Despite the implementation of anemia control interventions in Ghana, prevalence of anemia is still high in children under-five years although it has reduced by 24% between 2008 and 2019. Further reducing the prevalence of anemia requires identifying and targeting critical risk factors associated to anemia. This study seeks to identify predictors of anemia among children under-five years in Ghana. Data from 2019 Ghana MIS was analyzed using both fixed and random effect logistic regression models. Among the 2434 children under-five years, 54% (95% CI 52.0, 57.0) of them were anemic. In the multivariable multilevel model, the risk of anemia was found to be higher in younger children, children who had malaria, children whose mothers were not covered for health insurance, adolescent mothers’, non-Christian mothers and poorer households. Significant unobserved community level effects in anemia prevalence were observed. We observed high prevalence of anemia in children under-five and critical risk factors at the child, household, and community levels in this population of children. Multifaceted and targeted approaches are needed to help reduce the anemia prevalence in this setting so as to achieve multiple SDGs which are related to risk and prevalence of anemia by 2030.
Background. Although higher-risk sexual behavior (H-RSB) is a major contributor to the rapid rising rate of new HIV infections, there exists paucity of comprehensive evidence across the sub-Saharan African region. The purpose of this study was to determine the prevalence of H-RSB and its determinants across sub-Saharan Africa to inform policy. Method. Data were obtained from the Demographic and Health Survey (DHS) of ten sub-Saharan African (SSA) countries with their three most current DHS surveys from 2000 to 2016. Only participants who ever had sexual encounters in their lifetime were included in the study. Weighted adjusted Cox regression with robust variance and constant time was used to investigate disparities of H-RSB among the ten SSA countries. Relationships between sociodemographic, socioeconomic, knowledge, mass media, and H-RSB were investigated. Results. The trend and prevalence of higher-risk sexual behavior show that Lesotho experienced a decreasing trend of the prevalence of H-RSB from 8.92 in period one to 6.42 in period three. Ghana experienced a marginal increase from 6.22 in period one to 6.76 in period two and then to 6.43 in the third period. However, Malawi, Zambia, and Zimbabwe obtained a marginal increasing trend in the prevalence of H-RSB from period one to three: 2.75 to 3.74, 4.33 to 6.24, and 6.11 to 7.99, respectively. Meanwhile, the prevalence of H-RSB in Namibia and Uganda decreased in period two to 1.84 and 5.76 but increased in period three to 2.01 and 6.83, respectively. Generally, determinants of H-RSB among the countries include age, sex, religious affiliation, marital status, educational level, employment status, economic status, age at first sex, and status of circumcision. Conclusion. Trend of relatively high prevalence of H-RSB has been found across majority of the countries with key sociodemographic factors influencing H-RSB. Therefore, different targeted interventional approaches are needed in all the countries to help reduce H-RSB and the overall HIV incidence. If issues regarding sexual behavior and sexual health are not addressed adequately, H-RSB can negate all the appreciable efforts aimed at ending the HIV pandemic by 2030.
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