Minimum acceptable diet use and its associated factors among children aged 6-23 in Ghana: a mixed effect analysis using Ghana Demographic and Health Survey.

Introduction: Inappropriate feeding practices are a major contributor to child malnutrition. To monitor the feeding practices of young children, current and frequent studies are required. However, as far as our searches are concerned, there is a scarcity of up-to-date information on attainment of the minimum acceptable diet and its predictors in the study area. Therefore, this study aimed to assess the magnitude of attainment of the minimum acceptable diet and its associated factors among children aged 6-23 in Ghana by using the most recent data. Methods: Secondary data analysis was conducted based on the demographic and health survey data conducted in Ghana in 2022. A total weighted sample of 2,621 children aged 6-23 months in the 5 years preceding the survey was included in this study. A multi-level logistic regression model was used to identify the determinants of the minimum acceptable diet. The adjusted odds ratio at 95% Cl was computed to assess the strength and significance of the association between explanatory and outcome variables. Factors with a p-value of <0.05 are declared statistically significant. Results: The national prevalence of the attainment of the minimum acceptable diet in Ghana was 26.40% (95% CI: 24.82-28.06). Child from mother with higher education (AOR = 1.96; 95% CI: 1.56-3.31) and father with higher education (AOR = 1.59; 95% CI: 1.04-2.41), Children having postnatal visit (AOR = 1.29; 95% CI: 1.03-1.62), being in the child age of 9-11 months (AOR = 2.09; 95% CI: 1.42-5.03) and 12-23 months (AOR = 3.62; 95% CI: 2.61-5.03), being in a middle (AOR = 1.66; 95% CI: 1.14-3.06), and rich wealth quintile (AOR = 2.06; 95% CI: 1.37-3.10), breastfed children (AOR = 3.30; 95% CI: 2.38-4.56), being in a high-community poverty (AOR = 0.65; 95% CI: 0.44-0.96), and being in the Savannah region (AOR = 0.32; 95% CI: 0.16-0.67) were factors significantly associated with the minimum acceptable diet use. Conclusion: Many children are still far behind in meeting the minimum acceptable diet in Ghana as per 90% of WHO-recommended coverage. Measures should be taken to optimize the minimum acceptable diet attainment in the country. Thus, policymakers, the government, and other relevant authorities should focus on the early initiation of complementary feeding, the Savannah region, further empowering women, and enhancing breast-feeding and household wealth status.

Prevalence and determinants of inadequate dietary diversity among pregnant women in four Sub-Saharan Africa countries: a multilevel analysis of recent demographic and health surveys from 2021 to 2022.

Background: Diversity in the mother's diet can have major effects on the developing fetus throughout pregnancy. Approximately 1 million neonates die on their first day of life as a result of inadequate nutrition, which also complicates the mother's pregnancy and has a negative impact on the delivery outcome. Dietary diversity during pregnancy is poorly recognized in developing countries, despite the fact that it is detrimental. As a result, this study aimed to assess the prevalence and associated factors of inadequate dietary diversity in Burkina Faso, Ghana, Kenya, and Tanzania among pregnant women. Methods: Secondary data analysis was conducted using data from the most recent Demographic and Health Surveys, which included four countries in Sub-Saharan Africa between 2021 and 2022. A total of 80,083 pregnant women were included in this study. The women's dietary diversity was computed from 10 food categories. Based on the minimum diversity score, women were categorized as having inadequate dietary diversity if their diversity score was less than five food items and as having adequate dietary diversity if they took five or more food groups. A multilevel mixed-effects logistic regression model was used to identify the factors associated with inadequate dietary diversity. At p-values <0.05, significant factors correlated with inadequate diversity were identified. The result was interpreted using 95%CI and adjusted odds ratio. The best-fit model was determined to be the one with the lowest deviance and highest loglikelihood ratio. Results: The prevalence of inadequate dietary diversity among pregnant women in Burkina Faso, Ghana, Kenya, and Tanzania was 94.46%. Factors such as no formal education (AOR = 3.39, 95% CI: 2.54, 4.54), distance to health facilities (AOR = 1.36, 95% CI: 1.16, 1.60), poor wealth quantiles (AOR = 2.97, 95% CI: 2.41, 3.65), no media exposure (AOR = 1.84, 95% CI: 1.45, 2.35), low community ANC utilization (AOR = 1.21, 95% CI: 1.16, 1.60), and reside Burkina Faso (AOR = 1.47, 95% CI: 1.09, 1.99) were among the factors associated with inadequate dietary diversity. Conclusion: According to this study finding, pregnant women had a high percentage of inadequate dietary diversity. Factors at the individual and community levels contributed to the lack of diversity in nutrition. Thus, when developing policies and strategies, the health ministries of Burkina Faso, Kenya, Ghana, and Tanzania should to consider the women who underutilize antenatal care services, live in low wealth quantiles and who did not get formal education.

Intimate partner violence and associated factors among women during the COVID-19 pandemic in Ethiopia: a systematic review and meta-analysis.

