National Demographic Health Survey Research Articles

Prevalence and associated factors of teenage childbearing among Ethiopian women using semi-parametric and parametric proportional hazard and accelerated failure time models

BackgroundTeenage childbearing is a common issue for young people’s sexual and reproductive health in the world, particularly in low-income countries, and affects teenagers between the ages of 13 and 19. According to several academics, adolescent pregnancy accounts for the majority of Ethiopia’s population increase, and there has been little effort to address this threat. This study aimed to determine the prevalence and associated factors of the time to teenage childbearing in Ethiopia.MethodThis paper compares the results of the semi-parametric proportional hazard (PH), parametric PH, and accelerated failure time (AFT) models to find the model that best fits the data. The Akaike Information Criterion (AIC) was used to evaluate the performance of models examined in this investigation. Time to teenage childbearing was the study’s outcome variable, while the analysis considered various independent variables. We analyze data from the 2016 National Demographic Health Survey to assess the influence of different risk factors on teenage pregnancy among Ethiopian women.ResultsOut of the 10,274 teenagers (aged between 13 and 19) who participated in the 2016 survey, 6,430 (62.59%) were parents. The study findings revealed that these teenage parents were influenced by various time-related factors before becoming parents. The log-normal AFT model has the lowest AIC value and hence it is the best fit for this data. Results from this model indicated that significant factors influencing the time to teenage childbearing include the age of the household head, current age of the respondents, region, religion, educational attainment, wealth status, intention to use contraception, and recent sexual activity.ConclusionThis study reveals that 62.59% of surveyed teenagers aged 13 to 19 were parents. Various factors at both the individual and community levels: including the age of the household head, regional differences, religious affiliation, educational level, economic status, contraceptive intentions, and recent sexual activity, determine the time to teenage childbearing. Targeted interventions addressing these factors are essential for reducing teenage pregnancies and supporting adolescent parents effectively.

Utilization of maternal health facilities and rural women’s well-being: towards the attainment of sustainable development goals

BackgroundThe sustenance of any household is tied to the well-being of the mother's health before, during, and after pregnancy. Maternal health care has continued a downward slope, increasing maternal mortality in rural communities in Nigeria. Presently, few empirical findings connect maternal healthcare facilities' use to mothers' well-being in Nigeria. Using maternal health facilities and the well-being of rural women is crucial in achieving the United Nations’ Sustainable Development Goals 1, 2, and 3 (No poverty, zero hunger, good health, and well-being).ObjectiveThe objective of the study was to examine the level of maternal healthcare utilization and its effect on mothers’ well-being status among mothers in rural Nigeria.MethodsIn this study, secondary data extracted from the Nigeria’s 2018 National Demographic Health Survey was used. Data was analyzed with Multiple correspondence analysis, Fuzzy set analysis, and Extended ordered logit model.ResultsWomen in rural Nigeria were moderate users of maternal health care services and had moderate well-being indices (0.54 ± 0.2, 0.424 ± 0.2, respectively). Mothers' moderate well-being status was increased by using maternal health care facilities, having a larger household, and having mothers who worked exclusively in agriculture.ConclusionWe concluded that mothers in rural Nigeria use maternal healthcare facilities moderately, and their well-being level was improved using maternal healthcare facilities. Therefore, Nigeria’s Ministry of Health should raise awareness about the vitality of mothers using health care services before, during, and after pregnancy. In order to promote greater female participation in full-scale agricultural production, it is imperative for the Nigerian government to allocate substantial resources in the form of subsidies and incentives. The Nigerian government should source these resources from various channels, including expanded development cooperation. Additionally, policymakers should focus on designing developmental programmes specifically tailored for rural households and the health sector.

