scholarly journals Method-specific beliefs and subsequent contraceptive method choice: Results from a longitudinal study in urban and rural Kenya

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252977
Author(s):  
George Odwe ◽  
Yohannes Dibaba Wado ◽  
Francis Obare ◽  
Kazuyo Machiyama ◽  
John Cleland
Keyword(s):  
Sub Saharan Africa ◽  
Rural Site ◽  
Urban Site ◽  
Major Influence ◽  
Logit Analysis ◽  
Method Choice ◽  
Negative Beliefs ◽  
Family Planning Counseling ◽  
Sub Saharan

Introduction Evidence from sub-Saharan Africa, including Kenya, shows that negative beliefs about contraceptive methods are associated with non-use. However, little is known about the relationship between contraceptive beliefs and subsequent method choice. Methodology We used data from a two-year longitudinal survey of married women aged 15–39 years at enrollment from one urban site (Nairobi) and one rural site (Homa Bay) in Kenya. Analysis entails descriptive statistics and estimation of a conditional logit analysis to examine associations between method-specific beliefs and choice of injectables, implants or pills among women who were not using any method or were pregnant at baseline (round 1) but adopted these methods at 12-month follow-up (Nairobi, n = 221; Homa Bay n = 197). Results Beliefs about pills, injectables and implants among non-users were generally negative. With the partial exception of the pill in Nairobi, the majority thought that each method was likely to cause serious health problems, unpleasant side effects, menstrual disruption, and would be unsafe for long-term use. In both sites, satisfied past use of a method and the perception that a method is easy to use had a major influence on method choice. Concerns about menstrual disruption and safety for long-term use were unimportant in both sites. There were some marked differences between the two sites. Beliefs about long-term fertility impairment and perceived husband approval had strong influences on choice of injectables, implants or pills in the urban site but not in the rural site. Conclusion The relative importance of beliefs, some erroneous, in predisposing women to choose one method over another appears to be conditioned by the social context. There is need for family planning counseling programmes to pay attention to erroneous beliefs and misconceptions about contraceptives.

scholarly journals Decision Making under Climate Risks: An Analysis of Sub-Saharan Farmers’ Adaptation Behaviors

2012 ◽  
Vol 4 (4) ◽  
pp. 285-299 ◽  
Author(s):  
S. Niggol Seo
Keyword(s):  
Decision Making ◽  
Risk Measures ◽  
Integrated System ◽  
Sub Saharan Africa ◽  
Arid Zones ◽  
Logit Analysis ◽  
Climate Data ◽  
Climate Risks ◽  
Sub Saharan

Abstract This paper examines decision making under climate risks using farmers’ decisions in sub-Saharan Africa, where climate risks are very high. Two risk measures are obtained from the Climate Research Unit’s high-resolution climatology, diurnal temperature range (DTR) and coefficient of variation in precipitation (CVP), which are both averages of 30-yr climate data. Farm surveys of around 7600 households were matched cell by cell with the climate risk data. This paper finds that climate risks are indeed highest in the lowland arid zones in the Sahel. A spatial logit analysis shows that farmers in sub-Saharan Africa have adapted their agricultural systems to varying degrees of the CVP and the DTR. In the long term, if the CVP were to increase by 30%, an integrated system would increase by 7.0%. On the other hand, the two specialized systems fall: a crops-only system falls by 5.3% and a livestock-only system falls by 1.7%. When the DTR increases, farmers adapt by switching to a specialized livestock system. Under increased climate risks, this paper finds that farmers in the lowland savannahs and arid zones in the Sahel, where climate risks are high at present, will adapt by switching to an integrated system. Studies of climate risks, therefore, must account for behavioral responses of the individuals. These results can be utilized to help African farmers to adapt to increasing climate risks.

