The interclass correlation (ICC), median odds ratio (MOR), proportional change variance (PVC), and deviance were used for model comparison and fitness. The adjusted odds ratio (AOR) with 95% confidence interval (CI) was used to identify the significant factors of modern contraceptive use. Result The multilevel analysis demonstrated that Orthodox religion [AOR = 1.7; 95%CI: 1.4–2.10] protestant religion [AOR = 1.2; 95%CI: 0.93–1.62], married [AOR = 4.2; 95%CI: 1.93–9.07], primary education [AOR = 1.5; 95%CI: 1.26–1.76], secondary education [AOR = 1.36; 95%CI: 1.04–1.77 [AOR = 1.89; 95%CI: 1.37–2.61], middle [AOR = 1.4; 95%CI: 1.14–1.73], rich [AOR = 1.3; 95%CI: 1.06–2.68] were positively associated with modern contraceptive utilization, while the age group of 40–49 [AOR = 0.45, 95% CI: 0.34–0.58], and high community poverty [AOR = 0.62; 95%CI: 0.46–0.83] were negatively associated with modern contraceptive utilization. Conclusion The prevalence of modern contraception in Ethiopia remains low. Maternal age, religion, maternal education, marital status, wealth index, region, and community poverty were significant predictors of modern contraceptive utilization in Ethiopia. Governments and non-governmental organizations should expand their public health programs to poorer communities to increase the use of modern contraception in the country.

Sexual violence and associated factors among reproductive-age females with disabilities in central Sidama National Regional State, Ethiopia: a multilevel analysis

BackgroundSexual violence is one of the most common problems in reproductive health that causes different traumatic events that lead to mental, social, and physical problems. Females with disabilities are subjected to more traumatic events and consequences. In Ethiopia, there are limited evidences about the prevalence and associated factors of sexual violence among reproductive-aged females with disabilities. Therefore, this study aimed to assess the prevalence and associated factors of sexual violence among females with disabilities in reproductive-age in central Sidama National Regional State, Ethiopia.MethodsA multistage sampling technique was used to select 645 reproductive-age females with disabilities. Initially, three districts were purposefully selected, from which 30 kebeles and study participants were selected randomly from June 20 to July 15, 2022. A face-to-face interviewing technique was used to collect the data. The data were analyzed using a multilevel logistic regression analysis model. The measures of associations were reported using the adjusted odds ratio (AOR) and its 95% confidence interval (CI).ResultsThe prevalence of sexual violence among reproductive-age females with disabilities was 59.8% (95% CI: 56, 63.56). Residing in an urban setting (AOR = 0.51; 95% CI: 0.29, 0.88), being an adult (25 to 34 years old) (AOR = 5.9; CI: 3.01, 11.6), being an adult (35 to 49 years old) (AOR = 3.47; CI: 1.48, 8.14), having no sexuality information (AOR = 11.3; CI: 6.24, 20.5), and having hearing disabilities (AOR = 3.19; CI: 1.49, 6.83) were factors associated with sexual violence.ConclusionsSexual violence among reproductive-age females with disabilities is noticeably high. Place of residence, sexual orientation, age, and disability type were all factors associated with sexual violence. Therefore, providing sexuality education, giving high attention (information and education about sexuality) to rural residents, and considering females with hearing disabilities are important to minimize sexual violence among reproductive-age females with disabilities.

Awareness and related factors of depressive symptoms in breastfeeding people in South Korea: a survey-based cross-sectional study

ObjectivesThis study identifies depressive symptoms and the factors that could explain its presence in breastfeeding people.DesignThis study is a cross-sectional study from national survey data.Setting and participantsData were derived from...

Three fourths of women of reproductive age in emerging regions of Ethiopia are facing problems in accessing health care

Providing adequate and equal access health care is a key goal towards universal health coverage (UHC), but women continue to confront considerable inequities in accessing healthcare, particularly in the emerging regions of Ethiopia. Therefore, we identified the contributing factors to the problems in accessing health care among women of reproductive age in emerging regions of Ethiopia. Data from the 2016 Ethiopia Demographic and Health Survey were used. A total of 4680 women in reproductive age were included in the final analysis and a multilevel mixed-effect binary logistic regression analysis was done to identify the contributing factors to the problems in accessing health care. In the final model, a p-value of less than 0.05 and adjusted odds ratio (AOR) with 95% confidence interval (CI) were used to declare statistically significant factors. We found that 71.0% (95% CI 69.64–72.24%) of women in reproductive age had problems in accessing health care. Unmarried women (AOR = 1.30 95% CI 1.06–1.59), uneducated (AOR = 2.21 95% CI 1.48–3.30) and attended primary school (AOR = 1.58 95% 1.07–2.32), rural resident (AOR = 2.16 95% CI 1.40–2.02), poor (AOR = 2.95 95% CI 2.25–3.86) and middle wealth status (AOR = 1.74 95% CI 1.27–2.40), women who gave two births (AOR = 1.29 95% CI: 1.02–1.64) and not working (AOR = 1.33 95% CI 1.06, − 1.68) and working in agriculture (AOR = 1.88 95% CI 1.35–2.61) were factors that contributed for the problems in accessing health care. A significant proportion of women of reproductive age in emerging regions of Ethiopia face challenges in accessing healthcare, which places the country far from achieving its UHC targets. This issue is particularly prominent among unmarried, poor and middle wealth status, uneducated, non-working, and rural women of reproductive age. The government should develop strategies to improve women’s education, household wealth status, and occupational opportunities which would help to alleviate the barriers hindering healthcare access for women residing in emerging regions of Ethiopia.