Witnessing inter-parental violence in childhood and help-seeking behaviours in violence against women in Peru

BackgroundViolence against women (VAW) severely impacts their physical and mental health. In some cultures, women can normalize certain types of violence if they were linked to home models in childhood and, eventually, do not seek for help in adulthood. We aimed to determine, in Peruvian women, (1) the association between witnessing violence in their family of origin and VAW experienced in adulthood, (2) the extent to which women who have experienced VAW seek some help, and (3) identify VAW prevalence by Peruvian region.MethodsCross-sectional study of secondary data obtained from the 2019 National Demographic and Family Health Survey (ENDES). The outcome was VAW (psychological, physical and sexual violence), whereas the exposure was witnessing violence in the home of origin. Help-seeking behavior was a secondary outcome, for which VAW was the exposure. Prevalence ratios (PR) were estimated to assess both associations, unadjusted and adjusted for covariates (aPR).ResultsData from 14,256 women aged 15 to 49 years were analysed. 51.5% reported having experienced VAW and 43.8% witnessed violence in the home of origin during childhood. Witnessing inter-parental violence in childhood was associated with psychological violence aPR = 1.25 (95% CI: 1.17–1.33), physical aPR = 1.52 (95% CI: 1.38–1.67), and sexual aPR = 1.99 (95% CI: 1.57–2.52). Women who have experienced both types of violence (physical and sexual) were more likely to help-seeking (aPR = 1.30, 95% CI: 1.14–1.50) than women suffering only one type of violence.ConclusionWomen who reported having witnessed home violence in their childhood are more likely to experience Violence Against Women (VAW) by their current partner. Physical and sexual violence with a current partner was more associated with witnessing inter-parental violence in childhood, and when physical and sexual violence jointly occurred women were more help-seeking. The southern region of Peru is identified as an area of high vulnerability for women. It is crucial to promote educative and community-based programs aimed at the prevention and early recognition of VAW.

Factors associated with non-help-seeking among women victims of physical or sexual intimate partner violence in Peru: Findings from the National Demographic and Family Health Survey, 2017 to 2019.

To evaluate the factors associated with non-help-seeking in victims of physical or sexual intimate partner violence (IPV) in Peru. This was an analytical cross-sectional study of 3-year data from the Peruvian Demographic and Health Survey. The sample comprised women aged 18 to 49 who had experienced physical or sexual IPV at some time in their lives. The dependent variable was non-help-seeking after suffering physical or sexual IPV. Adjusted prevalence ratios (aPR) with their 95% confidence interval (CI) were calculated to assess the factors associated with non-help-seeking. In addition, a sensitivity analysis was carried out in which only women who suffered physical or sexual IPV in the last year were considered. Data from 15,265 female victims of physical or sexual IPV were analyzed. It was found that 57.4% did not seek help after suffering physical or sexual IPV. The main reasons for non-help-seeking included thinking it was unnecessary (42.3%) and embarrassment (14.9%). Age between 30 and 49 years old (PRa:1.15; 95%CI [1.06, 1.25]) and residing in a rural area (PRa:1.07; 95%CI [1.00, 1.13]) were associated with a higher probability of non-help-seeking. On the other hand, having a secondary education level (PRa:0.91; 95% CI [0.86, 0.97]) or higher (PRa:0.90; 95%CI [0.82, 0.99]), having a partner who drinks alcohol (PRa:0.94; 95%CI [0.89, 0.99]), having experienced physical or sexual IPV during a pregnancy (PRa:0.87; 95%CI [0.80, 0.94]), and having experienced moderate (PRa:0.81; 95%CI [0.76, 0.86]), or severe physical or sexual IPV (PRa:0.74; 95%CI [0.67, 0.82]), were associated with a lower probability of non-help-seeking. These associations were consistent in the sensitivity analysis. Half of the women who experience physical or sexual IPV do not seek help. There are sociodemographic factors related to this non-seeking of help that are useful for identifying and prioritizing interventions to reduce IPV and improve the health status of women.

Delays in seeking treatment for fever in children under five years of age in Nigeria: Evidence from the National Demographic Health Survey.

