Prevalence and determinants of breast self-examination practices among women in their reproductive age in Namibia: an analysis of the 2013 Namibia demographic and Health Survey.

BACKGROUND: In resource-constrained settings like Namibia, breast self-examination (BSE) is considered an important cost-effective intervention that is critical to the early detection of breast cancer, and better prognosis. Even though BSE is a simple, quick, and cost-free procedure, its practice varies across different contexts. Knowing the determinants of BSE is necessary to inform the implementation of policies and targeted interventions to improve the practice across the population. In Namibia, estimating the magnitude of BSE practice and its determinants using nationally representative data has received limited scholarly attention. Hence, the present study sought to examine the prevalence and determinants of BSE practices among women of reproductive age in Namibia. METHODS: This study relied on the 2013 Namibia Demographic and Health Survey (NDHS), analysing data from women aged 15-49 years. Statistical analyses including bivariate and multivariate logistic regression analyses were done using Stata version 14. Adjusted odds ratio (AOR) and confidence interval (CI) are presented. We followed the 'Strengthening the Reporting of Observational Studies in Epidemiology' (STROBE) statement. RESULTS: Only 30.67% of the respondents practiced BSE. The odds of performing BSE were higher among those with health insurance coverage [AOR = 1.59, 95% CI: 1.34, 1.89], those who were separated from their spouses [AOR = 1.36, 95% CI: 1.03, 1.80], those within the richest wealth index [AOR = 1.69, 95% CI: 1.23, 2.33, p ≤ 0.001], and among Catholics [AOR = 0.84, 95% CI: 0.71, 0.98]. Women with secondary [AOR = 2.44, 95% CI:1.78, 3.35, p ≤ 0.001] or higher education [AOR = 3.39, 95%CI:2.24, 5.14] had higher odds of performing BSE. Women aged between 20-49 years had a significantly higher likelihood to practice BSE. Compared to women who live in Khomas, those living in Erongo, Karas, and Omaheke, were more likely to practice BSE than those in Kavango, Ohangwena, Omusati, Oshana, and Oshikoto. CONCLUSION: We conclude that the determinants of BSE practice are age, educational level, marital status, health insurance coverage, religion, mobility in the last 12 months, early sexual debut, parity, household wealth index, and region of residence. Any policy or intervention to improve BSE practice among Namibian women of reproductive age must target adolescent girls, those with no formal education, those without health insurance coverage, multiparous women, and those in the poorest wealth index.

Peer victimization, prison climate, resilience and psychological distress of incarcerated juvenile offenders in Ghana: A serial mediation examination.

Most Ghanaian research in the area of victimization among children has focused on the school setting. Little research has been done in an attempt to understand inmate-on-inmate victimization within the juvenile correctional facilities in Ghana. This study, therefore, investigated the extent to which peer victimization influences psychological distress among juvenile offenders in the Senior Correctional Center of Ghana. A cross-sectional design was used to purposively sample 115 juvenile offenders for the study. Following mediation analysis performed in PROCESS, the results revealed that prison climate and resilience serially mediated the relationship between peer victimization and psychological distress. Independently, both prison climate and resilience mediated the relationship between peer victimization and psychological distress. It was recommended that anti-bullying programs ought to be institutionalized to create mental health awareness within the correctional facilities. Also, support systems such as the Listener Scheme need to be deployed within the correctional facilities.

HIV Testing among sexually active Ghanaians: an examination of the rural-urban correlates.

HIV testing is critical in reducing the risk of HIV transmission. We investigated the rural-urban correlates of HIV testing amongst sexually active Ghanaians using data from the 2017/2018 Ghana Multiple Indicator Cluster Survey Six (GMICS 6). Robust Poisson models (reporting Adjusted Prevalence Ratios (APR) and 95% Confidence Intervals (CIs)) were used to achieve this aim. About 46% of the participants had ever tested for HIV. According to the results, approximately 52% and 39% of urban and rural dwellers, respectively, have undergone HIV testing. HIV knowledge, HIV stigma, gender, age, education, marital status, childbirth history, sexual history, health insurance coverage, media exposure, household wealth, and region of residence were significantly related to HIV testing with observed variations across rural-urban areas. The findings call for the expansion of advocacy efforts towards encouraging HIV testing, targeting sexually active Ghanaians particularly in rural areas.

