scholarly journals Analysis of Non-Marital Fertility in Nigeria and Implications for Intervention and Future Research

2021 ◽  
Vol 10 (7) ◽  
pp. 256
Author(s):  
Oluwatobi Abel Alawode
Keyword(s):  
Marital Fertility ◽  
Sexual Debut ◽  
Wealth Index ◽  
Household Wealth ◽  
Sub Saharan Africa ◽  
Future Research ◽  
Poor Women ◽  
Region Of Residence ◽  
Sub Saharan ◽  
Using Data

Fertility and marriage are inextricably linked in sub-Saharan Africa, but recent changes, such as the rise in non-marital fertility, signals a weakening link, and the second demographic transition offers some explanations. Non-marital fertility comes with disadvantages, but it has not been adequately studied in Nigeria. Hence, this study examined the levels, patterns, and correlates of non-marital fertility, and offers implications for interventions and future research. Using data from the Nigeria Demographic and Survey 2008–2018, with a pooled weighted sample size of 11,925 unmarried women, percentage distribution was employed and a two-part model for count data was fitted, with the result showing that the level of non-marital fertility is 29%, and it is common among younger, rural dwelling, and uneducated unmarried women. The correlates of non-marital fertility include age, region of residence, level of education, religion, household wealth index, relationship status, ethnicity, work status, and age at sexual debut. Interventions to arrest rise of non-martial fertility due to its obvious disadvantages, should strengthen sexual and reproductive health programs for unmarried rural-dwelling young women, and revitalize welfare efforts for children born outside wedlock, for poor women, while future research should explore an in-depth understanding of non-marital births.

TIMING OF SEXUAL DEBUT AMONG UNMARRIED YOUTHS AGED 15–24 YEARS IN SUB-SAHARAN AFRICA

2017 ◽  
Vol 50 (2) ◽  
pp. 161-177 ◽  
Author(s):  
Joshua Amo-Adjei ◽  
Derek Anamaale Tuoyire
Keyword(s):  
Young People ◽  
Young Women ◽  
Rural Areas ◽  
Sexual Debut ◽  
Household Wealth ◽  
Sub Saharan Africa ◽  
African Countries ◽  
Sub Saharan ◽  
Female Headed Households ◽  
The Impact

SummaryThis study aimed to contribute to the evidence on the timing of sexual debut in young people in sub-Saharan African countries. Data were extracted from 34 nationally representative surveys conducted in the region between 2006 and 2014. The study sample comprised unmarried women (n=167,932) and men (n=76,900) aged 15–24 years. Descriptive techniques and Cox proportional regression models were used to estimate the timing of sexual debut, and Kaplan–Meier hazard curves were used to describe the patterns of sexual debut in each country by sex. For the countries studied, sexual debut for both women and men occurred between the ages of 15 and 18 years, with median ages of 16 for women and 17 for men. Overall, education and household wealth provided significant protection against early sexual debut among women, but the reverse was found among men for wealth. Women in rural areas, in female-headed households and in Central, South and West Africa reported higher hazards of early commencement of sexual activity than their counterparts in urban, male-headed households and East Africa. However, the impact of these variables on male sexual debut did not follow a consistent pattern. Varied timing, as well as country-specific risk factors associated with sexual debut for young women and men across sub-Saharan Africa, were identified. Sexual health programmes and interventions for young people may require different approaches for young women and men.

scholarly journals Determinants of Home Delivery among Mothers in Abobo District, Gambella Region, Ethiopia: A Case Control Study

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Asmelash Abera Mitiku ◽  
Abraham Lomboro Dimore ◽  
Solomon Berhanu Mogas
Keyword(s):  
Formal Education ◽  
Case Control Study ◽  
Negative Attitude ◽  
Wealth Index ◽  
Household Wealth ◽  
Home Delivery ◽  
Sub Saharan Africa ◽  
Care Visit ◽  
Sub Saharan ◽  
Control Study