In countries with high child mortality rates, such as Nigeria, early intervention for common childhood illnesses (e.g., pneumonia and malaria) is essential for improving clinical outcomes. The timely reporting and treatment of fever is therefore critical in making a differential diagnosis and choosing an appropriate course of treatment. The present study aimed to investigate the prevalence and major risk factors associated with delays in seeking treatment for fever in children under five years of age in Nigeria. This study used a total weighted sample of 7,466 children under five years of age from the 2018 National Nigerian Demographic and Health Survey. Multivariable binary logistic regression modelling was used to investigate the association between predisposing, enabling, need, health service and community level factors, and delay in treatment-seeking for fever. We report the delays in seeking treatment for childhood fever that was reported by mothers in the last two weeks prior to the national survey. The prevalence for delayed treatment was 62.1% (95% confidence interval [CI]: 60.1%, 64.1%). Our findings showed that there were fewer delays in seeking treatment in children aged 24-59 months (adjusted odds ratio [aOR] = 0.79, 95% CI: 0.68, 0.93), among mothers who were formally employed (aOR = 0.84; 95% CI: 0.73, 0.96), regularly attended antenatal services (aOR = 0.76, 95%CI: 0.66, 0.88), and for those who resided in wealthier households (aOR = 0.71; 95% CI: 0.56, 0.89). Children whose mothers resided in the North-West geopolitical zone of Nigeria were less likely to delay seeking treatment for fever (aOR = 0.55; 95% CI: 0.42, 0.73). However, mothers who had an unwanted pregnancy had a higher odds of delaying treatment for childhood fever (aOR = 1.58; 95% CI: 1.05, 2.39). There were significant delays in seeking treatment for childhood fever in poorer homes found in geopolitically unstable zones of Nigeria. Mothers who were poor, unemployed, and with younger children (<12 months) often delayed seeking treatment for their febrile child. Future health promotion strategies and microenterprise schemes should target both rural and urban mothers residing in poor households. Children under 12 months of age should be a priority.

Sociodemographic correlates of discrimination against PLHIV in High HIV prevalence states of India, NFHS 2016–21

This study investigates the socio-demographic correlates of HIV discrimination among individuals aged 15–49 years. This study also aims to assess the change in discriminatory attitudes towards PLHIV in high HIV prevalence states from 2016 to 2021 using data from the national Demographic Health Survey (4th and 5th). To identify factors associated with discriminatory attitudes, a multivariable logistic regression analysis was performed. Further, predicted probabilities and average marginal effects were computed, and the difference in discriminatory attitudes across both rounds was examined using a non-linear Fairlie decomposition. Mass media exposure, improved wealth index, and comprehensive knowledge significantly reduced the discriminatory attitudes towards PLHIV. Fairlie decomposition indicated that comprehensive knowledge, knowledge of mother-to-child transmission, and mass media exposure was significant contributor to the differences observed in the discriminatory attitude towards PLHIV across survey rounds. This study emphasizes the importance of spreading accurate information about HIV transmission modes and reinforces existing programmes and policies aimed at reducing stigma and discrimination against PLHIV. These programmes' efficiency and effectiveness can be ensured by linking them with community-level programmes and activities organized by Self Help Groups (SHGs), which have resulted in a paradigm shift in empowering women in India.

Early breastfeeding initiation: Exploring rates and determinants among postpartum women in Eastern Morocco

IntroductionBreast milk is the only complete food source for infants under the age of six months, as it provides the bioactive nutrients needed to strengthen the infant's immune system, promote growth, and facilitate tissue repair. Despite the many benefits of colostrum, the National Demographic and Family Health Survey of 2018 revealed that only 42% of women in Morocco were breastfeeding within an hour of giving birth. Therefore, the aim of this study was to determine the factors influencing breastfeeding initiation after discharge within the maternity ward of the Provincial Hospital of Taza, in the Eastern Region of Morocco. Materials and methodsA cross-sectional study was conducted over a four-month period among 400 women who had given birth and were breastfeeding in the maternity ward of Ibn Baja Hospital, in the city of Taza. Questionnaires were filled out on site to collect socio-demographic, obstetric, and timely breastfeeding initiation data, as well as its determinants, before the mothers' discharge from the maternity ward. Statistical analysis was performed using SPSS software. ResultsThe participants in this study were all breastfeeding mothers who had given birth at full term. Their average age was 28.43±6.18 years, and 94.5% of them were housewives. Of these, 74% lived in rural areas, 49% lived in large families, and 48% had been married for over 5 years. The study found that only 37% of mothers initiated breastfeeding within the first hour, 78% had a vaginal delivery, and 71.5% of mothers had at least a primary education compared to 75% of fathers. Among the newborns, the majority (99.5%) had a birth weight exceeding 2.5 kgs, of which 52% were female. 66% of mothers reported having already experienced breastfeeding, and 48.5% had information about early breastfeeding. 64.5% of the respondents had made the decision to breastfeed their newborns during pregnancy. Binary logistic regression analysis revealed the involvement of six factors in the determination of early breastfeeding, namely mother's age, parents' education, sex of the newborn, prior knowledge about early breastfeeding, as well as whether or not the mother had already been breastfed by her mother. ConclusionThe study found that just 37% of mothers initiated breastfeeding within one hour of delivery. This highlights the strong association between early breastfeeding initiation and factors such as parental education, newborn sex, prior knowledge about early breastfeeding, and the mother's breastfeeding history. To promote early breastfeeding initiation, it is recommended that women of childbearing age receive education on the topic, particularly those who are less educated.