RESUMEN: La prueba del VIH es fundamental para reducir el riesgo de transmisión del VIH. Investigamos los correlatos rural-urbanos de las pruebas del VIH entre los ghaneses sexualmente activos utilizando datos de la Encuesta de Indicadores Múltiples por Conglomerados de Ghana 2017/2018 (GMICS 6). Se utilizaron modelos robustos de Poisson (que informan de índices de prevalencia ajustados (APR) e intervalos de confianza (IC) del 95%) para lograr este objetivo. Alrededor del cuarenta y seis por ciento de los participantes se habían hecho alguna vez la prueba del VIH. Según los resultados, aproximadamente el cincuenta y dos por ciento y el treinta y nueve por ciento de los habitantes urbanos y rurales, respectivamente, se han realizado la prueba del VIH. El conocimiento del VIH, el estigma del VIH, el género, la edad, la educación, el estado civil, el historial de partos, el historial sexual, la cobertura de seguro médico, la exposición a los medios, la riqueza del hogar y la región de residencia se relacionaron significativamente con las pruebas del VIH con variaciones observadas entre las zonas rurales y urbanas. Los hallazgos exigen la expansión de los esfuerzos de promoción para alentar las pruebas del VIH, enfocándose en los ghaneses sexualmente activos, particularmente en las áreas rurales.

Patterns of victimization in Ghana's Senior Correctional Center: The experiences of juvenile offenders.

Victimization is considered a serious issue which affects children across the globe and this is particularly accentuated in the prison environment Research on prison victimization and psychological health however, has primarily focused on adult prisoners. There is little documentation on how victimization impacts the psychological health of juvenile offenders in correctional facilities. This article therefore explores the experiences of victimization among juvenile offenders in the Senior Correctional Center, Ghana. A total of 20 juvenile offenders were purposively sampled from Ghana's Senior Correction Center. Using thematic analysis, three themes were generated and discussed: forms of victimization, causes of victimization and impacts of victimization. It was revealed that, besides taking the form of either direct and or indirect physical assault, victimization also manifested in the form of verbal assault. Moreover, victimization was found to usually occur when young offenders direct their built-up frustrations at others or when victims possess specific attributes that make them targets. The various forms of victimization experienced by these young offenders impacts their well-being physically, psychologically and socially. It is recommended that stakeholders should practice stress management exercises, and establish a buddy system for juvenile offenders in the correctional facility.

Bullying and truancy amongst school-going adolescents in Timor-Leste: results from the 2015 global school-based health survey.

INTRODUCTION: Studies in Southeast Asia found that bullying commonly occurred among students, and it has a detrimental impact on their school attendance. However, there is a paucity of literature in Timor-Leste on the association between bullying and truancy. Therefore, this study examined the association between bullying and truancy among Timor-Leste school-going adolescents. METHODS: We used the 2015 Timor-Leste Global School-based Student Health Survey (GSHS) dataset to examine our hypothesis in logistic regression models for both full adolescents (N = 3609) and gender stratified samples. The models further controlled for other sociodemographic variables. Statistical significance was pegged at p ≤ 0.05, and the analyses were performed in Stata version 14. RESULTS: About 28% [95% CI:25.7, 30.8] and 36% [95% CI:33.5, 39.5] of school-going adolescents had experienced bullying and truancy, respectively. In-school adolescents who were bullied were more likely to be truant in school even after controlling for the effects of sex, age, grade in school, food insecurity, current substance use, number of friends, colleague support, and parental involvement. This relationship remained significant in the full and gender stratified models. Additionally, school-going adolescents who were currently using substances were truant. Males who were in a physical fight while females who were physically attacked were more likely to be truant. CONCLUSION: The study showed that bullying was related to truancy among school-going adolescents in Timor-Leste. Implementation of interventions such as Project START (Stop Truancy and Recommend Treatment) to curtail the incidence of bullying, regulation of current substance use, creating an enabling environment to reduce physical fights, and attacks will significantly reduce the rate of truancy among school-going adolescents in Timor-Leste.

