Urban–rural differences in the socioeconomic deprivation–Sexual behavior link in Kenya

Dodoo, F. Nii Amoo; Zulu, Eliya M.; Ezeh, Alex

doi:10.1016/j.socscimed.2006.10.007

Cited by 110 publications

(125 citation statements)

References 20 publications

(29 reference statements)

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“…37 Further, while targeting the best attainable level of health indicators at the national or sub-national (e.g., urban and rural areas) levels, health systems should also aim at reducing inequities between the poor and the non-poor. The findings of this study call for urgent attention by Kenya's Ministry of Health (MoH) and local authorities to the lack of quality health services in poor urban communities and the need to provide focused and sustained health education geared towards promoting use of obstetric services.…”

Section: Recommendationsmentioning

confidence: 99%

Provision and Use of Maternal Health Services among Urban Poor Women in Kenya: What Do We Know and What Can We Do?

2008

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In sub-Saharan Africa, the unprecedented population growth that started in the second half of the twentieth century has evolved into unparalleled urbanization and an increasing proportion of urban dwellers living in slums and shanty towns, making it imperative to pay greater attention to the health problems of the urban poor. In particular, urgent efforts need to focus on maternal health. Despite the lack of reliable trend data on maternal mortality, some investigators now believe that progress in maternal health has been very slow in sub-Saharan Africa. This study uses a unique combination of health facility-and individual-level data collected in the slums of Nairobi, Kenya to: (1) describe the provision of obstetric care in the Nairobi informal settlements; (2) describe the patterns of antenatal and delivery care, notably in terms of timing, frequency, and quality of care; and (3) draw policy implications aimed at improving maternal health among the rapidly growing urban poor populations. It shows that the study area is deprived of public health services, a finding which supports the view that low-income urban residents in developing countries face significant obstacles in accessing health care. This study also shows that despite the high prevalence of antenatal care (ANC), the proportion of women who made the recommended number of visits or who initiated the visit in the first trimester of pregnancy remains low compared to Nairobi as a whole and, more importantly, compared to rural populations. Bivariate analyses show that household wealth, education, parity, and place of residence were closely associated with frequency and timing of ANC and with place of delivery. Finally, there is a strong linkage between use of antenatal care and place of delivery. The findings of this study call for urgent attention by Kenya's Ministry of Health and local authorities to the void of quality health services in poor urban communities and the need to provide focused and sustained health education geared towards promoting use of obstetric services.

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Section: Recommendationsmentioning

confidence: 99%

Provision and Use of Maternal Health Services among Urban Poor Women in Kenya: What Do We Know and What Can We Do?

2008

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“…12,27 The association between wealth status and initiation of first sexual intercourse among Malawian males is inconsistent with the wealthiest (or the poorest) exhibiting the highest risky sexual behaviour since it is those in the middle and second quintiles who initiated sex earlier. A plausible explanation for a weaker association between wealth status and the age at first sexual intercourse among males is that the main motivation for first sex may be curiosity or experimentation.…”

Section: Is Poverty a Driver For Risky Sexual Behaviour? Evidence Fromentioning

confidence: 99%

“…Boys in the middle wealth quintiles were significantly more likely to have multiple sexual partners than those in the other wealth groups and it was not clear why this particular sub-group showed this tendency.. Other researchers have also reported weak or no association between socioeconomic status and multiple sexual partnership among young people. 8 However, higher rates of multiple sexual partnerships have been reported among poorer women aged 15-49 years in Kenya 12,13,27 as well as among younger women aged 15-24. 12 The context of two of the Kenyan studies was among very poor slum women, who sometimes give sexual favours for subsistence.…”

Section: Is Poverty a Driver For Risky Sexual Behaviour? Evidence Fromentioning

confidence: 99%

Is Poverty a Driver for Risky Sexual Behaviour? Evidence from National Surveys of Adolescents in Four African Countries

