Childhood mortality in sub-Saharan Africa: cross-sectional insight into small-scale geographical inequalities from Census data

Background: In epidemiological studies, several diseases share common risk factors or co-exist in their spatial prevalence. Disease mapping allows the health practitioners and epidemiologists to hypothesize the disease aetiology and gain better understanding of the geographical prevalence of the disease risks.Objective: This paper investigates the differences in small scale geographical variations and the underlying risk factors of child’s health outcomes (anemia, stunting and wasting) in Sub-Saharan Africa using spatial epidemiology. Method: The study first carried out an independent univariate analysis on each malnutrition indicator to identify underlying risk factors. A multivariate conditional autoregressive prior was explored to jointly model the spatial correlation between the undernutrition indicators and the small area-geographical disparities at sub-national levels in two sub-Saharan African countries.Results: The approach was implemented on data from National cross-sectional household- based demographic and health surveys conducted in 17,307 under-five children in Burkina Faso and Mozambique in 2010-2012. Out of these children, 31.8% are found to be stunted, 15.5% wasted and 30.9% had anemia among Burkina Faso children, while 42.5% of Mozambican children were stunted, 5.9% wasted and 30.9% suffered from iron-deficiency anemia. The multivariate analysis revealed that the spatial prevalence existed across regions in Burkina Faso with geographical variations in stunting estimated as: 0.7549, CI (0.4693, 1.264); wasting 0.9197; (95%CI : 0.535, 1.591)and anemia : 0.734; (0.4606, 1.214). In additin, the spatial correlation between stunting and wasting was negatively correlated: -0.998; 95% CI (-1.000, -0.984), and a perfect negative correlation;(-1) between stunting and anemia, and positive for wasting and anemia: 0.997; (0.978, 1.000). The spatial occurrence across provinces in Mozambique indicated that there was strong positive correlation between stunting and wasting; 0.986; (0.899, 1.000) and a significant negative correlation between stunting and anemia: -0.720, (-0.934, -0.308) and wasting and anemia: -0.640; (-0.903 -0.174) with individual geographical variability in child stunting: 1427, (913.6, 2268); wasting:1751, (1117, 2803) and anemia: 556, (279.5, 978.9). These extra random effect parameters computed in our multivariate approach would outperform a univariate analysis in similar studies. Our model further detected high prevalent of malnutrition and anemia in the northern Burkina Faso, but high anemia prevalent found in central Mozambique, and high stunting and wasting identified Southern Mozambique. In addition, the risk factors of malnutrition and iron deficiency anemia included household poverty, morbidity, short birth interval (less 18 months), breast feeding, antenatal attendance and maternal literacy.Conclusion: The statistical relevance of the identified risk factors in this study is useful to target specific individual interventions and the maps of the geographical inequalities in sub-national region can be used for designing nutrition interventions and allocation of scarce health resources.Keywords: Joint spatial mapping, childhood anemia, malnutrition, sub-Saharan Africa.

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Geographical Inequalities in Use of Improved Drinking Water Supply and Sanitation across Sub-Saharan Africa: Mapping and Spatial Analysis of Cross-sectional Survey Data

PLoS Medicine ◽

10.1371/journal.pmed.1001626 ◽

2014 ◽

Vol 11 (4) ◽

pp. e1001626 ◽

Cited By ~ 87

Author(s):

Rachel L. Pullan ◽

Matthew C. Freeman ◽

Peter W. Gething ◽

Simon J. Brooker

Keyword(s):

Drinking Water ◽

Spatial Analysis ◽

Water Supply ◽

Survey Data ◽

Sub Saharan Africa ◽

Drinking Water Supply ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Geographical Inequalities ◽

Sub Saharan

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Adolescent Suicidality as Seen in Rural Northeastern Uganda

Crisis ◽

10.1027/0227-5910/a000059 ◽

2011 ◽

Vol 32 (1) ◽

pp. 43-51 ◽

Cited By ~ 17

Author(s):

Eugene Kinyanda ◽

Ruth Kizza ◽

Jonathan Levin ◽

Sheila Ndyanabangi ◽

Catherine Abbo

Keyword(s):