Prevalence and risk factor for injury in sub-Saharan Africa: a multicountry study

2017 ◽  
Vol 24 (4) ◽  
pp. 272-278 ◽  
Author(s):  
Megan B Diamond ◽  
Shona Dalal ◽  
Clement Adebamowo ◽  
David Guwatudde ◽  
Carien Laurence ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Sub Saharan Africa ◽  
Health Concern ◽  
Rural Site ◽  
Urban Site ◽  
Injury Data ◽  
Sub Saharan ◽  
Serious Injury

IntroductionInjury-related morbidity is a neglected health concern in many low-income and middle-income countries. Most injury data in Africa have been collected from hospital-based studies, and few studies have occurred across multiple countries. Using data from a novel cohort, we examined the prevalence and incidence of serious injuries and associated risk factors across five sites in sub-Saharan Africa (SSA).MethodsA common baseline and follow-up survey was administered to participants. The study population included 1316 persons at baseline and 904 persons at follow-up. Frequencies were calculated, and logistic regression models were used to assess risk factors for injury.ResultsA total of 233 (17.7%) persons reported a serious injury at baseline and 60 (6.6%) reported a serious injury 6 months later at follow-up. Sixty-nine per cent of participants responded to the follow-up questionnaire. At baseline and follow-up, the most common cause of serious injury at urban sites was transport related, followed by poison/overdose. In rural Uganda, sharp instruments injuries were most common, followed by transport-related injuries. Living at an urban site was associated with an increased odds for serious injury compared with those at the rural site (OR: 1.83, 95% CI 1.15 to 2.90). Participants who consumed above a moderate amount of alcohol were at a higher risk of serious injury compared with those who did not consume alcohol (OR: 1.86, 95% CI 1.02 to 3.41). High level of education was an important risk factor for injury.ConclusionAt baseline and follow-up, common causes of serious injury were transport related, sharp instrument and poison/overdose. Alcohol consumption, urban location and education are important risk factors for injury. It is feasible to collect longitudinal injury data using a standardised questionnaire across multiples sites in SSA. Longitudinal data collection should be leveraged to obtain robust data on risk factors for injury in SSA.

Sovereign Wealth Funds and Long-Term Investments in Sub-Saharan Africa

2016 ◽  
Author(s):  
Boubacar Diallo ◽  
Fulbert Tchana Tchana ◽  
Albert G. Zeufack
Keyword(s):  
Sub Saharan Africa ◽  
Sovereign Wealth Funds ◽  
Sub Saharan

scholarly journals Mapping of affordability levels for photovoltaic-based electricity generation in the solar belt of sub-Saharan Africa, East Asia and South Asia

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sándor Szabó ◽  
Irene Pinedo Pascua ◽  
Daniel Puig ◽  
Magda Moner-Girona ◽  
Mario Negre ◽  
...  
Keyword(s):  
East Asia ◽  
South Asia ◽  
Electricity Generation ◽  
Sub Saharan Africa ◽  
Solar Photovoltaic ◽  
Term Operation ◽  
Sub Saharan ◽  
High Level ◽  
Do So

AbstractLack of access to modern forms of energy hampers efforts to reduce poverty. The provision of electricity to off-grid communities is therefore a long-standing developmental goal. Yet, many off-grid electrification projects neglect mid- and long-term operation and maintenance costs. When this is the case, electricity services are unlikely to be affordable to the communities that are the project’s primary target. Here we show that, compared with diesel-powered electricity generation systems, solar photovoltaic systems are more affordable to no less than 36% of the unelectrified populations in East Asia, South Asia, and sub-Saharan Africa. We do so by developing geo-referenced estimates of affordability at a high level of resolution (1 km2). The analysis illustrates the differences in affordability that may be found at the subnational level, which underscores that electrification investments should be informed by subnational data.

