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

Melesse, Dessalegn Y.; Mutua, Martin Kavao; Choudhury, Allysha; Wado, Yohannes Dibaba; Faye, Cheikh; Neal,; Boerma, Ties

doi:10.1136/bmjgh-2019-002231

Cited by 132 publications

(136 citation statements)

References 34 publications

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“…The older women on the other hand, with reduced possibilities of birth complications due to being multiparous, usually prefer home delivery using Traditional Birth Attendants (TBAs) for delivery as TBAs are considered as being more friendly and caring compared to SBAs [ 34 ]. It was, therefore, not surprising in our study that the highest prevalence of home delivery was recorded among women in their last reproductive years [ 45 – 49 ].…”

Section: Discussionmentioning

confidence: 90%

Prevalence and determinants of the place of delivery among reproductive age women in sub–Saharan Africa

2020

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Introduction Maternal mortality is an issue of global public health concern with over 300,000 women dying globally each year. In sub-Saharan Africa (SSA), these deaths mainly occur around childbirth and the first 24hours after delivery. The place of delivery is, therefore, important in reducing maternal deaths and accelerating progress towards attaining the 2030 sustainable development goals (SDGs) related to maternal health. In this study, we examined the prevalence and determinants of the place of delivery among reproductive age women in SSA. Materials and methods This was a cross-sectional study among women in their reproductive age using data from the most recent demographic and health surveys of 28 SSA countries. Frequency, percentage, chi-square, and logistic regression were used in analysing the data. All analyses were done using STATA. Results The overall prevalence of health facility delivery was 66%. This ranged from 23% in Chad to 94% in Gabon. More than half of the countries recorded a less than 70% prevalence of health facility delivery. The adjusted odds of health facility delivery were lowest in Chad. The probability of giving birth at a health facility also declined with increasing age but increased with the level of education and wealth status. Women from rural areas had a lower likelihood (AOR = 0.59, 95%CI = 0.57–0.61) of delivering at a health facility compared with urban women. Conclusions Our findings point to the inability of many SSA countries to meet the SDG targets concerning reductions in maternal mortality and improving the health of reproductive age women. The findings thus justify the need for peer learning among SSA countries for the adaption and integration into local contexts, of interventions that have proven to be successful in improving health facility delivery among reproductive age women.

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Section: Discussionmentioning

confidence: 90%

Prevalence and determinants of the place of delivery among reproductive age women in sub–Saharan Africa

2020

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“…Adolescents in Africa are at an elevated risk of a number of negative health outcomes associated with early and unsafe sexual activity, including infection with human immunodeficiency virus (HIV) and other sexually transmitted diseases and unintended pregnancy [ 1 ]. Although there has been a global decline in risky adolescent sexual behavior [ 2 , 3 ], this decline has been slow and has not had a large impact on HIV incidence.…”

Section: Introductionmentioning

confidence: 99%

“…Sub-Saharan Africa also carries the largest HIV burden; in 2016, globally approximately 260,000 adolescents between the ages of 15 and 19 years were newly infected with HIV, of whom 200,000 lived in 23 priority countries, which are predominantly sub-Saharan African countries [ 9 ]. Young people in the African Region have been reported to engage in risky sexual behaviors such as early sexual debut, engagement in multiple sexual partnerships and condomless sexual intercourse [ 1 , 10 , 11 ]. Many studies have reported associations between these behaviors and social determinants, including place of residence [ 10 , 12 ], educational status [ 10 , 12 ], wealth [ 12 , 13 ], family structure [ 14 ] and school attendance [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Socioeconomic variations in risky sexual behavior among adolescents in 14 sub-Saharan Africa countries who report ever having had sex

