scholarly journals Most of Africa's Nutritionally Deprived Women and Children are Not Found in Poor Households

2019 ◽  
Vol 101 (4) ◽  
pp. 631-644 ◽  
Author(s):  
Caitlin Brown ◽  
Martin Ravallion ◽  
Dominique van de Walle

Policymakers often assume that targeting observably poor households suffices in reaching nutritionally deprived individuals. We question that assumption. Our comprehensive assessment for sub-Saharan Africa reveals that undernourished women and children are spread widely across the household wealth and consumption distributions. Roughly three-quarters of underweight women and undernourished children are not found in the poorest 20% of households, and around half are not found in the poorest 40%. Countries with higher undernutrition tend to have higher shares of undernourished individuals in nonpoor households. Intrahousehold inequality accounts in part for our results, but other factors appear to be important, including common health risks.

2021 ◽  
pp. 1-32
Author(s):  
Aaron K. Christian ◽  
Fidelia A. A. Dake

Abstract Objective: Undernutrition and anaemia - the commonest micronutrient deficiency, continue to remain prevalent and persistent in sub-Saharan Africa (SSA) alongside a rising prevalence of overweight and obesity. However, there has been little research on the co-existence of all three conditions in the same household in recent years. This study examines the co-existence and correlates of the different conditions of household burden of malnutrition in the same household across SSA. Setting: The study involved twenty-three countries across SSA who conducted demographic and health surveys between 2008 and 2017. Participants: The analytical sample includes 145,020 households with valid data on the nutritional status of women and children pairs (i.e. women of reproductive age; 15-49 years and children under-five years). Design: Logistic regression analyses were used to determine household correlates of household burden of malnutrition. Results: Anaemia was the most common form of household burden of malnutrition, affecting about 7 out of 10 households. Double and Triple burden of malnutrition though less common, was also found to be present in 8 and 5 percent of the households respectively. The age of the household head, location of the household, access to improved toilet facilities and household wealth status were found to be associated with various conditions of household burden of malnutrition. Conclusions: The findings of this study reveal that, both double and triple burden of malnutrition is of public health concern in SSA, thus nutrition and health interventions in SSA must not be skewed towards addressing undernutrition only, but also address overweight/obesity and anaemia.


2021 ◽  
Vol 6 (1) ◽  
pp. e003773
Author(s):  
Edward Kwabena Ameyaw ◽  
Yusuf Olushola Kareem ◽  
Bright Opoku Ahinkorah ◽  
Abdul-Aziz Seidu ◽  
Sanni Yaya

BackgroundAbout 31 million children in sub-Saharan Africa (SSA) suffer from immunisation preventable diseases yearly and more than half a million children die because of lack of access to immunisation. Immunisation coverage has stagnated at 72% in SSA over the past 6 years. Due to evidence that full immunisation of children may be determined by place of residence, this study aimed at investigating the rural–urban differential in full childhood immunisation in SSA.MethodsThe data used for this study consisted of 26 241 children pooled from 23 Demographic and Health Surveys conducted between 2010 and 2018 in SSA. We performed a Poisson regression analysis with robust Standard Errors (SEs) to determine the factors associated with full immunisation status for rural and urban children. Likewise, a multivariate decomposition analysis for non-linear response model was used to examine the contribution of the covariates to the observed rural and urban differential in full childhood immunisation. All analyses were performed using Stata software V.15.0 and associations with a p<0.05 were considered statistically significant.ResultsMore than half of children in urban settings were fully immunised (52.8%) while 59.3% of rural residents were not fully immunised. In all, 76.5% of rural–urban variation in full immunisation was attributable to differences in child and maternal characteristics. Household wealth was an important component contributing to the rural–urban gap. Specifically, richest wealth status substantially accounted for immunisation disparity (35.7%). First and sixth birth orders contributed 7.3% and 14.9%, respectively, towards the disparity while 7.9% of the disparity was attributable to distance to health facility.ConclusionThis study has emphasised the rural–urban disparity in childhood immunisation, with children in the urban settings more likely to complete immunisation. Subregional, national and community-level interventions to obviate this disparity should target children in rural settings, those from poor households and women who have difficulties in accessing healthcare facilities due to distance.