MODELLING OF ACCESS TO MOSQUITO TREATED NET IN NIGERIA: USING MULTILEVEL LOGISTIC REGRESSION APPROACH

This research examined the current status of access to Mosquito Treated Net (MTN) for children under five years in Nigeria. Despite the National malaria elimination programme recommendation of long-lasting insecticide treated net as the cornerstone of malaria prevention in Nigeria, there exist disparity in access to this MTN. The data for the study was extracted from the 2018 National Demographic Health Survey (NDHS). Descriptive statistic was adopted to describe and explain the effects of the variances present in the study on the variables of interest using STATA15 software are presented. The results reveal that out of the 8627 household with under five children considered in the analysis 7431 (86.14%) have access to MTN while 1196 (13.86%) have no access to MTN at the time of data collection. The wealth index of parents, educational attainment and regions were found to be the major determinants of under-5 access to MTN in Nigeria. The results also reveals that the null random intercept model best fit the data. The intra- class-correlation coefficient reveals a regional variation in the numbers of under-5 that have access to MTN across geopolitical zones in Nigeria. The result shows a statistically significant result for the random intercepts at 5% level of significance with a variation of 0.044154. The estimate of the intra-class-correlation coefficient indicates a total variability of 0.2051(20.51%). The research concludes that wealth index, educational attainment and region are the major determinants of access to MTN in Nigeria.

Determinants, inequalities, and spatial patterns of diarrhea in the Peruvian under-five population: findings from nationally representative survey data.

To determine the associated factors, decompose the socioeconomic inequalities, and analyze the spatial distribution of childhood diarrhea in Peru. A cross-sectional analytical study was conducted using data from the National Demographic and Family Health Survey 2021. The dependent variable was the presence of diarrhea in the last two weeks. Three types of analysis were performed: (i) to evaluate the associated factors, generalized linear models of the Poisson family with logarithmic link were applied and prevalence ratios with their 95% confidence intervals were reported; (ii) for the analysis of inequalities, a decomposition of the Erreygers concentration index was performed using a generalized linear model; and (ii) a spatial autocorrelation analysis, hot spot analysis and cluster and outlier analysis were performed. A total of 18,871 children under 5 years of age were included. The prevalence of diarrhea in this population was 10.0%. Determinants such as being aged 0-23 months, being male, belonging to the poorest, poorer and rich wealth index, and residing in the Highlands and Jungle increased the probability of presenting diarrhea. In the decomposition analysis, diarrhea had a pro-poor orientation, with the greatest contributors were age 0-23 months, belonging to the poorest and poorer wealth indexes, and residing in the Highlands and Jungle. Spatial analysis showed that the highest concentrations and occurrence of this event were observed in departments of the Highlands and Jungle. Government institutions seeking to reduce the numbers and burden of childhood diarrhea should focus their strategies on promoting hygiene measures and improving access to water and sanitation services, especially in poor populations living in the Peruvian Highlands and Jungle.

Trends and Determinants of Non-Utilization of Modern Contraception in Ekiti State, Nigeria: A Ten-Year Review.

