South Africa Demographic Health Survey Research Articles

Correlation of Socio-Economic Factors, Diet, and Ownership of Consumer Electronics with Body Mass Index in Women of Childbearing Age: Insights from the 2016 South African Demographic Health Survey

The available evidence indicates a correlation between owning consumer electronics, such as cellphones and televisions, and a higher risk of obesity and increased adiposity. However, such studies are sparse in South Africa. Thus, the aim of this study is to examine the dietary and sociodemographic factors associated with various BMI categories, including the possession of consumer electronics, among women of reproductive age in South Africa. This is a secondary study of a population registry that includes dietary, BMI, and digital use items among women of reproductive age. The data is from the South Africa Demographic Health Survey (SADHS, 2016). Of the 3363 participants included in the analysis, women of normal weight were (35.5%), pre-obese (34.5%), obese (27.1%) and underweight (2.9%). Age was found to be significantly associated with pre-obesity at a <0.05 confidence interval. Owning a cellphone was significantly associated with being underweight and had 55% increased odds (1–0.45) (OR = 0.45; 95% CI 0.26–0.77, p = 0.004). Using internet almost daily was statistically significant with being underweight and had 55% (1–0.45) increased odds of being underweight (OR = 0.45; 95% CI 0.20–1.01, p = 0.054). Owning a cellphone and internet use was found to be significantly associated with being underweight. More research is needed to understand why cellphone ownership and using internet almost daily are significantly associated with being underweight.

A Comparative Cross-Sectional Study of the Prevalence and Determinants of Health Insurance Coverage in Nigeria and South Africa: A Multi-Country Analysis of Demographic Health Surveys.

Background: The core Universal Health Coverage (UHC) objectives are to ensure universal access to healthcare services by reducing all forms of inequalities. However, financial constraints are major barriers to accessing healthcare, especially in countries such as Nigeria and South Africa. The findings of this study may aid in informing and communicating health policy to increase financial access to healthcare and its utilization in South Africa and Nigeria. Nigeria-South Africa bilateral relations in terms of politics, economics and trade are demonstrated in the justification of the study setting selection. The objectives were to estimate the prevalence of health insurance coverage, and to explore the socio-demographic factors associated with health insurance in South Africa and Nigeria. Methods: This was a cross-sectional study using the 2018 Nigeria Demographic Health Survey and the 2016 South Africa Demographic Health Survey. The 2018 Nigeria Demographic Health Survey data on 55,132 individuals and the 2016 South Africa Demographic Health Survey on 12,142 individuals were used to investigate the prevalence of health insurance associated with socio-demographic factors. Percentages, frequencies, Chi-square and multivariate logistic regression were e mployed, with a significance level of p < 0.05. Results: About 2.8% of the Nigerian population and 13.3% of the South African population were insured (Nigeria: males—3.4%, females—2.7% vs. South Africa: males—13.9%, females—12.8%). The multivariate logistic regression analyses showed that higher education was significantly more likely to be associated with health insurance, independent of other socio-demographic factors in Nigeria (Model I: OR: 1.43; 95% CI: 0.34–1.54, p < 0.05; Model II: OR: 1.34; 95% CI: 0.28–1.42, p < 0.05) and in South Africa (Model I: OR: 1.33; 95% CI: 0.16–1.66, p < 0.05; Model II: OR: 1.76; 95% CI: 0.34–1.82, p < 0.05). Respondents with a higher wealth index and who were employed were independently associated with health insurance uptake in Nigeria and South Africa (p < 0.001). Females were more likely to be insured (p < 0.001) than males in both countries, and education had a significant impact on the likelihood of health insurance uptake in high wealth index households among both male and females in Nigeria and South Africa. Conclusion: Health insurance coverage was low in both countries and independently associated with socio-demographic factors such as education, wealth and employment. There is a need for continuous sensitization, educational health interventions and employment opportunities for citizens of both countries to participate in the uptake of wide health insurance coverage.

Multilevel Analysis of Urban-Rural Variations of Body Weights and Individual-Level Factors among Women of Childbearing Age in Nigeria and South Africa: A Cross-Sectional Survey.