Author(s):  
Sanni Yaya ◽  
Olanrewaju Oladimeji ◽  
Emmanuel Kolawole Odusina ◽  
Ghose Bishwajit

Abstract Background Adequate nutrition in early childhood is a necessity to achieve healthy growth and development, as well as a strong immune system and good cognitive development. The period from conception to infancy is especially vital for optimal physical growth, health and development. In this study we examined the influence of household structure on stunting in children &lt;5 yrs of age in sub-Saharan Africa (SSA) countries. Methods Demographic and Health Survey data from birth histories in 35 SSA countries were used in this study. The total sample of children born within the 5 yrs before the surveys (2008 and 2018) was 384 928. Children whose height-for-age z-score throughout was &lt;−2 SDs from the median of the WHO reference population were considered stunted. Percentages and χ2 tests were used to explore prevalence and bivariate associations of stunting. In addition, a multivariable logistic regression model was fitted to stunted children. All statistical tests were conducted at a p&lt;0.05 level of significance. Results More than one-third of children in SSA countries were reportedly stunted. The leading countries include Burundi (55.9%), Madagascar (50.1%), Niger (43.9%) and the Democratic Republic of the Congo (42.7%). The percentage of stunted children was higher among males than females and among rural children than their urban counterparts in SSA countries. Children from polygamous families and from mothers who had been in multiple unions had a 5% increase in stunting compared with children from monogamous families and mothers who had only one union (AOR 1.05 [95% CI 1.02 to 1.09]). Furthermore, rural children were 1.23 times as likely to be stunted compared with urban children (AOR 1.23 [95% CI 1.16 to 1.29]). Children having a &lt;24-mo preceding birth interval were 1.32 times as likely to be stunted compared with first births (AOR 1.32 [95% CI 1.26 to 1.38]). In addition, there was a 2% increase in stunted children for every unit increase in the age (mo) of children (AOR 1.02 [95% CI 1.01 to 1.02]). Multiple-birth children were 2.09 times as likely to be stunted compared with a singleton (AOR 2.09 [95% CI 1.91 to 2.28]). Conclusions The study revealed that more than one-third of children were stunted in SSA countries. Risk factors for childhood stunting were also identified. Effective interventions targeting factors associated with childhood stunting, such as maternal education, advanced maternal age, male sex, child’s age, longer birth interval, multiple-birth polygamy, improved household wealth and history of mothers’ involvement in multiple unions, are required to reduce childhood stunting in the region.