Background: During the Coronavirus Disease 2019 (COVID-19) pandemic, intimate partner violence increased globally, but most notably in Africa. Conditions such as movement restrictions, staying home, and school closures increased the risk of domestic violence against women. Intimate partner violence is violence demonstrated by an intimate partner against women including physical, sexual, and psychological violence. Despite existing laws against intimate partner violence in Ethiopia, enforcement by law and the judicial system remains inadequate. Thus, this research aims to identify factors contributing to intimate partner violence among women during the COVID-19 pandemic, drawing insights from the current literature. Method: We searched electronic databases, including PubMed, Google Scholar, CINAHL, Cochrane, and others. Two reviewers separately carried out the search, study selection, critical appraisal, and data extraction. A third party was involved in resolving disagreements among the reviewers. All 10 studies included in this study were published in English, with publication dates before 25 February 2024. Articles lacking an abstract and/or full-text, studies that did not identify the intended outcome, and qualitative studies were excluded from the analysis. A Microsoft Excel checklist was used to extract the data, which were then exported to STATA 11. I 2, funnel plots, and Egger's test were employed to measure heterogeneity and detect publication bias, respectively. A random-effects model was used to estimate the pooled prevalence of intimate partner violence and associated factors among women during the COVID-19 pandemic. Result: The meta-analysis includes a sample size of 6,280 women from 10 articles. The pooled prevalence of intimate partner violence and associated factors among women during the COVID-19 pandemic was found to be 31.60% (95% CI: 21.10-42.11) and significant factors were partner alcohol use with a pooled odds ratio of 1.93 (95% CI: 1.60-2.23), income loss during the COVID-19 pandemic with a pooled odds ratio of 9.86 (95% CI: 6.35-15.70), partner's literacy level/education status with a pooled odds ratio of 2.03 (95% CI: 1.57-2.63), and decision-making in the household with a pooled odds ratio of 1.82 (95% CI: 1.33-2.50). Conclusion: This systematic review and meta-analysis found preliminary evidence that intimate partner violence increased during the COVID-19 pandemic. A partner who has a history of alcohol use, women who had lost income during COVID-19, a partner who has no formal education, and household decisions made by the husband alone were statistically significant factors for intimate partner violence during the COVID-19 pandemic. This implies that the health sector must play a significant role in providing women who are victims of violence with comprehensive healthcare, advocating that violence against women should be viewed as unacceptable, and improving literacy to minimize the consequences of intimate partner violence among women.

Prevalence, spatial distribution and determinants of complete childhood pneumococcal conjugate vaccination in Ethiopia: spatial and multilevel analyses.

INTRODUCTION: Pneumococcal disease is a serious global public health concern. The primary causative agent of severe illnesses such as pneumonia, meningitis, acute otitis media, and bacteremia is the pneumococcus bacterium. The pneumococcal conjugate vaccine is a key strategy to reduce the burden of pneumococcal disease. Understanding the spatial distribution of complete childhood pneumococcal conjugate vaccine utilization and its associated factors is crucial for designing strategies to improve vaccination implementation. Therefore, this study aimed to determine the spatial distribution of complete childhood pneumococcal conjugate vaccination coverage and identify its determinants in Ethiopia. METHOD: A spatial and multilevel analysis was conducted using data from the 2019 Ethiopian Mini Demographic and Health Survey. The analysis included a total of 2,055 weighted children. The association between the outcome variable and the explanatory variables was determined by calculating adjusted odds ratios at a 95% confidence interval. Explanatory variables were considered significantly associated with the outcome if the p-value was less than 0.05. RESULT: The prevalence of complete childhood pneumococcal conjugate vaccination in Ethiopia was 53.94% (95% CI: 51.77, 56.08). Higher complete childhood pneumococcal vaccination coverage was observed in the Addis Ababa, Tigray, Amhara, Benishangul-Gumuz, and Oromia regions, while lower coverage was seen in the Afar, Somali, and SNNPR regions of Ethiopia. Factors significantly associated with complete childhood pneumococcal conjugate vaccination included maternal age, antenatal care visits, place of delivery, region, community women's literacy level, community poverty level, and community antenatal care utilization. CONCLUSION: The distribution of complete childhood pneumococcal conjugate vaccination exhibited spatial variability across Ethiopia. Approximately half of children aged twelve to thirty-five months received the full dose of the childhood pneumococcal conjugate vaccine in the country. Several factors were identified as statistically significant determinants of complete childhood pneumococcal conjugate vaccination, including maternal age, antenatal care visits, place of delivery, region, community women's literacy level, community poverty level, and community ANC utilization. Therefore, policies and strategies aimed at combating pneumococcal disease should consider these determinants and address areas with low vaccination coverage.

Early neonatal mortality and determinants in Ethiopia: multilevel analysis of Ethiopian demographic and health survey, 2019.

INTRODUCTION: Despite remarkable achievements in improving maternal and child health, early neonatal deaths still persist, with a sluggish decline in Ethiopia. As a pressing public health issue, it requires frequent and current studies to make appropriate interventions. Therefore, by using the most recent Ethiopian Mini Demographic Health Survey Data of 2019, we aimed to assess the magnitude and factors associated with early neonatal mortality in Ethiopia. METHODS: Secondary data analysis was conducted based on the demographic and health survey data conducted in Ethiopia in 2019. A total weighted sample of 5,753 live births was included for this study. A multilevel logistic regression model was used to identify the determinants of early neonatal mortality. The adjusted odds ratio at 95% Cl was computed to assess the strength and significance of the association between explanatory and outcome variables. Factors with a p-value of < 0.05 are declared statistically significant. RESULTS: The prevalence of early neonatal mortality in Ethiopia was 26.5 (95% Cl; 22.5-31.08) per 1000 live births. Maternal age 20-35 (AOR, 0.38; 95% Cl, 0.38-0.69), richer wealth index (AOR, 0.47; 95% Cl, 0.23-0.96), having no antenatal care visit (AOR, 1.86; 95% Cl, 1.05-3.30), first birth order (AOR, 3.41; 95% Cl, 1.54-7.56), multiple pregnancy (AOR, 18.5; 95% Cl 8.8-38.9), presence of less than two number of under-five children (AOR, 5.83; 95% Cl, 1.71-19.79) and Somali region (AOR, 3.49; 95% Cl, 1.70-12.52) were significantly associated with early neonatal mortality. CONCLUSION: This study showed that, in comparison to other developing nations, the nation had a higher rate of early newborn mortality. Thus, programmers and policymakers should adjust their designs and policies in accordance with the needs of newborns and children's health. The Somali region, extreme maternal age, and ANC utilization among expectant moms should all be given special consideration.

