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1

Windrich, Elaine, et Louise Bourgault. « Mass Media in Sub-Saharan Africa ». African Studies Review 39, no 3 (décembre 1996) : 200. http://dx.doi.org/10.2307/524952.

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ARMOUR, C. « Mass Media in Sub-Saharan Africa ». African Affairs 95, no 380 (1 juillet 1996) : 462–64. http://dx.doi.org/10.1093/oxfordjournals.afraf.a007745.

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Achia, Thomas N. O. « Tobacco Use and Mass Media Utilization in Sub-Saharan Africa ». PLOS ONE 10, no 2 (23 février 2015) : e0117219. http://dx.doi.org/10.1371/journal.pone.0117219.

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Záhořík, Jan. « Languages in Sub-Saharan Africa in a broader socio-political perspective ». Acta Orientalia Vilnensia 11, no 2 (1 janvier 2010) : 77–90. http://dx.doi.org/10.15388/aov.2010.3646.

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Charles University This study deals with language policies in Africa with a special focus on multi-ethnic and multi-lingual states including Sudan, Ethiopia, Nigeria, Cameroon, and Democratic Republic of Congo. The study will thus examine relations between state and minorities, the status of major and marginalized languages, the roles of European languages in politics as well as theoretical frameworks. Sub-Saharan Africa has undergone a remarkable process from linguistic imperialism to linguistic pluralism and revivalism. Until the 1960s the superior position of the European languages (English, French, and Portuguese) was evident, but after the Africanization of politics and society in many African countries, a strong accent on linguistic emancipation was initiated. Nowadays, many African countries follow the principle of linguistic pluralism where several languages enjoy the same rights and space in the media, administrative, education, etc. This study will discuss some important case studies and their specific language policies.
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Mutumba, Massy. « Mass media influences on family planning knowledge, attitudes and method choice among sexually active men in sub-Saharan Africa ». PLOS ONE 17, no 1 (27 janvier 2022) : e0261068. http://dx.doi.org/10.1371/journal.pone.0261068.

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Men are underrepresented in family planning (FP) research, and despite the widespread promotion of FP through mass media, there is no systematic evaluation on how mass media exposure influences their FP knowledge, attitudes and behavior. Using Demographic and Health Survey (DHS) data from 31 countries in Sub-Saharan Africa (SSA), collected between 2010 and 2019, this paper examines the associations between three types of traditional mass media (radio, television and print) with FP knowledge, attitudes and method choices among reproductive age men in SSA, relative to other socio-cultural factors. Estimates to quantify the relative contribution of each type of mass media, relative to other evidence-based socio-cultural influences on FP outcomes, were derived using the Shorrocks-Shapley decomposition. Radio exposure had the largest impact on FP knowledge, attitudes and method choice, accounting for 26.1% of the variance in FP knowledge, followed by Television (21.4%) and education attainment (20.7%). Mass media exposure had relatively minimal impact on FP method choice, and between the three types of mass media, television (8%) had the largest influence on FP method choice. Print media had comparatively lesser impact on FP knowledge (8%), attitudes (6.2%) and method choice (3.2%). Findings suggest that mass media exposure has positive influences on FP knowledge, attitudes and method choice but its influence on FP knowledge, attitudes and method choice is smaller relative to other socio-cultural factors such as education, household wealth and marital status. As such, efforts to increase FP uptake in Sub-Saharan Africa should take into consideration the impact of these socio-cultural economic factors.
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Bekalu, Mesfin Awoke, et Steven Eggermont. « Advancing HIV/AIDS Combination Prevention through mass media : a review of practices in sub-Saharan Africa ». Information Development 28, no 3 (2 février 2012) : 189–98. http://dx.doi.org/10.1177/0266666911433156.

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Kalembo, Fatch W., Maggie Zgambo et Du Yukai. « Effective Adolescent Sexual and Reproductive Health Education Programs in Sub-Saharan Africa ». Californian Journal of Health Promotion 11, no 2 (1 septembre 2013) : 32–42. http://dx.doi.org/10.32398/cjhp.v11i2.1529.

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Background: The objective of this review was to explore and identify feasible, socially acceptable and effective adolescent sexual and reproductive health education (ASRHE) programs in sub-Saharan Africa. Methods: Four databases were searched to identify studies conducted within the past 15 years which evaluate the effectiveness of ASRHE programs in sub-Saharan Africa. The databases searched were Embase, Medline, CINAHL, PyscINFO. A further search for relevant articles was made in the Google scholar website. The title and abstract of each article were analyzed for relevance by applying inclusion and exclusion criteria. Further scrutiny and extraction of the studies was completed by selecting only those studies which met the criteria for inclusion. Results: Fifteen studies were identified. School, peer, mass media, health facility and community based ASRHE programs showed positive impact in one or more of the following outcomes in adolescents in sub-Saharan Africa: ( i) knowledge of HIV transmission; (ii) perceived personal risk of contracting HIV/ AIDS; (iii) self-efficacy to negotiate condom use; (iv) discussion with others about HIV/AIDS or condom use; (v) abstinence from sexual relations; (vi) reduction in high-risk sexual behavior; (vii) condom use (vii) testing for sexually transmitted infection (STI) and (viii) treatment seeking behavior. Conclusion: ASRHE programs of diverse forms can produce positive change in adolescent sexual and reproductive health (ASRH). There is need for rigorous research to assess long term behavioral effects of culturally tailored comprehensive ASRHE programs in sub-Saharan Africa.
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Aboagye, Richard Gyan, Bright Opoku Ahinkorah, Abdul-Aziz Seidu, Collins Adu, John Elvis Hagan, Hubert Amu et Sanni Yaya. « Mass Media Exposure and Safer Sex Negotiation among Women in Sexual Unions in Sub-Saharan Africa : Analysis of Demographic and Health Survey Data ». Behavioral Sciences 11, no 5 (28 avril 2021) : 63. http://dx.doi.org/10.3390/bs11050063.

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(1) Background: Improving sexual autonomy among women in sexual unions comes with various benefits, including the reduction of sexually transmitted and blood-borne infections. We examined the relationship between mass media exposure and safer sex negotiation among women in sub-Saharan Africa (SSA). (2) Methods: The study involved a cross-sectional analysis of Demographic and Health Survey (DHS) data of 29 sub-Saharan African countries. A total of 224,647 women aged 15–49 were included in our analyses. We examined the association between mass media exposure and safer sex negotiation using binary logistic regression analysis. The results are presented using a crude odds ratio (cOR) and adjusted odds ratio (aOR), with their respective confidence intervals (CIs). Statistical significance was set at p < 0.05. (3) Results: The overall prevalence of safer sex negotiation among women in sexual unions in SSA was 71.6% (71.4–71.8). Women exposed to mass media had higher odds of negotiating for safer sex compared with those who had no exposure (aOR = 1.94; 95% CI = 1.86–2.02), and this persisted after controlling for covariates (maternal age, wealth index, maternal educational level, partner’s age, partner’s educational level, sex of household head, religion, place of residence, and marital status) (aOR = 1.40; 95% CI = 1.35–1.46). The disaggregated results showed higher odds of safer sex negotiation among women exposed to mass media in all the individual countries, except Ghana, Comoros, Rwanda, and Namibia. (4) Conclusions: The findings could inform policies (e.g., transformative mass media educational seminars) and interventions (e.g., face-to-face counselling; small group sensitization sessions) in SSA on the crucial role of mass media in increasing safer sex practice among women in sexual unions. To accelerate progress towards the achievement of the Sustainable Development Goal five’s targets on empowering all women and safeguarding their reproductive rights, the study recommends that countries such as Ghana, Comoros, Rwanda, and Namibia need to intensify their efforts (e.g., regular sensitization campaigns) in increasing safer sex negotiation among women to counter power imbalances in sexual behaviour.
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UCHUDI, JOSEPH, MONICA MAGADI et MOHAMMOD MOSTAZIR. « A MULTILEVEL ANALYSIS OF THE DETERMINANTS OF HIGH-RISK SEXUAL BEHAVIOUR IN SUB-SAHARAN AFRICA ». Journal of Biosocial Science 44, no 3 (9 novembre 2011) : 289–311. http://dx.doi.org/10.1017/s0021932011000654.

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SummaryA number of authors have identified multiple concurrent sexual partnerships by both men and women to lie at the root of the HIV/AIDS epidemic in sub-Saharan Africa. This study applies multilevel models to Demographic and Health Survey data collected during 2003–2008 in 20 sub-Saharan African countries to examine the influence of social and cultural context on involvement with multiple sexual partnerships in the region, above and beyond the effects of individual characteristics. The findings provide support for the ecological argument that health behaviours are shaped and determined by societal conditions, in addition to the effects of individual and household characteristics. Involvement with multiple sex partners is most prevalent in societies in which sexual norms are widely permissive and where polygyny is common. Individual autonomy is substantial and attitudes towards sexuality are more liberal among men and women who live in communities in which sexual norms are widely permissive. Men and women who are most likely to have multiple sex partners in the sub-Saharan region are those who initiated sexual activity earlier and those who have the individual attributes (e.g. young age, urban residence, education, media exposure and working for cash and away from home) that bring to them more rights and/or decision-making autonomy, but not necessarily more financial resources and economic security (mostly among women). On the other hand, involvement with multiple partners is determined by cultural norms (i.e. permissive sexual norms) and social change (i.e. mass education, expansion of cash employment). The findings suggest a number of opportunities for more effective policy and programmatic responses to curb the prevalence of multiple partnerships in sub-Saharan Africa.
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Okedo-Alex, Ijeoma Nkem, Ifeyinwa Chizoba Akamike, Obumneme Benaiah Ezeanosike et Chigozie Jesse Uneke. « Determinants of antenatal care utilisation in sub-Saharan Africa : a systematic review ». BMJ Open 9, no 10 (octobre 2019) : e031890. http://dx.doi.org/10.1136/bmjopen-2019-031890.

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ObjectivesTo identify the determinants of antenatal care (ANC) utilisation in sub-Saharan Africa.DesignSystematic review.Data sourcesDatabases searched were PubMed, OVID, EMBASE, CINAHL and Web of Science.Eligibility criteriaPrimary studies reporting on determinants of ANC utilisation following multivariate analysis, conducted in sub-Saharan Africa and published in English language between 2008 and 2018.Data extraction and synthesisA data extraction form was used to extract the following information: name of first author, year of publication, study location, study design, study subjects, sample size and determinants. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist for reporting a systematic review or meta-analysis protocol was used to guide the screening and eligibility of the studies. The Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies was used to assess the quality of the studies while the Andersen framework was used to report findings.Results74 studies that met the inclusion criteria were fully assessed. Most studies identified socioeconomic status, urban residence, older/increasing age, low parity, being educated and having an educated partner, being employed, being married and Christian religion as predictors of ANC attendance and timeliness. Awareness of danger signs, timing and adequate number of antenatal visits, exposure to mass media and good attitude towards ANC utilisation made attendance and initiation of ANC in first trimester more likely. Having an unplanned pregnancy, previous pregnancy complications, poor autonomy, lack of husband’s support, increased distance to health facility, not having health insurance and high cost of services negatively impacted the overall uptake, timing and frequency of antenatal visits.ConclusionA variety of predisposing, enabling and need factors affect ANC utilisation in sub-Saharan Africa. Intersectoral collaboration to promote female education and empowerment, improve geographical access and strengthened implementation of ANC policies with active community participation are recommended.
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de-Graft Aikins, Ama, Vivian A. Dzokoto et Earl Yevak. « Mass media constructions of ‘socio-psychological epidemics’ in sub-Saharan Africa : The case of genital shrinking in 11 countries ». Public Understanding of Science 24, no 8 (7 septembre 2015) : 988–1006. http://dx.doi.org/10.1177/0963662515600391.