An increase in correct usage of modern contraception is vital in reducing the maternal mortality ratio and Under-5 mortality, leading towards the achievement of Sustainable Development Goal 3. Our study examined the trends and factors affecting non-utilization of modern contraceptives over a 10-year period in Ekiti State, Nigeria. This study used data from three consecutive National Demographic Health Surveys (NDHS) - 2008, 2013, and 2018 - with a weighted sample size of 1,357 women of reproductive age (15-49 years). Data on contraceptive use on these women, provided by the NDHS, were extracted and analysed using IBM SPSS version 25. The sample was weighted to adjust for disproportionate sampling and non-response. Pearson's chi-square and binary logistic regression were used to assess the factors associated with non-utilization of modern contraceptives. The mean age of the women was 30 years. Modern contraceptive use increased from 13.1% in 2008 to 23.0% in 2018, while unmet need for modern contraceptives decreased from 84.8% in 2008 to 75.4% in 2018. Identified predictors of non-utilization of modern contraceptive were age 20-24 years [aOR=0.33, 95%CI=0.19-0.59], 25-29 years [aOR=0.34, 95%CI=0.18-0.64], 30-34 years [aOR=0.46, 95%CI=0.22-0.94], 35-39 years [aOR=0.29, 95%CI=0.14-0.61] and 40-44 years [aOR=0.37, 95%CI=0.17-0.80] compared to age 15-19 years; living in urban areas [aOR=0.72, 95%CI=0.53-0.98] compared to in rural areas; higher level of education [aOR=0.46, 95%CI=0.21-0.98] compared to no education; and desire for more children [aOR=0.48, 95%CI=0.32-0.73] compared to not wanting more children. Although contraceptive usage increased over time, the factors associated with non-utilization were being an adolescent, living in a rural area, lower level of education, and desire for more children.

Linkages between men's wealth status and the ideal number of children: A trend and multilevel analysis of survey data in Nigeria.

Most African societies practice a patriarchal family system that endows a man with authority and dominance in the family and society with a defined role of being the breadwinner of the home. A man is expected to have a great influence in determining the ideal number of children in the family and take a domineering role in decision-making, especially those related to household resource allocation. Therefore, this study examines the relationship between men's wealth status and an ideal number of children. The study used secondary data from the National Demographic Health Survey (NDHS) from 2003 to 2018. The objectives were achieved using descriptive and inferential statistics, including frequency, mean, ANOVA, and multilevel analysis techniques. Wealth status significantly influenced the ideal number of children considering the crude and adjusted regression analysis. After adjusting for individual-level and contextual factors, the odd ratio of ideal number of children was significantly lower among men in the richest categories of the wealth index. Moreover, men with two wives and above, uneducated men, Northern residents, men living in high community family norms, low community family planning, high community poverty, and low community level of education desired a high number of children. The analyses suggest the need for a consideration of community structures to provide lucrative employment for men and would experience an appreciable fertility decline in line with the objectives and targets stated in Nigeria's population policies and programmes.

Factors Associated with Symptoms of Depression among People with Obesity: Analysis of a 3-Year-Peruvian National Survey.

Obesity and depression contribute to the global burden of economic cost, morbidity, and mortality. Nevertheless, not all people with obesity develop depression. To determine the factors associated with depressive symptoms among people aged 15 or older with obesity from the National Demographic and Family Health Survey (ENDES in Spanish 2019-2021). Cross-sectional analytical study. The outcome of interest was the presence of depressive symptoms, assessed using the Patient Health Questionnaire-9 (PHQ-9). Crude (cPR) and adjusted (aPR) prevalence ratios were estimated using GLM Poisson distribution with robust variance estimates. The prevalence of depression symptoms was 6.97%. In the multivariate analysis, a statistically significant association was found between depressive symptoms and female sex (PRa: 2.59; 95% CI 1.95-3.43); mountain region (PRa: 1.51; 95% CI 1.18-1.92); wealth index poor (PRa: 1.37; 95% CI 1.05-1.79, medium (PRa: 1.49; 95% CI 1.11-2.02), and rich (PRa: 1.65; 95% CI 1.21-2.26); daily tobacco use (PRa: 2.05, 95% CI 1.09-3.87); physical disability (PRa: 1.96, 95% CI 1.07-3.57); and a history of arterial hypertension (PRa: 2.05; 95% CI 1.63-2.55). There are several sociodemographic factors (such as being female and living in the Andean region) and individual factors (daily use of tobacco and history of hypertension) associated with depressive symptoms in Peruvian inhabitants aged 15 or older with obesity. In this study, the COVID-19 pandemic was associated with an increase in depressive symptoms.