A cholera outbreak among semi-nomadic pastoralists in northeastern Uganda: epidemiology and interventions

2011 ◽  
Vol 140 (8) ◽  
pp. 1376-1385 ◽  
Author(s):  
M. J. CUMMINGS ◽  
J. F. WAMALA ◽  
M. EYURA ◽  
M. MALIMBO ◽  
M. E. OMEKE ◽  
...  
Keyword(s):  
Female Gender ◽  
Sub Saharan Africa ◽  
Cholera Outbreak ◽  
Community Based ◽  
Nomadic Pastoralists ◽  
Sub Saharan ◽  
Water And Sanitation Infrastructure ◽  
Sanitation Infrastructure ◽  
Village Health Teams

SUMMARYIn sub-Saharan Africa, many nomadic pastoralists have begun to settle in permanent communities as a result of long-term water, food, and civil insecurity. Little is known about the epidemiology of cholera in these emerging semi-nomadic populations. We report the results of a case-control study conducted during a cholera outbreak among semi-nomadic pastoralists in the Karamoja sub-region of northeastern Uganda in 2010. Data from 99 cases and 99 controls were analysed. In multivariate analyses, risk factors identified were: residing in the same household as another cholera case [adjusted odds ratio (aOR) 6·67, 95% confidence interval (CI) 2·83–15·70], eating roadside food (aOR 2·91, 95% CI 1·24–6·81), not disposing of children's faeces in a latrine (aOR 15·76, 95% CI 1·54–161·25), not treating drinking water with chlorine (aOR 3·86, 95% CI 1·63–9·14), female gender (aOR 2·43, 95% CI 1·09–5·43), and childhood age (10–17 years) (aOR 7·14, 95% CI 1·97–25·83). This is the first epidemiological study of cholera reported from a setting of semi-nomadic pastoralism in sub-Saharan Africa. Public health interventions among semi-nomadic pastoralists should include a two-faceted approach to cholera prevention: intensive health education programmes to address behaviours inherited from insecure nomadic lifestyles, as well as improvements in water and sanitation infrastructure. The utilization of community-based village health teams provides an important method of implementing such activities.

Cost determination and sustainable financing for rural water services in sub-Saharan Africa

Water Policy ◽  
2007 ◽  
Vol 9 (4) ◽  
pp. 373-391 ◽  
Author(s):  
Peter A. Harvey
Keyword(s):  
Sub Saharan Africa ◽  
Water Services ◽  
Innovative Strategies ◽  
Water Users ◽  
Sub Saharan ◽  
The Cost ◽  
National Governments ◽  
Cost Determination ◽  
Sustainable Financing

Access to safe, sufficient and affordable water in rural Africa will not increase unless sustainable financing strategies are developed which ensure the sustainability of existing water services. There is a strong need for international donors and national governments to confront the true costs associated with sustained service provision in order to develop practicable long-term financing mechanisms. This paper presents a systematic approach that can be applied to determine the overall cost of service delivery based on respective cost estimates for operation and maintenance, institutional support, and rehabilitation and expansion. This can then be used to develop a tariff hierarchy which clearly indicates the cost to water users of different levels of cost recovery, and which can be used as a planning tool for implementing agencies. Community financing mechanisms to ensure sustained payment of tariffs must be matched to specific communities and their economic characteristics; a blanket approach is unlikely to function effectively. Innovative strategies are also needed to ensure that the rural poor are adequately served, for which a realistic, targeted and transparent approach to subsidy is required.

scholarly journals Educational Gender Inequality in Sub‐Saharan Africa: A Long‐Term Perspective

2021 ◽  
Author(s):  
Joerg Baten ◽  
Michiel de Haas ◽  
Elisabeth Kempter ◽  
Felix Meier zu Selhausen
Keyword(s):  
Gender Inequality ◽  
Sub Saharan Africa ◽  
Sub Saharan

scholarly journals Impact of rural versus urban setting on kidney markers: a cross-sectional study in South-Kivu, DRCongo

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Mannix Imani Masimango ◽  
Michel P. Hermans ◽  
Espoir Bwenge Malembaka ◽  
Pierre Wallemacq ◽  
Ernest Kiswaya Sumaili ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Democratic Republic Of Congo ◽  
Urban Setting ◽  
Sub Saharan Africa ◽  
Rural Site ◽  
Urban Site ◽  
Cross Sectional ◽  
South Kivu