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Babalola, Stella, Maria-Elena Figueroa et Susan Krenn. « Association of Mass Media Communication with Contraceptive Use in Sub-Saharan Africa : A Meta-Analysis of Demographic and Health Surveys ». Journal of Health Communication 22, no 11 (2 novembre 2017) : 885–95. http://dx.doi.org/10.1080/10810730.2017.1373874.

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Aboagye, Richard Gyan, Abdul-Aziz Seidu, Bright Opoku Ahinkorah, Abdul Cadri, James Boadu Frimpong, John Elvis Hagan, Nigussie Assefa Kassaw et Sanni Yaya. « Association between frequency of mass media exposure and maternal health care service utilization among women in sub-Saharan Africa : Implications for tailored health communication and education ». PLOS ONE 17, no 9 (29 septembre 2022) : e0275202. http://dx.doi.org/10.1371/journal.pone.0275202.

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Introduction Awareness creation through mass media has the potential to promoted positive behaviors and discourage negative health-related behaviors through direct and indirect pathways. In this study, we examined the association between exposure to mass media and maternal health care services utilization among women in sub-Saharan Africa. Methods We used data from the recent Demographic and Health Surveys (DHS) conducted between 2010 and 2020. A total of 28 countries with a survey dataset within 2010–2020 were included in our study. We included 199,146 women who had ever had a pregnancy in the last five years preceding the survey. Weighting was applied. Multilevel mixed-effect models were considered to account for cluster-level variations and correct inferences. Fixed and random effects estimates were reported. Adjusted odds ratio (aOR) with their 95% confidence intervals (CIs) were used to present the results. Also, we presented the random intercept variations, intraclass correlation coefficient, and model fitness. Results Women who listened to radio at least once every week (aOR = 1.11, 95% CI = 1.07,1.15) were more likely to attend ANC as against those who did not listen to radio at all. Also, women who watched television at least once a week (aOR = 1.39, 95% CI = 1.33,1.46) were more likely to attend ANC compared to those who did not watch television at all. Women who read newspaper/magazine at least once a week (aOR = 1.27, 95% CI = 1.14,1.41); listened to radio at least once a week (aOR = 1.12, 95% CI = 1.07,1.17); and watched television at least once a week (aOR = 1.32, 95% CI = 1.24,1.40), were more likely to utilize SBA than those who did not read newspaper/magazine; listen to radio; and watch television at all. Women who read newspaper/magazine at least once a week (aOR = 1.35, 95% CI = 1.27,1.45); listened to radio at least once a week (aOR = 1.37, 95% CI = 1.32,1.42); and watched television at least once a week (aOR = 1.39, 95% CI = 1.32,1.47) were more likely to utilize PNC compared to those who did not. Conclusions The study identified a strong positive relationship between mass media exposure and maternal health care services utilization. Specifically, exposure to radio and television were positively associated with ANC visitations. Moreover, exposure to mass media (newspaper/magazine, radio and television) were positively associated with SBA and PNC utilization. Policymakers and other non-governmental organizations should continuously invest resources in the design and implementation of maternal health service utilization educational programs through all the mass media channels to scale up women’s maternal health service services utilization uptake in sub-Saharan Africa.
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Kimaru-Muchai, Serah. « Stakeholder Involvement in Upscaling of Soil Fertility Research Output in Tharaka-Nithi County, Kenya ». Journal of Global Awareness 2, Fall/Winter (13 décembre 2021) : 1–22. http://dx.doi.org/10.24073/jga/2/02/06.

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Food insecurity in Sub-Saharan Africa has prompted a lot of research in the development of soil fertility technologies; however, few of the recommendations from soil fertility management research have been put into use by the target end-users. The objective of the study was to investigate information exchange pathways used by researchers in upscaling of soil fertility in Maara and Mbeere South Sub-counties in Kenya. Structured questionnaires were used to collect information from 22 researchers and 240 farmers. Data was analyzed using descriptive statistics like frequency, mean, and percentages, while Chi-square, Kendal's correlation coefficient was used to test the magnitude of the relationship between dependent and independent variables. Inadequate resources materials and poor networking among stakeholders were among the challenges that the researchers faced in the dissemination of their research outputs. The findings also showed that there was a positive and significant correlation between farm size and the mass media approach. Researchers and extension agents should use a mixed approach; this is the use of combined individual, group, and mass media approaches to cater to the different preferences based on socio-economic characteristics of farmers.
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Amu, Hubert, Kwamena Sekyi Dickson, Kenneth Setorwu Adde, Kwaku Kissah-Korsah, Eugene Kofuor Maafo Darteh et Akwasi Kumi-Kyereme. « Prevalence and factors associated with health insurance coverage in urban sub-Saharan Africa : Multilevel analyses of demographic and health survey data ». PLOS ONE 17, no 3 (4 mars 2022) : e0264162. http://dx.doi.org/10.1371/journal.pone.0264162.

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Introduction With the vision of achieving Universal Health Coverage (UHC) by the year 2030, many sub-Saharan African (SSA) countries have implemented health insurance schemes that seek to improve access to healthcare for their populace. In this study, we examined the prevalence and factors associated with health insurance coverage in urban sub-Saharan Africa (SSA). Materials and methods We used the most recent Demographic and Health Survey (DHS) data from 23 countries in SSA. We included 120,037 women and 54,254 men residing in urban centres in our analyses which were carried out using both bivariable and multivariable analyses. Results We found that the overall prevalence of health insurance coverage was 10.6% among females and 14% among males. The probability of being covered by health insurance increased by level of education. Men and women with higher education, for instance, had 7.61 times (95%CI = 6.50–8.90) and 7.44 times (95%CI = 6.77–8.17) higher odds of being covered by health insurance than those with no formal education. Males and females who read newspaper or magazine (Males: AOR = 1.47, 95%CI = 1.37–1.57; Females: AOR = 2.19, 95%CI = 1.31–3.66) listened to radio (Males: AOR = 1.29, 95%CI = 1.18–1.41; Females: AOR = 1.42, 95%CI = 1.35–1.51), and who watched television (Males: AOR = 1.80, 95%CI = 1.64–1.97; Females: AOR = 1.86, 95%CI = 1.75–1.99) at least once a week had higher odds of being covered by health insurance. Conclusion The coverage of health insurance in SSA is generally low among urban dwellers. This has negative implications for the achievement of universal health coverage by the year 2030. We recommend increased public education on the benefits of being covered by health insurance using the mass media which we found to be an important factor associated with health insurance coverage. The focus of such mass media education could target the less educated urban dwellers, males in the lowest wealth quintile, and young adults (15–29 years).
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Cort, David A., Kathryn Reynolds et Debadatta Chakraborty. « HIV stigma beliefs and unprotected sex among teenagers and young adults in sub-Saharan Africa : The moderating role of mass media exposure ». Social Science & ; Medicine 317 (janvier 2023) : 115615. http://dx.doi.org/10.1016/j.socscimed.2022.115615.

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Kumar, BN, G. Holmboe-Ottesen, N. Lien et M. Wandel. « Ethnic differences in body mass index and associated factors of adolescents from minorities in Oslo, Norway : a cross-sectional study ». Public Health Nutrition 7, no 8 (décembre 2004) : 999–1008. http://dx.doi.org/10.1079/phn2004644.

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AbstractObjectives:To examine ethnic differences in body mass index (BMI), food habits and physical activity, and determine the factors contributing to differences in BMI.Design and method:In 2000–2001, 7343 (response rate 88%) 15- and 16-year-old students, enrolled in lower secondary schools in Oslo, participated in the cross-sectional Oslo Health Study. Of these participants, 1719 were defined as ethnic minorities.Results:Significant gender and ethnic differences in mean BMI were observed. Of the ethnic minority adolescents, 5.8% were underweight (<5th percentile of the US Centers for Disease Control and Prevention (CDC)/National Center for Health Statistics (NCHS) reference distribution) and 9.1% were overweight (>85th percentile of the US CDC/NCHS reference distribution). BMI was not significantly associated with either socio-economic factors or physical activity. Food habits and physical activity differed with ethnicity but not with socio-economic factors. An ordinal regression showed that girls from East Asia (odds ratio (OR) 0.4) and boys from sub-Saharan Africa (OR 0.4) had lower BMI than the Western group. Among girls, higher BMI was associated with less frequent consumption of chocolates and sweets, full-fat milk and breakfast (OR 2.4, 1.7 and 1.7, respectively). Higher BMI, for both boys and girls, was associated with current and past dieting (OR 3.7 and 4.2, respectively).Conclusions:Adolescent food habits and physical activity varied by gender and ethnicity but not with socio-economic factors. BMI was associated with ethnicity, gender and food habits, but no significant relationship was observed with socio-economic factors or physical activity. Ethnicity, in addition to gender, should be taken into consideration when studying BMI and associated factors among adolescents.
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Teshale, Achamyeleh Birhanu, Zemenu Tadesse Tessema, Adugnaw Zeleke Alem, Yigizie Yeshaw, Alemneh Mekuriaw Liyew, Tesfa Sewunet Alamneh, Getayeneh Antehunegn Tesema et Misganaw Gebrie Worku. « Knowledge about mother to child transmission of HIV/AIDS, its prevention and associated factors among reproductive-age women in sub-Saharan Africa : Evidence from 33 countries recent Demographic and Health Surveys ». PLOS ONE 16, no 6 (11 juin 2021) : e0253164. http://dx.doi.org/10.1371/journal.pone.0253164.