Association between socioeconomic level and cardiovascular risk in the Peruvian population.

ABSTRACTOBJECTIVETo determine the association between socioeconomic level and the presence of obesity, hypertension and type 2 diabetes mellitus in the Peruvian population.METHODSSecondary analysis of data from the National Demographic and Family Health Survey ( Encuesta Nacional Demográfica y de Salud Familiar , Endes) from 2018 to 2020. The outcomes were obesity, hypertension, and type 2 diabetes mellitus. The exposure variables were two indicators of socioeconomic status: educational level (< 7 years, 7–11 years, and 12+ years) and wealth index (in tertiles). Models were created using Poisson regression, reporting prevalence ratios (PR) and 95% confidence intervals (95%CI).RESULTSData from 98,846 subjects were analyzed. Mean age: 45.3 (SD: 16.0) years, and 55.5% were women. The prevalence of obesity was 26.0% (95%CI: 25.4–26.6); of hypertension, 24.9% (95%CI: 24.3–25.5); and of type 2 diabetes mellitus, 4.8% (95%CI: 4.5–5.1). In multivariate model, and compared with those with a low wealth index, those with a high wealth index had a higher prevalence of obesity (PR = 1.49; 95%CI: 1.38–1.62), hypertension (PR = 1.09; 95%CI: 1.02–1.17) and type 2 diabetes mellitus (PR = 1.72; 95%CI: 1.29–2.29). On the other hand, higher educational level was only associated with a reduction in the prevalence of obesity (PR = 0.89; 95%CI: 0.84–0.95).CONCLUSIONSThere is a differential association between the wealth index, educational level and markers of noncommunicable diseases. There is evidence of a positive association between wealth index and obesity, hypertension and type 2 diabetes mellitus, whereas educational level was only negatively associated with obesity.

Trends and determinants of adolescent pregnancy: Results from Kenya demographic health surveys 2003–2014

BackgroundAdolescent pregnancy increases the risk of disability and death due to unsafe abortion, prolonged labour and delivery, and complications after birth. Availability of accurate data is important to guide decision-making related to adolescent sexual reproductive health (ASRH). This study analyses the trends in prevalence and factors associated with adolescent pregnancy in Kenya using data from three national Demographic Health Surveys (2003, 2008/2009, 2014).MethodsOur analysis focused on a subsample of data collected from women aged 20 to 24 years. A trend analysis was performed to establish a change in the rate of adolescent pregnancy in 2003, 2008/2009, and 2014 survey data points. Binary Logistic regression and pooled regression analysis were used to explore factors associated with adolescent pregnancy.ResultsThe percentage of women aged 20 to 24 years who reported their first pregnancy between ages 15 and 19 years was 42% in 2003 and 42.2% in 2009 but declined to 38.9% in 2014. Using regression analyses, we established that education status, marital status, religion and wealth quintile were associated with adolescent pregnancy. Trend analysis shows that there was an overall decreasing trend in adolescent pregnancy between 2003 and 2014.ConclusionAlthough Kenya has made strides in reducing the prevalence of adolescent pregnancy in the last decade, much more needs to be done to further reduce the burden, which remains high.DefinitionAdolescents: Although WHO defines the adolescence period as being 10–19 years, this paper focuses on the late adolescent period, 15–19 years, here in referred to as adolescents.

Individual and community-level factors associated with non-institutional delivery of women of childbearing-age in Nigeria

Maternal health is a major concern in Africa especially due to high level of maternal mortality in the region. A significant cause of high mortality is the unavailability of health facilities and preference for home-based delivery often carried out by unskilled health attendants. Reports reveal that 69% of young women in Nigeria opt for home-based delivery in Nigeria and some of these mothers lose their lives as a result of childbirth complications that are not properly attended to. This trend calls for urgent concern in the nation’s health system. Against this backdrop, this study examined the determinants of non-institutional delivery among women of reproductive age in Nigeria using the country’s National Demographic Health Survey [NDHS] (2018. Demographic health survey data. NPC and ICF, Abuja, Nigeria and Rockville. MD, USA) The data for this study include 12,567 of women of childbearing-age contained in the NDHS data. To analyse the data, the multilevel binary logistic regression was used to examine the determinants of non-institutional delivery among the women of childbearing-age. The results were presented using adjusted odds ratios (AOR) with 95% confidence interval. The result revealed that 56.8% of women preferred to have their children outside health institutions. The findings further revealed that educated women including urban dwellers, women with some level of formal education, high exposure to news media, high level of income and women with significant level of autonomy were less likely to deliver their babies outside health institutions. Based on the findings of the study, that there is the need to expand educational opportunities for Nigerian women, enhance and strengthen advocacy, and utilise focused group discussions, family outreach programmes and peer education to educate mothers on the benefits of using healthcare facilities during childbirth.

