Influence of women empowerment on childhood (12-23 months) immunization coverage: Recent evidence from 17 sub-Saharan African countries.

BACKGROUND: There is a global consensus that child immunization plays an important role in promoting the health and well-being of children. Despite the quintessential role of immunization, not all children receive full immunization coverage. We examined the association between women empowerment and childhood immunization coverage in sub-Saharan Africa (SSA). METHODS: The most recent Demographic and Health Survey data of 17 SSA countries were used for the analysis, with a sample of 19,223. The outcome and exposure variables were full immunization coverage and women empowerment, respectively. Full immunization was computed from percentage of children between the ages of 12 and 23 months who had received the following vaccines at any point in time: one dose of Bacille Calmette-Guérin, three doses of the vaccine protecting against diphtheria, pertussis, and tetanus or the tetravalent/pentavalent vaccine, three doses of the polio vaccine, and one dose of the measles vaccine (either as a standalone measles vaccine or as part of a combination with other immunogens). Women's empowerment was an index of labour participation, acceptance towards spousal violence, decision-making capacity and general knowledge level. Descriptive analysis and multilevel logistic regression were performed. Results were reported in adjusted odds ratio with a corresponding 95% confidence interval. RESULTS: The study found that 56.6% of children were fully immunized. Children of employed mothers were 1.16 times more likely to be fully immunized. Children of mothers with higher acceptance toward violence were less likely to be fully immunized [aOR = 0.90, CI 0.81, 0.99]. The odds of full immunization were higher among children born to mothers with high [aOR = 1.11, CI 1.01, 1.22] decision-making capacity. Higher odds of full immunization were found among children born to mothers with medium [aOR = 1.24, CI 1.13, 1.36] to high [aOR = 1.44, CI 1.27, 1.63] general knowledge level. CONCLUSIONS: We conclude that empowering women through livelihood empowerment interventions can increase their decision-making capacity and foster their resolve to ensure the full immunization of their children. This can be achieved by consciously investing in initiatives such as vocational training programs, job placement services, or support for entrepreneurship initiatives to encourage and support women's workforce participation.

Factors associated with the utilisation of skilled delivery services in Papua New Guinea: evidence from the 2016-2018 Demographic and Health Survey.

BACKGROUND: We sought to determine the prevalence and factors associated with the use of skilled assistance during delivery in Papua New Guinea. METHODS: We analysed nationally representative data from 5210 women in Papua New Guinea using the 2016-2018 Demographic and Health survey. Both bivariate and multivariable analyses were performed. Statistical significance was set at p<0.05. RESULTS: The prevalence of skilled assistance during delivery was 57.6%. The richest women (adjusted OR [AOR]=3.503, 95% CI 2.477 to 4.954), working women (AOR=1.221, 95% CI 1.037 to 1.439), women with primary (AOR=1.342, 95% CI 1.099 to 1.639), secondary or higher education (AOR=2.030, 95% CI 1.529 to 2.695), women whose partners had a secondary or higher level of education (AOR=1.712, 95% CI 1.343 to 2.181], women who indicated distance was not a big problem in terms of healthcare (AOR=1.424, 95% CI 1.181 to 1.718), women who had ≥4 antenatal care (ANC) visits (AOR=10.63, 95% CI 8.608 to 13.140), women from the Islands region (AOR=1.305, 95% CI 1.045 to 1.628), those who read newspapers or magazines (AOR=1.310, 95% CI 1.027 to 1.669) and women who watched television (AOR=1.477, 95% CI 1.054 to 2.069) less than once a week had higher odds of utilising skilled attendants during delivery. On the contrary, women in the Momase region (AOR=0.543, 95% CI 0.438 to 0.672), women in rural areas (AOR=0.409, 95% CI 0.306 to 0.546), as well as women with a parity of 3 (AOR=0.666, 95% CI 0.505 to 0.878) or ≥4 (AOR=0.645, 95% CI 0.490 to 0.850) had lower odds of utilising skilled attendance during delivery. CONCLUSION: There is relatively low use of skilled delivery services in Papua New Guinea. Wealth, employment status, educational level, parity and number of ANC visits, as well as access to healthcare and place of residence, influence the utilisation of skilled delivery services.

Suicidal behaviours among in-school adolescents in Mozambique: Cross-sectional evidence of the prevalence and predictors using the Global School-Based Health Survey data.