Trachoma prevention practice and associated factors among mothers having children aged under nine years in Andabet district, northwest Ethiopia, 2022: A multi-level analysis.

The world health organization (WHO) adopted the Surgery, Antibiotic, facial cleanliness, and environmental improvement (SAFE) strategy for the prevention of trachoma, and different prevention strategies have been employed in Andabet district. Trachoma still has a high prevalence despite these efforts. So, it is imperative to assess ground trachoma prevention practice (TPP) since there are insufficient studies in the study area. To determine the magnitude and factors associated with TPP among mothers having children aged under nine years in Andabet district, Northwest Ethiopia. A community-based cross-sectional study involving 624 participants was conducted June 1-30, 2022. Systematic random sampling was carried out to select study participants. Multi-level binary logistic regression analysis was used to identify factors associated with poor TPP. Descriptive and summary statistics were performed and variables with p-value < 0.05 in the best-fitted model were declared to be significantly associated with poor TPP. In this study, the proportion of poor TPP was found to be 50.16% (95%CI = 46.23, 54.08). In the multi-variable multi-level logistic regression; having no formal education (AOR = 2.95; 95%CI: 1.41,6.15) and primary education (AOR = 2.33; 95%CI:1.04, 5.24), being a farmer (AOR = 3.02; 95%CI:1.73,5.28), and merchant (AOR = 2.63; 95%CI:1.20, 5.75), time taken to water point >30 minutes (AOR = 4.60,95CI:1.30,16.26) and didn't receive health education about trachoma (AOR = 2.36;95CI:1.16,4.79) were significantly associated with poor TPP. The proportion of poor TPP was high relative to other studies. Level of education, occupation, time taken to the water point, and health education were significantly associated with poor TPP. Therefore, taking special attention to these high-risk groups could decrease the poor TPP.

Low Level of Well-being in Young People With Physical-Mental Multimorbidity: A Population-Based Study

PurposeWe aimed to examine whether wellbeing, health behavior, and youth life among young people (YP) with co-occurrence of physical-mental conditions, that is, multimorbidity differ from YP with exclusively physical or mental conditions. MethodsThe population included 3,671 YP reported as having a physical or/and mental condition from a Danish nationwide school-based survey (aged 14–26 years). Wellbeing was measured by the five-item World Health Organization Well-Being Index and life satisfaction by the Cantril Ladder. YP's health behavior and youth life were evaluated in seven domains: home, education, activities/friends, drugs, sleep, sexuality, and self-harm/suicidal thoughts, in accordance with the Home, Education and employment, Eating, Activities, Drugs, Sexuality, Suicide and depression, and Safety acronym. We performed descriptive statistics and multilevel logistic regression analysis. ResultsA total of 52% of YP with physical-mental multimorbidity reported a low level of wellbeing, compared to 27% of YP with physical conditions and 44% with mental conditions. YP with multimorbidity had significantly higher odds of reporting poor life satisfaction, compared to YP with exclusively physical or mental conditions. YP with multimorbidity had significantly higher odds for psychosocial challenges and health risk behavior, compared to YP with physical conditions, along with increased odds for loneliness (23.3%), self-harm (63.1%), and suicidal thoughts (54.2%), compared to YP with mental conditions. DiscussionYP with physical-mental multimorbidity had higher odds for challenges and low wellbeing and life satisfaction. This is an especially vulnerable group and systematic screening for multimorbidity and psychosocial wellbeing is needed in all healthcare settings.

Exploring associations between household environmental factors and handwashing with essential agents in sub-Saharan Africa.

3 billion people lack proper home hand hygiene facilities globally. Of these, 1.4 billion (18%) lack soap or water, while 1.6 billion (22%) have neither. This analysis explores the link between living conditions and the use of essential agents in sub-Saharan Africa. This secondary data analysis examines potential associations between the domiciliary environment and the use of essential agents in sub-Saharan Africa. Eighteen demographic and health surveys were used to analyze the association between household environmental factors and handwashing with essential agents. STATA version 16 was used to analyze data from 203,311 households across weighted samples. Using a multivariable multilevel mixed effect logistic regression analysis, it was possible to determine how each independent factor affected the outcome while taking the data clustering into account. The adjusted odds ratio and its associated 95% confidence interval were used to assess the independent factors' statistical significance. Only one in three households 34.84%, practiced handwashing with essential agents, with the highest prevalence in Angola (70.2%) and the lowest in Malawi (6.5%). Educational status [aOR = 1.77; 95%(CI = 1.68-1.86)], female headship[aOR = 1.09; 95%(CI = 1.06-1.2)], household wealth[aOR = 4.08; 95%(CI = 3.84-4.33)], not sharing toilets with other homes[aOR = 1.13; 95%(CI = 1.10-1.17)], having a fixed place for hand washing[aOR = 1.49; 95%(CI = 1.45-1.54)], not having regular access to water [aOR = 0.09; 95%(CI = 0.095-0.10)]and being a rural resident [aOR = 0.85; 95%(CI = 0.82-0.88)] were associated with handwashing. sub-Saharan nations are failing to demonstrate advancements in handwashing practices. There are still a lot of homes without access to basic infrastructure for handwashing and household water sources. For essential agent adoption programs to be successful in an environment with limited resources, Water, Sanitation, and Hygiene measures must be implemented. Furthermore, it is critical to include contextual factors from the current study as well as socio-cultural and psychological characteristics that dissuade people from using essential agents in intervention strategies.