Abstract Background Most studies of chronic kidney disease (CKD) in Sub-Saharan Africa (SSA) have been conducted in urban settings. They relied on GFR estimated from serum creatinine alone and on the inexpensive, convenient urinary dipstick to assess proteinuria. The dipstick for proteinuria has not been directly compared with the gold standard albumin-to-creatinine ratio (ACR) in a large-sized study in SSA. We hereby assessed the influence of rural versus urban location on the level, interpretation, and diagnostic performance of proteinuria dipstick versus ACR. Methods In a cross-sectional population-based study of CKD in both urban (n = 587) and rural (n = 730) settings in South-Kivu, Democratic Republic of Congo (DRC), we assessed the prevalence, performance (sensitivity, specificity, positive predictive value and negative predictive value) and determinants of a positive dipstick proteinuria as compared with albuminuria (ACR). Albuminuria was subdivided into: A1 (< 30 mg/g creatinine), A2 (30 to 299 mg/g creatinine) and A3 (≥ 300 mg/g creatinine). Results The overall prevalence of positive dipstick proteinuria (≥ 1+) was 9.6 % (95 % CI, 7.9–11.3) and was higher in rural than in urban residents (13.1 % vs. 4.8 %, p < 0.001), whereas the prevalence of albuminuria (A2 or A3) was similar in both sites (6 % rural vs. 7.6 % urban, p = 0.31). In both sites, dipstick proteinuria ≥ 1 + had a poor sensitivity (< 50 %) and positive predictive value (< 11 %) for the detection of A2 or A3. The negative predictive value was 95 %. Diabetes [aOR 6.12 (1.52–24.53)] was a significant predictor of A3 whereas alkaline [aOR 7.45 (3.28–16.93)] and diluted urine [aOR 2.19 (1.35–3.57)] were the main predictors of positive dipstick proteinuria. Conclusions ACR and dipstick proteinuria have similar positivity rates in the urban site whereas, in the rural site, dipstick was 2-fold more often positive than ACR. The poor sensitivity and positive predictive value of the dipstick as compared with ACR makes it unattractive as a screening tool in community studies of CKD in SSA.

scholarly journals Aging, Health, and Quality of Life for Older People Living With HIV in Sub-Saharan Africa: A Review and Proposed Conceptual Framework

2017 ◽  
Vol 31 (1) ◽  
pp. 109-138 ◽  
Author(s):  
Mark J. Siedner
Keyword(s):  
Quality Of Life ◽  
Conceptual Framework ◽  
Care Delivery ◽  
Sub Saharan Africa ◽  
People Living With Hiv ◽  
Sub Saharan ◽  
Living With Hiv ◽  
The Impact

Objective: The number of people living with HIV (PLWH) over 50 years old in sub-Saharan Africa is predicted to triple in the coming decades, to 6-10 million. Yet, there is a paucity of data on the determinants of health and quality of life for older PLWH in the region. Methods: A review was undertaken to describe the impact of HIV infection on aging for PLWH in sub-Saharan Africa. Results: We (a) summarize the pathophysiology and epidemiology of aging with HIV in resource-rich settings, and (b) describe how these relationships might differ in sub-Saharan Africa, (c) propose a conceptual framework to describe determinants of quality of life for older PLWH, and (d) suggest priority research areas needed to ensure long-term gains in quality of life for PLWH in the region. Conclusions: Differences in traditional, lifestyle, and envirnomental risk factors, as well as unique features of HIV epidemiology and care delivery appear to substantially alter the contribution of HIV to aging in sub-Saharan Africa. Meanwhile, unique preferences and conceptualizations of quality of life will require novel measurement and intervention tools. An expanded research and public health infrastructure is needed to ensure that gains made in HIV prevention and treamtent are translated into long-term benefits in this region.

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