scholarly journals Prenatal care coverage and correlates of HIV testing in sub-Saharan Africa: Insight from demographic and health surveys of 16 countries

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242001
Author(s):  
Oluwafemi Emmanuel Awopegba ◽  
Amarachi Kalu ◽  
Bright Opoku Ahinkorah ◽  
Abdul-Aziz Seidu ◽  
Anthony Idowu Ajayi
Keyword(s):  
Prenatal Care ◽  
Pregnant Women ◽  
Hiv Testing ◽  
Health Surveys ◽  
Central Africa ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
West And Central Africa ◽  
Sub Saharan ◽  
Ssa Countries

Background Prenatal screening of pregnant women for HIV is central to eliminating mother-to-child-transmission (MTCT) of HIV. While some countries in sub-Saharan Africa (SSA) have scaled up their prevention of MTCT programmes, ensuring a near-universal prenatal care HIV testing, and recording a significant reduction in new infection among children, several others have poor outcomes due to inadequate testing. We conducted a multi-country analysis of demographic and health surveys (DHS) to assess the coverage of HIV testing during pregnancy and also examine the factors associated with uptake. Methods We analysed data of 64,933 women from 16 SSA countries with recent DHS datasets (2015–2018) using Stata version 16. Adjusted and unadjusted logistic regression models were used to examine correlates of prenatal care uptake of HIV testing. Statistical significance was set at p<0.05. Results Progress in scaling up of prenatal care HIV testing was uneven across SSA, with only 6.1% of pregnant women tested in Chad compared to 98.1% in Rwanda. While inequality in access to HIV testing among pregnant women is pervasive in most SSA countries and particularly in West and Central Africa sub-regions, a few countries, including Rwanda, South Africa, Zimbabwe, Malawi and Zambia have managed to eliminate wealth and rural-urban inequalities in access to prenatal care HIV testing. Conclusion Our findings highlight the between countries and sub-regional disparities in prenatal care uptake of HIV testing in SSA. Even though no country has universal coverage of prenatal care HIV testing, East and Southern African regions have made remarkable progress towards ensuring no pregnant woman is left untested. However, the West and Central Africa regions had low coverage of prenatal care testing, with the rich and well educated having better access to testing, while the poor rarely tested. Addressing the inequitable access and coverage of HIV testing among pregnant women is vital in these sub-regions.

scholarly journals Women’s decision-making capacity and HIV testing in sub-Saharan Africa: A multi-country analysis of Demographic and Health Surveys

2020 ◽  
Author(s):  
Abdul-Aziz Seidu ◽  
Joseph Kojo Oduro ◽  
Bright Opoku Ahinkorah ◽  
Eugene Budu ◽  
Francis Appiah ◽  
...  
Keyword(s):  
Decision Making ◽  
Hiv Testing ◽  
Health Surveys ◽  
Demographic Characteristics ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Odds Ratios ◽  
Decision Making Capacity ◽  
Sub Saharan ◽  
Ssa Countries

Abstract IntroductionGlobal commitment to stop HIV and ensure access to HIV treatment call for women empowering as these efforts play a major role in mother to child transmission. We explored the association between women decision-making capacity and HIV testing in sub-Saharan Africa (SSA). Materials and methodsWe used data from current Demographic and Health Surveys (DHS) conducted between January 1, 2010 and December 31, 2016 in 30 countries within SSA. At the descriptive level, we calculated the prevalence of women who had undergone HIV testing and decision-making capacity in each of the countries as well as prevalence of HIV testing across their socio-demographic characteristics. We used Binary Logistic Regression to explore the likelihood of HIV testing by decision-making capacity and socio-demographic characteristics at 5% margin of error. The results were presented as Crude Odds Ratios (CORs) and Adjusted Odds Ratios (AORs). ResultsWe found that overall, 10.0% of women had decision-making with Nigeria (4.5%) and Zimbabwe (21.3%) recording the least and the highest respectively. In terms of HIV testing, the prevalence of HIV testing in the 30 SSA countries was 64.4%, with Guinea (12.8%) having the least. The highest occurred in Lesotho (99%) and Rwanda (99%). Women who had capacity to make decisions had higher likelihood of HIV testing [AOR=1.04, CI=1.02–1.09]. Women from Rwanda had the highest likelihood of HIV testing [AOR=53.92, CI=41.31–70.37] with women from Guinea having the least likelihood [AOR=0.10, CI=0.08–0.11]. Other determinants to HIV testing were level of education, wealth status, believing that a healthy-looking person can have HIV, watching television almost every day, age and place of residence.Conclusion SSA countries intending to improve HIV testing need to incorporate women decision-making capacity strategies in terms of education and counselling into the available policies. This is essential because our study indicates that as women are able to make decisions in their households, the possibility for them to test for their HIV status increases.