Introduction. Home delivery is one of the major reasons for high maternal mortality ratio in sub-Saharan Africa. Sub-Saharan Africa and South Asia together contribute over 85% of maternal deaths, of which, only half of deliveries are institutional. However, data are scarce on the availability of information with regard to the determinant factors for this high prevalence of home delivery in the study area. Objective. This study is aimed at determining factors associated with home delivery, among mothers in Abobo Woreda, Gambella region, Southwest Ethiopia, 2019. Methods. A case control study conducted from 12 March 2019 up to 2 April 2019 on 88 cases and 176 controls. Cases include mothers who gave birth at home and those mothers who gave birth at health facility in the last one year preceding the study included as controls. Data entry was made using Epi-Data version 3.1, and analysis was made using SPSS version 20. A binary logistic regression analysis was conducted to assess candidate variables and subsequently a multivariable regression to determine the statistical associations. Adjusted odds ratio (AOR) with 95% confidence interval (CI) was calculated to determine strength of association, and p value <0.05 was used to establish significant associations. Results. No formal education (AOR: 5.07; 95% CI: 2.18-11.50), poor knowledge on obstetric complications (AOR: 3.83; 95% CI: 1.98-7.40), negative attitude towards delivery service (AOR: 3.25; 95% CI: 1.70-6.19), poor household wealth index (AOR: 4.55; 95% CI: 2.01-10.31), and no antenatal care visit (AOR: 3.29; 95% CI: 1.63-6.63) were found to be significantly associated with home delivery. Conclusions. The findings do support that no formal education, poor knowledge on obstetric complications, negative attitude towards delivery service, poor household wealth index, and no antenatal care visit showed a significant association with home delivery.

scholarly journals POLYGYNY AND WOMEN'S HEALTH IN RURAL MALI

2013 ◽  
Vol 46 (1) ◽  
pp. 66-89 ◽  
Author(s):  
R. M. BOVE ◽  
EMILY VALA-HAYNES ◽  
CLAUDIA VALEGGIA
Keyword(s):  
Mixed Methods ◽  
Women’S Health ◽  
Women's Health ◽  
Social Power ◽  
Wealth Index ◽  
Household Wealth ◽  
Sub Saharan Africa ◽  
Theory Approach ◽  
Sub Saharan ◽  
The Impact

SummaryWomen's social networks and social power are increasingly seen as important factors modulating their health in sub-Saharan Africa. Polygyny, a common marital structure in many societies, mediates important intra-household relationships by requiring both competition and co-operation among co-wives. Using mixed methods, semi-structured questionnaires were administered to 298 women aged 15–84 living in the Kolondiéba region of rural Mali in 1999, and supplemented by detailed interviews with 40 women. Three categories of outcome were explored: illness experience, therapeutic itinerary and social support received. Quantitative data were analysed using regression analysis and qualitative data using a grounded theory approach. In quantitative analyses, controlling for age and household wealth index, senior wives were less likely to be escorted to a healer by their husbands during illness than were junior wives or monogamous women. Polygynous women were also less likely to obtain a treatment for which there was a monetary fee. Fewer than one-third of polygynous women reported the assistance of a co-wife during illness in any given task. In qualitative analyses, women further related varied mechanisms through which polygyny impacted their health trajectories. These ranged from strongly supportive relationships, to jealousy because of unequal health or fertility, bias in emotional and material support provided by husbands, and accusations of wrong-doing and witchcraft. This study highlights the need for more prospective mixed methods analyses to further clarify the impact of polygyny on women's health-related experiences and behaviours in sub-Saharan Africa.

scholarly journals Dynamic Role of Mother Empowerment in reducing malnutrition among children: Evidence from Sub-Saharan Africa

2020 ◽  
Vol 6 (1) ◽  
pp. 135-146
Author(s):  
Mariam Abbas Soharwardi ◽  
Tusawar Iftikhar Ahmad
Keyword(s):  
Strong Predictor ◽  
Wealth Index ◽  
Household Wealth ◽  
Sub Saharan Africa ◽  
Binary Logistic Regression Analysis ◽  
Age At First Birth ◽  
African Countries ◽  
Cross Sectional ◽  
Sub Saharan

In Sub-Saharan Africa, two out of five children are malnourished and malnutrition causes almost half of the child deaths (45%). Mothers are the primary caretaker of children's health, but unfortunately, most of the mothers, are not empowered in Sub-Saharan Africa. This study examined the role of mother’s empowerment in the reduction of malnutrition (stunting, wasting, and underweight) among children under five years of age in twenty-two Sub-Saharan African countries. Cross-sectional data from the most recent Demographic Health Survey (2011-2016) of twenty-two countries are used to analyze the relationship between mother's empowerment and child malnutrition through the binary logistic regression analysis. Results show that the countries with low empowerment, the prevalence of malnutrition is high. Mother empowerment is found to be a statistically significant predictor in reducing malnutrition. Mother’s education, body mass index, and age at first birth proved to be a strong predictor for reducing malnutrition. Household wealth index and household locality also have a statistically significant impact on the reduction of malnutrition. At the household level, malnutrition of children can be minimized by empowering boosting their self-esteem, self-confidence, economic resources, social resources, awareness and decision making.

scholarly journals Socioeconomic determinants of cumulative fertility in Ghana

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252519
Author(s):  
Samuel H. Nyarko
Keyword(s):  
Negative Binomial ◽  
Sexual Debut ◽  
Negative Binomial Regression ◽  
Household Wealth ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
Socioeconomic Disparities ◽  
Demographic And Health Surveys ◽  
Cumulative Fertility ◽  
Sub Saharan

