Background: Many underlying factors are assumed to contribute to the disparities in magnitude of childhood malnutrition. Notwithstanding, socioeconomic inequalities remain key measures to determine chronic and hidden hunger among under-five children. This study was undertaken to explore childhood malnutrition problems that are associated to household wealth-related and mother's educational attainment in sub-Saharan Africa (SSA). Methods: Secondary data from birth histories in 35 SSA countries was used. The Demographic and Health Survey (DHS) data of 384,747 births between 2008 and 2017 in 35 countries was analyzed. The outcome variables of interest were mainly indicators of malnutrition: stunting, underweight, wasting, overweight, anemia, and under-five children survival. Household wealth-related and mother's educational level were the measures of socioeconomic status. Concentration index and Lorenz curves were the main tools used to determine inequalities for nutritional outcomes. The statistical significance level was determined at 5%. Results: Based on the results, Burundi (54.6%) and Madagascar (48.4%) accounted for the highest prevalence of stunted children. Underweight children were 32.5% in Chad and 35.5% in Niger. Nigeria (16.6%) and Benin (16.4%) had the highest burdens of wasted children. Overall, overweight and under-five survival were significantly more in the higher household wealth, compared with the lower household wealth (Conc. Index = 0.0060; p < 0.001 and Conc. Index = 0.0041; p = 0.002 respectively). Conversely, stunting (Conc. Index = − 0.1032; p < 0.001), underweight (Conc. Index = − 0.1369; p < 0.001), wasting (Conc. Index = − 0.0711; p < 0.001), and anemia (Conc. Index = − 0.0402; p < 0.001) were significantly lower in the higher household wealth status, compared with the lower household wealth groups. Furthermore, under-five children survival was significantly more from mothers with higher educational attainment, compared with children from mothers with lower educational attainment (Conc. Index = 0.0064; p < 0.001). Conversely, stunting (Conc. Index = − 0.0990; p < 0.001), underweight (Conc. Index = − 0.1855; p < 0.001), wasting (Conc. Index = − 0.1657; p < 0.001), overweight (Conc. Index = − 0.0046; p < 0.001), and anemia (Conc. Index = 0.0560; p < 0.001) were significantly more among children from mothers with lower educational attainment. The test for differences between children from urban vs. rural was significant in stunted, underweight, overweight, and anemia for household wealth status. Also, the difference in prevalence between children from urban vs. rural was significant in stunted, underweight, and wasted for mother's educational attainment.

Background Skin-to-skin contact (SSC) between mother and the newborn brings many benefits including its potential to promote the survival of the newborn. Nevertheless, it is a practice that is underutilized in many resource-constrained settings including The Gambia where a high rate of maternal and child mortality has been reported. In this study, we examined the prevalence and determinants of mother and newborn SSC in The Gambia. Methods We used secondary data from The Gambia Multiple Indicator Cluster Survey (MICS)—2018. Data from 9205 women between 15-49 years who gave birth within 5 years of the survey was extracted for the analysis. Percentages and chi-square test were used for analyses. The significant variables from chi-square test were included in the multivariable binary logistic regression model to calculate the adjusted odds ratios (with corresponding 95% CI) of the factors associated with mother and newborn SSC. Results The results of this study showed that the national prevalence of mother and newborn SSC was 35.7%. Across local government areas; Mansakonko (47.8%) and Kerewan (44.2%) had the highest prevalence, while Basse (28.5%) and Brikama (26.5%) had the least prevalence of mother and newborn SSC in The Gambia. Based on results from the logit model, normal weight (at least 2.5 kg) children were 1.37 times as likely to have mother and newborn SSC, compared with the low birthweight (< 2.5 kg) children (OR = 1.37; 95% CI: 1.05, 1.78). In addition, there was 38% increase in the odds of rural women who reported mother and newborn SSC, compared with urban women (OR = 1.38; 95% CI: 1.06, 1.79). Women who delivered at health facility were 3.35 times as likely to have mother and newborn SSC, compared with women who delivered at home (OR = 3.35; 95% CI: 2.37, 4.75). Furthermore, women who initiated antenatal care (ANC) after the first trimester had 21% reduction in the odds of mother and newborn SSC, compared with women who initiated ANC within the first trimester (OR = 0.79; 95% CI: 0.68, 0.93). Conclusion The prevalence of mother and newborn SSC was low. In addition, geographical residence, birth weight, urban-rural residential status, place of delivery, and timing to ANC initiation were associated with mother and newborn SSC. There is a need to promote institutional based delivery using skilled birth attendance, promote early ANC initiation and healthy fetal growth.