Predictors of long-acting contraceptive utilization hot spots in Ethiopia: using geographical weighted regression analysis.

Background: The use of long-acting contraceptives is a common health challenge in Ethiopia. Therefore, the current study aimed to assess the determinants of using long-acting contraceptive hot spots in Ethiopia using data from the Ethiopian Mini Demographic and Health Survey for 2019. Methods: This study used data from the Ethiopia Mini Demographic and Health Survey 2019 and included a total weighted sample of 8,885 women in the analysis. The geographical variation of long-acting contraceptive usage was initially observed using hot spot analysis. Arc GIS version 10.7 was used for geographically weighted regression. Ordinarily, least squares regression was performed to identify predictors that explain the geographical variation in the use of long-acting contraceptives. Geographic weighted regression was used to predict the hot spot area of long-acting contraceptive methods. Results: The overall prevalence of long-acting contraceptive utilization use was 6.9% (95% confidence interval: 6.4-7.45). Most of the statistically significant hot spots for long-acting contraceptives were found in lactated areas of the Oromia part of Amhara and Dire Dawa. Primary education, followers of the Muslim religion, marital status, and women with >4 children were the determinants of spatial variation use of hot spot areas for long-acting contraceptive methods. Conclusions: A detailed map of long-acting contraceptive use hot spots and their determinants will enable decisions to target their sociodemographic-related predictors of women.

Spatial distribution and determinants of measles vaccination dropout among under-five children in Ethiopia: A spatial and multilevel analysis of 2019 Ethiopian demographic and health survey.

BACKGROUND: Each year, vaccine-preventable diseases cost the lives of 8.8 million under-five children. Although vaccination prevents 1-2 million childhood deaths worldwide, measles vaccination dropouts are not well studied in developing countries, particularly in Ethiopia. Therefore, this study aims to assess the spatial distribution of the measles vaccination dropout and its determinants among under-five children in Ethiopia. METHODS: Data from Ethiopian Demographic and Health Survey 2019 was used for data analysis. The study used a total of 5,753 children. Spatial autocorrelations was used to determine the spatial dependency of measles vaccination dropout. Ordinary interpolation was employed to forecast measles vaccination dropout. Factors associated with measles vaccination dropout were declared significant at p-values <0.05. The data were interpreted using the confidence interval and adjusted odds ratio. A model with the lowest deviance and highest logliklihood ratio was selected as the best-fit model. RESULTS: In Ethiopia, one in three under-five children had measles vaccination dropouts. Factors such as birth interval (AOR = 1.87, 95% CI: 1.30, 2.70), unmarried marital status women (AOR = 3.98, 95% CI: 1.08, 8.45), ≤1 number of under-five children (AOR = 3.86, 95% CI: 2.56, 5.81), rural place of residence (AOR = 2.43, 95% CI: 2.29, 3.11), low community-level ANC utilization (AOR = 3.20, 95% CI: 2.53, 3.56), and residing in Benishangul Gumuz (AOR = 1.80, 95% CI: 1.061, 3.06) had higher odds of measles vaccination dropout. CONCLUSIONS: Measles vaccination dropout rates in Ethiopia among under-five children were high compared to the maximum tolerable vaccination dropout level of 10% by the WHO. Both individual and community-level variables were determinants of measles vaccination dropout. The ministry of health in Ethiopia should give attention to those mothers of under-five children who reported underutilization of ANC services and rural residences while designing policies and strategies in areas of high spatial clustering of vaccine dropout in Ethiopia.

Suboptimal micronutrient intake among children aged 6 to 23 months in Ethiopia: Further analysis of the demographic and health survey.

BACKGROUND: The recommended essential micronutrient such as food rich in vitamin-A or iron, multiple micronutrient powder or iron supplement, routine daily consumption of iodine, and vitamin-A supplement are deficient among children in Ethiopia. This has been a significant public health problem despite the government efforts. Although few studies have examined the micronutrient intake among children, they are limited in scope and methodological measurements. Analyzing the micronutrient intake among children across all regions and leveraging all essential micronutrient elements are crucial for generating improved evidence to better inform policy. Thus, we examined the micronutrient intake among children aged 6 to 23 months in Ethiopia. METHODS: We used data from the Ethiopian Demographic and Health Survey. A two-stage stratified sampling technique was employed, and 1392 children aged 6 to 23 months were included in our analysis. We conducted a multilevel mixed-effect binary logistic regression analysis to identify determinants of micronutrient intake. In the final model, we used a p-value of less than 0.05 and Adjusted Odds Ratio (AOR) with their 95% confidence interval (CI). RESULTS: We found that only 27.6% (95% CI: 26.8-31.6) of children aged 6 to 23 months were received the recommended micronutrients in Ethiopia. We identified that maternal educational status (Educated mothers (AOR = 2.09, 95%CI:1.23-3.58)), health facility delivery (AOR = 2.14, 95%CI:1.42-2.98), household wealth status (middle quantile (AOR = 1.80, 95%CI:1.01-3.21)), children's age (12 to 23 months age (AOR = 2.36, 95% CI: 1.33-4.21)), and mother's exposure to media (AOR = 1.70, 95%CI: 1.42-2.04) were increased micronutrient intake, whereas residing in the rural communities (AOR = 0.27, 95%CI: 0.21-0.34) decreased micronutrient intake. CONCLUSIONS: Nearly three-fourths of children aged 6 to 23 months did not receive the recommended essential micronutrients in Ethiopia. Therefore, there is a need to broaden strategies aimed at enhancing the intake by improving information and knowledge dissemination among mothers during facility visits and through media channels.