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Background In sub-Saharan Africa (SSA) 90 percent of babies acquired HIV/AIDS from infected mothers. Maternal knowledge about mother to child transmission (MTCT) of HIV/AIDS and its prevention is a cornerstone for elimination of MTCT of HIV/AIDS. Despite this, there is limited evidence about knowledge about MTCT of HIV/AIDS and its prevention and associated factors in SSA. Therefore, this study aimed to assess knowledge of MTCT of HIV/AIDS, its prevention (PMTCT) and, associated factors among reproductive-age women in sub-Saharan Africa. Objective To assess Knowledge about mother to child transmission of HIV/AIDS and its prevention and associated factors among reproductive-age women in Sub-Saharan Africa. Methods The recent SSA countries’ Demographic and Health Surveys (DHS), which were conducted from 2008/09 to 2018/19, was our data source. We appended 33 countries’ DHS data for our analysis. For our study, a total weighted sample of 350,888 reproductive-age women was used. Due to the hierarchical nature of the DHS data, we conducted a multilevel analysis. Finally, the adjusted odds ratio with its 95% confidence interval was reported, and variables with p-value≤0.05 were considered as significant predictors of knowledge of MTCT of HIV/AIDS and its prevention. Results In this study, 56.21% (95% CI: 56.05–56.38) of respondents had correct knowledge about MTCT of HIV/AIDS and its prevention among reproductive-age women in SSA. In the multilevel logistic regression analysis: being in the older age group, better education level, being from a rich household, having mass media exposure, having parity of one and above were associated with higher odds of knowledge about MTCT of HIV/AIDS and its prevention. However, being perceiving distance from the health facility as a big problem was associated with lower odds of knowledge about MTCT of HIV/AIDS and its prevention. Conclusion Knowledge about MTCT of HIV/AIDS and its prevention among reproductive-age women in SSA was low. Therefore, it is better to consider the high-risk groups during the intervention to increase awareness about this essential public health issue and to tackle its devastating outcome.
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Teshale, Achamyeleh Birhanu, et Getayeneh Antehunegn Tesema. « Discriminatory attitude towards people living with HIV/AIDS and its associated factors among adult population in 15 sub-Saharan African nations ». PLOS ONE 17, no 2 (4 février 2022) : e0261978. http://dx.doi.org/10.1371/journal.pone.0261978.

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Background Discrimination of people living with HIV/AIDS is one of the reported obstacles to the achievement of universal access to HIV/AIDS prevention, treatment, care, and support programs. Many international agencies have made combating HIV/AIDS stigma and discrimination a top priority. However, previous evidence in different parts of Africa revealed that the magnitude of HIV/AIDS-related discriminatory attitude is significantly high. Objective To assess discriminatory attitude towards people living with HIV/AIDS and its associated factors among the adult population in 15 sub-Saharan African nations. Methods We have used the 15 Demographic and Health Survey data that were conducted in sub-Saharan Africa (SSA) from 2015 to 2019/20. Each country’s data was appended and a total weighted sample of 318,186 (unweighted sample = 315,448) adults who had ever heard of AIDS was used for the final analysis. The two discriminatory attitude questions were used to get the outcome variable and those who answered “Yes” or “don’t know” for both questions were counted as if they had no discriminatory attitude towards people living with HIV/AIDS. To assess the factors associated with discriminatory attitude towards people living with HIV/AIDS, we have fitted a multilevel binary logistic regression model. Bivariable analysis was done to select eligible variables for the multivariable analysis. Finally, variables with p<0.05, in the multivariable analysis, were considered as significant predictors of discriminatory attitude towards people living with HIV/AIDS. Results The prevalence of discriminatory attitude towards HIV/AIDS in the 15 sub-Saharan African nations was 47.08% (95% CI: 47.08, 47.42), which ranges from 17.64% (95% CI: 17.22, 18.07) in Malawi to 79.75% (95% CI: 79.02, 80.45) in Guinea. In the multivariable analysis, both individual level and community level variables were significantly associated with discriminatory attitude towards people living with HIV/AIDS. Being younger age, no formal education, never married, low socioeconomic status, male-headed household, non-contraceptive use, no mass media exposure, and incorrect comprehensive knowledge towards HIV/AIDS were among the individual-level factors that were associated with higher odds of discriminatory attitude towards people living with HIV/AIDS. While being from urban residence and the western SSA region were among the community-level factors that were significantly associated with higher odds discriminatory attitude towards people living with HIV/AIDS. Conclusion The prevalence of discriminatory attitude towards people living with HIV/AIDS in 15 sub-Saharan African nations was high. Both individual and community-level factors were associated with discriminatory attitude towards people living with HIV/AIDS. Therefore, special attention should be given to those who are poor, uneducated, and younger adults. In addition, it is better to strengthen the accessibilities of different media for adult populations to create an appropriate attitude towards people with HIV/AIDS.
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Teshale, Achamyeleh Birhanu, et Getayeneh Antehunegn Tesema. « Timely initiation of breastfeeding and associated factors among mothers having children less than two years of age in sub-Saharan Africa : A multilevel analysis using recent Demographic and Health Surveys data ». PLOS ONE 16, no 3 (23 mars 2021) : e0248976. http://dx.doi.org/10.1371/journal.pone.0248976.

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Background Despite the significant advantages of timely initiation of breastfeeding (TIBF), many countries particularly low- and middle-income countries have failed to initiate breastfeeding on time for their newborns. Optimal breastfeeding is one of the key components of the SDG that may help to achieve reduction of under-five mortality to 25 deaths per 1000 live births. Objective To assess the pooled prevalence and associated factors of timely initiation of breastfeeding among mothers having children less than two years of age in sub-Saharan Africa. Methods We used pooled data from the 35 sub-Saharan Africa (SSA) Demographic and Health Surveys (DHS). We used a total weighted sample of 101,815 women who ever breastfeed and who had living children under 2 years of age. We conducted the multilevel logistic regression and variables with p<0.05, in the multivariable analysis, were declared significantly associated with TIBF. Results The pooled prevalence of TIBF in SSA was 58.3% [95%CI; 58.0–58.6%] with huge variation between countries, ranging from 24% in Chad to 86% in Burundi. Both individual and community level variables were associated with TIBF. Among individual-level factors; being older-aged mothers, having primary education, being from wealthier households, exposure to mass media, being multiparous, intended pregnancy, delivery at a health facility, vaginal delivery, single birth, and average size of the child at birth were associated with higher odds of TIBF. Of community-level factors, rural place of residence, higher community level of ANC utilization, and health facility delivery were associated with higher odds of TIBF. Conclusion In this study, the prevalence of TIBF in SSA was low. Both individual and community-level factors were associated with TIBF. The authors recommend interventions at both individual and community levels to increase ANC utilization as well as health facility delivery that are crucial for advertising optimal breastfeeding practices such as TIBF.
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Harris, Colette. « The functioning of gender, with special reference to the global south ». International Conference on Gender Research 5, no 1 (13 avril 2022) : pp97–104. http://dx.doi.org/10.34190/icgr.5.1.98.

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This paper proposes theorising gender through complementary sets of behavioural prescriptions or norms rather than by a focus on women (and men). It posits the idea that gender is integral to a disciplinary regime aimed at producing social order, with masculinity at its centre. What appear as advantages to men simultaneously pressure them into conforming to their cultural and socio-economic group’s notions of masculinity including exerting control over wives and offspring. Four complementary foundational norms for both sexes are identified. They evolved during the nineteenth-century in industrialised Europe and were spread to the global south first through Christianisation and colonialism and later through gender and development programmes and mass/social media. These norms are first economic support for sustaining material life versus social reproduction and caring; secondly, male disciplining of (submissive) wives and children; thirdly heterosexuality, marriage and the biological production of children; and fourthly men’s protection of vulnerable women and their ascriptive (ethnic/religious) group for the context, as also the state. These do not determine behaviour but oblige everyone to consider them in negotiating their own conduct, with the most insecure interpreting them most narrowly. The ideology of masculinism supports the regime at the macro level, while also influencing individual behaviour at grassroots. Drawing on cases from my work in Latin America and Sub-Saharan Africa, I show how this functions in practice in relation to how men treat each other and how it impinges on familial gender relations, with particular emphasis on Sub-Saharan Africa, and especially Kaduna, Nigeria. I also discuss how supporting men to delink their behaviour from the norms of masculinity (thus defying masculinism) can make a positive contribution to family life and I posit the importance of further research on the effects of the norms for both sexes to improve our understanding of the functioning of gender.
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Budu, Eugene, Bright Opoku Ahinkorah, Abdul-Aziz Seidu, Ebenezer Kwesi Armah-Ansah, Tarif Salihu, Richard Gyan Aboagye et Sanni Yaya. « Intention to use contraceptives among married and cohabiting women in sub-Saharan Africa : a multilevel analysis of cross-sectional data ». BMJ Open 12, no 11 (novembre 2022) : e060073. http://dx.doi.org/10.1136/bmjopen-2021-060073.

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ObjectiveTo examine the factors associated with intention to use contraceptives among married and cohabiting women in sub-Saharan Africa (SSA).DesignData for the study were extracted from the most recent Demographic and Health Surveys of 29 countries in SSA conducted from 2010 to 2020. We included a total of 180 682 women who were married or cohabiting. Multilevel regression analysis was carried out and the results were presented as adjusted odds ratio (AOR), with 95% confidence interval (CI).Setting29 countries in SSA.ParticipantsWomen aged 15–49 years in sexual unions.Outcome measureIntention to use contraceptives.ResultsThe pooled prevalence of intention to use contraceptives among married and cohabiting women in the 29 countries was 41.46%. The prevalence ranged from 18.28% in Comoros to 71.39% in Rwanda. Intention to use contraceptives was lower among women aged 45–49 (AOR=0.06, 95% CI= 0.05 to 0.07), those with no education (AOR=0.60, 95% CI= 0.58 to 0.61), and primary education (AOR=0.90, 95% CI 0.88 to 0.93), married women (AOR=0.81, 95% CI= 0.79 to 0.84), those of the poorest wealth quintile (AOR=0.78, 95% CI= 0.75 to 0.82), and women who were not exposed to mass media (AOR=0.87, 95% CI= 0.86 to 0.90). Women with four or more births (AOR=2.09, 95% CI= 1.99 to 2.19) had greater likelihood of contraceptive use intention compared to those with no birth. Women in rural settings were found to have greater likelihood of intention to use contraceptives compared to those in urban settings (AOR=1.10, 95% CI= 1.07 to 1.14).ConclusionThere is a low prevalence of contraceptive use intention among married and cohabiting women in SSA with differences between countries. It is imperative for policymakers to consider these factors when developing and executing contraceptive programmes or policies to enhance contraceptive intents and use among married and cohabiting women. To resolve discrepancies and increase contraceptive intention among women, policymakers and other key stakeholders should expand public health education programmes.
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Faye, Sylvain Landry B., Ralf Krumkamp, Seydou Doumbia, Moctar Tounkara, Ricardo Strauss, Henri Gautier Ouedraogo, Tani Sagna et al. « Factors influencing hesitancy towards adult and child COVID-19 vaccines in rural and urban West Africa : a cross-sectional study ». BMJ Open 12, no 4 (avril 2022) : e059138. http://dx.doi.org/10.1136/bmjopen-2021-059138.

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ObjectivesThis study aims: (1) to identify and describe similarities and differences in both adult and child COVID-19 vaccine hesitancy, and (2) to examine sociodemographic, perception-related and behavioural factors influencing vaccine hesitancy across five West African countries.DesignCross-sectional survey carried out between 5 May and 5 June 2021.Participants and setting4198 individuals from urban and rural settings in Burkina Faso, Guinea, Mali, Senegal and Sierra Leone participated in the survey.Study registrationThe general protocol is registered on clinicaltrial.gov.ResultsFindings show that in West Africa at the time only 53% of all study participants reported to be aware of COVID-19 vaccines, and television (60%, n=1345), radio (56%; n=1258), social media (34%; n=764) and family/friends/neighbours (28%; n=634) being the most important sources of information about COVID-19 vaccines. Adult COVID-19 vaccine acceptance ranges from 60% in Guinea and 50% in Sierra Leone to 11% in Senegal. This is largely congruent with acceptance levels of COVID-19 vaccinations for children. Multivariable regression analysis shows that perceived effectiveness and safety of COVID-19 vaccines increased the willingness to get vaccinated. However, sociodemographic factors, such as sex, rural/urban residence, educational attainment and household composition (living with children and/or elderly), and the other perception parameters were not associated with the willingness to get vaccinated in the multivariable regression model.ConclusionsPrimary sources of information about COVID-19 vaccines include television, radio and social media. Communication strategies addressed at the adult population using mass and social media, which emphasise COVID-19 vaccine effectiveness and safety, could encourage greater acceptance also of COVID-19 child vaccinations in sub-Saharan countries.Trial registration numberNCT04912284.
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Puplampu, Adikwor Ewoenam, Seth Afagbedzi, Samuel Dery, Dzifa Adimle Puplampu et Chris Guure. « Determinants of Higher-Risk Sexual Behavior in Some Selected African Countries ». Scientifica 2021 (3 septembre 2021) : 1–13. http://dx.doi.org/10.1155/2021/8089293.