INTRODUCTION: Despite interventions by low and middle-income countries toward the achievement of the global Sustainable Development Goal (SDG) on promoting mental health and well-being of their populace by the year 2030, suicidal behaviours continue to be major causes of premature mortality, especially among young people. This study examined the prevalence and predictors of suicidal behaviours among in-school adolescents in Mozambique. MATERIALS AND METHODS: This was a cross-sectional study of 1918 in-school adolescents using data from the 2015 Global School-based Health Survey (GSHS) of Mozambique. The outcome variables (suicidal ideation, suicidal plan, and suicidal attempt) were measured with single items in the survey. Both bivariate and multivariate analyses were performed using chi-square test of independence and binary logistic regression respectively. Results are presented as Adjusted Odds Ratios for the binary logistic regression analysis. Statistical significance was set at p<0.05. RESULTS: The prevalence of suicidal behaviours 12 months prior to the survey were 17.7%, 19.6% and 18.5% for suicidal ideation, suicidal plan, and suicidal attempt respectively. Adolescents who experienced anxiety had higher odds of suicidal ideation [AOR = 1.616, 95%CI = 1.148-2.275], suicidal plan [AOR = 1.507, 95%CI = 1.077-2.108], and suicidal attempt [AOR = 1.740, 95%CI = 1.228-2.467]. Adolescents who were physically attacked in school were also more likely to ideate [AOR = 1.463, 95%CI = 1.115-1.921], plan [AOR = 1.328, 95%CI = 1.020-1.728], and attempt [AOR = 1.701, 95%CI = 1.306-2.215] suicide. Having close friends was, however, an important protective factor against suicidal ideation [AOR = 0.694, 95%CI = 0.496-0.971], plan [AOR = 0.625, 95%CI = 0.455-0.860], and attempt [AOR = 0.529, 95%CI = 0.384-0.729]. Peer support also reduced the risk of suicidal ideation [AOR = 0.704, 95%CI = 0.538,0.920] and plan [AOR = 0.743, 95%CI = 0.572,0.966] among the in-school adolescents. CONCLUSION: Suicidal behaviours constitute major public health challenges among in-school adolescents in Mozambique. The behaviours are predominant among adolescents who are physically attacked and those who experience anxiety. Conversely, having close friends serves as a protective factor against suicidal behaviours. To ensure that Mozambique meets the SDG target of promoting the mental health of all by the year 2030, the Government of Mozambique and educational authorities should urgently design and implement innovative interventions and strengthen existing ones that seek to address physical attacks and anxiety among in-school adolescents. School administrations should also incorporate programmes that seek to congregate students and offer platforms for social interaction and cohesion.

Factors contributing to primary caregiver delay in presenting children with chronic kidney disease for medical care in Ghana.

BACKGROUND: Conforming to the 2016 World Kidney Day focus on raising awareness of the early detection of kidney diseases in children, we report on factors that contribute to primary caregiver delay in presenting their children with chronic kidney disease (CKD) for medical care in Kumasi, Ghana. AIM: The objective of the study was to explore and describe the factors that contribute to primary caregiver delay in presenting children with CKD for medical care in Kumasi, Ghana. SETTING: The study was conducted in the Paediatric Renal Unit in Kumasi, Ghana. METHODS: A qualitative study was conducted in January 2017. Semi-structured interviews were used to collect data from a convenience sample of 10 primary caregivers whose children were admitted for CKD, but were not too ill. The primary caregivers had to respond to the research question: What factors contribute to your delay in presenting your child with CKD for medical care? Thematic data analysis and the ecological model of Schneider (2017) were used to organise the findings. RESULTS: Four themes and related subthemes, including intrapersonal-related factors, interpersonal-related factors, community-related factors and infrastructural factors were identified as those that contribute to delay in presenting children with CKD for medical care. CONCLUSION: The findings show that primary prevention strategies for CKD in children should not only focus on personal-related factors but also cut across all levels of the socio-ecological model in order for them to be effective.

Factors contributing to primary caregiver delay in presenting children with chronic kidney disease for medical care in Ghana

Background: Conforming to the 2016 World Kidney Day focus on raising awareness of the early detection of kidney diseases in children, we report on factors that contribute to primary caregiver delay in presenting their children with chronic kidney disease (CKD) for medical care in Kumasi, Ghana.Aim: The objective of the study was to explore and describe the factors that contribute to primary caregiver delay in presenting children with CKD for medical care in Kumasi, Ghana.Setting: The study was conducted in the Paediatric Renal Unit in Kumasi, Ghana.Methods: A qualitative study was conducted in January 2017. Semi-structured interviews were used to collect data from a convenience sample of 10 primary caregivers whose children were admitted for CKD, but were not too ill. The primary caregivers had to respond to the research question: What factors contribute to your delay in presenting your child with CKD for medical care? Thematic data analysis and the ecological model of Schneider (2017) were used to organise the findings.Results: Four themes and related subthemes, including intrapersonal-related factors, interpersonal-related factors, community-related factors and infrastructural factors were identified as those that contribute to delay in presenting children with CKD for medical care.Conclusion: The findings show that primary prevention strategies for CKD in children should not only focus on personal-related factors but also cut across all levels of the socio-ecological model in order for them to be effective

Factors contributing to primary caregiver delay in presenting children with chronic kidney disease for medical care in Ghana

Background: Conforming to the 2016 World Kidney Day focus on raising awareness of the early detection of kidney diseases in children, we report on factors that contribute to primary caregiver delay in presenting their children with chronic kidney disease (CKD) for medical care in Kumasi, Ghana. Aim: The objective of the study was to explore and describe the factors that contribute to primary caregiver delay in presenting children with CKD for medical care in Kumasi, Ghana. Setting: The study was conducted in the Paediatric Renal Unit in Kumasi, Ghana. Methods: A qualitative study was conducted in January 2017. Semi-structured interviews were used to collect data from a convenience sample of 10 primary caregivers whose children were admitted for CKD, but were not too ill. The primary caregivers had to respond to the research question: What factors contribute to your delay in presenting your child with CKD for medical care? Thematic data analysis and the ecological model of Schneider (2017) were used to organise the findings. Results: Four themes and related subthemes, including intrapersonal-related factors, interpersonal-related factors, community-related factors and infrastructural factors were identified as those that contribute to delay in presenting children with CKD for medical care. Conclusion: The findings show that primary prevention strategies for CKD in children should not only focus on personal-related factors but also cut across all levels of the socio-ecological model in order for them to be effective