Prevalence of early initiation of breastfeeding and its associated factors among women in Mauritania: evidence from a national survey.

BACKGROUND: Timely initiation of breastfeeding is crucial for positive health outcomes for babies and mothers. Understanding the factors influencing timely initiation of breastfeeding is vital for reducing child morbidities and mortalities in Mauritania. This study, therefore, assessed the prevalence of early initiation of breastfeeding and its associated factors among women in Mauritania, providing significant insights for improving maternal and child health in the country. METHODS: We performed a secondary analysis of the 2019-2021 Mauritania Demographic and Health Survey data. A weighted sample of 4,114 mother-child pairs was included in the study. We used percentage to present the prevalence of early initiation of breastfeeding. A four-modelled multilevel binary logistic regression was used to examine the factors associated with early initiation of breastfeeding. The regression results were presented using adjusted odds ratio (aOR) with their respective 95% confidence interval (CI). Stata software version 17.0 was used to perform all the analyses. RESULTS: The prevalence of early initiation of breastfeeding was 57.3% (95% CI 54.5, 60.00). Birth order was associated with early initiation of breastfeeding with the highest odds among those in the fourth birth order (aOR 1.61; 95% CI 1.08, 2.39). Mothers who practiced skin-to-skin contact were more likely to initiate breastfeeding early than those who did not (aOR 1.46; 95% CI 1.14, 1.87). There were regional disparities in the early initiation of breastfeeding. The odds of timely initiation of breastfeeding was lower among women who were delivered by caesarean section (aOR 0.22; 95%CI 0.14, 0.36), those who were working (aOR 0.57; 95% CI 0.45, 0.73), those who had four or more antenatal care visits (aOR 0.67; 95%CI 0.47, 0.94)], and those in the richest wealth quintile (aOR 0.61; 95% CI 0.38, 0.98) compared to those who had normal delivery, those who were not working, those who had zero antenatal care visits, and those in the poorest wealth quintile households, respectively. CONCLUSION: Our study found a relatively low prevalence of early initiation of breastfeeding among women in Mauritania. Factor such as birth order, region of residence, mother and newborn skin-to-skin contact after birth, antenatal care visits, caesarean delivery, employment status, and wealth index were associated with early initiation of breastfeeding. Improving optimal breastfeeding practices, such as early initiation of breastfeeding in Mauritania, should be given adequate attention. There is a need for interventions such as baby-friendly facilities, providing an enabling environment for mothers to breastfeed their newborns early. Addressing regional health access disparities is important to improve early initiation of breastfeeding and other maternal, newborn, and child health interventions.

Assessment of intention to use modern contraceptives among women of reproductive age in Benin: evidence from a national population-based survey.

BACKGROUND: Women's intentions to use any contraceptive method are critical for better understanding their future needs and making them more likely to act on that intention. This study assessed the factors associated with the intention to use modern contraceptives among women of reproductive age in Benin. METHODS: This was a cross-sectional study that used the 2017-2018 Benin Demographic and Health Survey (BDHS). The study analyzed a weighted sample of 13, 582 women of reproductive age who were non-users of contraceptives. The intention to use contraceptives was the outcome variable. Multivariate logistic regression analysis was conducted to determine the factors associated with the intention to use contraceptives among women of reproductive age. The results were estimated using an adjusted odds ratios (aOR) with a 95% confidence interval (CI) and statistical significance set at p < 0.05. RESULTS: Approximately 35.0% of the women had the intention to use modern contraception. We found that women aged between 30 and 34 (aOR = 0.70, 95%CI: 0.57, 0.86), 35-39 (aOR = 0.52, 95%CI: 0.42, 0.66), 40-44(aOR = 0.30, 95%CI: 0.22, 0.39) and 45-49 (aOR = 0.10, 95%CI: 0.07, 0.14), Muslim women (aOR = 0.68, 95%CI: 0.53, 0.85) and those who perceived the distance to a health facility not to be a big problem (aOR = 0.75, 95%CI: 0.67, 0.84) were less likely to have the intention to use modern contraceptives compared with their counterparts. On the other hand, women who attained primary (aOR = 1.21, 95%CI: 1.07, 1.36), secondary (aOR = 1.39, 95%CI: 1.21, 1.59), and higher education (aOR = 1.60, 95%CI: 1.13, 2.26), women who were employed (aOR = 1.39, 95%CI: 1.23, 1.57), women with no religion (aOR = 1.32, 95%CI: 1.04, 1.69), women whose partners were working (aOR = 1.69, 95%CI: 1.16, 2.44), women who heard about family planning in the media (aOR = 1.51, 95%CI: 1.16, 2.44), and women in the poorer (aOR = 1.31, 95%CI: 1.10, 1.54), middle (aOR = 1.42, 95%CI: 1.20, 1.67]), richer (aOR = 1.23, 95%CI: 1.03, 1.47), and richest households (aOR = 1.42, 95%CI: 1.15, 1.75) were more likely to have the intention to use contraceptives than their counterparts. CONCLUSION: The study provides valuable insights into the intention to use contraceptives among women of reproductive age in Benin. The findings indicate that the proportion of women who have intention to use contraceptives remains low. The findings of this study could inform the development of targeted interventions and policies to increase access to and uptake of contraceptives in Benin, with the ultimate aim of improving the reproductive health and well-being of women and their families.