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Background. Although higher-risk sexual behavior (H-RSB) is a major contributor to the rapid rising rate of new HIV infections, there exists paucity of comprehensive evidence across the sub-Saharan African region. The purpose of this study was to determine the prevalence of H-RSB and its determinants across sub-Saharan Africa to inform policy. Method. Data were obtained from the Demographic and Health Survey (DHS) of ten sub-Saharan African (SSA) countries with their three most current DHS surveys from 2000 to 2016. Only participants who ever had sexual encounters in their lifetime were included in the study. Weighted adjusted Cox regression with robust variance and constant time was used to investigate disparities of H-RSB among the ten SSA countries. Relationships between sociodemographic, socioeconomic, knowledge, mass media, and H-RSB were investigated. Results. The trend and prevalence of higher-risk sexual behavior show that Lesotho experienced a decreasing trend of the prevalence of H-RSB from 8.92 in period one to 6.42 in period three. Ghana experienced a marginal increase from 6.22 in period one to 6.76 in period two and then to 6.43 in the third period. However, Malawi, Zambia, and Zimbabwe obtained a marginal increasing trend in the prevalence of H-RSB from period one to three: 2.75 to 3.74, 4.33 to 6.24, and 6.11 to 7.99, respectively. Meanwhile, the prevalence of H-RSB in Namibia and Uganda decreased in period two to 1.84 and 5.76 but increased in period three to 2.01 and 6.83, respectively. Generally, determinants of H-RSB among the countries include age, sex, religious affiliation, marital status, educational level, employment status, economic status, age at first sex, and status of circumcision. Conclusion. Trend of relatively high prevalence of H-RSB has been found across majority of the countries with key sociodemographic factors influencing H-RSB. Therefore, different targeted interventional approaches are needed in all the countries to help reduce H-RSB and the overall HIV incidence. If issues regarding sexual behavior and sexual health are not addressed adequately, H-RSB can negate all the appreciable efforts aimed at ending the HIV pandemic by 2030.
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Seidu, Abdul-Aziz. « Mixed effects analysis of factors associated with barriers to accessing healthcare among women in sub-Saharan Africa : Insights from demographic and health surveys ». PLOS ONE 15, no 11 (9 novembre 2020) : e0241409. http://dx.doi.org/10.1371/journal.pone.0241409.

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Background Access to healthcare is one of the key global concerns as treasured in the Sustainable Development Goals. This study, therefore, sought to assess the individual and contextual factors associated with barriers to accessing healthcare among women in sub-Saharan Africa (SSA). Materials and methods Data for this study were obtained from the latest Demographic and Health Surveys (DHS) conducted between January 2010 and December 2018 across 24 countries in SSA. The sample comprised 307,611 women aged 15–49. Data were analysed with STATA version 14.2 using both descriptive and multilevel logistic regression modelling. Statistical significance was set at p<0.05. Results It was found that 61.5% of women in SSA face barriers in accessing healthcare. The predominant barriers were getting money needed for treatment (50.1%) and distance to health facility (37.3%). Women aged 35–39 (AOR = 0.945, CI: 0.911–0.980), married women (AOR = 0.694, CI: 0.658–0.732), richest women (AOR = 0.457, CI:0.443–0.472), and those who read newspaper or magazine at least once a week (AOR = 0.893, CI:0.811–0.983) had lower odds of facing barriers in accessing healthcare. However, those with no formal education (AOR = 1.803, CI:1.718–1.891), those in manual occupations (AOR = 1.551, CI: 1.424–1.689), those with parity 4 or more (AOR = 1.211, CI: 1.169–1.255), those who were not covered by health insurance (AOR = 1.284, CI: 1.248–1.322), and those in rural areas (AOR = 1.235, CI:1.209–1.26) had higher odds of facing barriers to healthcare access. Conclusion Both individual and contextual factors are associated with barriers to healthcare accessibility in SSA. Particularly, age, marital status, employment, parity, health insurance coverage, exposure to mass media, wealth status and place of residence are associated with barriers to healthcare accessibility. These factors ought to be considered at the various countries in SSA to strengthen existing strategies and develop new interventions to help mitigate the barriers. Some of the SSA African countries can adopt successful programs in other parts of SSA to suit their context such as the National Health Insurance Scheme (NHIS) and the Community-based Health Planning and Services concepts in Ghana.
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Guyon, Agnès B., Victoria J. Quinn, Michael Hainsworth, Priscilla Ravonimanantsoa, Voahirana Ravelojoana, Zo Rambeloson et Luann Martin. « Implementing an Integrated Nutrition Package at Large Scale in Madagascar : The Essential Nutrition Actions Framework ». Food and Nutrition Bulletin 30, no 3 (septembre 2009) : 233–44. http://dx.doi.org/10.1177/156482650903000304.

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Background Madagascar has some of the highest rates of child stunting, maternal malnutrition, and infant mortality in sub-Saharan Africa. Objective To improve infant and young child feeding practices, increase uptake of micronutrient supplements, and improve women's dietary practices through implementation of a nutrition project based on the Essential Nutrition Actions (ENA) framework. Methods Interventions included training, interpersonal communication, community mobilization, and mass media. Changes in practices were assessed through a comparison of data for children under 2 years of age from representative cross-sectional household surveys collected at baseline in 2000 ( n = 1,200) and at the end of program implementation in 2005 ( n = 1,760). The surveys were conducted in six districts with a population of 1.4 million. Results The rate of initiation of breastfeeding within 1 hour of birth increased from 32% to 68%, the rate of exclusive breastfeeding of infants under 6 months of age increased from 42% to 70%, the rate of continuation of breastfeeding at 20 to 23 months increased from 43% to 73%, the rate of feeding children the minimum recommended number of meals per day at 6 to 23 months increased from 87% to 93%, the rate of iron–folic acid supplementation during pregnancy increased from 32% to 76%, and the rate of postpartum vitamin A supplementation increased from 17% to 54% ( p <.001 for all changes). Modest improvement was achieved in maternal dietary practices during lactation and feeding of the sick child after illness. The results were inconclusive regarding food diversity for complementary feeding. No improvements were reported in increasing food intake during child illness or pregnancy. Conclusions The ENA framework allows broad-scale improvement of nutritional practices to be achieved through the maximization of contacts using multiple program opportunities within existing health systems and community structures and through mass media.
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Hollowell, Jennifer, Mari Dumbaugh, Mireille Belem, Sylvain Kousse, Tessa Swigart, Chantal Korsaga, Pokiandi Solange Lankoande, Kokovi Hogban Lawson et Zelee Hill. « ‘Grandmother, aren’t you going to sing for us?’ Current childcare practices and caregivers’ perceptions of and receptivity to early childhood development activities in rural Burkina Faso ». BMJ Global Health 4, no 2 (mars 2019) : e001233. http://dx.doi.org/10.1136/bmjgh-2018-001233.

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IntroductionEffective stimulation and responsive caregiving during the first 2 years is crucial for children’s development. By age 3–4 years, over 40% of children in sub-Saharan Africa fail to meet basic cognitive or socioemotional milestones, but there are limited data on parenting and childcare practices. This study, conducted to inform the design of a mass media intervention, explored practices, perceptions, motivators and obstacles to childhood development-related practices among parents and caregivers of children aged 0–2 years in rural Burkina Faso.MethodsWe performed two rounds of six focus groups with 41 informants in two villages, using an adapted version of the Trials of Improved Practices methodology. These first explored beliefs and practices, then introduced participants to the principles and benefits of early childhood development (ECD) and provided illustrative examples of three practices (interactive ways of talking, playing and praising) to try with their children. One week later, further discussions explored participants’ experiences and reactions. Data were analysed inductively using thematic content analysis.ResultsExisting activities with young children were predominantly instructive with limited responsive interaction and stimulation. Participants were receptive to the practices introduced, noted positive changes in their children when they adopted these practices and found engagement with children personally rewarding.ConclusionInteractive, stimulating activities with young children did not appear to be widespread in the study area, but caregivers were receptive to information about the importance of early stimulation for children’s development. ECD messages should be tailored to the local sociocultural context and consider time limitations.
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Konlan, Kennedy D., Roberta M. Amoah, Joel A. Saah, Abdul Razak Doat, Kennedy Dodam Konlan, Milipaak Japiong et Juliana A. Abdulai. « The use of emergency contraception among female senior high students in the Ho municipality of the Volta Region, Ghana ». International Journal of Reproduction, Contraception, Obstetrics and Gynecology 9, no 6 (27 mai 2020) : 2383. http://dx.doi.org/10.18203/2320-1770.ijrcog20202316.

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Background: Emergency contraception (EC) is one option for preventing unplanned pregnancy when it is available and properly used. Unsafe abortions are responsible for nearly one third of maternal deaths in sub-Saharan Africa and about quarter of unsafe abortions are among teenagers.Methods: A quantitative descriptive cross-sectional study. Data was collected using a pretested questionnaire. 260 senior high students were selected using a systematic sampling method in the Volta Region, Ghana. Data were cleaned and entered into SPSS version 22 and analysed into descriptive statistics.Results: Respondents acquired awareness about EC from friends (36.9%), family members (5.6%) and the mass media (41.6%). The required time for EC to be taken were stated as immediately after sex (57.9%), 24 hours after sex (1.2%) and (30.6%) did not know. 28.4% of participants indicated they would not use EC in the future as their faith was against it, 18.0% believed EC is ineffective and 24.9% consider it dangerous to their health. Reasons for use of EC included condom slipped (35.7%), inability to be on daily pill (33.7%), forced unprotected sex (8.2%) and miscalculation of the safe menstrual period (22.4%). There was a significant relationship between age and history of use of EC (p=0.000, c2=8.128, n=260).Conclusions: Strengthening education in Senior High Schools on sexual and reproductive health, with special emphasis on emergency contraceptives as a pregnancy preventive procedure will remain imperative to reducing the canker of maternal mortality attributed to adolescent abortions while improving understanding of the appropriate use of EC.
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Aboagye, Richard Gyan, Joshua Okyere, Abdul-Aziz Seidu, John Elvis Hagan et Bright Opoku Ahinkorah. « Experience of Intimate Partner Violence among Women in Sexual Unions : Is Supportive Attitude of Women towards Intimate Partner Violence a Correlate ? » Healthcare 9, no 5 (11 mai 2021) : 563. http://dx.doi.org/10.3390/healthcare9050563.