Determinants of life satisfaction among Ghanaians aged 15 to 49 years: A further analysis of the 2017/2018 Multiple Cluster Indicator Survey.

The inclusion of life satisfaction in government policies as a tracker of the social and economic progress of citizens has been recommended. This has encouraged the scientific investigation of life satisfaction levels of people in tandem with factors responsible for these levels. Only a few studies have attempted to do this in Ghana with mixed findings. This study, therefore, extends previous literature by examining the determinants of life satisfaction among Ghanaians in two ways: a full sample and a gender-stratified sample. We analysed cross-sectional data from the 2017/2018 Ghana Multiple Indicator Cluster Survey Six (MICS 6). A sample of 20,059 women and men of ages ranging from 15 to 49 years participated in this study. The Cantril's Self-Anchoring Ladder Life Satisfaction scale was used to capture the life satisfaction of participants alongside relevant sociodemographic questions. About 35% of participants reported they were satisfied in life with males reporting more suffering levels [39.59%; 95% CI:36.38, 42.88] and females more thriving levels [36.41%; 95% CI:35.01, 37.84]. In the full sample multivariable model, gender, age, parity, education, marital status, wealth index, and region of residence were significantly associated with life satisfaction. Gender variations were also found across these associations. These findings collectively provide useful information for policymakers and practitioners to optimize interventions for the Ghanaian population aimed at improving life satisfaction. Evidence from this study also calls on the government of Ghana to begin tracking the life satisfaction of her citizens.

Exposure to substance and current substance among school-going adolescents in Timor-Leste.

Few studies have examined how exposure to substance influences adolescent's use of substance in Timor-Leste. We assessed this relationship using nationally representative data from Timor-Leste to address this gap. Data was pulled from the 2015 Timor-Leste Global school-based student health survey. Data of students aged 13-17years (N = 3700) from class 7-11 across schools in Timor-Leste were analyzed for this study. Second-hand smoking exposure (AOR = 1.57 [1.31, 1.89] and parental tobacco use, AOR = 1.94 [1.54, 2.44]) was significantly related to in-school adolescent's current use of substance after adjusting for covariates. Current substance use was also positively associated with being male, being in class 10-12, and being food insecure and negatively associated with having at least three close friends and benefiting from parental supervision. To reduce substance use among in-school adolescents, policymakers must consider the inclusion of all models in the social learning environment of adolescents in Timor-Leste.

Relationship between mothers'/caregivers' reported learning difficulty and internalizing symptoms (anxiety and depression) of children aged 5-17 years in Ghana.

BACKGROUND: Children with learning difficulties are vulnerable to internalizing symptoms, particularly anxiety and depression. However, only few studies have examined this relationship in low-and-middle-income countries using a nationally representative data. AIMS: This study aimed to examine the relationship between learning difficulty and internalizing symptoms of children aged 5-17 years in Ghana while controlling for covariates. METHODS AND PROCEDURES: We analyzed children's data using mothers'/caregivers' reports from the 2017/2018 Ghana Multiple Indicator Cluster Survey Six (MICS 6). Data of 8,958 children aged 5-17 years were used for the analysis. OUTCOMES AND RESULTS: About 20% of the children had some learning difficulties whereas 5% could not learn at all. Learning difficulty was associated with symptoms of anxiety and depression of children. Specifically, children who had some learning difficulties had higher odds of feeling anxious [APOR = 1.28, 95% CI:1.11, 1.49, p = 0.001] while those with some difficulties [APOR=1.24, 95% CI:1.07, 1.44, p = 0.004] and a lot of difficulties or could not learn at all [APOR=1.74, 95% CI:1.28, 2.37, p < 0.01] had higher odds of feeling depressed. CONCLUSION AND IMPLICATIONS: The findings call on stakeholders in education and health to prioritize the mental health of all school-going children, particularly those with learning difficulties in Ghana.