Determinants of health insurance coverage among women in Mauritania: a multilevel analysis.

BACKGROUND: Health insurance has been documented as one of the primary methods of financing healthcare for Sustainable Development Goals (SDGs) by 2030. Yet, there is a dearth of evidence on the determinants of health insurance coverage among women in Mauritania. We examine the factors associated with health insurance coverage among women in Mauritania using a nationally representative survey dataset. METHODS: We analyzed secondary data from the 2019-2021 Mauritania Demographic and Health Survey. A weighted sample of 15,714 women of reproductive age (15-49 years) was included in the study. Multilevel regression analysis was used to examined the factors associated with health insurance coverage. The results were presented using an adjusted odds ratio (aOR) with a 95% confidence interval (CI). RESULTS: The coverage of health insurance among women was 8.7%. The majority of the women subscribed to social security health insurance (7.6%). Women aged 35 years and above [aOR = 1.54; 95% CI = 1.24, 1.92] were more likely to be covered by health insurance relative to those aged 15-24. The likelihood of being covered by health insurance increased with increasing level of education with the highest odds among women with higher education [aOR = 6.09; 95% CI = 3.93, 9.42]. Women in the richest wealth index households [aOR = 22.12; 95% CI = 9.52, 51.41] and those with grand parity [aOR = 2.16; 95% CI = 1.62, 2.87] had the highest odds of being covered by health insurance. Women who were working, those who watched television, and those who used the internet were more likely to be covered by health insurance relative to their counterparts who were not working, those who did not watch television, and those who did not use the internet. Women residing in Tiris zemour et Inchiri [aOR = 3.60; 95%CI = 1.60, 8.10], Tagant (aOR = 3.74; 95% CI = 1.61, 8.68], and Adrar [aOR = 2.76; 95% CI = 1.36, 5.61] regions were more likely to be covered by health insurance compared with those from Hodh Echargui. CONCLUSION: Health insurance coverage among the women in our study was low. Achieving the SDG targets of ensuring universal health coverage and lowering maternal mortality to less than 70 deaths per 100,000 live births requires the implementation of interventions to increase health insurance coverage, taking into consideration the identified factors in the study. We recommend effective public education and awareness creation on the importance of being covered by health insurance by leveraging television and internet platforms. Also, interventions to increase health insurance coverage should consider younger women and those in rural areas.

"Some believe those who say they can cure it" perceived barriers to antiretroviral therapy for children living with HIV/AIDS: Qualitative exploration of caregivers experiences in tamale metropolis.

BACKGROUND: HIV/AIDS is now a chronic disease, as adherence to anti-retrovirals impacts positively on the quality as well as expectancy of life. However, there exist multifaceted barriers to treatments for which children are most disadvantaged. Since Ghana subscribed to the "treat all" policy less percentage (25.5%) of children (2-14 years) living with HIV/AIDS have been enrolled on the antiretroviral program compared to other categories of the population by 2019. At present no study has explored these barriers to children living with HIV/AIDS enrollment and adherence. This study aims to explore the perceived barriers of caregivers of children living with HIV/AIDS in the Tamale Metropolis. METHODS: We used descriptive phenomenology to explore the phenomena. Caregivers were purposively selected and interviewed till information became repetitive at the ninth (9th) caregiver. A semi-structured interview guide was used to collect data through face-to-face in-depth interviews which were audio recorded. The interviews lasted an average of 47 minutes. Audio interviews were transcribed verbatim (English) and translated back-to-back (Daghani) before analysis was done manually according to Collaizi's seven-step approach. We used the Guba and Lincoln guidelines to ensure the rigour of the study and its findings. Results are presented in themes and supported with quotes. RESULTS: Six themes emerged from the analysis of the caregivers' transcripts; (1) denial of HIV/AID diagnosis, (2) stock-outs and privacy at the clinic, (3) busy schedule and poor support, (4) ignorance and alternative herbal cure, (5) stigma and discrimination, (6) transportation and distance. CONCLUSION: Perceived barriers are multi-dimensional and encountered by all PLWHA, especially children. These barriers could derail the gains of HIV/AIDS interventions among children. Adherence counselling among caregivers alongside campaigns among faith and herbal healers are of grave concern to reduce myths of cure.