scholarly journals Women’s healthcare decision-making capacity and HIV testing in sub-Saharan Africa: a multi-country analysis of demographic and health surveys

2020 ◽  
Author(s):  
Abdul-Aziz Seidu ◽  
Joseph Kojo Oduro ◽  
Bright Opoku Ahinkorah ◽  
Eugene Budu ◽  
Francis Appiah ◽  
...  
Keyword(s):  
Decision Making ◽  
Hiv Testing ◽  
Health Surveys ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Healthcare Decision ◽  
Healthcare Decision Making ◽  
Decision Making Capacity ◽  
Sub Saharan ◽  
Ssa Countries

Abstract Background Global commitment to stop Human Immunodeficiency Virus (HIV) and ensure access to HIV treatment calls for women empowerment, as these efforts play major roles in mother-to-child transmission. We explored the association between women’s healthcare decision-making capacity and HIV testing in sub-Saharan Africa (SSA). Methods We used data from the current Demographic and Health Surveys (DHS) conducted between January 1, 2010 and December 31, 2018 in 28 countries in SSA. At the descriptive level, we calculated the prevalence of HIV testing in each of the countries. This was followed by the distribution of HIV testing across the socio-demographic characteristics of women. Finally, we used binary logistic regression to explore the likelihood of HIV testing by women’s health care decision-making capacity and socio-demographic characteristics. The results were presented as Crude Odds Ratios (COR) and Adjusted Odds Ratios (AOR) with their corresponding 95% confidence intervals signifying precision. Statistical significance was set at p-value <0.05. Results We found that prevalence of HIV testing in the 28 SSA countries was 64.4%, with Congo DR having the least (20.2%) and the highest occurred in Rwanda (97.4%). Women who took healthcare decisions alone [COR=3.183, CI=2.880-3.519] or with their partners [COR=2.577, CI=2.335-2.844] were more likely to test for HIV, compared to those whose healthcare decisions were taken by others, and this persisted after controlling for significant covariates: [AOR=1.507, CI=1.321-1.720] and [AOR=1.518, CI=1.334-1.728] respectively. Conclusion SSA countries intending to improve HIV testing need to incorporate women’s healthcare decision-making capacity strategies. These strategies can include education and counselling. This is essential because our study indicates that the capacity of women to make healthcare decisions has an association with their decision to test for their HIV status.

scholarly journals Women’s healthcare decision-making capacity and HIV testing in sub-Saharan Africa: a multi-country analysis of demographic and health surveys

2020 ◽  
Author(s):  
Abdul-Aziz Seidu ◽  
Joseph Kojo Oduro ◽  
Bright Opoku Ahinkorah ◽  
Eugene Budu ◽  
Francis Appiah ◽  
...  
Keyword(s):  
Decision Making ◽  
Hiv Testing ◽  
Health Surveys ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Healthcare Decision ◽  
Healthcare Decision Making ◽  
Decision Making Capacity ◽  
Sub Saharan ◽  
Ssa Countries