The pace of decline in fertility rates in sub-Saharan Africa appears to have slowed or stalled in the last few decades. This study examines the socioeconomic associated with cumulative fertility in Ghana. Negative binomial regression models were used to estimate determinants of cumulative fertility using data from the Ghana Demographic and Health Surveys of 2003, 2008, and 2014. The composition of children ever born by women did not change considerably over the study periods. Socioeconomic disparities in educational attainment, household wealth, employment, and employer status are significantly associated with cumulative fertility risks in Ghana. The current age of women, age at sexual debut, and marital status, among others, are also linked to cumulative fertility levels. Place and region of residence are also linked to fertility in Ghana. Cumulative fertility levels in Ghana are underscored by considerable socioeconomic disparities among women of reproductive age. Fertility regulation policies should hinge on improving the socio-economic wellbeing of women in Ghana.

scholarly journals Adolescent sexual and reproductive health in sub-Saharan Africa: who is left behind?

2020 ◽  
Vol 5 (1) ◽  
pp. e002231 ◽  
Author(s):  
Dessalegn Y Melesse ◽  
Martin K Mutua ◽  
Allysha Choudhury ◽  
Yohannes D Wado ◽  
Cheikh M Faye ◽  
...  
Keyword(s):  
Reproductive Health ◽  
Sexual And Reproductive Health ◽  
Sexual Debut ◽  
Household Wealth ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Rural Residence ◽  
Modern Contraceptives ◽  
Urban Rural ◽  
Sub Saharan

Adolescent sexual and reproductive health (ASRH) continues to be a major public health challenge in sub-Saharan Africa where child marriage, adolescent childbearing, HIV transmission and low coverage of modern contraceptives are common in many countries. The evidence is still limited on inequalities in ASRH by gender, education, urban–rural residence and household wealth for many critical areas of sexual initiation, fertility, marriage, HIV, condom use and use of modern contraceptives for family planning. We conducted a review of published literature, a synthesis of national representative Demographic and Health Surveys data for 33 countries in sub-Saharan Africa, and analyses of recent trends of 10 countries with surveys in around 2004, 2010 and 2015. Our analysis demonstrates major inequalities and uneven progress in many key ASRH indicators within sub-Saharan Africa. Gender gaps are large with little evidence of change in gaps in age at sexual debut and first marriage, resulting in adolescent girls remaining particularly vulnerable to poor sexual health outcomes. There are also major and persistent inequalities in ASRH indicators by education, urban–rural residence and economic status of the household which need to be addressed to make progress towards the goal of equity as part of the sustainable development goals and universal health coverage. These persistent inequalities suggest the need for multisectoral approaches, which address the structural issues underlying poor ASRH, such as education, poverty, gender-based violence and lack of economic opportunity.

scholarly journals Inequalities in early marriage, childbearing and sexual debut among adolescents in sub-Saharan Africa

2021 ◽  
Vol 18 (S1) ◽  
Author(s):  
Dessalegn Y. Melesse ◽  
Réka M. Cane ◽  
Aveneni Mangombe ◽  
Macellina Y. Ijadunola ◽  
Adom Manu ◽  
...  
Keyword(s):  
Public Health ◽  
Adolescent Girls ◽  
Urban Areas ◽  
Sexual Debut ◽  
Household Wealth ◽  
Sub Saharan Africa ◽  
Early Marriage ◽  
Health Concern ◽  
Urban Rural ◽  
Sub Saharan

Abstract Background Adolescent sexual and reproductive health (ASRH) is a major public health concern in sub-Saharan Africa (SSA). However, inequalities in ASRH have received less attention than many other public health priority areas, in part due to limited data. In this study, we examine inequalities in key ASRH indicators. Methods We analyzed national household surveys from 37 countries in SSA, conducted during 1990–2018, to examine trends and inequalities in adolescent behaviors related to early marriage, childbearing and sexual debut among adolescents using data from respondents 15–24 years. Survival analyses were conducted on each survey to obtain estimates for the ASRH indicators. Multilevel linear regression modelling was used to obtain estimates for 2000 and 2015 in four subregions of SSA for all indicators, disaggregated by sex, age, household wealth, urban–rural residence and educational status (primary or less versus secondary or higher education). Results In 2015, 28% of adolescent girls in SSA were married before age 18, declined at an average annual rate of 1.5% during 2000–2015, while 47% of girls gave birth before age 20, declining at 0.6% per year. Child marriage was rare for boys (2.5%). About 54% and 43% of girls and boys, respectively, had their sexual debut before 18. The declines were greater for the indicators of early adolescence (10–14 years). Large differences in marriage and childbearing were observed between adolescent girls from rural versus urban areas and the poorest versus richest households, with much greater inequalities observed in West and Central Africa where the prevalence was highest. The urban–rural and wealth-related inequalities remained stagnant or widened during 2000–2015, as the decline was relatively slower among rural and the poorest compared to urban and the richest girls. The prevalence of the ASRH indicators did not decline or increase in either education categories. Conclusion Early marriage, childbearing and sexual debut declined in SSA but the 2015 levels were still high, especially in Central and West Africa, and inequalities persisted or became larger. In particular, rural, less educated and poorest adolescent girls continued to face higher ASRH risks and vulnerabilities. Greater attention to disparities in ASRH is needed for better targeting of interventions and monitoring of progress.