Low Socioeconomic Status ◽

Sub Saharan Africa ◽

Psychosocial Risk ◽

Psychiatric Nurses ◽

Health Concern ◽

Cross Sectional ◽

Childhood Experiences ◽

Low Socioeconomic ◽

Dsm Iv ◽

Sub Saharan

Background: Suicidal behavior in adolescence is a public health concern and has serious consequences for adolescents and their families. There is, however, a paucity of data on this subject from sub-Saharan Africa, hence the need for this study. Aims: A cross-sectional multistage survey to investigate adolescent suicidality among other things was undertaken in rural northeastern Uganda. Methods: A structured protocol administered by trained psychiatric nurses collected information on sociodemographics, mental disorders (DSM-IV criteria), and psychological and psychosocial risk factors for children aged 3–19 years (N = 1492). For the purposes of this paper, an analysis of a subsample of adolescents (aged 10–19 years; n = 897) was undertaken. Results: Lifetime suicidality in this study was 6.1% (95% CI, 4.6%–7.9%). Conclusions: Factors significantly associated with suicidality included mental disorder, the ecological factor district of residence, factors suggestive of low socioeconomic status, and disadvantaged childhood experiences.

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Suicidal ideation and associated factors among school-going adolescents in rural Ghana

Current Psychology ◽

10.1007/s12144-021-01378-3 ◽

2021 ◽

Author(s):

Emmanuel Nii-Boye Quarshie ◽

Samuel Kofi Odame

Keyword(s):

Suicidal Ideation ◽

Associated Factors ◽

Attempted Suicide ◽

Sub Saharan Africa ◽

Rural Adolescents ◽

African Countries ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Rural Ghana ◽

Sub Saharan

AbstractSuicidal ideation is a critical risk for attempted suicide and eventual suicide. Little is known about suicidal ideation among rural adolescents in most sub-Saharan African countries. We aimed to estimate the 12-month prevalence of suicidal ideation and to describe some of the common and gender-specific associated factors among in-school adolescents in rural Ghana. We conducted a cross-sectional survey involving a random sample of 1101 in-school adolescents aged 10–19 years in a rural district in Eastern Ghana. The Suicidal Behavior Questionnaire-Revised was used to assess suicidal ideation. Overall, 25.1% participants (95% CI = 22.5–27.7), representing 28.3% females (95% CI = 24.7–32.2) and 21.5% males (95% CI = 18.0–25.2) reported suicidal ideation during the previous 12 months. Females who experienced personal and interpersonal adversities mainly outside the family context were likely to report suicidal ideation, while suicidal ideation among males was associated with conflict with parents. Regardless of gender, adolescents who reported exposure to a friend’s attempted suicide were about two times more likely to report suicidal ideation. The prevalence of suicidal ideation among adolescents in rural Ghana compares with in-school estimates from other countries within sub-Saharan Africa, but also underscores the need for targeted and universal prevention programmes and intervention efforts to mitigate the potential transition from suicidal ideations to suicidal attempts and eventual deaths by suicide among rural adolescents.

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Maternal healthcare utilsation and complete childhood vaccination in sub-Saharan Africa: a cross-sectional study of 29 nationally representative surveys

BMJ Open ◽

10.1136/bmjopen-2020-045992 ◽

2021 ◽

Vol 11 (5) ◽

pp. e045992

Author(s):

Eugene Budu ◽

Bright Opoku Ahinkorah ◽

Richard Gyan Aboagye ◽

Ebenezer Kwesi Armah-Ansah ◽

Abdul-Aziz Seidu ◽

...

Keyword(s):