Background Proper nutrition is crucial for enhancing brain function and improving learning. Over time, large evidence has existed to show that childhood undernutrition, marked by stunting, is connected with age-long reduction in cognitive and academic achievement. It is of interest to achieve healthy growth and optimal cognitive development in early childhood. The objective of this study was to examine stunting considered to adversely influence cognitive development among children and therefore of public health importance. Results About two thirds (64.3%) of under-five children attained optimal cognition. Stunted children had 7% reduction in optimal cognitive development, compared with not stunted children (RR = 0.93; 95%CI 0.83, 0.98). Among the covariates, geographical region was significantly associated with optimal cognitive development. In addition, children of Islamic, traditional/other religion, and no religion had significant reduction in optimal cognitive development, compared with children of Christianity belief. Children from mothers who had secondary and tertiary education, listened to radio, and watched television had an increase in optimal cognitive development, compared with children from uneducated mothers. Furthermore, children from mothers who are employed had an 8% increase in optimal cognitive development (RR = 1.08; 95%CI: 1.02, 1.14). Conclusion Due to the adverse impact of stunting on optimal cognitive development, we suggest that government and stakeholders in child welfare should ensure that development programmes combine health and nutrition services with early learning and rely on families as partners to have children’s cognitive development effectively. Early childhood cognitive development programmes should be implemented through families and caregivers, with special focus on disadvantaged children as a poverty reduction strategy, and ensure that all children are adequately nourished.

Socioeconomic inequality is a major factor to consider in the prevention of human immunodeficiency virus (HIV) transmission. The aim of this study was to investigate socioeconomic inequalities in HIV prevalence among Namibian women. Data from a population-based household survey with multistage-stratified sample of 6501 women were used to examine the link between socioeconomic inequalities and HIV prevalence. The weighted HIV prevalence was 13.2% (95% CI: 12.1–14.3%). The HIV prevalence among the poorest, poorer, middle, richer, and richest households was 21.4%, 19.7%, 16.3%, 11.0%, and 3.7%, respectively. Similarly, 21.2%, 21.7%, 11.8%, and 2.1% HIV prevalence was estimated among women with no formal education and primary, secondary, and higher education, respectively. Women from poor households (Conc. Index = −0.258; SE = 0.017) and those with no formal education (Conc. Index = −0.199; SE = 0.015) had high concentration of HIV infection, respectively. In light of these findings, HIV prevention strategies must be tailored to the specific drivers of transmission in low socioeconomic groups, with special attention paid to the vulnerabilities faced by women and the dynamic and contextual nature of the relationship between socioeconomic status and HIV infection.

Background Despite the common restrictive abortion laws, abortion remains widespread in sub-Saharan Africa (SSA) countries. Women still utilize abortion services and put their lives and health at risk because abortion can only be procured illegally in private facilities such as mid-level or small patent medicine store that may be manned by unskilled providers or through a non-medicated approach. The objective of this study was to investigate the prevalence of abortion, the reasons women had abortions, median years to first abortion after sexual debut and examine the factors of time to first abortion among women of reproductive age in the Republic of Congo. Methods We used data from the most recent Republic of Congo Demographic and Health Survey (DHS). A total sample of 3622 women aged 15–49 years was analyzed. We estimated the overall prevalence of abortion and median years to first abortion. Furthermore, we examined the factors of time to first abortion after sexual debut using multivariable Cox regression and reported the estimates using adjusted Hazard Ratio (aHR) and 95% confidence intervals (CI). Statistical significance was determined at p < 0.05. Results The prevalence of abortion was 60.0% and median years of time to first abortion after sexual debut was 9.0. The prominent reasons for abortion were due to too short birth interval (23.8%), lack of money (21.0%) and that husband/partner did not need a child at that time (14.0%). Women’s age and region were notable factors in timing to first abortion. Furthermore, women from poorer, middle, richer and richest households had 34, 67, 86 and 94% higher risk of abortion respectively, when compared with women from poorest households (all p < 0.05). Women currently in union/living with a man and formerly in union had 41 and 29% reduction in the risk of abortion respectively, when compared with those never in union (all p < 0.05). In addition, women with primary and secondary+ education had 42 and 76% higher risk of abortion respectively, when compared with women with no formal education (all p < 0.05). Conclusion There was high prevalence of abortion with short years at first abortion. Abortion was associated with women’s characteristics. There is need for unwanted pregnancy prevention intervention and the improvement in pregnancy care to reduce adverse pregnancy outcomes among women.