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Intimate partner violence (IPV) is predominant in sub-Saharan Africa (SSA), with nearly 40 percent of women reporting IPV at some point in time. In this study, we investigated whether a supportive attitude towards IPV is associated with past-year experience of IPV among women in sexual unions in SSA. This study involved a cross-sectional analysis of data from the Demographic and Health Survey (DHS) of 23 countries in SSA. Bivariate and multivariable binary logistic regression analyses were performed to determine the association between attitude towards IPV and past-year experience of IPV. The regression results were presented in a tabular form using crude odds ratio (cOR) and adjusted odds ratio (aOR) at 95% confidence intervals (CIs). In the pooled countries, we found that women who had supportive attitude towards IPV were more likely to experience IPV compared to those who rejected IPV (cOR = 1.72, 95% CI = 1.64, 1.79), and this persisted after controlling for maternal age, marital status, wealth, maternal education level, place of residence, and mass-media exposure (aOR = 1.72, 95% CI = 1.64, 1.79). The same trend and direction of association between attitude towards IPV and experience of IPV was also found in all the 23 studied countries. This study has demonstrated that women who accept IPV are more likely to experience IPV. Hence, we recommend that efforts to end IPV must focus primarily on changing the attitudes of women. This goal can be achieved by augmenting women’s empowerment, education, and employment interventions, as well as sensitizing women in relation to the deleterious ramifications of accepting IPV. Furthermore, reducing IPV is critical towards the achievement of Sustainable Development Goal 3.
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Lawal, Folake B., et Abimbola M. Oladayo. « Sources and Factors Related to Oral Health-Care Information Among Dental Patients of a Teaching Hospital in Ibadan, Nigeria ». International Quarterly of Community Health Education 40, no 1 (4 mars 2019) : 17–22. http://dx.doi.org/10.1177/0272684x19833847.

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Background The World Health Organization has described oral diseases as a global health problem in developing countries and this is mainly attributed to low level of oral health awareness. It, therefore, becomes imperative to investigate how people are informed about oral health care. Aim To determine the sources of oral health-care information and predictors of oral health awareness among individuals seeking dental care at a major tertiary health institution in sub-Saharan Africa. Methods A cross-sectional study was conducted among patients aged 16 years and older attending the dental outpatients of a major teaching hospital using structured questionnaires. Data obtained were analyzed with SPSS version 23. Results A total of 292 patients with a mean age of 38.4 ( SD = 16.3) years participated in the study of which 188 (64.4%) had been educated about oral health prior to the dental consultation. The major source of oral health-care information was dental clinics for 174 (92.6%) participants. The educators or resource persons were mainly dentists 105 (55.9%) and nurses or therapists 67 (35.6%). Females were more likely to have received oral health-care information (odds ratio [ OR] = 1.8, CI [1.1, 3.0], p = .021). Those with previous dental visits were also more likely to have received information about oral health care ( OR = 2.6, CI [1.6, 4.2], p < .001). Conclusion Dental clinics and dentists were the major sources of oral health-care information; being female and previous dental visits were significant positive predictors of being a recipient of oral health-care information. Dental public health education through mass and social media should be made a priority to improve access to oral health-care information.
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Komodromos, Marcos. « Interactive radio, social network sites and development in Africa : a literature review study ». Journal of Enterprising Communities : People and Places in the Global Economy 15, no 2 (5 avril 2021) : 282–95. http://dx.doi.org/10.1108/jec-06-2020-0111.

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Purpose The technology determinism theory facilitated in assessing the impact of interactive radio and social network sites (SNSs) on development factors such as education, agriculture, health, and governance, by conducting an integrative and comprehensive literature review focusing on African countries. This paper aims to conduct this literature review to provide comprehensive empirical evidence on the impact of interactive radio and SNSs on development in Africa. Design/methodology/approach This study examined articles that were retrieved from online databases including EBSCOhost, Elsevier, Science Direct, SAGE Journals, Springer and Wiley Online Library. The keywords used included interactive radio, radio, development in Africa, SNS, agriculture, education, health, peace and governance. Search phrases were formulated using boolean operators “AND” and “OR.” Findings Study results revealed that interactive radio and SNSs improve knowledge among farmers and allow the dissemination of information on innovative agricultural techniques, which supports the adoption of sustainable practices. Interactive radio promotes political accountability because the strategies provide the voiceless and powerless communities with a platform to express themselves. This paper discovers that the incorporation of SNS with existing multimedia communication facilitates the dissemination of health-related information on illnesses such as Ebola, HIV, hypertension, diabetes and Polio, and interactive radio and SNS promote education among marginalized communities and under-served rural schools. Research limitations/implications The findings on the impact of interactive radio and SNSs do not represent all 54 countries in Africa. Although the studies included in this literature review were conducted in several countries such as South Africa, Nigeria, Somalia, Kenya, Malawi, Ghana, Tanzania, Uganda and Zambia, this limited the generalizability of the findings and recommendations. Also, the other potential limitation is that using the inclusion-exclusion criteria could have resulted in bias when selecting the studies to include in the review. Practical implications The paper might serve as a valuable source of information for students, academics and entrepreneurs where the impact of interactive radio and SNSs on agriculture, education, health and governance, which are core determinants of development in Africa, has been assessed for further case studies in this area. Social implications The use of interactive radio has helped in decreasing health issues caused by a deficiency in vitamin A among children in sub-Saharan Africa. Originality/value The development of sustainable and effective interactive radio programs is dependent on the collaboration of the core stakeholders such as governmental ministries, donor organizations and the mass communication sector. Numerous open sources on technology radio stations are available to employ social media managers to help in the application of knowledge.
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Chukwu, Chinedu, Herbert Onuoha, Kwala Adline Katty Okorafor, Oluwaseun Ojomo, Olugbenga A. Mokuolu et Michael Ekholuenetale. « Geopolitical zones differentials in intermittent preventive treatment in pregnancy (IPTp) and long lasting insecticidal nets (LLIN) utilization in Nigeria ». PLOS ONE 16, no 7 (16 juillet 2021) : e0254475. http://dx.doi.org/10.1371/journal.pone.0254475.

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Background The coverage of long lasting insecticidal nets (LLIN) and intermittent preventive treatment of malaria in pregnancy (IPTp) uptake for the prevention of malaria commonly vary by geography. Many sub-Saharan Africa (SSA) countries, including Nigeria are adopting the use of LLIN and IPTp to fight malaria. Albeit, the coverage of these interventions to prevent malaria across geographical divisions have been understudied in many countries. In this study, we aimed to explore the differentials in LLIN and IPTp uptake across Nigerian geopolitical zones. Methods We analyzed data from Nigeria Multiple Indicator Cluster Survey (MICS) 2016–17. The outcome variables were IPTp and LLIN uptake among women of childbearing age (15–49 years). A total sample of 24,344 women who had given birth were examined for IPTp use and 36,176 women for LLIN use. Percentages, Chi-square test and multivariable logit models plots were used to examine the geopolitical zones differentials in IPTp and LLIN utilization. Data was analyzed at 5% level of significance. Results The overall prevalence of IPTp was 76.0% in Nigeria. Moreover, there were differences across geopolitical zones: North Central (71.3%), North East (76.9%), North West (78.2%), South East (76.1%), South South (79.7%) and South West (72.4%) respectively. Furthermore, the prevalence of LLIN was 87.7%% in Nigeria. Also, there were differences across geopolitical zones: North Central (89.1%), North East (91.8%), North West (90.0%), South East (77.3%), South South (81.1%) and South West (69.8%) respectively. Women who have access to media use, married, educated and non-poor were more likely to uptake IPTp. On the other hand, rural dwellers and those with media use were more likely to use LLIN. Conversely, married, educated, non-poor and women aged 25–34 and 35+ were less likely to use LLIN. Conclusion Though the utilization of IPTp and LLIN was relatively high, full coverage are yet to be achieved. There was geopolitical zones differentials in the prevalence of IPTp and LLIN in Nigeria. Promoting the utilization of IPTp and LLINs across the six geopolitical zones through intensive health education and widespread mass media campaigns will help to achieve the full scale IPTp and LLIN utilization.
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Musoke, David, Rawlance Ndejjo, Solomon Tsebeni Wafula, Simon Kasasa, Jessica Nakiyingi-Miiro et Miph Boses Musoke. « Malaria health seeking practices for children, and intermittent preventive treatment in pregnancy in Wakiso District, Uganda ». African Health Sciences 21, no 4 (14 décembre 2021) : 1722–32. http://dx.doi.org/10.4314/ahs.v21i4.28.

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Background: Timely health care among children with suspected malaria, and intermittent preventive treatment (IPTp) in pregnancy avert related morbidity and mortality in endemic regions especially in sub-Saharan Africa. Malaria burden has steadily been declining in endemic countries due to progress made in scaling up of such important interventions. Objectives: The study assessed malaria health seeking practices for children under five years of age, and IPTp in Wakiso district, Uganda. Methods: A structured questionnaire was used to collect data from 727 households. Chi-square and Fisher’s exact tests were performed in STATA to ascertain factors associated with the place where treatment for children with suspected malaria was first sought (government versus private facility) and uptake of IPTp. Results: Among caretakers of children with suspected malaria, 69.8% sought care on the day of onset of symptoms. The place where treatment was first sought for the children (government versus private) was associated with participants’ (household head or other adult) age (p < 0.001), education level (p < 0.001) and household income (p = 0.011). Among women who had a child in the five years preceding the study, 179 (63.0%) had obtained two or more IPTp doses during their last pregnancy. Uptake of two or more IPTp doses was associated with the women’s education level (p = 0.006), having heard messages about malaria through mass media (p = 0.008), knowing the recommended number of IPTp doses (p < 0.001), and knowing the drug used in IPTp (p < 0.001). Conclusion: There is need to improve malaria health seeking practices among children and pregnant women particularly IPTp through programmes aimed at increasing awareness among the population. Keywords: Health seeking behaviour; intermittent preventive treatment; malaria; children; pregnancy; Uganda.
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Amedonu, Edem Kojo, Joshua Kwabena Aniaku et Adam Fusheini. « Assessment of High School Students’ Knowledge, Attitudes and Vaccination Status of Hepatitis B Virus in Hohoe, Ghana : A Cross-sectional Study ». Open Public Health Journal 13, no 1 (21 juin 2020) : 298–305. http://dx.doi.org/10.2174/1874944502013010298.

