IntroductionDespite the decline in infant and under-five mortality rates since the last decade, Ghana did not meet the millennium development goal (MDG) 4 target. To implement effective interventions that could fast-track progress towards achieving the sustainable development goal 3 in 2030, factors contributing to the decline in child mortality throughout the MDG period and which factor(s) has/have been consistent in affecting child survival in the last decade need to be understood.MethodsThis study used Demographic and Health Surveys (DHS) from 2003, 2008 and 2014 and data from World Bank Development Indicators (2000–2018). We employed modified Poisson with robust SE and multivariate decomposition approach to assess risk factors of child mortality using DHS data from 2003, 2008 and 2014. Penalised regression was used assess the effect of 25 country-level contextual factors on child survival.ResultsThe risk of infant mortality is approximately five times higher among mothers who had multiple births compared with mothers who had single birth over the last decade (adjusted relative risk 4.6, 95% CI 3.2 to 6.6, p<0.001). An increase in the annual percentage of female labour force participation (FLFP) is associated with the reduction of approximately 10 and 18 infant and under-five annual deaths per 1000 live births, respectively.ConclusionsThis study found that multiple births and shorter birth spacing are associated with increased risk of infant and under-five deaths over the last decade. Increased in FLFP, and the proportion of children sleeping under bed-net are associated with reduced risk of both infants and under-five deaths.
ObjectiveDespite the huge financial investment in the free maternal healthcare policy (FMHCP) by the Governments of Ghana and Burkina Faso, no study has quantified the impact of FMHCP on the relative reduction in neonatal and infant mortality rates using a more rigorous matching procedure with the difference in differences (DID) analysis. This study used several rounds of publicly available population-based complex survey data to determine the impact of FMHCP on neonatal and infant mortality rates in these two countries.DesignA quasi-experimental study to evaluate the FMHCP implemented in Burkina Faso and Ghana between 2007 and 2014.SettingDemographic and health surveys and maternal health surveys conducted between 2000 and 2014 in Ghana, Burkina Faso, Nigeria and Zambia.ParticipantsChildren born 5 years preceding the survey in Ghana, Burkina Faso, Nigeria and Zambia.Primary outcome measuresNeonatal and infant mortality rates.ResultsThe Propensity Score Kernel Matching coupled with DID analysis with modified Poisson showed that the FMHCP was associated with a 45% reduction in the risk of neonatal mortality rate in Ghana and Burkina Faso compared with Nigeria and Zambia (adjusted relative risk (aRR)=0.55, 95% CI: 0.40 to 0.76, p<0.001). In addition, infant mortality rate has reduced significantly in both Ghana and Burkina Faso by approximately 54% after full implementation of FMHCP compared with Nigeria and Zambia (aRR=0.46, 95% CI: 0.36 to 0.59, p<0.001).ConclusionThe FMHCP had a significant impact and still remains relevant in achieving Sustainable Development Goal 3 and could provide lessons for other sub-Saharan countries in the design and implementation of a similar policy.