Baseline anemia and its associated factors among adult cancer patients at Northwest Amhara Regional State Referral Hospitals, Northwest Ethiopia, 2021.

Introduction: Currently, the problem of cancer has been increasing around the world, predominantly in middle- and low-income countries. Anemia, a major and often overwhelming health burden for cancer patients, significantly distorts their quality of life. It is well-established that the length of treatment increases the frequency of anemia, with hematological malignancies experiencing nearly double the rate compared to solid tumors. Despite this established knowledge, data on the prevalence of anemia among cancer patients in Ethiopia remains scarce, according to the investigators. Objective: This study aimed to assess the prevalence of baseline anemia and associated factors among adult cancer patients at Northwest Amhara Comprehensive Specialized Hospitals, oncology treatment units, Northwest Ethiopia, in 2021. Methods: This study employed an institutional-based cross-sectional design and was conducted in Northwest Amhara Comprehensive Specialized Hospitals. A systematic random sampling technique was used to select 315 participants. The data were collected using interviewer-administered questionnaires and chart reviews of existing medical records using a structured and pretested questionnaire format. The data were entered into Epi. Data version 4.6 and analyzed using Stata version 14.0. Bivariable and multivariable logistic regression were carried out to identify factors associated with anemia. Adjusted odds ratios with a 95% confidence interval and variables with a p-value of < 0.05 were considered significantly associated with anemia. Results: The prevalence of baseline anemia among adult patients with cancer was found to be 34.84%. Being a woman (AOR = 1.97; 95% CI: 1.00-3.87), being underweight (AOR = 1.96; 95% CI: 1.09-3.52), and having stage III cancer (AOR = 2.35; 95% CI: 1.12-3.01) were significantly associated with anemia. Conclusion: The prevalence of baseline anemia among adult cancer patients was significant. Women, cancer patients with an underweight body mass index, and those diagnosed with clinical-stage III cancer were more likely to have baseline anemia. For health policymakers and healthcare providers, it is better to give special attention to female patients, patients who are underweight, and patients with advanced-stage cancer to reduce the risk of developing the outcome. This would allow for timely intervention to manage anemia and potentially improve treatment tolerance and quality of life for cancer patients.

Mortality of neonates born to mothers of extreme reproductive age in Ethiopia; multilevel mixed effect analysis of Ethiopian demographic and health survey data of 2016.

Introduction: Neonatal mortality is still a major public health problem in middle- and low-income countries like Ethiopia. Despite strategies and efforts made to reduce neonatal death, the mortality rate declines at a slower pace in the country. Though there are studies conducted on neonatal mortality and its determinants, our searches of the literature have found no study on the extent of mortality of neonates born to mothers of extreme reproductive age in the study area. Therefore, this study aimed to assess the magnitude and factors associated with the mortality of neonates born to mothers of extreme reproductive age in Ethiopia. Methods: Secondary data analysis was conducted using 2016 Ethiopian Demographic and Health Survey data. The final study contained an overall weighted sample of 2,269 live births. To determine the significant factors in newborn deaths, a multilevel binary logistic regression was fitted. For measuring the clustering impact, the intra-cluster correlation coefficient, median odds ratio, proportional change in variance, and deviation were employed for model comparison. The adjusted odds ratio with a 95% confidence interval was presented in the multivariable multilevel logistic regression analysis to identify statistically significant factors in neonatal mortality. A P-value of less than 0.05 was declared statistically significant. Results: The neonatal mortality rate of babies born to extreme aged reproductive women in Ethiopia was 34 (95% Cl, 22.2%-42.23%) per 1,000 live birth. Being twin pregnancy (AOR = 10; 95% Cl: 8.61-20.21), being from pastoralist region (AOR = 3.9; 95% Cl: 1.71-8.09), having larger baby size (AOR = 2.93; 95% Cl: 1.4-9.12) increase the odds of neonatal mortality. On the other hand, individual level media exposure (AOR = 0.3; 95% Cl: 0.09-0.91) and community level media exposure (AOR = 0.24; 95% Cl: 0.07-0.83), being term gestation (AOR = 0.14; 95% Cl: 0.01-0.81) decreases the odds of neonatal mortality born to mothers of extreme reproductive age. Conclusion: Ethiopia had a greater rate of neonatal death among babies born at the extremes of reproductive age than overall reproductive life. Multiple pregnancies, larger baby sizes, emerging regions, term gestation, and media exposure were found to be significant factors associated with the mortality of neonates born to mothers of extreme reproductive age. Therefore, the concerned bodies should give emphasis to mothers giving birth before the age of 20 and above 35, access to media, healthy pregnancy, and special attention to pastoralists to reduce the burden of neonatal mortality.

Spatial Variation and Determinants of Inadequate Minimum Meal Frequency among Children Aged 6-23 Months in Ethiopia: Spatial and multilevel analysis using Ethiopian Mini Demographic and Health Survey (EMDHS) 2019.