Background: An unhealthy body weight is an adverse effect of malnutrition associated with morbidity among women of childbearing age. While there is increasing attention being paid to the body weights of children and adolescents in Nigeria and South Africa, a major surge of unhealthy body weight in women has received less attention in both countries despite its predominance. The purpose of this study was to explore the prevalence of body weights (underweight, normal, overweight, and obese) and individual-level factors among women of childbearing age by urban–rural variations in Nigeria and South Africa. Methods: This study used the 2018 Nigeria Demographic Health Survey data (n = 41,821) and 2016 South Africa Demographic Health Survey (n = 8514). Bivariate, multilevel, and intracluster correlation coefficient analyses were used to determine individual-level factors associated with body weights across urban–rural variations. Results: The prevalence of being overweight or obese among women was 28.2% and 44.9%, respectively, in South Africa and 20.2% and 11.4% in Nigeria. A majority, 6.8%, of underweight women were rural residents in Nigeria compared to 0.8% in South Africa. The odds of being underweight were higher among women in Nigeria who were unemployed, with regional differences and according to breastfeeding status, while higher odds of being underweight were found among women from poorer households, with differences between provinces and according to cigarette smoking status in South Africa. On the other hand, significant odds of being overweight or obese among women in both Nigeria and South Africa were associated with increasing age, higher education, higher wealth index, weight above average, and traditional/modern contraceptive use. Unhealthy body weights were higher among women in clustering areas in Nigeria who were underweight (intracluster correlation coefficient (ICC = 0.0127), overweight (ICC = 0.0289), and obese (ICC = 0.1040). Similarly, women of childbearing age in clustering areas in South Africa had a lower risk of experiencing underweight (ICC = 0.0102), overweight (ICC = 0.0127), and obesity (ICC = 0.0819). Conclusions: These findings offer a deeper understanding of the close connection between body weights variations and individual factors. Addressing unhealthy body weights among women of childbearing age in Nigeria and South Africa is important in preventing disease burdens associated with body weights in promoting Sustainable Development Goal 3. Strategies for developing preventive sensitization interventions are imperative to extend the perspectives of the clustering effect of body weights on a country level when establishing social and behavioral modifications for body weight concerns in both countries.

Determinants and levels of cervical Cancer screening uptake among women of reproductive age in South Africa: evidence from South Africa Demographic and health survey data, 2016

BackgroundCervical cancer (CC) is the cancer with the most incidents and the leading cause of cancer mortality among women in South Africa. CC screening is one of the most cost-effective control approaches for the disease burden. This study assessed the determinants and individual-level indicators of cervical cancer screening uptake among women of reproductive age in South Africa.MethodsWe analyzed data from the 2016 South Africa Demographic Health Survey. Our analysis focused on 5903 women (15–49 years). We conducted Chi-square test for bivariate analysis, and multivariate binary logistics regression was used to analyze independent association between individual-level factors and women who have had Pap smear testing. Statistical significance was set at p < 0.05.ResultsThe mean age at cervical cancer screening uptake among women in South Africa was 40.8 years (SD 18.6, range 15–95 years). A majority of the women (39.3%) were aged 45 years and above and 54.6% of them resides in urban settlements. About 35.4% of women (n = 2098) have had a Pap smear test, with 66.5% of them who had a Pap smear test resides in Western Cape province. The proportion of women who had a Pap smear test was significantly higher among those with higher educational attainment (68.7%, p = 0.000), in the rich wealth index (50.1%, p = 0.000), and those with health insurance cover (60.3%, p = 0.000). Pap smear testing was found to be more prevalent among women aged 45+ years, were in the white population group, had higher education, were divorced, and had health insurance cover. The predominance of Pap smear test was 14% higher among women who are working in the professional/formal sector (AOR; 1.38, 95% CI; 1.14–1.69). The uptake of Pap smear test was also higher among women aged 35–44 years.ConclusionsThe prevalence of cervical cancer uptake is substantially low among women aged 15–24 years in South Africa and shows a degree of between-provinces differences. Therefore, heath educational interventions aimed at increasing the uptake of cervical cancer screening services in South Africa are critically needed.

Prevalence and Socio-Demographic Correlates of Body Weight Categories Among South African Women of Reproductive Age: A Cross-Sectional Study.

Background: The shift in disease patterns has been connected with increased body weight burden, becoming a major public health concern in South Africa, as previous studies have assessed overweight or obesity among certain populations. However, little is known about bodyweight burden (underweight, overweight, and obesity) among women aged 15–49 years. Therefore, this study was conducted to identify the prevalence and its associated socio-demographic correlates of bodyweight categories among women of reproductive age in South Africa.Methods: The present study used the South Africa Demographic Health Survey (2016 SADHS) data for 2016. A total of 3,263 women of reproductive age were included in the analysis. Both bivariable and multivariable logistics regressions were performed to determine the prevalence and socio-demographic correlates of bodyweight categories among women in South Africa. Thus, this study used the criteria of the WHO standard body mass index (BMI) cut-offs to classify bodyweight categories. The odds ratios (ORs) with 95% CIs were estimated for potential determinants included in the final model.Results: The overall prevalence of body weight burden was 66.5%, with 4.9% underweight, 27.1% overweight, and 34.5% obese (p < 0.05). The identified factors associated with underweight among women of reproductive age were those from “other” population group [adjusted odds ratio (AOR) 2.65: 95% CI 1.40–5.00], rural residence (AOR 1.23: 95% CI 0.75–2.02), and Northern Cape Province (AOR 1.58: 95% CI 0.65–3.87). For overweight/obese, the main factors were those aged 45–49 years (AOR 10.73: 95% CI 7.41–15.52), tertiary education (AOR 1.41: 95% CI 0.97–2.03), and residing in Eastern Cape (AOR 1.27: 95% CI 0.82–1.99) and KwaZulu-Natal Provinces (AOR 1.20: 95% CI 0.78–1.84).Conclusion: The findings presented in this study indicate the concurrence of underweight and overweight/obese among women aged 15–49 years in South Africa. Despite underweight prevalence being on the decline, yet overweight/obese is increasing over time. The health implication of body weight burden needs rapid and effective interventions, focusing on factors such as rural, education, population group, older age 45–49 years, and Provinces (Northern Cape, Eastern Cape, and KwaZulu-Natal) – the high-risk groups identified herein are of most importance to curb the growing burden among South African women of reproductive age.