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Background: Hepatitis B Virus (HBV) is a highly infectious disease and a major global public health threat. About one-third of the world’s population is estimated to be infected with Sub-Saharan Africa and East Asia, regarded as high prevalence regions of between 5-10% of the adult population chronically infected. Comprehensive knowledge of HBV in highly endemic areas like Ghana among population groups is crucial to mitigating the effects of the disease. Thus, the objective of this study was to assess the knowledge of students of two high schools on the Hepatitis B Virus (HBV) in the Hohoe Municipality of the Volta Region of Ghana to identify and describe their risk of infection, attitude, test, and vaccination status. Methods: A descriptive cross-sectional survey was conducted in the two Senior High Schools. The survey involved 244 students of both boys and girls from years one to three. Recruitment was through a stratified simple random sampling technique. Data was collected via respondents’ self-administered questionnaire. Data was analysed using STATA version 12.0. Results: The results of the study showed moderate knowledge, especially of the modes of transmission and prevention among the majority of the respondents (89.2%). Protection against the virus was a concern as about 19.5% reported receiving the HBV vaccine, with 7.2% completing all three doses. Respondents also showed a generally positive disposition towards the disease. The school and mass media were the main sources of information about HBV. Conclusion: The findings of the study showed that high school students (teenagers) have various misconceptions about HBV as the majority of students in the Hohoe municipality had moderate knowledge of HBV. The study also established that teenagers are at risk of contracting the virus, given the low vaccination status, as seen in the study.
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Nicolaou, Veronique, Larske Soepnel, Kenneth Huddle, Kerstin Klipstein-Grobusch, Naomi S. Levitt et Shane A. Norris. « Cardiometabolic outcomes of women exposed to hyperglycaemia first detected in pregnancy at 3-6 years post-partum in an urban South African setting ». PLOS ONE 17, no 2 (9 février 2022) : e0263529. http://dx.doi.org/10.1371/journal.pone.0263529.

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Background Hyperglycaemia first detected during pregnancy(HFDP) has far-reaching maternal consequences beyond the pregnancy. Our study evaluated the cardiometabolic outcomes in women with prior HFDP versus women without HFDP 3–6 years post-partum in urban South Africa. Design and methods A prospective cohort study was performed of 103 black African women with prior HFDP and 101 without HFDP, 3–6 years post-partum at Chris Hani Baragwanath Academic Hospital, Soweto. Index pregnancy data was obtained from medical records. Post-partum, participants were re-evaluated for anthropometric measurements, body composition utilizing dual energy X-ray absorptiometry(DXA) and biochemical analysis (two-hour 75gm OGTT fasting insulin, lipids, creatinine levels and glucose levels). Cardiovascular risk was assessed by Framingham risk score(FRS). Carotid intima media thickness(cIMT) was used as a surrogate marker for subclinical atherosclerosis. Factors associated with progression to cardiometabolic outcomes were assessed using multivariable logistic and linear regression models. Results Forty-six(45.1%) HFDP women progressed to diabetes compared to 5(4.9%) in non HFDP group(p<0.001); only 20(43.4%) were aware of their diabetic status in the whole group. The odds(OR, 95% confidence interval(CI)) of progressing to type 2 diabetes(T2DM) and metabolic syndrome(MetS) after correcting for confounders in the HFDP group was 10.5(95% CI 3.7–29.5) and 6.3(95%CI 2.2–18.1), respectively. All visceral fat indices were found to be significantly higher in the HFDP group after adjusting for baseline body mass index. Ten-year estimated cardiovascular risk(FRS) and mean cIMT was statistically higher in the HFDP group(8.46 IQR 4.9–14.4; 0.48 mm IQR 0.44–0.53 respectively) compared to the non-HFDP group(3.48 IQR 2.1–5.7; 0.46mm IQR 0.42–0.50) respectively and this remained significant for FRS but was attenuated for cIMT after correcting for confounders. HIV did not play a role in progression to any of these outcomes. Conclusion Women with a history of HFDP have a higher risk of cardiometabolic conditions within 6 years post-partum in an urban sub-Saharan African setting.
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Tsega, Daniel, Melaku Admas, Asmare Talie, Tesfa Birlew Tsega, Molla Yigzaw Birhanu, Simegn Alemu et Belayneh Mengist. « Maternity Continuum Care Completion and Its Associated Factors in Northwest Ethiopia ». Journal of Pregnancy 2022 (17 février 2022) : 1–10. http://dx.doi.org/10.1155/2022/1309881.

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Background. Continuum care is a basic package approach for women to receive essential services throughout pregnancy, childbirth, and postpartum, and it is critical for women and their infants’ survival and well-being. Although it is an effective strategy for improving maternal and child health, it has not been implemented adequately in less developed countries, primarily in sub-Saharan Africa, including Ethiopia, where 55% of women have been dropped out from the continuum of care. Therefore, this study is aimed at assessing maternity continuum care completion and its associated factors within northwest Ethiopia, 2020. Materials and Methods. A community-based cross-sectional study design was considered among 504 women from March 10 to March 30, 2020, using pretested and structured questionnaires administered via face-to-face interviews. To select study participants, a simple random sampling technique was used. Data were coded, checked, and entered into EpiData software (V. 4.2), then transferred to SPSS (V. 25) for further analysis. A bivariable analysis with 95% CI was performed, and variables with P 0.25 during binary logistic regression were entered into a multivariable analysis to assess predictors’ independent effect. Results. About 177 (37.6%) women completed maternal continuum care. Women with secondary education and above ( AOR = 2.75 , 95% CI 1.42-5.32), urban residence ( AOR = 2.45 , 95% CI 1.35-4.45), using ambulance transport ( AOR = 3.96 , 95% CI 2.19-7.19), mass media exposure ( AOR = 3.64 , 95% CI 2.02-6.56), and distance from health facilities ( AOR = 3.22 , 95% CI 1.84-5.63) showed significant positive associations with completion of maternity continuum care. Conclusion. However, a higher proportion of mothers completed the continuum of maternity care in the district than Ethiopian Demographic and Health Survey 2016 (9.1%); further interventions are compulsory to reach the acceptable level. Hence, comprehensive awareness-raising, education, and promotion activities at the community and health facility levels and empowering women in health care and decision-making backing to expand the completion of maternity continuum of care are necessary.
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Dey, Teesta, Sam Ononge, Andrew Weeks et Lenka Benova. « Immediate postnatal care following childbirth in Ugandan health facilities : an analysis of Demographic and Health Surveys between 2001 and 2016 ». BMJ Global Health 6, no 4 (avril 2021) : e004230. http://dx.doi.org/10.1136/bmjgh-2020-004230.

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IntroductionProgress in reducing maternal and neonatal mortality, particularly in sub-Saharan Africa, is insufficient to achieve the Sustainable Developmental Goals by 2030. The first 24 hours following childbirth (immediate postnatal period), where the majority of morbidity and mortality occurs, is critical for mothers and babies. In Uganda,<50% of women reported receiving such care. This paper describes the coverage, changes over time and determinants of immediate postnatal care in Uganda after facility births between 2001 and 2016.MethodsWe analysed the 2006, 2011 and 2016 Ugandan Demographic and Health Surveys, including women 15–49 years with most recent live birth in a healthcare facility during the survey 5-year recall period. Immediate postnatal care coverage and changes over time were presented descriptively. Multivariable logistic regression was used to examine determinants of immediate postnatal care.ResultsData from 12 872 mothers were analysed. Between 2006 and 2016, births in healthcare facilities increased from 44.6% (95% CI: 41.9% to 47.3%) to 75.2% (95% CI: 73.4% to 77.0%) and coverage of immediate maternal postnatal care from 35.7% (95% CI 33.4% to 38.1%) to 65.0% (95% CI: 63.2% to 66.7%). The majority of first checks occurred between 1 and 4 hours post partum; the median time reduced from 4 hours to 1 hour. The most important factor associated with receipt of immediate postnatal care was women having a caesarean section birth adjusted OR (aOR) 2.93 (95% CI: 2.28 to 3.75). Other significant factors included exposure to mass media aOR 1.38 (95% CI: 1.15 to 1.65), baby being weighed at birth aOR 1.84 (95% CI: 1.58 to 2.14) and receipt of antenatal care with 4+Antenatal visits aOR 2.34 (95% CI: 1.50 to 3.64).ConclusionIn Uganda, a large gap in coverage remains and universal immediate postnatal care has not materialised through increasing facility-based births or longer length of stay. To ensure universal coverage of high-quality care during this critical time, we recommend that maternal and newborn services should be integrated and actively involve mothers and their partners.
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Tewodros, Tsedenia, Liris Berra, Carolina Escobar et Amy Webb Girard. « Systematic Review of Social Behavior Change Strategies and Behavior Change Techniques Used in Nutrition Sensitive Agriculture Interventions ». Current Developments in Nutrition 6, Supplement_1 (juin 2022) : 867. http://dx.doi.org/10.1093/cdn/nzac065.051.

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Abstract Objectives While social behavior change (SBC) is an important component of nutrition sensitive agriculture interventions (NSeAI), there is limited research on what specific behavior change techniques (BCT) are effective. This systematic review aims to 1) describe SBC design and implementation in the context of NSeAI 2) examine the BCTs used in NSeAI and 3) quantify associations between BCTs and improvements in diet diversity. Methods Literature on NSeAI with nutrition SBC was systematically reviewed. Papers published in 2000–2021, aimed to improve diet quality, and described nutrition SBC activities were selected. Agriculture-nutrition pathways and SBC approaches used by interventions were mapped. BCTs were coded using a validated taxonomy. Effectiveness ratios (ERs) were calculated to assess BCTs in relation to program success. Trials were considered effective if there was significant improvement (P &lt; 0.05) in household, women's, and child diet diversity. Results Of the 56 interventions included in the study, most were in Sub-Saharan Africa (n = 30) and Asia (n = 21). Thirty-three interventions used formative research to guide SBC design; only six discussed applying a specific behavioral theory. Interventions aimed to increase home production for home consumption (n = 54); increase women's empowerment (n = 30) and increase agricultural income (n = 25) as a pathway to improved nutrition. Fifty-two projects used interpersonal communication, 36 projects used community engagement and 12 used mass media as an approach to behavior change. The most frequently used BCTs included “instructions on how to perform the behavior” (n = 56), “social support (unspecified)” (n = 39), and using a “credible source” for information dissemination (n = 35). On average, projects used 7 BCTs. The BCT “behavioral practice” had the highest effectiveness ratio (ER = 1.0). Conclusions Interventions focused predominantly on the home production for home consumption pathway. Women's empowerment and agriculture for income pathways were less frequent. All interventions provided instructions on how to perform the behavior but relatively few provided opportunities for ‘behavioral practice’; however, this BCT had the highest effectiveness ratio with all interventions using this BCT demonstrating significant improvements in diet quality. Funding Sources Bill & Melinda Gates Foundation.
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Tembo, Moses C., Elias Kuntashula et Thomson Kalinda. « Climate Change Awareness and Joint Decision to Adopt Agroforestry and Conservation Agriculture Practices in Zambia ». Journal of Sustainable Development 10, no 4 (30 juillet 2017) : 107. http://dx.doi.org/10.5539/jsd.v10n4p107.