Background: Poor quality of life (QoL) disrupts social functioning, fulfilment of basic needs, and is associated with depressive disorder (DD). Objective: We answered the question of whether there is a common risk factor for DD across six low- and middle-income countries (LMICs) and determined whether this risk factor can be ranked consistently as the most important predictor of DD in all six LMICs. We estimated the effect of DD on QoL for each country and meta-analyzed the results to generate a pooled effect estimate of DD on QoL in the six LMICs. Methods: We used data from the WHO Study on Global Ageing and Adult Health (SAGE). This study involved a total of 35,164 older adults aged ≥ 50 yr. in six LMICs: China, 13,408; Ghana, 4,305; India, 7,108; Mexico, 2,309; Russian Federation, 3,763; and South Africa, 3,842. We conducted an extensive literature review to select the list of 58 potential risk factors associated with DD. We used double selection Least Absolute Shrinkage and Selection Operator Poisson regression model to identify country-specific risk factors associated with DD. Weighted dominance analysis (WDA) was performed to determine the most important risk factor of DD. To estimate the effect of DD on QoL, we used inverse probability weighting Poisson regression adjustment for each country, and meta-analysis techniques for a pooled estimate of the overall effect. Results: The risk factors for DD were generally country specific. However, asthma was the most common and the most important predictor of DD across all six SAGE countries. In Ghana, the prevalence of DD among older adults who have been diagnosed with asthma or have experienced symptoms of asthma in the 12 months preceding the survey was 14 times that among those without asthma or asymptomatic of asthma [Adjusted Prevalence Ratio (aPR), 14.46, 95% confidence interval (CI): 10.47 - 19.97; p < 0.001]. Similarly, it was 14 times in South Africa (aPR, 14.6; 95% CI: 8.18 - 26.14; p < 0.00) but in Mexico, it was 4 times (aPR, 4.39; 95% CI: 3.00 - 6.42; p < 0.001) and in China (aPR, 5.99; 95% CI: 4.32 - 8.31; p < 0.001) and Russia (aPR, 5.90; 95% CI: 3.9 - 9.0; p < 0.001), it was 6 times. In India, it was 5 times (aPR=5.1; 95% CI: 4.3 - 6.0; p < 0.001. Generally, there was evidence of 8% increase in poor QoL due to the presence of DD (Pooled estimate, 0.08; 95% CI: 6.0 – 12; p < 0.001). Specifically, in China, there was evidence of 12% increase in poor QoL that could be attributed to DD (prevalence difference (PD), 0.12; 95% CI: 0.07 - 0.18; p < 0.001). In India (PD, 0.08; 95% CI: 0.04 - 0.13; p < 0.01) and Russian Federation (PD, 0.08; 95% CI: 0.01 - 0.15; p < 0.01), there was evidence of 8% increase in poor QoL. Although, there was some increase in poor QoL in Mexico, Ghana, and South Africa due to DD, the increase was not statistically significant. Conclusion: Although different factors could explain the prevalence of DD among older adults in the six LMICs, it was evident that asthma patients amongst this population were at a higher risk of DD. Clinical evaluation and potential diagnosis and treatment of DD among older adults who present with asthma could potentially enhance their QoL
Background The diagnosis and treatment of Depressive Disorders (DD) remain a challenge in low and middle-income countries (LMICs). Identifying the most important correlate of DD would serve as a guide in the design and implementation of targeted intervention in resource-constrained LMICs. This study determined whether there is/are common risk factor(s) of DD across the six LMICs and whether there is a risk factor that can be ranked consistently as the most important predictor of DD in all the six LMICs. We further estimated the impact of DD on the quality of life (QoL).Methods We used data from the World Health Organization Study on Global Ageing and Adult Health. Weighted dominance analysis was performed to determine the most important risk factor of DD. We applied inverse probability weighting Poisson regression adjustment to estimate the impact of DD on QoL for each country and further estimated the overall effect of DD on QoL in the six countries by computing a weighted average of the country-specific estimate using the technique of meta-analysis.Results Among the 58 risk factors investigated, Asthma was the most common and the most important predictor of DD across all six LMICs. DD contributed to a 12% increase in the poor QoL in China, (prevalence difference (PD)=0.12; 95% CI: 0.07-0.18, p<0.001). In India (PD=0.08; 95% CI: 0.04-0.13, p<0.01) and Russian Federation (PD=0.08; 95% CI: 0.01-0.15, p<0.01). Although there was some increase in poor QoL in Mexico, Ghana, and South Africa due to DD, the increase was not statistically significant.Conclusions Asthma is a major contributing factor to the high prevalence of DD among older adults and could have a direct or indirect effect on QoL. We recommend integrated intervention for Asthma patients that incorporates the diagnosis and treatment of DD. Access to quality mental healthcare should be a major government priority in LMICs.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.