Paving the way to understanding female-headed households: Variation in household composition across 103 low- and middle-income countries.

BackgroundFemale-headed households (FHHs) are regarded as disadvantaged. There are multiple social trajectories that can lead to women heading households. It is important to distinguish between these trajectories, as well as societal norms and contextual factors, to understand how and when are FHHs represented as a dimension of gender inequity. Our analysis defines and describes a typology of 16 FHH types (FHH16) based on demographic characteristics.MethodsThis cross-sectional study used national Demographic Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS) in 103 low- and middle-income countries (LMICs) to identify a typology of FHHs based on the family composition and additional household members. We performed descriptive analyses at the household level to generate median proportions of the FHH16 types and selected household characteristics. We conducted cluster analyses to explore FHH16 patterns across naturally grouped clusters of countries and described selected social and economic indicators at the ecological level.ResultsThe most common FHH16 types were those where the women household heads lived with children only, were alone, or lived with men, women, and children, but without a husband. In Africa and South Asia, the most common FHH was one where women heads resided with children only. In East Asia and the Pacific, the highest proportion of FHHs were those with men, women, and children. In MENA and Eastern Europe & Central Asia, households with women heads living alone were the most prevalent. Latin America had more FHHs with husbands, comparatively, and the most common FHHs were those with heads living alone or with children. Our exploratory cluster analysis generated five clusters with unique FHH16 patterns. The clusters had distinct geographic, contextual and economic characteristics.ConclusionsOur typology showed that FHHs are heterogeneous within and between countries. The ecological analysis emphasized further variation created by different societal and cultural factors. Research around their vulnerabilities and strengths needs to consider these factors and their influence on socioeconomic status and health-related outcomes within households headed by women.

Gender and occupation of household head as major determinants of malnutrition among children in Nigeria

Gender inequality and malnutrition are regarded as inseparable parts of the vicious cycle of poverty, being considered a cause and an effect of hunger and poverty. The majority of rural households practise subsistent farming with low returns, specifically among women, which affects the nutritional status of the households, particularly children five years old and under. Examining the gender and occupational effect of households’ heads on the nutritional status of children in Nigeria is therefore important. Potential respondents’ details were obtained from the Nigerian National Demographic Health Survey (NDHS) data, the data being analyze using descriptive statistics, Z-scores and ordered probit model. The study revealed that most malnourished children were males in female-headed households living in rural areas in the northwest zone of the country. Human capital development, gender and sector focused nutritional policy measures are essential to address malnutrition among children in Nigeria.

Impact of Covid-19 among Women of Reproductive Age in Nigeria

Background: This paper examined the impact of the covid-19 pandemic among women of reproductive age in Nigeria. Pandemics however, are not new to the human society. Nevertheless, humanitarian crises, including health emergencies like covid-19 affect men and women differently. The pandemic exposed sharp economic and social inequalities and widened the already existing gap with the most vulnerable in society, including unequal impacts affecting women and girls by virtue of their gender. This review provided information on the physical, economic and social impact of covid-19 pandemic among women of reproductive age in Nigeria. Methods: Grey literature such as reports and research briefs from WHO, UN, UNICEF, World Bank, Care International, Plan International. Partners West Africa Nigeria and National Demographic Health Survey Nigeria was used for this review. In addition literature searches from peer-reviewed articles published between 2001 to date in databases such as Pubmed and Google Scholar were also used for this review. Conclusion: Some of these impacts, as this review has found, include different types of social and economic problems such as loss of jobs, income decline, increased stress, worries, increase in sexual and gender-based violence and concerns that have had significant impact on the mental health and social well-being of women, children, and other vulnerable groups. Recommendation: Civil Society Organizations and Development Partners should lead interventions around the many forms of violence that women face across their life cycle and in all contexts of their lives- private, public and technology driven spaces. Furthermore, Government should develop operational plans that will include capacity assessments and risk analyses by the State and Local Government authorities; and extending the reach of public health and socioeconomic interventions by civil society and Non-governmental organization.