Abstract Background Global commitment to stop Human Immunodeficiency Virus (HIV) and ensure access to HIV treatment calls for women empowerment as these efforts play major roles in mother-to-child transmission. We explored the association between women’s healthcare decision-making capacity and HIV testing in sub-Saharan Africa (SSA). Methods We used data from the current Demographic and Health Surveys (DHS) conducted between January 1, 2010 and December 31, 2018 in 28 countries in SSA. At the descriptive level, we calculated the prevalence of HIV testing in each of the countries. This was followed by the distribution of HIV testing across the socio-demographic characteristics of women. Finally, we used binary logistic regression to explore the likelihood of HIV testing by women’s health care decision-making capacity and socio-demographic characteristics. The results were presented as Crude Odds Ratios (COR) and Adjusted Odds Ratios(AOR) with their corresponding 95% confidence intervals signifying precision. Statistical significance was set at p-value <0.05. Results We found that prevalence of HIV testing in the 28 SSA countries was 64.4%, with Congo DR having the least (20.2%) and the highest occurred in Rwanda (97.4%). Women who took healthcare-decisions alone [COR=3.183, CI=2.880-3.519] or with their partners [COR=2.577, CI=2.335-2.844] were more likely to test for HIV compared to those whose healthcare-decisions were taken by others and this persisted after controlling for significant covariates [AOR=1.507, CI=1.321-1.720] and [AOR=1.518, CI=1.334-1.728], respectively. Conclusion SSA countries intending to improve HIV testing need to incorporate women’s healthcare decision-making capacity strategies. These strategies can include education and counselling. This is essential because our study indicates that the capacity of women to make healthcare decisions has an association with their decision to test for their HIV status.

scholarly journals Adherence to Iron Supplementation in 22 Sub-Saharan African Countries and Associated Factors among Pregnant Women: A Large Population-Based Study

2019 ◽  
Vol 3 (12) ◽  
Author(s):  
Djibril M Ba ◽  
Paddy Ssentongo ◽  
Kristen H Kjerulff ◽  
Muzi Na ◽  
Guodong Liu ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Iron Supplementation ◽  
Population Based ◽  
Sub Saharan Africa ◽  
Deficiency Anemia ◽  
Demographic And Health Surveys ◽  
Factors Associated ◽  
Sub Saharan ◽  
Ssa Countries ◽  
Antenatal Visits

ABSTRACT Background Iron deficiency anemia during pregnancy is a significant public health problem in sub-Saharan Africa (SSA) and is associated with serious adverse health outcomes. Although it is recommended that all women receive iron supplementation during pregnancy, little research has been conducted to measure overall compliance with this recommendation or variation across SSA countries. Objectives To assess prevalence and sociodemographic-economic factors associated with adherence to iron supplementation among pregnant women in SSA. Methods This was a weighted population-based cross-sectional study of 148,528 pregnant women aged 15–49 y in 22 SSA countries that participated in the Demographic and Health Surveys (DHS) in 2013–2018 and measured iron supplementation during pregnancy. Adherence to iron supplementation was defined as using iron supplementation for ≥90 d during pregnancy of the most recent birth. Results The overall prevalence of adherence to ≥90 d of iron supplementation during pregnancy was 28.7%, ranging from 1.4% in Burundi to 73.0% in Senegal. Factors associated with adherence included receiving ≥4 antenatal care visits [adjusted Prevalence Ratio (aPR): 25.73; 95% CI: 22.36, 29.60] compared with no antenatal visits; secondary or higher education (aPR: 1.17; 95% CI: 1.14, 1.19) compared with no education; wealthy (aPR: 1.13; 95% CI: 1.10, 1.16) compared with poor; and older women aged 35–49 y (aPR: 1.07; 95% CI: 1.05, 1.10) compared with younger women aged 15–24 y. Conclusions Adherence to iron supplementation during pregnancy in SSA is low and varies substantially across countries and in relation to factors such as number of antenatal visits, education, and level of family wealth. These results underscore the need for increased efforts to improve the uptake of iron supplementation for pregnant women in SSA.

scholarly journals Risk factors for prelacteal feeding in sub-Saharan Africa: a multilevel analysis of population data from twenty-two countries

2017 ◽  
Vol 20 (11) ◽  
pp. 1953-1962 ◽  
Author(s):  
Anselm S Berde ◽  
Hilal Ozcebe
Keyword(s):  
Risk Factors ◽  
Breast Feeding ◽  
Health Surveys ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Prelacteal Feeding ◽  
Birth Rank ◽  
Sub Saharan ◽  
Ssa Countries ◽  
Prelacteal Feeds