Strategies Adopted by Novice Nurse Educators to Facilitate Their Transition From Practice to Academia: A Qualitative Study in Ghana.

INTRODUCTION: The successful transition of nurses from clinical practice to academia is essential to the training of a proficient future nursing workforce. However, deprived of requisite support and guidance, novice nurse educators often find the transition from bedside nursing practice to the classroom challenging and hence, adopt some coping strategies to facilitate their transition. Yet, little is known about the strategies adopted by Ghanaian novice nurse educators to facilitate their transition. OBJECTIVE: This study explored the strategies adopted by novice nurse educators to facilitate their transition from practice to academia in three nursing training colleges in Ghana. METHODS: This study adopted a descriptive qualitative study design. The study used a purposive sampling technique to recruit 12 novice nurse educators. Data were generated through individual in-depth interviews using a semistructured interview guide. Interviews were audio-recorded, transcribed verbatim, and analyzed manually through thematic analysis. RESULTS: Novice nurse educators adopted a wide range of strategies to facilitate their transition from practice to academia. Four major themes emerged: (1) seeking support from peers, (2) attending workshops and conferences, (3) relying on performance appraisal and feedback, and (4) applying past clinical nursing knowledge. CONCLUSION: The strategies adopted to facilitate the transition were mostly self-inspired and informal, which calls for more formal and evidence-based strategies to facilitate the transition process. College authorities must create, or adopt and modify faculty mentorship models to mentor novice nurse educators, develop and implement college-specific orientation programmes for novice nurse educators, and implement regular online tutor appraisals by students.

Exploring the reasons for novice nurse educators' transition from practice to academia in Ghana.

BACKGROUND: There is an increasing transition rate of experienced clinical nurses from practice to academia. When nurses transition from practice to academia for the right reasons, it culminates in job satisfaction and retention. Thus, understanding what attracts clinical nurses to academia is an important consideration for employing and retaining competent nurse educators. Yet, there are gaps in research about what motivates nurses to transition from practice to academia within the Ghanaian context. This study aimed to explore the reasons for novice nurse educators' transition from practice to academia in three Health Training Institutions in the Upper East Region of Ghana. METHODS: This qualitative descriptive phenomenology study used a purposive sampling method to select 12 novice nurse educators. Data were collected using a semi-structured interview guide through individual face-to-face in-depth interviews. Written informed consent was obtained and interviews were audio-taped and transcribed verbatim. Data analysis was done manually guided by Colaizzi's method of data analysis. RESULTS: Novice nurse educators transitioned from practice to academia because they were dissatisfied with their clinical nursing practice, they wanted more flexible work, they wanted to work autonomously, and they previously taught their clients in the clinical setting. Four themes emerged namely: (1) dissatisfied with clinical nursing, (2) quest for flexible work role, (3) quest for work autonomy, and (4) previous clinical teaching. CONCLUSION: The reasons for transitioning from practice to academia were mostly born out of novice nurse educators' previous negative experiences in the clinical setting which ought to be considered in the recruitment and retention of teaching staff to train the future nurses. There is the need to revise and implement a tutor recruitment policy that takes into account, what attracts clinical nurses to the academic setting.

Caregivers' Experiences with Caring for a Child Living with HIV/AIDS: A Qualitative Study in Northern Ghana.

With the advent of Anti-Retroviral Therapy, Human Immune Virus, and Acquire Immuno-Deficiency Syndrome is increasingly becoming a chronic disease as life expectancy among People Living With HIV/AIDS has increased. For Children Living With HIV/AIDS the role of the caregivers becomes essential as caregivers' decisions affect CLWH health. However, the experiences of these caregivers are often unnoticed while all interventions are directed at PLWH. This study aimed at exploring the experiences of caregivers of CLWH in some selected hospitals in northern Ghana. This study employed a qualitative descriptive phenomenological approach. Purposive sampling technique was used to recruit 9 participants from 3 public hospitals in the Tamale Metropolis of Ghana. Data was manually analyzed using the approach of Collaizi and the findings were presented in themes and sub-themes. We conducted individual face to face interviews in English and Dagbani from September to November 2019. These interviews were conducted at the convenience of the participants in hospitals and at their homes. They were introduced to the study while awaiting to take antivirals for their CLWH. Five themes emerged: changed family dynamics, discovery of diagnosis, reaction to diagnosis, disclosure, stigma and discrimination, and burden and challenges of care. Caregivers were severely impacted by caring for CLWH and traumatized by changed family dynamics which exposed them to many difficulties. Stigma was widely perpetrated by immediate family members and majority reacted badly to their children HIV-positive status with fear, shame, guilt and even suicidal ideation.