scholarly journals Decomposing the rural–urban gap in factors associated with childhood immunisation in sub-Saharan Africa: evidence from surveys in 23 countries

2021 ◽  
Vol 6 (1) ◽  
pp. e003773
Author(s):  
Edward Kwabena Ameyaw ◽  
Yusuf Olushola Kareem ◽  
Bright Opoku Ahinkorah ◽  
Abdul-Aziz Seidu ◽  
Sanni Yaya
Keyword(s):  
Decomposition Analysis ◽  
Household Wealth ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Childhood Immunisation ◽  
Urban Settings ◽  
Factors Associated ◽  
Rural And Urban ◽  
Full Immunisation ◽  
Sub Saharan

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.

scholarly journals Household structure, maternal characteristics and children’s stunting in sub-Saharan Africa: evidence from 35 countries

2020 ◽  
Author(s):  
Sanni Yaya ◽  
Olanrewaju Oladimeji ◽  
Emmanuel Kolawole Odusina ◽  
Ghose Bishwajit
Keyword(s):  
Birth Interval ◽  
Household Wealth ◽  
Household Structure ◽  
Sub Saharan Africa ◽  
Physical Growth ◽  
Multiple Birth ◽  
Rural Children ◽  
Sub Saharan ◽  
Ssa Countries ◽  
Childhood Stunting

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.

scholarly journals Prevalence and determinants of chronic kidney disease in women with hypertensive disorders in pregnancy in Nigeria: a cohort study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Salisu M. Ishaku ◽  
Timothy Olusegun Olanrewaju ◽  
Joyce L. Browne ◽  
Kerstin Klipstein-Grobusch ◽  
Gbenga A. Kayode ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Gestational Hypertension ◽  
Monitoring Program ◽  
Sub Saharan Africa ◽  
Future Research ◽  
Hypertensive Disorders ◽  
Hypertensive Disorders In Pregnancy ◽  
Sub Saharan ◽  
In Pregnancy

Abstract Background Worldwide, hypertensive disorders in pregnancy (HDPs) complicate between 5 and 10% of pregnancies. Sub-Saharan Africa (SSA) is disproportionately affected by a high burden of HDPs and chronic kidney disease (CKD). Despite mounting evidence associating HDPs with the development of CKD, data from SSA are scarce. Methods Women with HDPs (n = 410) and normotensive women (n = 78) were recruited at delivery and prospectively followed-up at 9 weeks, 6 months and 1 year postpartum. Serum creatinine was measured at all time points and the estimated glomerular filtration rates (eGFR) using CKD-Epidemiology equation determined. CKD was defined as decreased eGFR< 60 mL/min/1.73m2 lasting for ≥ 3 months. Prevalence of CKD at 6 months and 1 year after delivery was estimated. Logistic regression analyses were conducted to evaluate risk factors for CKD at 6 months and 1 year postpartum. Results Within 24 h of delivery, 9 weeks, and 6 months postpartum, women with HDPs were more likely to have a decreased eGFR compared to normotensive women (12, 5.7, 4.3% versus 0, 2 and 2.4%, respectively). The prevalence of CKD in HDPs at 6 months and 1 year postpartum was 6.1 and 7.6%, respectively, as opposed to zero prevalence in the normotensive women for the corresponding periods. Proportions of decreased eGFR varied with HDP sub-types and intervening postpartum time since delivery, with pre-eclampsia/eclampsia showing higher prevalence than chronic and gestational hypertension. Only maternal age was independently shown to be a risk factor for decreased eGFR at 6 months postpartum (aOR = 1.18/year; 95%CI 1.04–1.34). Conclusion Prior HDP was associated with risk of future CKD, with prior HDPs being more likely to experience evidence of CKD over periods of postpartum follow-up. Routine screening of women following HDP-complicated pregnancies should be part of a postpartum monitoring program to identify women at higher risk. Future research should report on both the eGFR and total urinary albumin excretion to enable detection of women at risk of future deterioration of renal function.

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