Primary healthcare services and maternal mortality in Ugep

This paper focusses on pregnancy related deaths which is a contemporary issue in modern day Nigeria. Maternal Mortality is more pronounced in Ugep, Cross River State with the maternal mortality ratio of l200/100,000 which is higher than the national figure of 1100/100,000 (Nigerian Partnership for Safe Motherhood, 2018). In Nigeria, about 75 % of women die as a result of these complications either during the course of giving birth or the week preceding delivery (Choudhry, 2012). Recent statistics shows that Maternal deaths account for 32% of all deaths among women age 15–49 in Nigeria. The maternal mortality rate for the seven-year period preceding NDHS 2013 survey was 1.05 maternal deaths per 1000 women. The maternal mortality ratio was 576 maternal deaths per 100,000 live births. The lifetime risk of maternal death indicates that out of every 30 women in Nigeria, one will have a death related to pregnancy or childbearing (NDHS, 2013). Statistics further revealed that pregnancy complications in 2012 led to the death of over 52,000 women in Nigeria (Dada, 2016). Maternal Mortality in the seven years preceding the National Demographic Health Survey in 2013 records the figure of live births to be 575 per 100,000, which implies that for one single pregnancy complications resulting to death, more than 20 others are confronted with disabilities which may last a life time, (NDHS, 2013). The theoretical application combines aspects of the Environmental Precedence Theory, Rational Choice Theory and the Health Belief Model (HBM) to explain core variables of the relationship between maternal health practices and pregnancy outcomes. Several conclusions were inferred from the application of sociological theories to the chosen contemporary issue.

Season of Data Collection of Child Dietary Diversity Indicators May Affect Conclusions About Longer-Term Trends in Peru, Senegal, and Nepal.

ABSTRACTBackgroundThe WHO-UNICEF minimum dietary diversity (MDD) indicator for children aged 6–23 mo is a global monitoring indicator used to track multi-year population-level changes in dietary quality, but the influence of seasonality on MDD estimates remains unclear.ObjectivesTo examine how seasonality of data collection may influence population-level MDD estimates and inferences about MDD changes over multiple survey years.MethodsWe selected countries with 3 or more consecutive years of MDD data collection, including continuous national Demographic Health Surveys in Senegal (2012–2017; n = 12,183) and Peru (2005–2016; n = 35,272) and the Policy and Science for Health, Agriculture, and Nutrition sentinel site seasonal surveys (covering 3 seasons/y) in Nepal (2013–2016; n = 1309). The MDD prevalence (≥5 of 8 food groups) and an 8-item continuous Food Group Score (FGS) and 95% CIs were estimated by month and compared for lean and non-lean seasons using ordinary least squares regression with dummy variables for year.ResultsThe national prevalence of MDD was higher in Peru (75.4%) than in Nepal (39.1%) or in Senegal (15.7%). Children in Peru were 1.8% (coefficient, –0.0179; 95% CI, –0.033 to –0.002) less likely to achieve MDD during the lean season. Similar seasonal magnitudes were observed in Senegal (coefficient, –0.0347; 95% CI, –0.058 to –0.011) and Nepal (coefficient, –0.0133; 95% CI, –0.107 to 0.081). The FGS was about 0.1 item lower during the lean season in all 3 countries. In comparison, MDD increased by an average rate of only 4.2 and 4.4 percentage points per 5 y in Peru and Senegal, respectively. Intakes of specific food groups were stable across months in all countries, with the provitamin A–rich food group exhibiting the most seasonality.ConclusionsThe magnitude of seasonal variation in MDD prevalence was smaller than expected but large relative to longer-term changes. If large-scale surveys are not conducted in the same season, biased conclusions about trends are possible.