Healthcare Utilisation ◽

Cross Sectional Study ◽

Sub Saharan Africa ◽

Childhood Vaccination ◽

Outcome Variable ◽

Service Utilisation ◽

Sectional Study ◽

Maternal Healthcare ◽

Cross Sectional ◽

Sub Saharan

ObjectiveThe objective of the study was to examine the association between maternal healthcare utilisation and complete childhood vaccination in sub-Saharan Africa.DesignOur study was a cross-sectional study that used pooled data from 29 countries in sub-Saharan Africa.ParticipantsA total of 60 964 mothers of children aged 11–23 months were included in the study.Outcome variablesThe main outcome variable was complete childhood vaccination. The explanatory variables were number of antenatal care (ANC) visits, assistance during delivery and postnatal care (PNC).ResultsThe average prevalence of complete childhood vaccination was 85.6%, ranging from 67.0% in Ethiopia to 98.5% in Namibia. Our adjusted model, children whose mothers had a maximum of three ANC visits were 56% less likely to have complete vaccination, compared with those who had at least four ANC visits (adjusted OR (aOR)=0.44, 95% CI 0.42 to 0.46). Children whose mothers were assisted by traditional birth attendant/other (aOR=0.43, 95% CI 0.41 to 0.56) had lower odds of complete vaccination. The odds of complete vaccination were lower among children whose mothers did not attend PNC clinics (aOR=0.26, 95% CI 0.24 to 0.29) as against those whose mothers attended.ConclusionThe study found significant variations in complete childhood vaccination across countries in sub-Saharan Africa. Maternal healthcare utilisation (ANC visits, skilled birth delivery, PNC attendance) had significant association with complete childhood vaccination. These findings suggest that programmes, interventions and strategies aimed at improving vaccination should incorporate interventions that can enhance maternal healthcare utilisation. Such interventions can include education and sensitisation, reducing cost of maternal healthcare and encouraging male involvement in maternal healthcare service utilisation.

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Leveraging community based organizations and fintech to improve small-scale renewable energy financing in sub-Saharan Africa

Energy Research & Social Science ◽

10.1016/j.erss.2021.101949 ◽

2021 ◽

Vol 73 ◽

pp. 101949

Author(s):

Hemen Mark Butu ◽

Benyoh Emmanuel Kigha Nsafon ◽

Sang Wook Park ◽

Jeung Soo Huh

Keyword(s):

Renewable Energy ◽

Sub Saharan Africa ◽

Small Scale ◽

Community Based ◽

Community Based Organizations ◽

Sub Saharan

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Unravelling the Perspectives of Day and Night Traders in Selected Markets within a Sub-Saharan African City with a Malaria Knowledge, Attitude and Practice Survey

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18073468 ◽

2021 ◽

Vol 18 (7) ◽

pp. 3468

Author(s):

Patience B. Tetteh-Quarcoo ◽

Nicholas T. K. D. Dayie ◽

Kevin Kofi Adutwum-Ofosu ◽

John Ahenkorah ◽

Emmanuel Afutu ◽

...

Keyword(s):

Cross Sectional Study ◽

Malaria Treatment ◽

Sub Saharan Africa ◽

African City ◽

Cross Sectional ◽

Attitudes And Practices ◽

Treatment Type ◽

Significant Difference ◽

High Knowledge ◽

Sub Saharan

Background: Malaria is still endemic in sub-Saharan Africa, with a high disease burden. Misconceptions about malaria contribute to poor attitudes and practices, further increasing the burden in endemic countries. Studies have examined the knowledge, attitudes, and practices (KAP) of malaria among different populations. However, there seems to be no available literature reporting on the perspectives of day and night market traders. To the best of our knowledge, this is the first report on malaria KAP with a focus on day and night market traders. Methods: A descriptive cross-sectional study involving day and night market traders in 10 selected markets within the Greater Accra Region of Ghana was carried out. Data were collected from consenting respondents using a structured questionnaire. Results: Of the 760 respondents (33.3% (n = 253) night and 66.7% (n = 507) day traders) interviewed, there was no significant difference between the day and night market traders in terms of malaria KAP. Although the market traders had an overall moderate knowledge (54.0% of the day traders and 56.5% of the night traders), misconceptions about malaria (especially that it could be caused by exposure to the sun) still existed among the traders. Moreover, the majority of the traders who demonstrated high knowledge (43.98%, n = 250) did not always take laboratory tests to confirm their suspicion, indicating poor attitude. Furthermore, the market traders’ choice of drug for malaria treatment (p = 0.001) and preferred malaria treatment type (orthodox or herbal) (p = 0.005) were significantly associated with their knowledge level. Conclusions: Despite the observation that no significant difference in KAP exists between day and night market traders, appropriate health education programs and interventions still need to be directed at misconceptions, poor attitudes, and poor practices revealed by this study. This will ultimately help in the prevention and control of malaria in Ghana, and globally.

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