Introduction: Minimum meal frequency is the number of times children eat in a day. Without adequate meal frequency, infants and young children are prone to malnutrition. There is little information on the spatial distribution and determinants of inadequate meal frequency at the national level. Therefore, we aimed to investigate the spatial distribution and determinants of inadequate meal frequency among young children in Ethiopia. Methods: The most recent Ethiopian demographic and health survey data was used. The analysis was conducted using a weighted sample of 1,610 children aged 6-23 months old. The Global Moran's I was estimated to assess the regional variation in minimum meal frequency. Further, a multivariable multilevel logistic regression model was fitted to identify factors associated with inadequate meal frequency. The AOR (adjusted odds ratio) at 95% CI (confidence interval) was computed to assess the strength and significance of the relationship between explanatory variables and the outcome variable. Factors with a p-value of <0.05 are declared statistically significant. Results: This study revealed that the prevalence of inadequate meal frequency was found to be 30.56% (95% CI: 28.33-32.88). We identified statistically significant clusters of high inadequate meal frequency, notably observed in Somalia, northern Amhara, the eastern part of southern nations and nationalities, and the southwestern Oromia regions. Child age, antenatal care (ANC) visit, marital status, and community level illiteracy were significant factors that were associated with inadequate meal frequency. Conclusion: According to the study findings, the proportion of inadequate meal frequency among young children in Ethiopia was higher and also distributed non-randomly across Ethiopian regions. As a result, policymakers and other concerned bodies should prioritize risky areas in designing intervention. Thus, special attention should be given to the Somalia region, the northern part of Amhara, the eastern part of Southern nations and nationalities, and southwestern Oromia.

Human papillomavirus vaccination coverage among young women in the three sub-Saharan African countries using Demographic and Health Surveys data.

Cervical cancer is the fourth most common cancer, with 99% of cases linked to human papillomavirus (HPV) infection. It reflects global inequity as its burden is highest in low- and middle-income countries. The aim of this study was to determine the HPV vaccination coverage and its determinant factors among young women in the three sub-Saharan African countries. Data from the Demographic and Health Surveys among three sub-Saharan African countries were used for analysis. A total of 4,952 women were included in the study. Stata 14 was used to analyze the data. The determinants of the outcome variable were identified using a multilevel mixed-effects logistic regression model. Factors with p-values < 0.05 at 95% confidence interval were declared statistically significant. About 7.5% young women were vaccinated for HPV vaccine against cervical cancer in the current study. Younger age, use of internet, rich economic class, and individual-level media exposure were found to be favorable conditions, whereas being employed was negatively associated with HPV vaccination. Only few segments of young women in these three countries got HPV vaccination. The authors recommend that increasing internet use, media exposure, and economic level of young women will increase the HPV vaccination rates. Furthermore, creating awareness among employed women will also increase the possibility of HPV vaccination.

Determinants of preterm birth among reproductive age women in sub-Saharan Africa: Evidence from the most recent Demographic and Health Survey data-2019-2022.

INTRODUCTION: Preterm birth is the leading cause of both infant and neonatal mortality. It also had long-term consequences for the physical and neurological development of a growing child. The majority of these and related problems occur in low- and middle-income countries, particularly in sub-Saharan Africa, due to resource scarcity to sustain the lives of premature babies. Despite this, there is a paucity of recent information on the pooled prevalence and factors associated with preterm birth in sub-Saharan Africa. Therefore, this study aimed to update the pooled prevalence and determinants of preterm birth in sub-Saharan Africa based on the most recent Demographic and Health Survey data. METHODS: A cross-sectional study design using the most recent demographic and health survey data from eight sub-Saharan African countries was used. We included a total weighted sample of 74,871 reproductive-aged women who gave birth in the five years preceding the survey. We used a multilevel logistic regression model to identify associated factors of preterm birth in sub-Saharan Africa. The adjusted odds ratio at 95% Cl was computed to assess the strength and significance of the association between explanatory and outcome variables. Factors with a p-value of <0.05 are declared statistically significant. RESULTS: In this study, the pooled prevalence of preterm birth among reproductive-aged women in eight sub-Saharan African countries was 3.11% (95% CI: 2.98-3.25). Working mothers (AOR = 0.61; 95% CI: 0.38-0.97), being married (AOR = 0.63; 95% CI: 0.40-0.99), and having media exposure (AOR = 0.59; 95% CI: 0.36-0.96) decrease the odds of preterm birth. On the other hand, being low birth weight (AOR = 17.7; 95% CI: 10.7-29.3), having multiple pregnancies (AOR = 3.43; 95% CI: 1.82-6.45), having a history of terminated pregnancies (AOR = 1.56; 95% CI: 1.01-2.41), being un-educated (AOR = 3.16; 95% CI: 1.12-8.93), being of a maternal age above 35 (AOR = 1.63; 95% CI: 1.08-2.45), maternal alcohol use (AOR = 19.18; 95% CI: 13.6-38.8), and being in the low socio-economic status (AOR = 1.85; 95% CI: 1.11-3.07) of the community increase the odds of preterm birth. CONCLUSION: The burden of preterm birth among reproductive-age women in sub-Saharan Africa showed improvements as compared to previous findings. To further lessen the burden, policymakers and other pertinent organizations must prioritize maternal health, expand media access, educate and empower women, and promote a healthy lifestyle for reproductive-age women.

The prevalence of adolescent fatherhood and its associated factors in East African countries.