AbstractObjectiveTo examine the risk factors of prelacteal feeding (PLF) among mothers in sub-Saharan Africa (SSA).DesignWe pooled data from Demographic and Health Surveys in twenty-two SSA countries. The key outcome variable was PLF. A multilevel logistic regression model was used to explore factors associated with PLF.SettingDemographic and Health Surveys in twenty-two SSA countries.SubjectsMother–baby pairs (n 95348).ResultsPrevalence of PLF in SSA was 32·2 %. Plain water (22·1 %), milk other than breast milk (5·0 %) and sugar or glucose water (4·1 %) were the predominant prelacteal feeds. In the multivariable analysis, mothers who had caesarean section delivery had 2·25 times the odds of giving prelacteal feeds compared with mothers who had spontaneous vaginal delivery (adjusted OR=2·25; 95 % CI 2·06, 2·46). Other factors that were significantly associated with increased likelihood of PLF were mother’s lower educational status, first birth rank, fourth or above birth rank with preceding birth interval less than or equal to 24 months, lower number of antenatal care visits, home delivery, multiple birth, male infant, as well as having an average or small sized baby at birth. Mothers aged 20–34 years were less likely to give prelacteal feeds compared with mothers aged ≤19 years. Belonging to the second, middle or fourth wealth quintile was associated with lower likelihood of PLF compared with the highest quintile.ConclusionsTo achieve optimal breast-feeding, there is a need to discourage breast-feeding practices such as PLF. Breast-feeding promotion programmes should target the at-risk sub-population groups discovered in our study.

scholarly journals Media Exposure and HIV Testing Among Youth in Sub-Saharan Africa: Evidence From Demographic and Health Surveys (DHS)

SAGE Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. 215824401985155 ◽  
Author(s):  
Oluwaseyi Dolapo Somefun ◽  
Stephen Ojiambo Wandera ◽  
Clifford Odimegwu
Keyword(s):  
Hiv Testing ◽  
Health Surveys ◽  
Media Exposure ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Sub Saharan

scholarly journals Is improvement in indicators of women’s empowerment associated with uptake of WHO recommended IPTp-SP levels in sub-Saharan Africa? A multilevel approach

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e047606
Author(s):  
Edward Kwabena Ameyaw ◽  
Carolyne Njue ◽  
Roberta Mensima Amoah ◽  
Francis Appiah ◽  
Linus Baatiema ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Low Income ◽  
Community Level ◽  
Sub Saharan Africa ◽  
Outcome Variable ◽  
Demographic And Health Surveys ◽  
Major Public Health Problem ◽  
Country Level ◽  
Sub Saharan ◽  
Ssa Countries

ObjectivesThe global burden of malaria has reduced considerably; however, malaria in pregnancy remains a major public health problem in sub-Saharan Africa (SSA), where about 32 million pregnant women are at risk of acquiring malaria. The WHO has recommended that pregnant women in high malaria transmission locations, including SSA, have intermittent preventive treatment of malaria during pregnancy with at least three doses of sulphadoxine-pyrimethamine (IPTp-SP). Therefore, we investigated the prevalence of IPTp-SP uptake and associated individual-level, community-level and country-level predictors in SSA.DesignA cross-sectional survey was conducted using recent Demographic and Health Surveys datasets of 20 SSA countries. A total of 96 765 women were included. Optimum uptake of IPTp-SP at most recent pregnancy was the outcome variable. We fitted three-level multilevel models: individual, community and country parameters at 95% credible interval.ResultsIn all, 29.2% of the women had optimal IPTp-SP uptake ranging from 55.1% (in Zambia) to 6.9% (in Gambia). The study revealed a high likelihood of optimum IPTp-SP uptake among women with high knowledge (aOR=1.298, Crl 1.206 to 1.398) relative to women with low knowledge. Women in upper-middle-income countries were more than three times likely to have at least three IPTp-SP doses compared with those in low-income countries (aOR=3.268, Crl 2.392 to 4.098). We found that community (σ2=1.999, Crl 1.088 to 2.231) and country (σ2=1.853, Crl 1.213 to 2.831) level variations exist in optimal uptake of IPTp-SP. According to the intracluster correlation, 53.9% and 25.9% of the variation in optimum IPTp-SP uptake are correspondingly attributable to community-level and country-level factors.ConclusionsThe outcome of our study suggests that low-income SSA countries should increase budgetary allocation to maternal health, particularly for IPTp-SP interventions. IPTp-SP advocacy behavioural change communication strategies must focus on women with low knowledge, rural dwellers, married women and those who do not meet the minimum of eight antenatal care visits.

scholarly journals Preterm birth and its associated factors among reproductive aged women in sub-Saharan Africa: evidence from the recent demographic and health surveys of sub-Sharan African countries