Madise¹,

Zulu²,

Ciera³

2007

African Journal of Reproductive Health

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This paper contributes to conflicting evidence on the link between poverty and risky sexual behaviour by examining the effect of wealth status on age at first sex, condom use, and multiple partners using nationally representative adolescents' data from Burkina Faso, Ghana, Malawi, and Uganda. The results show that the wealthiest girls in Burkina Faso, Ghana, and Malawi had later sexual debut compared with their poorer counterparts but this association was not significant for Uganda. Wealth status was weaker among males and significant only in Malawi, where those in the middle quintile had earlier sexual debut. Wealthier adolescents were most likely to use condoms at the last sexual act, but wealth status was not associated with number of sexual partners. Although the link between wealth status and sexual behaviour is not consistent, there is evidence that poor females are vulnerable to infection because of earlier sexual debut and non-use of condoms. (Afr J Reprod Health 2007; 11[3]:83-98) RÉSUMÉ Est-ce que la pauvreté est un moteur des comportements sexuels risqués? Evidence tirée de l'enquête nationale sur les adolescents dans quatre pays africains. Cet article contribue à l'évidence contradictoire sur le lien entre la pauvreté et le comportement sexuel risqué tout en examinant l'effet que la situation de richesse a sur l'âge au moment du premier acte sexuel, l'emploi du préservatif et les partenaires multiples; ceci à l'aide des données à représentation nationale auprès des adolescents au Burkina-Faso, au Ghana, au Malawi et en Ouganda. Les résultats ont montré que les filles les plus riches au Burkina-Faso, au Ghana et au Malawi ont eu leur premier acte sexuel plus tard par rapport à leur homologues moins riches, mais ce rapport n'était pas significatif pour l'Ougnada. La situation de richesse était plus faible chez les mâles et elle était significative seulement au Malawi où ceux de richesse moyenne ont eu un premier acte sexuel plus tôt. Les adolescents les plus riches avaient plus la possibilité d'utiliser le préservatif au cours du dernier acte sexuel, mais la situation de richesse n'était pas liée au nombre de partenaires sexuels. Bien que le lien entre la situation de richesse et le comportement sexuel ne soit pas coherent, il y a l'évidence que les femelles pauvres sont vulnérables à l'infection à cause d'un début sexuel antérieur et le non emploi des préservatifs. (Rev Afr Santé Reprod 2007; 11[3]:83-98).

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“…Demographers and epidemiologists have debated for decades what may explain the vastly different HIV epidemic seen across the globe and reasons why Sub-Saharan Africa, where transmission is mostly heterosexually driven, has been so devastated by HIV. Plausible explanations may include high rates of other sexually transmitted infections that facilitate HIV acquisition and transmission, poor access to quality health care, insufficient or ineffective primary prevention programs, poverty, and engaging in behaviours associated with increased risk such as alcohol use and the practice of having multiple and concurrent sexual partners [3][4][5].…”

Section: Hiv and Aids In Sub-saharan Africanmentioning

confidence: 99%

Partnering with Batswana Youth and Families for HIV and AIDS Prevention

Seloilwe¹,

Magowe²,

Dithole³

et al. 2013

WJA

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Introduction: This qualitative study triangulated data from adolescents, parents, and key informants in Gaborone, Botswana on adolescents' risks for HIV infection, STIs and pregnancy, the types of relationships they get into, and preventive measures they use to protect themselves against HIV infection. The goal of this qualitative research is to inform adaptation of an intervention originally developed, implemented, and evaluated in the US that was effective in reducing the risk of HIV infection and early pregnancy by delaying initiation of sexual relationships of abstinent adolescents and lowering sexual risk behaviours of adolescents who were already sexually active. The objectives of this study were to conduct in-depth interviews with youth, key informants and parents; determine the behavioural risks that young people face; Assess youth and parents' attitudes toward providing a risk reduction programme for adolescents and Use the data to adapt an evidence-based programme for Botswana. Methodology: In-depth qualitative interviews with 40 youth, 20 key informants and 40 parents elicited information on the risks and relationships that youth engaged in and their suggestions how their risky behaviours could be minimized or counteracted. Findings: Youth of both sexes engage in risky sexual behaviours that could predispose them to contracting HIV and STI infections or unplanned pregnancies. Risks were associated with use of alcohol and drugs: commonly marijuana, and engaging in unsafe sexual relations. Youth, key informants and parents showed a high level of acceptability for offering a primary prevention intervention program for adolescents. In addition, all groups of participants concurred on the importance of offering a separate program for parents to equip them with skills that can enable to them to guide their adolescents to safely transit into adulthood through education and family communication skills. Other risks confronting adolescents included sexual initiations from either older men or women (sugar daddy and mummy syndrome) in exchange for material and financial gains. Conclusion: Informants endorsed the need for primary prevention programs addressing adolescents and their families to reduce risk behaviours among Batswana youth to provide them with skills and minimise the risk of HIV infection among adolescents.

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Urban–rural differences in the socioeconomic deprivation–Sexual behavior link in Kenya

Cited by 110 publications

References 20 publications

Provision and Use of Maternal Health Services among Urban Poor Women in Kenya: What Do We Know and What Can We Do?

Provision and Use of Maternal Health Services among Urban Poor Women in Kenya: What Do We Know and What Can We Do?

Is Poverty a Driver for Risky Sexual Behaviour? Evidence from National Surveys of Adolescents in Four African Countries

Partnering with Batswana Youth and Families for HIV and AIDS Prevention

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