BACKGROUND: In developing nations, the phenomenon of adolescent fatherhood poses significant challenges, including increased risk of poverty, limited educational opportunities, and potential negative health outcomes for both the young fathers and their children. However, an overwhelming majority of research has concentrated on teenage motherhood. Adolescent fatherhood in poor nations has been the subject of little research. Few public health initiatives address adolescent fatherhood, in contrast to adolescent motherhood. Although there is currently more being done in industrialized nations to recognize adolescent fatherhood in clinical settings and the academic community. Undeveloped nations such as East Africa still have more problems that need to be resolved. Therefore, this study aimed to investigate the prevalence of and factors contributing to adolescent fatherhood in East Africa. METHODS: Data from the Demographic and Health Surveys (DHS), collected between 2011 and 2022 in 12 East African nations, were used in this analysis. For a weighted sample of 36,316 male adolescents aged 15-24 years, we examined variables, as well as the prevalence of adolescent fatherhood. Univariate and multivariable logistic regression analyses were performed to identify candidate factors and significant explanatory variables associated with the outcome variable. The results are presented using adjusted odds ratios (AORs) at 95% confidence intervals (CIs). P values of ≤ 0.2 and < 0.05 were used to investigate statistically significant factors in the univariate and multivariable logistic regression analyses, respectively. RESULTS: The overall prevalence of adolescent fatherhood was 11.15% (95% CI = 10.83,11.48) in East Africa. Age at first sex 20-24 years (AOR = 0.44, 95% CI:0.41,0.48), age-20-24 years old (AOR = 17.03,95% CI = 15.01,19.33), secondary/higher education (AOR = 0.57, 95% CI = 0.49,0.67), poor wealth (AOR = 2.27, 95% CI = 2.05,2.52), middle wealth (AOR = 1.70, 95% CI = 1.51,1.90), employed (AOR = 3.92, 95% CI = 3.40,4.54), utilized modern contraceptives (AOR = 0.75, 95% CI = 0.69,0.81), and female household heads (AOR = 0.43, 95% CI = 0.39,0.48) were associated with adolescent fatherhood. CONCLUSIONS: Adolescent fatherhood is more prevalent, in East Africa. These findings highlight the complexity of adolescent fatherhood and suggest that multiple factors, including socio-demographic characteristics and reproductive health behaviors, play a role in determining the likelihood of becoming an adolescent father. Understanding these associations can inform targeted interventions and policies aimed at reducing adolescent fatherhood rates and addressing the specific needs and challenges faced by young fathers in East Africa. Further research and interventions should focus on promoting education, economic opportunities, and access to modern contraceptives, while also addressing gender dynamics and social norms that contribute to adolescent fatherhood in the region.

Early neonatal mortality and determinants in sub-Saharan Africa: Findings from recent demographic and health survey data.

INTRODUCTION: Neonatal mortality during the first week of life is a global issue that is responsible for a large portion of deaths among children under the age of five. There are, however, very few reports about the issue in sub-Saharan Africa. For the sake of developing appropriate policies and initiatives that could aid in addressing the issue, it is important to study the prevalence of mortality during the early neonatal period and associated factors. Thus, the aim of this study was to ascertain the prevalence of and pinpoint the contributing factors to early neonatal mortality in sub-Saharan Africa. METHOD: Data from recent demographic and health surveys in sub-Saharan African countries was used for this study. The study included 262,763 live births in total. The determinants of early newborn mortality were identified using a multilevel mixed-effects logistic regression model. To determine the strength and significance of the association between outcome and explanatory variables, the adjusted odds ratio (AOR) at a 95% confidence interval (CI) was computed. Independent variables were deemed statistically significant when the p-value was less than the significance level (0.05). RESULT: Early neonatal mortality in sub-Saharan Africa was 22.94 deaths per 1,000 live births. It was found to be significantly associated with maternal age over 35 years (AOR = 1.77, 95% CI: 1.34-2.33), low birth weight (AOR = 3.27, 95% CI: 2.16, 4.94), less than four ANC visits (AOR = 1.12, 95% CI: 1.01, 1.33), delivery with caesarean section (AOR = 1.81, 95% CI: 1.30-2.5), not having any complications during pregnancy (AOR = 0.76, 95% CI: 0.61, 94), and community poverty (AOR = 1.32, 95% CI: 1.05-1.65). CONCLUSION: This study found that about twenty-three neonates out of one thousand live births died within the first week of life in sub-Saharan Africa. The age of mothers, birth weight, antenatal care service utilization, mode of delivery, multiple pregnancy, complications during pregnancy, and community poverty should be considered while designing policies and strategies targeting early neonatal mortality in sub-Saharan Africa.

Minimum milk feeding frequency and its associated factors among non-breastfed children aged 6-23 months in sub-saharan Africa: a multilevel analysis of the recent demographic and health survey data.