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tesfa Sewunet Alamneh ◽  
Achamyeleh Birhanu Teshale ◽  
Misganaw Gebrie Worku ◽  
Zemenu Tadesse Tessema ◽  
Yigizie Yeshaw ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Health Surveys ◽  
Associated Factors ◽  
Sub Saharan Africa ◽  
Eastern Africa ◽  
Demographic And Health Surveys ◽  
Pooled Prevalence ◽  
Sub Saharan ◽  
Reproductive Aged Women ◽  
Ssa Countries

Abstract Background Globally, preterm birth is the leading cause of neonatal and under-five children mortality. Sub-Saharan African (SSA) accounts for the majority of preterm birth and death following its complications. Despite this, there is limited evidence about the pooled prevalence and associated factors of preterm birth at SSA level using nation-wide representative large dataset. Therefore, this study aimed to determine the pooled prevalence and associated factors of preterm birth among reproductive aged women. Methods The recent Demographic and Health Surveys (DHSs) data of 36 SSA countries were used. We included a total weighted sample of 172,774 reproductive-aged women who were giving birth within five years preceding the most recent survey of SSA countries were included in the analysis. We used a multilevel logistic regression model to identify the associated factors of preterm birth in SSA. We considered a statistical significance at a p-value less than 0.05. Results In this study, 5.33% (95% CI: 5.23, 5.44%) of respondents in SSA had delivered preterm baby. Being form eastern Africa, southern Africa, rural area, being educated, substance use, having multiple pregnancy, currently working history, having history of terminated pregnancy, and previous cesarean section delivery, primi-parity, and short birth interval were associated with higher odds of preterm birth among reproductive aged women. However, having better wealth index, being married, wanted pregnancy, and having four or more antenatal care visit were associated with lower odds for a preterm birth among reproductive aged women. Conclusion The prevalence of preterm birth among reproductive-aged women remains a major public health problem in SSA. Preterm birth was affected by various socio-economic and obstetrical factors. Therefore, it is better to consider the high-risk groups during intervention to prevent the short-term and long-term consequences of preterm birth.

scholarly journals What has comprehensive HIV/AIDS knowledge got to do with HIV testing among men in Kenya and Mozambique? Evidence from Demographic and Health Surveys

2021 ◽  
pp. 1-14
Author(s):  
Eugene Budu ◽  
Abdul-Aziz Seidu ◽  
Ebenezer Kwesi Armah-Ansah ◽  
Aliu Mohammed ◽  
Collins Adu ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Health Surveys ◽  
Scale Up ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Odds Ratios ◽  
African Countries ◽  
Aids Knowledge ◽  
Sub Saharan ◽  
Hiv Aids

Abstract People living with undiagnosed HIV are big contributors to the transmission of the virus. Although measures have been made to scale up HIV prevention and voluntary counselling and testing in sub-Saharan Africa, testing coverage remains low in many sub-Saharan African countries, including Mozambique and Kenya, where most people live with HIV/AIDS. Studies have shown that, in most countries in sub-Saharan Africa, men are less likely to test for HIV compared with women. This study examined the relationship between comprehensive HIV/AIDS knowledge and HIV testing among men in Kenya and Mozambique. Data were from the men’s re-code file of the Demographic and Health Surveys of Mozambique and Kenya. Binary logistic regression models were generated and the results presented as crude odds ratios (cOR) and adjusted odds ratios (aOR). The prevalences of HIV testing in Kenya and Mozambique were 80.1% and 46.7%, respectively. Men in Mozambique who had comprehensive HIV/AIDS knowledge (aOR=1.26, CI: 1.07–1.47) were more likely to test for HIV compared with their counterparts who had no comprehensive HIV/AIDS knowledge. In Kenya, men who had comprehensive HIV/AIDS knowledge (aOR=1.23, CI: 1.09–1.39) were more likely to test for HIV compared with their counterparts who had no comprehensive HIV/AIDS knowledge. This study found a statistically strong significant association between comprehensive HIV/AIDS knowledge and HIV testing among men in Kenya and Mozambique. To improve HIV testing rate among men, it is important that interventions are geared towards improving men’s comprehensive HIV/AIDS knowledge, perhaps by expanding HIV/AIDS education programmes and campaigns. This could improve HIV testing rates and ensure the realization of the global HIV/AIDS target of 95-95-95 by the year 2030.

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