1984 ◽  
Vol 40 (2) ◽  
pp. 185-197
Author(s):  
Vanita Ray

The past decade has witnessed a staggering increase in the number of refugees in Africa; from 1.5 millions in 1969, their numbers have today risen to more than 5 million—that is, of the 10 mlliion refugees in the world, 5 millions are African. Even more alarming is the fact that the number of refugees in Africa is now greater than the populations of very many African countries. They criss-cross the entire continent and there is not a single country in Africa which has not been affected by the refugee problem. And always behind the flight of these peoples is the spectre of injustice and strife, of racial persecution or civil war—all violations of human rights. The first major group of African refugees arose as a result of national liberation struggles; thousands were dispersed to the neighbouring countries. While the National Liberation Front of Algeria (FLN) fought for the country's independence (beginning 1956), many women and children waited in refugee camps in Tunisia and Morocco. Thereafter, fortunately, most of sub-Saharan Africa obtained independence peacefully, but as the waves of independence struck the strongholds of settler and white dominated southern Africa, the travails of refugees emerged once more. Massive movements of people accompanied the strife in Angola, Mozambique, as well as Guinea Bissau. Thereafter, there was a stream of refugees from South Africa, Namibia and Zimbabwe. Meanwhile, because of internal conflicts, Africa was having its own refugee problems. Some of the most serious ones arose out of the inter-ethnic clashes in Burundi and Rwanda, with the Tutsi fleeing Rwanda and the Hutu escaping Burundi. Then the civil war in Zaire (formerly Belgian Congo) occurred in different places at different times (1960–65 and then again in March 1977–78), and has still not completely subsided. Similar is the case of Chad; the civil war in the country, which has recurred time and again, has sent large numbers of refugees fleeing to the Cameroons. Again the 20 year civil war in Sudan caused much of its southern population to scatter to the surrounding countries and as they were returning home, Sudan started receiving Ethiopian refugees from 1967—first from Eritrea, then other parts of Ethiopia. The warfare in Ogaden, the defeat of the Somalia Army by Soviet-armed and Cuban-reinforced. Ethiopian forces in 1977–78, left Ethiopia, Somalia and Djibouti with large displaced populations. Large sections of the populations of Guinea, Equatorial Guinea and Uganda were forced to seek exile because of harsh rule in their countries. New waves of refugees—millions of men, women and children—came out from Nigeria following the civil war in that country. Finally, the other important category of refugee that the continent cannot ignore are the “economic” refugees—people who leave their home simply because they cannot eke out a living or are escaping starvation due to the recent droughts. This last category usually pass unnoticed as long as the host countries accept them. Nevertheless, when sent back to their own countries, as Ghana and Uganda did and most other countries would ultimately do, they have difficult problems of integration. Keeping in mind this conceptual heterogeneity of the refugees in Africa, an attempt is made to analyze three types of problems and their combinations which cause refugee migrations in sub-Saharan Africa. For this purpose, sub-Saharan Africa may be divided into three parts—Southern Africa, that is the frontline states; Tropical Black Africa and states neighbouring the Sahara. For further analysis, the cause for which people seek refuge may be characterized as: 1. Domestic instability arising out of tribal issue conflicts and apartheid; 2. Border clashes, again resulting out of tribal rivaries and apartheid; 3. Foreign intervention towards preserving domestic clientele.


BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e029545 ◽  
Author(s):  
Dickson Abanimi Amugsi ◽  
Zacharie Tsala Dimbuene ◽  
Catherine Kyobutungi

ObjectiveTo investigate the correlates of the double burden of malnutrition (DBM) among women in five sub-Saharan African countries.DesignSecondary analysis of Demographic and Health Surveys (DHS). The outcome variable was body mass index (BMI), a measure of DBM. The BMI was classified into underweight (BMI <18.50 kg/m2), normal weight (18.50–24.99 kg/m2), overweight (25.0–29.9 kg/m2) and obesity (≥30.0 kg/m2).SettingsGhana, Nigeria, Kenya, Mozambique and Democratic Republic of Congo (DRC).SubjectsWomen aged 15–49 years (n=64698).ResultsCompared with normal weight women, number of years of formal education was associated with the likelihood of being overweight and obese in Ghana, Mozambique and Nigeria, while associated with the likelihood of being underweight in Kenya and Nigeria. Older age was associated with the likelihood of being underweight, overweight and obese in all countries. Positive associations were also observed between living in better-off households and overweight and obesity, while a negative association was observed for underweight. Breastfeeding was associated with less likelihood of underweight in DRC and Nigeria, obesity in DRC and Ghana, overweight in Kenya and overweight and obesity in Mozambique and Nigeria relative to normal weight.ConclusionsOur analysis reveals that in all the countries, women who are breastfeeding are less likely to be underweight, overweight and obese. Education, age and household wealth index tend to associate with a higher likelihood of DBM among women. Interventions to address DBM should take into account the variations in the effects of these correlates.


