Decomposing the rural-urban gap in the factors of under-five mortality in sub-Saharan Africa? Evidence from 35 countries

Yaya, Sanni; Uthman, Olalekan A.; Okonofua, Friday; Bishwajit, Ghose

doi:10.1186/s12889-019-6940-9

Cited by 101 publications

(103 citation statements)

References 25 publications

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“…The data were secondary and authors have no influence over the selection and measurement of the variables. As the data were self-reported, the chances of recall and reporting bias cannot be ignored [33,34].…”

Section: Discussionmentioning

confidence: 99%

Determinants of prenatal care use and HIV testing during pregnancy: a population-based, cross-sectional study of 7080 women of reproductive age in Mozambique

Yaya¹,

Oladimeji

et al. 2019

BMC Pregnancy Childbirth

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Background:In low-income countries with poor coverage of healthcare services such as Mozambique, antenatal care serves as a vital tool for providing life-saving and cost-effective services for pregnant mothers. Nonetheless, many countries in Africa, including Mozambique, are struggling to attain an optimum level of antenatal care (at least 4 visits) utilisation among pregnant women. In the present study, we aimed to assess the sociodemographic and economic factors associated with antenatal care use in Mozambique. Methods: Cross-sectional data from the latest round of Mozambique Demographic and Health Survey (2011) on women aged 15-49 years (n = 7080) were analysed. The outcome measures were early and adequate antenatal visit and HIV tests during the last pregnancy. Data were analysed using descriptive and multivariate regression methods. The predictor variables included various demographic (e.g. age, parity), empowerment (e.g. type of employment, household wealth status) and sociocultural factors (e.g. ethnicity, religion). Results: Of the 7080 women whose data was analyzed, 15.3 and 60.1% had early and adequate ANC visits respectively while 75.4% received HIV test during ANC visits. The odds of early ANC visits were higher [OR = 1.300, 95%CI = 1.062, 1.592] among women in the rural areas compared with those in the urban areas. However, participants in rural areas had lower odds [OR = 0.788, 0.687,0.902] of receiving HIV tests during ANC visits. Women in the urban areas with secondary [OR = 1.296, 95%CI = 1.007,1.666] and higher [OR = 1.663, 95%CI = 1.052,2.628] education had higher odds of having early ANC visit. Those in the higher wealth quintiles also had significantly increased odds of using all three types of ANC indicators, particularly for rural women in the highest wealth quintile [OR = 4.776, 95%CI = 1.250,18.24]. Being within the higher wealth quintiles was found to significantly increase the odds of using all three types of ANC indicators, particularly women from rural areas with highest wealth quintile [OR = 4.776, 95%CI = 1.250,18.24]. Conclusion: About two-fifth of the women in Mozambique are not using adequate antenatal care and about and a quarter do not take HIV tests during pregnancy. The sources of low and unequal use of these vital health services might be rooted in women's socioeconomic status and cultural issues that require special policy and research attention.

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Section: Discussionmentioning

confidence: 99%

Determinants of prenatal care use and HIV testing during pregnancy: a population-based, cross-sectional study of 7080 women of reproductive age in Mozambique

Yaya¹,

Oladimeji

et al. 2019

BMC Pregnancy Childbirth

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“…Furthermore, to explore the disparities in the burden of disability between elderly and non-elderly, risk difference (per 1000 population) was utilized. Risk Difference was calculated as the difference between the prevalence of disability between elderly and non-elderly sub-groups for the total population and by the selected background characteristics (27). A positive risk difference suggests that the prevalence of disability is higher among the elderly sub-group and vice versa.…”

Section: Discussionmentioning

confidence: 99%

Measuring the contributions of elderly and non-elderly age-groups to the disability burden in India: A Decomposition Analysis.

