ObjectiveThe objective of the paper was to investigate the spatial distribution and correlates of tobacco smoking in various regions of Zambia.MethodsThis paper adopts a cross-sectional study design. The study used data from the 2013/2014 Zambia Demographic Health Survey which is a nationwide health survey conducted in all the 10 provinces. A random sample of men and women from 15 920 households was successfully selected and interviewed. All women aged 15–49 and men aged 15–59 who were either permanent residents of the households or visitors present in the households on the night before the survey were eligible to be interviewed.ResultsThe results show that 8.2% and 11% of Zambians in urban and rural areas smoke, respectively. In urban areas, the risk of being a cigarette smoker was 2.31 (CI: 1.69 to 3.16) and 2.03 (CI: 1.36 to 3.02) times higher for the divorced and separated. However, the risk of being a cigarette smoker was lower for those with some formal education. In rural areas, the risk of being a cigarette smoker was lower for the married (relative risk ratios (RRR): 0.69, CI: 0.55 to 0.86) and those with a formal education. Nevertheless, in rural areas, the risk of being a pipe and other smoker was higher for those who were self-employed (RRR: 8.46, CI: 2.95 to 24.20) and with an occupation (RRR: 2.37, CI: 1.39 to 4.02) but was lower among women.ConclusionTobacco smoking varies between and within regions as well as provinces. Therefore, interventions to curbsmoking should target specific demographic, socioeconomic and cultural factors and how they are spatially distributed.
Background:The purpose of the assessment was to conduct an evaluation on the status of respectful maternal care Ndola and Kitwe districts in the Copperbelt Province.
Methods:The assessment used a cross-sectional study design and captured quantitative data on self-reporting of experiences of respectful maternal care during child birth among women in the reproductive age group with a child below the age of 2 years. The study was conducted in two urban districts of the Copperbelt Province of Zambia specifically in Ndola and Kitwe districts. The sample size was 471 resident women of the selected 18 high volume health facilities. Cluster sampling was used to select the sampling units referred to as catchment areas of the health facilities. A structured interview questionnaire was used to conduct household interviews. Univariate and bivariate analysis were conducted on quantitative data to provide descriptive statistics. Chi-square analysis was performed to ascertain associations.
Results:The study successfully visited and interviewed 470 women in household giving a 99% response rate. Findings show that 31% were aged between 20 to 24 years, three quarters (75%) were married/living with a partner, 4 in 10 (40%) had a basic education and two-thirds (66%) were not engaged in any form of employment or economic activity. The findings show that on average, 18% of the women had experienced physical abuse by a service provider during child birth. Prominent issues that led to ill-treatment included 43% of the women not provided comfort/pain-relief. On average 41% of the women received non-consented care from the service provider. Women (74%) indicated that the service provider did not allow women to assume position of choice during birth. The findings also show that about 22% of women's right to confidentiality and privacy were not adhered to. Women (42%) also reported that there were no drapes or covering to protect their privacy and 19% indicated that there were no curtains or other visual barrier to protect woman during exams. Findings also show that on average 31% of women's right to dignified care was not adhered to. Overall in the study, 13% of the women were discriminated based on specific attributes. The findings indicate that on average 39% of the women were abandoned or denied care. Key issues include, 65% of the women reported being left without care or unattended to and 28% service provider did not respond in a timely way. Further, only 6% of the women were detained in the health facility.
Conclusion:The maternal outcomes observed such as home deliveries and deliveries by skilled and unskilled birth attendants mirror the quality of care in health facilities. Indications of non-adherence to the rights of child bearing women are a barrier to achieving quality of care for child bearing women. There is need to comprehensively train service providers in respectful maternal care and devise mechanisms for implementation and supportive supervision.Perceptions and experiences of the mistreatment of women during childbirth in...
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