Background: Despite the common restrictive abortion laws, abortion remains widespread in sub-Saharan Africa (SSA) countries. Women still utilize abortion services and put their lives and health at risk because abortion can only be procured illegally in private facilities such as mid-level or small patent medicine store that may be manned by unskilled providers or through a non-medicated approach. The objective of this study was to determine median years and factors of time to first abortion after sexual debut among Congolese women.Methods: We used data from the most recent Republic of Congo Demographic and Health Survey (DHS). A total sample of 3,622 women aged 15-49 years was analyzed. We estimated the overall prevalence of abortion and median years to first abortion. Furthermore, we examined the factors of time to first abortion after sexual debut using multivariable Cox regression and reported the estimates using adjusted Hazard Ratio (aHR) and 95% confidence intervals (CI). Statistical significance was determined at p<0.05.Results: The prevalence of abortion was 60.0% and median years of time to first abortion after sexual debut was 9.0. The prominent reasons for abortion were due to too short birth interval (23.8%), lack of money (21.0%) and that husband/partner did not need a child at that time (14.0%). Women’s age and region were notable factors in timing to first abortion. Furthermore, women from poorer, middle, richer and richest households had 34%, 67%, 86% and 94% higher risk of abortion respectively, when compared with women from poorest households. Women currently in union/living with a man and formerly in union had 41% and 29% reduction in the risk of abortion respectively, when compared with those never in union. In addition, women with primary and secondary+ education had 42% and 76% higher risk of abortion respectively, when compared with women with no formal education. Conclusion: There was high prevalence of abortion with short years at first abortion. Abortion was associated with women’s characteristics. There is need for unwanted pregnancy prevention intervention and the improvement in pregnancy care to reduce adverse pregnancy outcomes among women.

Background: Despite the common restrictive abortion laws, abortion remains widespread in sub-Saharan Africa (SSA) countries. Women still utilize abortion services and put their lives and health at risk because abortion can only be procured illegally in private facilities such as mid-level or small patent medicine store that may be manned by unskilled providers or through a non-medicated approach. The objective of this study was to determine median years and factors of time to first abortion after sexual debut among Congolese women.Methods: We used data from the most recent Republic of Congo Demographic and Health Survey (DHS). A total sample of 3,622 women aged 15-49 years was analyzed. We estimated the overall prevalence of abortion and median years to first abortion. Furthermore, we examined the factors of time to first abortion after sexual debut using multivariable Cox regression and reported the estimates using adjusted Hazard Ratio (aHR) and 95% confidence intervals (CI). Statistical significance was determined at p<0.05.Results: The prevalence of abortion was 60.0% and median years of time to first abortion after sexual debut was 9.0. The prominent reasons for abortion were due to too short birth interval (23.8%), lack of money (21.0%) and that husband/partner did not need a child at that time (14.0%). Women’s age and region were notable factors in timing to first abortion. Furthermore, women from poorer, middle, richer and richest households had 34%, 67%, 86% and 94% higher risk of abortion respectively, when compared with women from poorest households (aHR estimates). Women currently in union/living with a man and formerly in union had 41% and 29% reduction in the risk of abortion respectively, when compared with those never in union (aHR estimates). In addition, women with primary and secondary+ education had 42% and 76% higher risk of abortion respectively, when compared with women with no formal education (aHR estimates).Conclusion: There was high prevalence of abortion with short years at first abortion. Abortion was associated with women’s characteristics. There is need for unwanted pregnancy prevention intervention and the improvement in pregnancy care to reduce adverse pregnancy outcomes among women.

Background: Despite the common restrictive abortion laws, abortion remains widespread in sub-Saharan Africa (SSA) countries. Women still utilize abortion services and put their lives and health at risk because abortion can only be procured illegally in private facilities such as mid-level or small patent medicine store that may be manned by unskilled providers or through a non-medicated approach. The objective of this study was to determine median years and factors of time to first abortion after sexual debut among Congolese women.Methods: We used data from the most recent Republic of Congo Demographic and Health Survey (DHS). A total sample of 3,622 women aged 15-49 years was analyzed. We estimated the overall prevalence of abortion and median years to first abortion. Furthermore, we examined the factors of time to first abortion after sexual debut using multivariable Cox regression and reported the estimates using adjusted Hazard Ratio (aHR) and 95% confidence intervals (CI). Statistical significance was determined at p<0.05.Results: The prevalence of abortion was 60.0% and median years of time to first abortion after sexual debut was 9.0. The prominent reasons for abortion were due to too short birth interval (23.8%), lack of money (21.0%) and that husband/partner did not need a child at that time (14.0%). Women’s age and region were notable factors in timing to first abortion. Furthermore, women from poorer, middle, richer and richest households had 34%, 67%, 86% and 94% higher risk of abortion respectively, when compared with women from poorest households (aHR estimates). Women currently in union/living with a man and formerly in union had 41% and 29% reduction in the risk of abortion respectively, when compared with those never in union (aHR estimates). In addition, women with primary and secondary+ education had 42% and 76% higher risk of abortion respectively, when compared with women with no formal education (aHR estimates). Conclusion: There was high prevalence of abortion with short years at first abortion. Abortion was associated with women’s characteristics. There is need for unwanted pregnancy prevention intervention and the improvement in pregnancy care to reduce adverse pregnancy outcomes among women.