Reducing neonatal deaths in South Africa: Progress and challenges

Although current levels of the neonatal mortality rate (NMR) are within reach of the Sustainable Development Goal (SDG) target of 12 per 1 000 live births, the absolute number of deaths is unacceptably high for a lower-middle-income country such as South Africa (SA). Neonatal mortality over the last decade has declined very slowly, and is not commensurate with the level of government investment in healthcare. The recent neonatal mortality rate of 21 per 1 000 live births reported by the SA Demographic Health Survey is of major concern. This paper reviews recent efforts to reduce the neonatal mortality rate, including support for the implementation of neonatal policies and plans, and strengthening programmes to deliver low-cost, high-impact interventions. We review recent estimates of the NMR and causes of neonatal deaths, and discuss how the mortality from preventable causes of death could be reduced. If SA is to meet the SDG target, special attention should be given to the availability of high-impact interventions, providing an adequate number of appropriately trained healthcare providers and a more active role played by ward-based community health workers and district clinical specialist teams.

Explaining the Increase in Condom Use Among South African Young Females

Since 1998 South Africa has experienced stability in HIV prevalence among its 15 to 19 year olds, and to a lesser extent among its 20 to 24 year olds. While a few studies point to behavioural change, mainly an increase in condom use, none has established the reasons. This article explores the influence of various information sources about AIDS upon the use of condoms among rural and urban South African young females, using the South Africa Demographic Health Survey of 1998 (1998 SADHS), while controlling for various socioeconomic and cultural parameters. The results show that condom use among urban residents was positively correlated with mass media exposure, television as a source of information about AIDS, and the number of mass media sources from which the respondent received information about AIDS. Condom use among rural residents was associated with the number of sources of information about AIDS, exposure to mass media, and the language and education of the respondent. Among urban residents condom use was almost twice as high as among rural residents. The results from the article indicate that three elements influenced the increase in condom use among females: the threat of AIDS, mass media, and receptiveness to condom use. The receptiveness was culturally dependent.

Family planning and its implications

Background: Sub-Saharan Africa has the highest average fertility rate in the world. In 2009, the average number of births per woman was 5.1—more than twice as many as in South Asia (2.8) or Latin America and the Caribbean (2.2). More than 100 million women in less developed countries, or about 17 percent of all married women, would prefer to avoid a pregnancy but are not using any form of family planning. Currently, approximately 24.8 percent of African women have unmet needs for family planning; this simply means 24.8 million women of reproductive age who prefer to avoid or postpone childbearing are not using any method of contraception. Objective: To make a review of trends of family planning practice in Sub Saharan Africa from 1980 to 2010 among women of reproductive age. Methodology: Meta-analysis of detailed literature by authors of articles published since 1980 from various sources, including Demographic Health Survey (DHS) of 1990 to 1995, 2000 to 2005, and of 2005-2010 from Sub-Saharan Africa such as South Africa Demographic Health Survey (SADHS) and Tanzania (TDHS); and observation on the relationship between family planning use and fertility in Africa. Findings: An analysis of fertility trends in 23 countries of Sub-Saharan Africa from 1980 to 1995 showed that in two-thirds of the countries there was evidence of fertility decline, with a particularly rapid decline in Kenya and Zimbabwe. Furthermore 2010 statistics show the African total fertility rate to be standing at 4.7. These rates reflect contraceptive prevalence of these specific regions.Generally in all world regions, contraceptive use corresponds with fertility patterns. In regions where contraceptive use is widespread, fertility is low but in regions where contraceptive use is uncommon, fertility is high. Conclusion: The paper has shown that the high fertility pattern in Africa is among others, a result of the ineffectiveness of family planning programs. Recommendation: The overall low rate of contraceptive prevalence and high unmet need for family planning suggests the need for African national governments and population policy makers to rethink access to contraceptives. Correspondence to: Glory. A. Msacky E-MAIL: glorymsacky@gmail.com