Ali

Merdad

Bellizzi³

2021

Int J Equity Health

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Background Equity is a guiding principle of the Global Strategy for Women, Children and Adolescents’ Health (2016–2030) aimed at improving adolescent health and responding more effectively to adolescents’ needs. We investigated the socioeconomic differentials in having multiple sexual partners and condom use among unmarried adolescents who reported ever having had sex aged 15–19 years in 14 sub-Saharan countries. Methods Using the most recent publicly available Demographic and Health Surveys conducted between 2011 and 2018, we calculated survey- and sex-specific proportions of two or more partners and condomless sex, both overall and by selected socioeconomic characteristics and we fitted logistic regression models to estimate the survey- and sex-specific adjusted odds ratios. The pooled adjusted odds ratios were estimated using multilevel logistic regression. Results In most countries, higher percentages of male adolescents than female adolescents reported having more than one partner in the last 12 months. Conversely, a lower percentage of young male reported having condomless sex when compared to young female: from 19.8% in Gabon to 84.5% in Sierra Leone among male adolescents and from 32.6% in Gabon to 93.2% in Sierra Leone among female adolescents. In the multilevel analyses, condomless sex was associated with place of residence, wealth and schooling for both female and male adolescents, while among male adolescents multiple partnerships was significantly associated with place of residence. Conclusion Our findings on disparities in condomless sex associated with socioeconomic characteristics might reflect constraint choice and decision making. Results also suggest the need for educational programming and services and better access to barrier methods.

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“…Global burden of disease estimated that 5.1 million deaths occurred from injuries in 2010, of which 12% are attributed to unintentional injuries among children and adolescents [ 2 ]. In sub-Saharan African (SSA), 250 million people are aged 10–19 years and this number is expected to increase by 24% by 2020 [ 3 ]; however, less attention is paid to adolescent injuries largely due to the greater attention devoted to widespread nutrition deficiencies and communicable diseases [ 4 ]. The estimated incidence of injuries for children is 53.1/100000 in SSA [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Factors Associated with Serious Injuries among Adolescents in Ghana: Findings from 2012 Global School Health Survey

Ackah

Salifu

Boakye³

2021

The Scientific World Journal

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Introduction. Injuries are of public health concern and the leading cause of residual disability and death among teenagers, especially in low- and middle-income countries (LMICs). In Ghana, the burden of injury among adolescents is under-reported. Hence, the study sought to determine the prevalence of serious injuries (SI) and the potential factors influencing these injuries among school children in Ghana. Methods. This study was conducted in Ghana among Junior High School (JHS) and senior high school students (SHS) using the 2012 Global School-Based Student Health Survey (GSHS) data. The GSHS employed two-stage cluster sampling method. Serious injuries (SI) and independent factors were measured via self-administered questionnaires. Pearson chi-square test between each explanatory variable and serious injuries was conducted and the level of statistical significance was set at 5%. The significant variables from the chi-square test were selected for multiple logistic regression analysis. Multiple logistic regression was performed to estimate the adjusted odds ratio (AOR) at 95% confidence interval (CI). Results. The prevalence of SI in the past 12 months was 66% [CI=61.8–70.2] . The most common cause of SI was fall, 36%. The common types of injuries were cut/stab wounds and broken/dislocated bone. In the multiple logistic regression analysis, after controlling for other variables, educational level (AOR = 0.64, CI = 0.44–0.90, p < 0.015), suicidal ideation (AOR = 1.58, CI = 1.00–2.48, p < 0.002), suicidal attempt (AOR = 1.88, CI = 1.29–2.72, p < 0.001), having at least one close friend (AOR = 1.49, CI = 1.17–1.89, p < 0.002), school truancy (AOR = 1.66, CI = 1.31–2.09, p < 0.000), smoking marijuana (AOR = 2.64, CI = 1.22–5.69), and amphetamine use (AOR = 2.95, CI = 1.46–5.69) were independently associated with SI. Conclusion. The findings of the study established a high prevalence of SI among adolescents in Ghana, with cut/stab wound and broken/dislocated bone being the most reported type of injuries. This study also revealed that factors such as educational level, suicidal ideation, suicidal attempt, at least one close friend, school truancy, smoking marijuana, and amphetamine use are associated with SI among the adolescents. Therefore, pragmatic interventional programs should be targeted at these factors to curb the rate of SI among junior and senior school students.

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

Cited by 132 publications

References 34 publications

Prevalence and determinants of the place of delivery among reproductive age women in sub–Saharan Africa

Prevalence and determinants of the place of delivery among reproductive age women in sub–Saharan Africa

Socioeconomic variations in risky sexual behavior among adolescents in 14 sub-Saharan Africa countries who report ever having had sex

Factors Associated with Serious Injuries among Adolescents in Ghana: Findings from 2012 Global School Health Survey

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