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Climate change is one of the biggest challenges that small holder farmers face in Sub-Saharan Africa, including Zambia. In response to this, various interventions such as Agroforestry (AF) and Conservation Agriculture (CA) have been promoted within the country so as to enhance uptake among farmers and ultimately mitigate climate change. However, the adoption rates of these technologies has been low. To understand the adoption process several adoption studies have focused on the effects of socio-economic and other institutional factors on adoption of the technologies. The direct link between small holder farmer’s climate change awareness and the uptake of both AF and CA is an area that has received less attention among these studies. This paper estimates the effect of climate change awareness on the adoption of AF and CA, and establishes whether the adoption of the two technologies is jointly determined in Zambia. Data used emanated from the Indaba Agricultural Policy Research Institute (IAPRI) and University of Zambia (UNZA) Climate Change and Land Use Project that implemented a supplemental climate change survey in 2013 on Rural Agricultural Livelihood Survey (RALS 2012) panel sample of 1,231 households in six districts of Zambia. Results showed that the majority of farmers (77.2 %) were aware of climate change issues and their consequences on agriculture production and the environment. It was also observed that holding other factors constant, a farmer aware of climate change and its consequences was 6% more likely to adopt both AF and CA compared to those not aware. The decision to adopt AF and CA was found to be jointly determined by farmers. In addition to climate change awareness, the other factors affecting the joint decision to adopt the two technologies included gender, farmer group membership of the household head as well as ownership of radio sets and rippers. There is need therefore to deliberately increase climate change awareness among smallholder farmers and promote the simultaneous uptake of both AF and CA through the mass media and the provision of an environment that increases accessibility to tools that ease up the uptake of these technologies.
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Abigail Marnah et Stephen Manortey. « Prevalence and risk factors for motorcycle accidents presenting to the Korle-Bu Teaching Hospital, Ghana ». World Journal of Advanced Research and Reviews 16, no 1 (30 octobre 2022) : 368–82. http://dx.doi.org/10.30574/wjarr.2022.16.1.1048.

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Introduction: Road traffic injury is of great public health concern, as it stands as the eighth leading cause of death globally with the most affected being the youth aged 15-29 years. It is projected that by 2030, road traffic deaths will become the fifth leading cause of death globally unless urgent action is taken to avert it. Lack of employment has forced many youths in Sub-Saharan Africa into the commercial use of motorcycles known commonly as “Okada” business. Unfortunately, most of these riders do not undertake any formal and structured training or are licensed to be riders. Motorcyclists are among the most vulnerable road users in Ghana; they contribute to about 34% of all road traffic injuries. There is a progressive increase in motorcycle-related accidents as a result of the rise in the use of these bikes for commercial transport despite it being illegal. Statistics from the National Road Safety Commission of Ghana indicate that in 2020 road traffic crashes involving motorcycles killed 1,056 and injured 4,684 commuters. The primary aim of this study is to identify the prevalence and the associated risk factors for motorcycle accident cases and to assess the knowledge of motorcyclists’ on-road regulations on admission at the Korle-Bu Teaching Hospital, a national referral point for all emergency cases in Ghana. Methods: The study employed a cross-sectional design that used a structured questionnaire to collect data from 200 respondents using a systematic sampling technique for enrolment. Pearson's Chi-square test statistics were used to estimate the association between helmet usage and respondents’ knowledge level of road regulations on selected socio-demographic characteristics. Results: The results revealed that demographic characteristics such as age (p <0.001), marital status (p<0.001), education (p=0.035) and occupation (p=0.002) have shown a strong association with helmet use. Further analysis conducted on respondents’ knowledge level of road regulations showed a statistically significant association with their education (p <0.001), religion (p=0.001) and occupation (p=0.006). Less than 40% of the participants reported insuring their motors and having valid national health insurance. The accident victims attributed the cause of their situation to non-adherence to road signs and overspeeding. Conclusion: Motorcycle-related accidents could be reduced through law enforcement agencies, continuous mass education using all media available and helmet use. Also, there should be a collaboration between all road sectors and road users to find a solution to the current motor accident trend.
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« Mass media in sub-Saharan Africa ». Choice Reviews Online 33, no 06 (1 février 1996) : 33–3138. http://dx.doi.org/10.5860/choice.33-3138.

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Budu, Eugene, Bright Opoku Ahinkorah, Joshua Okyere, Abdul-Aziz Seidu, Richard Gyan Aboagye et Sanni Yaya. « Awareness of obstetric fistula and its associated factors among women of reproductive age in sub-Saharan Africa ». Tropical Medicine and Health 50, no 1 (2 août 2022). http://dx.doi.org/10.1186/s41182-022-00443-2.

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Abstract Background Awareness about obstetric fistula and its concomitant factors is central to efforts to eliminate obstetric fistula in sub-Saharan Africa. We, therefore, assessed the magnitude of obstetric fistula awareness and its associated factors among women of reproductive age in sub-Saharan Africa. Methods Data for the study were extracted from the most recent Demographic and Health Surveys of 14 countries in sub-Saharan Africa. We included 185,388 women aged 15–49 years in this study. Percentages were used to summarise the prevalence of obstetric fistula awareness across the 14 countries studied. We adopted a multivariable multilevel binary logistic regression to examine the factors associated with obstetric fistula awareness in sub-Saharan Africa. We presented the results of the regression analysis using adjusted odds ratios with their 95% confidence intervals. Statistical significance was set at p < 0.05. Results The average prevalence of obstetric fistula awareness was 37.9%, ranging from 12.8% in Gambia to 63.9% in Uganda. Awareness of obstetric fistula was low among never married and cohabiting women compared to married women. Compared with women with parity 4 or more, those with no birth had the lowest odds of obstetric fistula awareness. The study also showed that obstetric fistula awareness was lower among women who were working, those who are not exposed to mass media, those in the poorest wealth category, those who have never had sex, and those in communities with low literacy level. The study however found that the odds of obstetric fistula awareness increased with age and education, and was higher in urban areas compared to rural areas. Women, who had ever terminated a pregnancy were more likely to be aware of obstetric fistula compared to those who had never terminated a pregnancy. Conclusion The study demonstrated a low awareness of obstetric fistula among women in sub-Saharan Africa. Educative and sensitisation interventions should incorporate the factors identified in the present study during its implementation. To raise women’s awareness of obstetric fistula, there is the need for sub-Saharan African countries to consciously raise community literacy rate, increase access to mass media platforms and invest intensively in formal education for women.
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Ahinkorah, Bright Opoku, John Elvis Hagan, Abdul-Aziz Seidu, Obasanjo Afolabi Bolarinwa, Eugene Budu, Collins Adu, Joshua Okyere, Anita Gracious Archer et Thomas Schack. « Association between female genital mutilation and girl-child marriage in sub-Saharan Africa ». Journal of Biosocial Science, 7 février 2022, 1–12. http://dx.doi.org/10.1017/s0021932021000687.

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Abstract Two commonly linked harmful practices that negatively impact the health of girls and women in sub-Saharan Africa, and threaten their development and quality of life, are female genital mutilation and girl-child marriage. The central focus of the study was to investigate the association between female genital mutilation and girl-child marriage in sub-Saharan Africa. Data from the most recent Demographic and Health Surveys of twelve sub-Sahara African countries were pooled. A total of 14,748 women aged 20–24 were included in the study. A multilevel logistic regression analysis was employed, with reported adjusted odds ratios (aORs) and associated 95% confidence intervals (CIs). The overall prevalence of FGM in the twelve countries was 52.19%, with the highest prevalence in Guinea (97.17%). The overall prevalence of girl-child marriage in the twelve countries was 57.96%, with the highest prevalence in Chad (78.06%). Women who had never experienced female genital mutilation were less likely to experience girl-child marriage (aOR=0.76, CI=0.71–0.82) compared with those who had ever experienced female genital mutilation. Age 24 (aOR=0.47, CI=0.43–0.52), secondary/higher level of education (aOR=0.31, CI=0.28–0.35), richest wealth quintile (aOR=0.56, CI=0.47–0.66), exposure to mass media (aOR=0.81, CI=0.74–0.88) medium community literacy level (aOR=0.63, CI=0.57–0.69) and low community socioeconomic status (aOR=0.67, CI=0.49–0.92) were found to be protective against girl-child marriage. The findings reveal that female genital mutilation is associated with girl-child marriage in sub-Saharan Africa. The continued practice will adversely affect the reproductive health outcomes of girls in the sub-region. Policies aimed at eliminating female genital mutilation and girl-child marriage should focus on compulsory basic education, poverty alleviation and increasing access to mass media. Further, campaigns should cover more communities with lower literacy levels and medium socioeconomic status.
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Zegeye, Betregiorgis, Mpho Keetile, Bright Opoku Ahinkorah, Edward Kwabena Ameyaw, Abdul-Aziz Seidu et Sanni Yaya. « Utilization of deworming medication and its associated factors among pregnant married women in 26 sub-Saharan African countries : a multi-country analysis ». Tropical Medicine and Health 49, no 1 (30 juin 2021). http://dx.doi.org/10.1186/s41182-021-00343-x.

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Abstract Background Deworming is one of the strategies to reduce the burden of anemia among pregnant women. Globally, pregnant women in sub-Saharan Africa are more affected by anemia. Therefore, this study examined both the coverage and demographic, socioeconomic, and women empowerment-related factors associated with the utilization of deworming medication among pregnant married women in sub-Saharan Africa. Methods We used data from the most recent Demographic and Health Surveys of 26 countries in sub-Saharan Africa conducted between 2010 and 2019. Using Stata version-14 software, analysis was done on 168,910 pregnant married women. Bivariate and multivariable logistic regression analyses were conducted to examine the factors associated with the utilization of deworming medication. The results were presented using adjusted odds ratios (aORs) at 95% confidence intervals (CIs). Results The pooled results showed that about 50.7% (95% CI 48.2–53.3%) of pregnant married women in the studied countries took deworming medications, and this varied from as high as 84.1% in Sierra Leone to as low as 2% in Angola. Regarding sub-regional coverage, the highest and lowest coverages were seen in East Africa (67.6%, 95% CI 66.0–69.1%) and West Africa (24.3%, 95% CI 22.4–26.4%) respectively. We found higher odds of utilization of deworming medication among older pregnant married women (aOR=1.93, 95% CI 1.32–2.84), women with educated husbands (aOR=1.40, 95% CI 1.11–1.77), wealthier women (aOR=3.12, 95% CI 1.95–4.99), women exposed to media (aOR=1.46, 95% CI 1.18–1.80), and those who had four or more antenatal care visits (aOR=1.51, 95% CI 1.24–1.83). Conclusions Enhancing women’s education, disseminating information about maternal healthcare services through mass media, and ensuring that women from economically disadvantaged households benefit from national economic growth can be considered as deworming medication improvement strategies in sub-Saharan Africa. Moreover, providing more attention to adolescents or young pregnant women and increasing the number of antenatal care visits could be considered to increase deworming uptake among pregnant married women.
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Tetteh, Justice Kanor, James Boadu Frimpong, Eugene Budu, Collins Adu, Aliu Mohammed, Bright Opoku Ahinkorah et Abdul-Aziz Seidu. « Comprehensive HIV/AIDS knowledge and HIV testing among men in sub-Saharan Africa : a multilevel modelling ». Journal of Biosocial Science, 5 novembre 2021, 1–16. http://dx.doi.org/10.1017/s0021932021000560.