BACKGROUND: Poor infant and child feeding practices, in combination with increased rates of infectious diseases, are the main immediate causes of malnutrition during the first two years of life. Non-breastfed children require milk and other dairy products, as they are rich sources of calcium and other nutrients. As far as our search is concerned, there is no evidence on the pooled magnitude and determinants of minimum milk feeding frequency among non-breastfed children in sub-Saharan Africa conducted using the most recent indicators for assessing infant and young child feeding practices published in 2021. Therefore, this study is intended to determine the magnitude and associated factors of minimum milk feeding frequency among non-breastfed children aged 6-23 months in sub-Saharan Africa using the most recent guideline and demographic and health survey dataset. METHODS: Data from the most recent health and demographic surveys, which were carried out between 2015 and 2022 in 20 sub-Saharan African countries, were used. The study comprised a weighted sample consisting of 13,315 non-breastfed children between the ages of 6 and 23 months. STATA/SE version 14.0 statistical software was used to clean, recode, and analyze data that had been taken from DHS data sets. Utilizing multilevel mixed-effects logistic regression, the factors associated with the outcome variable were identified. Model comparison and fitness were assessed using deviance (-2LLR), likelihood ratio test, median odds ratio, and intra-class correlation coefficient. Finally, variables with a p-value < 0.05 and an adjusted odds ratio with a 95% confidence interval were declared statistically significant. RESULTS: The pooled magnitude of minimum milk feeding frequency among non-breastfed children aged 6-23 months in sub-Saharan African countries was 12.39% (95% CI: 11.85%, 12.97%). Factors like maternal educational level [AOR = 1.61; 95% CI (1.35, 1.91)], marital status of the mother [AOR = 0.77; 95% CI (0.67, 0.89)], maternal working status [AOR = 0.80; 95% CI (0.71, 0.91)], media exposure [AOR = 1.50; 95% CI (1.27, 1.77)], wealth index [AOR = 1.21; 95% CI (1.03, 1.42)], place of delivery [AOR = 1.45; 95% CI (1.22, 1.72)], ANC visit attended during pregnancy [AOR = 0.49; 95% CI (0.39, 0.62)], PNC checkup [AOR = 1.57; 95% CI (1.40, 1.76)], child's age [AOR = 0.70; 95% CI (0.53, 0.93)], and residence [AOR = 2.15; 95% CI (1.87, 2.46)] were significantly associated with minimum milk feeding frequency. CONCLUSIONS: In sub-Saharan Africa, the proportion of minimum milk feeding frequency among non-breastfed children aged between 6 and 23 months was low. The likelihood of minimum milk feeding frequency increases with high levels of education, unemployment, media exposure, rich wealth status, being unmarried, having a child born in a health facility, getting PNC checks, being between 6 and 8 months old, and living in an urban area. Hence, promoting women's education, increasing the economic status of the household, disseminating nutrition information through media, strengthening maternal health service utilization like health facility delivery and PNC services, and giving prior attention to mothers with older children and from rural areas are strongly recommended.

Individual and community level factors associated with discriminatory attitudes against people living with HIV/AIDS among women of reproductive age in three sub-Saharan African countries: evidence from the most recent demographic and health survey (2021/22).

INTRODUCTION: HIV-related stigma and discrimination significantly affects health, and well-being, willingness to be tested for HIV, initiation and adherence to antiretroviral therapy, and quality of life. However, the findings of the prior studies revealed that the prevalence of discrimination against people living with HIV is high. Thus, we aimed to assess the magnitude of discriminatory attitudes against people living with HIV/AIDS and associated factors in three sub-Saharan African countries. METHODS: The appended and most recent Demographic and Health Survey dataset of three sub-Saharan African countries from 2021 to 2022 was used for data analysis. A total of 56,690 women aged 15-49 years were included in this study as a weighted sample. The determinants of discriminatory attitudes against people living with HIV/AIDS were determined using a multilevel mixed-effects logistic regression model. Significant factors associated with discriminatory attitudes against people living with HIV/AIDS in the multilevel mixed-effect logistic regression model were declared significant at p-values < 0.05. The adjusted odds ratio (AOR) and confidence interval (CI) were used to interpret the results. RESULT: The overall prevalence of discriminatory attitudes against people living with HIV/AIDS was 28.19% (95% CI: 27.74%, 28.64%). In the multivariable analysis, individual level (being young, being an internet user, being tested for HIV, and having comprehensive knowledge about HIV) and community level (being a rural dweller) were factors associated with discriminatory attitudes against people living with HIV/AIDS. CONCLUSION: The prevalence of discriminatory attitudes against people living with HIV/AIDS in three sub-Saharan African countries was high. Individual and community-level variables were associated with discriminatory attitudes against people living with HIV/AIDS. Therefore, special consideration should be given to rural dwellers and young adults. In addition, better to strengthen the accessibility of Internet and HIV testing services, and improve HIV-related education to reduce the magnitude of discriminatory attitudes against people living with HIV/AIDS.

Recommended homemade fluid utilization for the treatment of diarrhea and associated factors among children under five in sub-Saharan African countries: a multilevel analysis of the recent demographic and health survey.

INTRODUCTION: Diarrhea is a common public health problem and the third leading cause of death in the world among children under the age of five years. An estimated 2 billion cases and 1.9 million deaths are recorded among children under the age of five years every year. It causes body fluid loss and electrolyte imbalance. Even though, early initiation of recommended homemade fluid is a simple and effective approach to prevent diarrhea-related complications and mortality of children, recommended homemade fluid utilization for the treatment of diarrhea is still low in sub-Saharan African countries. Therefore, this study aimed to assess the magnitude of recommended homemade fluid utilization for the treatment of diarrhea and associated factors among children under five in sub-Saharan African countries. METHOD: The most recent Demographic and Health Survey dataset of 21 sub-Saharan African countries from 2015 to 2022 was used for data analysis. A total of 33,341 participants were included in this study as a weighted sample. Associated factors were determined using a multilevel mixed-effects logistic regression model. Significant factors in the multilevel mixed-effect logistic regression model were declared significant at p-values < 0.05. The adjusted odds ratio (AOR) and confidence interval (CI) were used to interpret the results. RESULT: The overall recommended homemade fluid utilization for the treatment of diarrhea among children under five in sub-Saharan African countries was 19.08% (95% CI = 18.66, 19.51), which ranged from 4.34% in Burundi to 72.53% in South Africa. In the multivariable analysis, being an educated mother/caregiver (primary and secondary level) (AOR = 1.15, 95% CI: 1.04, 1.27) and (AOR = 1.30, 95% CI: 1.15, 1.1.47), the primary and secondary level of fathers education (AOR = 1.53, 95% CI: 1.37, 1.71) and (AOR = 1.41, 95% CI: 1.19, 1.1.68), having antenatal care follow-up (AOR = 1.16, 95% CI: 1.01, 1.33), having multiple children (AOR = 1.17, 95% CI: 1.07, 1.28), and being an urban dweller (AOR = 1.15, 95% CI: 1.04, 1.27) were factors associated with recommended homemade fluid utilization. CONCLUSION: The overall recommended homemade fluid utilization for the treatment of diarrhea was low. Individual and community-level variables were associated with recommended homemade fluid utilization for the treatment of diarrhea. Therefore, special consideration should be given to rural dwellers and caregivers who have three and below children. Furthermore, better to strengthen the antenatal care service, mother/caregiver education, and father's education to enhance recommended homemade fluid utilization for the treatment of diarrhea.