Author(s):  
Phillips Edomwonyi Obasohan ◽  
Stephen J. Walters ◽  
Richard Jacques ◽  
Khaled Khatab

Background/Purpose: Globally, anaemia is a severe public health condition affecting over 24% of the world’s population. Children under five years old and pregnant women are the most vulnerable to this disease. This scoping review aimed to evaluate studies that used classical statistical regression methods on nationally representative health survey data to identify the individual socioeconomic, demographic and contextual risk factors associated with developing anaemia among children under five years of age in sub-Saharan Africa (SSA). Methods/Design: The reporting pattern followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. The following databases were searched: MEDLINE, EMBASE (OVID platform), Web of Science, PUBMED, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, Scopus, Cochrane library, African Journal of online (AJOL), Google Scholar and Measure DHS. Results: The review identified 20 relevant studies and the risk factors for anaemia were classified as child-related, parental/household-related and community- or area-related factors. The risk factors for anaemia identified included age, birth order, sex, comorbidities (such as fever, diarrhoea and acute respiratory infection), malnutrition or stunting, maternal education, maternal age, mother’s anaemia status, household wealth and place of residence. Conclusion: The outcome of this review is of significant value for health policy and planners to enable them to make informed decision that will correct any imbalances in anaemia across socioeconomic, demographic and contextual characteristics, with the view of making efficient distributions of health interventions.


Author(s):  
Alison Pye ◽  
Sara Ronzi ◽  
Bertrand Hugo Mbatchou Ngahane ◽  
Elisa Puzzolo ◽  
Atongno Humphrey Ashu ◽  
...  

Household air pollution (HAP) caused by the combustion of solid fuels for cooking and heating is responsible for almost 5% of the global burden of disease. In response, the World Health Organisation (WHO) has recommended the urgent need to scale the adoption of clean fuels, such as liquefied petroleum gas (LPG), in low and middle-income countries (LMICs). To understand the drivers of the adoption and exclusive use of LPG for cooking, we analysed representative survey data from 3343 peri-urban and rural households in Southwest Cameroon. Surveys used standardised tools to collect information on fuel use, socio-demographic and household characteristics and use of LPG for clean cooking. Most households reported LPG to be clean (95%) and efficient (88%), but many also perceived it to be expensive (69%) and unsafe (64%). Positive perceptions about LPG’s safety (OR = 2.49, 95% CI = 2.04, 3.05), cooking speed (OR = 4.31, 95% CI = 2.62, 7.10), affordability (OR = 1.7, 95% CI = 1.38, 2.09), availability (OR = 2.17, 95% CI = 1.72, 2.73), and its ability to cook most dishes (OR = 3.79, 95% CI = 2.87, 5.01), were significantly associated with exclusive LPG use. Socio-economic status (higher education) and household wealth (higher income) were also associated with a greater likelihood of LPG adoption. Effective strategies to raise awareness around safe use of LPG and interventions to address financial barriers are needed to scale wider adoption and sustained use of LPG for clean cooking, displacing reliance on polluting solid fuels.


2021 ◽  
Vol 10 (2) ◽  
pp. 251-257
Author(s):  
Elizabeth Afibah Armstrong-Mensah ◽  
David-Praise Ebiringa ◽  
Kaleb Whitfield ◽  
Jake Coldiron

Genital Chlamydia trachomatis (CT) has adverse health outcomes for women and children. In pregnant women, the infection causes adverse obstetric outcomes including pelvic inflammation, ectopic pregnancy, and miscarriage. In children, it causes adverse birth outcomes such as skin rash, lesions, limb abnormalities, conjunctivitis, neurological damage, and even death. This article discusses genital CT prevalence, risk factors, and adverse pregnancy and birth outcomes among women and children in sub-Saharan Africa as well as challenges associated with the mitigation of the disease. A comprehensive search of databases including PubMed, ResearchGate, and Google Scholar was conducted using keywords such as genital chlamydia trachomatis, adverse pregnancy outcomes, adverse birth outcomes, and sub-Saharan African. We found that genital CT prevalence rates in some sub-Saharan Africa countries were higher than others and that risk factors such as the lack of condom use, having multiple sexual partners, and low educational levels contribute to the transmission of the infection. We also found that negative cultural practices, illiteracy among women, and the lack of access to screening services during pregnancy are some of the challenges associated with CT mitigation in sub-Saharan Africa. To reduce genital CT transmission in sub-Saharan Africa, efforts must be made by country governments to eliminate negative cultural practices, promote female literacy, and provide access to screening services for pregnant women.   Copyright © 2021 Armstrong-Mensah et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License CC BY 4.0.


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