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Abstract This study investigated the association between comprehensive HIV/AIDS knowledge and HIV testing among men in sub-Saharan Africa (SSA). Data were taken from the most recent (2010–2019) Demographic and Health Survey men’s recode files of 29 countries in SSA. A total of 104,398 men who had complete information on all the variables of interest were included in the study. The outcome variable was HIV testing. A multilevel logistic regression analysis was conducted to determine the association between comprehensive HIV/AIDS knowledge and HIV testing. The results of the fixed effects model were presented as adjusted odds ratios (AORs) with 95% confidence intervals (CIs). The average prevalences of HIV testing and comprehensive HIV/AIDS knowledge among men in SSA were 53.5% and 50.8% respectively. Rwanda and Niger recorded the highest (93.6%) and lowest prevalences (9.8%) respectively. The prevalence of comprehensive HIV/AIDS knowledge among men in the 29 countries was 50.8%, with the highest in Rwanda (76.4%) and the lowest in Benin (31.1%). Men who had no comprehensive HIV/AIDS knowledge were less likely to test for HIV compared with those who had comprehensive HIV/AIDS knowledge (AOR=0.59, CI: 0.57–0.60). Men who were older than 20 years, married or cohabiting, with at least secondary education, in the richest wealth quintile, exposed to mass media, used condoms and with multiple sexual partners were more likely to test for HIV. To improve HIV testing among men in SSA, this study recommends that policymakers and stakeholders step up comprehensive HIV/AIDS knowledge sensitization and education using effective tools such as mass media.
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Ahinkorah, Bright Opoku, Eugene Budu, Richard Gyan Aboagye, Ebenezer Agbaglo, Francis Arthur-Holmes, Collins Adu, Anita Gracious Archer, Yaa Boahemaa Gyasi Aderoju et Abdul-Aziz Seidu. « Factors associated with modern contraceptive use among women with no fertility intention in sub-Saharan Africa : evidence from cross-sectional surveys of 29 countries ». Contraception and Reproductive Medicine 6, no 1 (1 août 2021). http://dx.doi.org/10.1186/s40834-021-00165-6.

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Abstract Background In sub-Saharan Africa, the majority of women of reproductive age who want to avoid pregnancy do not use any method of contraception. This study sought to determine the factors associated with modern contraceptive use among women with no fertility intention in sub-Saharan Africa. Methods This study used data from the Demographic and Health Surveys of 29 countries in sub-Saharan Africa. A total of 87,554 women aged 15–49 with no fertility intention and who had completed information on all the variables of interest were considered in this study. Using a multilevel logistic regression analysis, four models were used to examine the individual and contextual factors associated with modern contraceptive use. The results were presented as adjusted odds ratios (aOR), with their respective confidence intervals (CIs). Statistical significance was set at p< 0.05. Results The prevalence of modern contraceptive use was 29.6%. With the individual-level factors, women aged 45–49 had lower odds of using modern contraceptives (aOR = 0.33, 95% CI = 0.28, 0.39). Women who had their first sex at age 15–19 (aOR = 1.12, 95% CI = 1.07, 1.17), those with higher education (aOR = 1.93, 95% CI = 1.75, 2.13), and women who were exposed to newspaper (aOR = 1.15, 95% CI = 1.10, 1.20) and radio (aOR = 1.21, 95% CI = 1.17, 1.26) had higher odds of modern contraceptive use. In terms of the contextual factors, women living in urban areas (aOR = 1.06, 95% CI = 1.02, 1.11), women in the richest wealth quintile (aOR = 1.55, 95% CI = 1.43, 1.67), and those in communities with medium literacy level (aOR = 1.11, 95% CI = 1.06, 1.16) and medium community socio-economic status (aOR = 1.17, 95% CI = 1.10, 1.23) had higher odds of modern contraceptive use. Across the geographic regions in sub-Saharan Africa, women in Southern Africa had higher odds of modern contraceptive use (aOR = 5.29, 95% CI = 4.86, 5.76). Conclusion There is a relatively low prevalence of modern contraceptive use among women with no fertility intention in sub-Saharan Africa, with cross-country variations. Women’s age, age at first sex, level of education, mass media exposure, place of residence, community literacy level and community socio-economic status were found to be associated with modern contraceptive use. It is, therefore, important for policy makers to consider these factors when designing and implementing programmes or policies to increase contraceptive use among women who have no intention to give birth. Also, policymakers and other key stakeholders should intensify mass education programmes to address disparities in modern contraceptive use among women.
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Yaya, Sanni, Olalekan A. Uthman, Agbessi Amouzou et Ghose Bishwajit. « Mass media exposure and its impact on malaria prevention behaviour among adult women in sub-Saharan Africa : results from malaria indicator surveys ». Global Health Research and Policy 3, no 1 (4 juillet 2018). http://dx.doi.org/10.1186/s41256-018-0075-x.

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Nonterah, Engelbert A., Nigel J. Crowther, Abraham Oduro, Godfred Agongo, Lisa K. Micklesfield, Palwendé R. Boua, Solomon S. R. Choma et al. « Poor cardiovascular health is associated with subclinical atherosclerosis in apparently healthy sub-Saharan African populations : an H3Africa AWI-Gen study ». BMC Medicine 19, no 1 (10 février 2021). http://dx.doi.org/10.1186/s12916-021-01909-6.

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Abstract Background The cardiovascular health index (CVHI) introduced by the American Heart Association is a valid, accessible, simple, and translatable metric for monitoring cardiovascular health in a population. Components of the CVHI include the following seven cardiovascular risk factors (often captured as life’s simple 7): smoking, dietary intake, physical activity, body mass index, blood pressure, glucose, and total cholesterol. We sought to expand the evidence for its utility to under-studied populations in sub-Saharan Africa, by determining its association with common carotid intima-media thickness (CIMT). Methods We conducted a cross-sectional study involving 9011 participants drawn from Burkina Faso, Ghana, Kenya, and South Africa. We assessed established classical cardiovascular risk factors and measured carotid intima-media thickness of the left and right common carotid arteries using B-mode ultrasonography. Adjusted multilevel mixed-effect linear regression was used to determine the association of CVHI with common CIMT. In the combined population, an individual participant data meta-analyses random-effects was used to conduct pooled comparative sub-group analyses for differences between countries, sex, and socio-economic status. Results The mean age of the study population was 51 ± 7 years and 51% were women, with a mean common CIMT of 637 ± 117 μm and CVHI score of 10.3 ± 2.0. Inverse associations were found between CVHI and common CIMT (β-coefficients [95% confidence interval]: Burkina Faso, − 6.51 [− 9.83, − 3.20] μm; Ghana, − 5.42 [− 8.90, − 1.95]; Kenya, − 6.58 [− 9.05, − 4.10]; and South Africa, − 7.85 [− 9.65, − 6.05]). Inverse relations were observed for women (− 4.44 [− 6.23, − 2.65]) and men (− 6.27 [− 7.91, − 4.64]) in the pooled sample. Smoking (p < 0.001), physical activity (p < 0.001), and hyperglycemia (p < 0.001) were related to CIMT in women only, while blood pressure and obesity were related to CIMT in both women and men (p < 0.001). Conclusion This large pan-African population study demonstrates that CVHI is a strong marker of subclinical atherosclerosis, measured by common CIMT and importantly demonstrates that primary prevention of atherosclerotic cardiovascular disease in this understudied population should target physical activity, smoking, obesity, hypertension, and hyperglycemia.
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Gebremichael, Shewayiref Geremew, et Setegn Muche Fenta. « Determinants of institutional delivery in Sub-Saharan Africa : findings from Demographic and Health Survey (2013–2017) from nine countries ». Tropical Medicine and Health 49, no 1 (26 mai 2021). http://dx.doi.org/10.1186/s41182-021-00335-x.

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Abstract Introduction Institutional delivery is a major concern for a country’s long-term growth. Rapid population development, analphabetism, big families, and a wider range of urban-rural health facilities have had a negative impact on institutional services in Sub-Saharan Africa (SSA) countries. The aim of this study was to look into the factors that influence women’s decision to use an institutional delivery service in SSA. Methods The most recent Demographic and Health Survey (DHS), which was conducted in nine countries (Senegal, Ethiopia, Malawi, Rwanda, Tanzania, Zambia, Namibia, Ghana, the Democratic Republic of Congo) was used. The service’s distribution outcome (home delivery or institutional delivery) was used as an outcome predictor. Logistic regression models were used to determine the combination of delivery chances and different covariates. Results The odds ratio of the experience of institutional delivery for women living in rural areas vs urban area was 0.44 (95% confidence interval (CI) 0.41–0.48). Primary educated women were 1.98 (95% CI 1.85–2.12) times more likely to deliver in health institutes than non-educated women, and secondary and higher educated women were 3.17 (95% CI 2.88–3.50) times more likely to deliver in health centers with facilities. Women aged 35–49 years were 1.17 (95% CI 1.05–1.29) times more likely than women aged under 24 years to give birth in health centers. The number of ANC visits: women who visited four or more times were 2.98 (95% CI 2.77–3.22) times, while women who visited three or less times were twice (OR = 2.03; 95% CI 1.88–2.18) more likely to deliver in health institutes. Distance from home to health facility were 1.18 (95% CI 1.11–1.25) times; media exposure had 1.28 (95% CI 1.20–1.36) times more likely than non-media-exposed women to delivery in health institutions. Conclusions Women over 24, primary education at least, urban residents, fewer children, never married (living alone), higher number of prenatal care visits, higher economic level, have a possibility of mass-media exposure and live with educated husbands are more likely to provide health care in institutions. Additionally, the distance from home to a health facility is not observed widely as a problem in the preference of place of child delivery. Therefore, due attention needs to be given to address the challenges related to narrowing the gap of urban-rural health facilities, educational level of women improvement, increasing the number of health facilities, and create awareness on the advantage of visiting and giving birth in health facilities.
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Mindu, Tafadzwa, et Moses J. Chimbari. « Factors influencing uptake of schistosomiasis research findings in ingwavuma area, uMkhanyakude District, Kwazulu-Natal, South Africa ». Journal of Public Health in Africa 12, no 1 (28 septembre 2021). http://dx.doi.org/10.4081/jphia.2021.1060.

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Background: Research uptake is concerned with spreading ideas across multiple levels of the community. Barriers such as poverty, lack of infrastructure, illiteracy and culture prevent information sharing in arid rural areas of sub-Saharan Africa. Objective: This study explores the factors influencing schistosomiasis research uptake and the available channels for the uptake of research findings from a transdisciplinary and eco-health research project on schistosomiasis in Ingwavuma area, uMkhanyakude district, KwaZulu-Natal province in South Africa. Methods: This case study conducted in 2017 involved 78 primary school children and 73 heads of household recruited through convenience and purposive sampling. Data were collected through focus group discussions, then transcribed and analysed by the researcher using thematic analysis. Results: Factors such as poor knowledge, water and sanitation problems, and lack of sufficient health workers hindered the uptake of schistosomiasis research findings. Participants recommended several platforms to share schistosomiasis research findings with the community, including: door to door visits; social gatherings such as sports events, talent shows, and religious gatherings; mass media platforms such as radio and television; social media platforms such as WhatsApp, Facebook and Twitter; and printed media such as posters, booklets and pamphlets. Conclusions: There is a need to train health workers and peer educators in this area of South Africa to educate people about schistosomiasis infection, screening and treatment through home visits or social events. Schistosomiasis research findings must be synthesised and packaged in different forms for dissemination via multimedia media-based communication channels.
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