Chanda

Puri

Yadav

2020

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Background Disability has been an essential component of the health and development framework of India. Despite policy norms, a surge in disability across the population interrogates the role of the increasing elderly population in terms of chronic diseases led disabilities. The regional variation in demographic transitions possesses an unequal risk for the occurrence of disability in the population. The demographic and socio-economic factors can explain the inequality contributed by the elderly and non-elderly population. Methods We have used the National Sample Survey-76th round (2018) to measure the risk difference of disability between elderly and non-elderly age-groups across selected background characteristics. Fairlie’s decomposition technique has been adopted to measure the contribution made by the socio-economic factors in explaining the differences in the prevalence of disability. Distribution of states with respect to prevalence and risk difference of disability between elderly and non-elderly are plotted, to understand the regional inequality in the occurrence of disability in India. Results The study calculates a risk difference of 68 per 1000 population in India, explaining a higher risk of disability among the elderly that varies across socio-economic factors. Belonging from the Central region of India represents a higher risk of disability at old age (risk difference 76.8 per 1000 population) than the rest of the regions in India. Gender, marital status, and education explain 72 percent of the gap in the occurrence of disability between two broad age-groups. Despite having a similar disability prevalence, Kerala and Odisha have risk differences of 32 and 85 per 1000 population, respectively. Conclusions The gap in the disability prevalence is significantly explained by the marital status and educational status of the individuals. Disparity in the risk difference of disability among elderly and non-elderly across states suggests that large size of the elderly population is not the only reason for the increasing disability burden in India. Inadequate healthcare infrastructure and access also results into an unmet health care need pertaining to disability. Study suggests a policy relevance for disability-inclusive and geriatric centric healthcare and social supports in synchronisation with the demand realised by the states in India.

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“…Such women may feel less motivated to test for HIV. In terms of socio-economic status, education, urban living and wealth status, have been identi ed as strong predictors for HIV testing in previous studies [21,23,25,[31][32][33][34][35][36][37]. Education and wealth status are forms of empowerment.…”

Section: Discussionmentioning

confidence: 99%

Women’s healthcare decision-making capacity and HIV testing in sub-Saharan Africa: a multi-country analysis of demographic and health surveys

Seidu

Oduro

Budu

et al. 2020

Preprint

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Background Global commitment to stop Human Immunodeficiency Virus (HIV) and ensure access to HIV treatment calls for women empowerment as these efforts play major roles in mother-to-child transmission. We explored the association between women’s healthcare decision-making capacity and HIV testing in sub-Saharan Africa (SSA). Methods We used data from the current Demographic and Health Surveys (DHS) conducted between January 1, 2010 and December 31, 2018 in 28 countries in SSA. At the descriptive level, we calculated the prevalence of HIV testing in each of the countries. This was followed by the distribution of HIV testing across the socio-demographic characteristics of women. Finally, we used binary logistic regression to explore the likelihood of HIV testing by women’s health care decision-making capacity and socio-demographic characteristics. The results were presented as Crude Odds Ratios (COR) and Adjusted Odds Ratios(AOR) with their corresponding 95% confidence intervals signifying precision. Statistical significance was set at p-value <0.05. Results We found that prevalence of HIV testing in the 28 SSA countries was 64.4%, with Congo DR having the least (20.2%) and the highest occurred in Rwanda (97.4%). Women who took healthcare-decisions alone [COR=3.183, CI=2.880-3.519] or with their partners [COR=2.577, CI=2.335-2.844] were more likely to test for HIV compared to those whose healthcare-decisions were taken by others and this persisted after controlling for significant covariates [AOR=1.507, CI=1.321-1.720] and [AOR=1.518, CI=1.334-1.728], respectively. Conclusion SSA countries intending to improve HIV testing need to incorporate women’s healthcare decision-making capacity strategies. These strategies can include education and counselling. This is essential because our study indicates that the capacity of women to make healthcare decisions has an association with their decision to test for their HIV status.

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Decomposing the rural-urban gap in the factors of under-five mortality in sub-Saharan Africa? Evidence from 35 countries

Cited by 101 publications

References 25 publications

Determinants of prenatal care use and HIV testing during pregnancy: a population-based, cross-sectional study of 7080 women of reproductive age in Mozambique

Determinants of prenatal care use and HIV testing during pregnancy: a population-based, cross-sectional study of 7080 women of reproductive age in Mozambique

Measuring the contributions of elderly and non-elderly age-groups to the disability burden in India: A Decomposition Analysis.

Women’s healthcare decision-making capacity and HIV testing in sub-Saharan Africa: a multi-country analysis of demographic and health surveys

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