Coverage, spatial distribution and determinants of childhood inactivated poliovirus vaccine immunization in Ethiopia.

INTRODUCTION: Polio eradication is a current and common strategy throughout the globe. The study of the newly introduced inactivated poliovirus vaccine provides a grasp on the current status of immunization and identifies any disparities in the implementation of the vaccine throughout Ethiopia. Thus, this study aimed to demonstrate the spatial distribution, coverage, and determinants of inactivated poliovirus vaccine immunization in Ethiopia. METHOD: Spatial distribution and determinants of inactivated poliovirus vaccine immunization in Ethiopia were conducted using Ethiopian mini-demographic and health survey 2019 data. A total of 2,056 weighted children aged 12 to 35 months were included in the analysis. The association between the outcome and explanatory variables was determined by commuting the adjusted odds ratio at a 95% confidence interval. The p-value of less than 0.05 was used to declare factors as significantly associated with the inactivated poliovirus vaccine immunization. RESULT: The weighted national coverage of inactivated poliovirus vaccine immunization in Ethiopia was 51.58% at a 95% confidence interval (49.42, 53.74). While the rates of inactivated poliovirus vaccine immunization were observed to be greater in Addis Ababa, Tigiray, Amahara, and Benishangul Gumuz provinces and lower in the Somali, Afar, and SNNPR provinces of Ethiopia, Antenatal care follow-up, place of delivery, place of residence, and region were significantly associated with inactivated poliovirus immunization in Ethiopia. CONCLUSION: The distribution of inactivated poliovirus immunization was spatially variable across Ethiopia. Only about half of the children aged twelve to thirty-five months received the inactivated poliovirus vaccine in the country. The factors, both at the individual and community level, were significantly associated with inactivated poliovirus immunization. Therefore, policies and strategies could benefit from considering antenatal care follow-up, place of delivery, place of residence, and region while implementing inactivated poliovirus vaccine immunization.

Prompt treatment of fever and its associated factors among under-five children in sub-Saharan Africa: A multilevel analysis of evidence from 36 countries.

INTRODUCTION: Despite the decrease in the global under-five mortality rate, the highest rates of mortality are reported in sub-Saharan Africa. More than one-third of all deaths among under-five children are either from lower respiratory tract infections, diarrhea, or malaria. Poor treatment-seeking behavior for fever among mothers of under-five children is a big concern in sub-Saharan Africa. However, the pooled prevalence of prompt treatment of fever and its associated factors among under-five children in the region using nationally representative data is not known. Therefore, the findings of this study will inform policymakers and program managers who work on child health to design interventions to improve the timely and appropriate treatment of fever among under-five children. METHODS: Data from the recent demographic and health surveys of 36 countries in sub-Saharan Africa conducted between 2006 and 2022 were used. A total weighted sample of 71,503 living children aged under five years with a fever was included in the study. Data extracted from DHS data sets were cleaned, recorded, and analyzed using STATA/SE version 14.0 statistical software. Multilevel mixed-effects logistic regression was used to determine the factors associated with the outcome variable. Intra-class correlation coefficient, likelihood ratio test, median odds ratio, and deviance (-2LLR) values were used for model comparison and fitness. Finally, variables with a p-value <0.05 and an adjusted odds ratio with a 95% confidence interval were declared statistically significant. RESULTS: The pooled prevalence of prompt treatment of fever among under-five children in sub-Saharan African countries was 26.11% (95% CI: 25.79%, 26.44%). Factors like maternal education [AOR = 1.18; 95% CI (1.13, 1.25)], maternal working status [AOR = 1.34; 95% CI (1.27, 1.41)], media exposure [AOR = 1.05; 95% CI (1.01, 1.10)], household wealth index [AOR = 1.13; 95% CI (1.06, 1.19)], distance to a health facility [AOR = 1.18; 95% CI (1.13, 1.23)], healthcare decisions [AOR = 1.34; 95% CI (1.01, 1.77)], visited healthcare facility last 12 months [AOR = 1.45; 95% CI (1.38, 1.52)], antenatal care attendance [AOR = 1.79; 95% CI (1.61, 1.99)], place of delivery [AOR = 1.55; 95% CI (1.47, 1.63)], and community-level antenatal care utilization [AOR = 1.08; 95% CI (1.02,1.14)] were significantly associated with prompt treatment of fever among under-five children. CONCLUSION: The pooled prevalence of prompt treatment of fever among under-five children in sub-Saharan African countries was low. Educated women, working mothers, having media exposure, rich household wealth status, perceiving distance to a health facility was not a big problem, making healthcare decisions with husband or partner, visiting healthcare facility in the last 12 months, antenatal care attendance, health facility delivery, and high community-level antenatal care utilization increase the odds of prompt treatment of fever. Therefore, women's empowerment, information dissemination through mass media, maintaining regular visits to healthcare facilities, and strengthening health facility delivery and antenatal care services are strongly recommended.