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Individual and Community-level factors associated with early marriage in Zambia: a mixed effect analysis | BMC Women's Health

Child marriage has long been a public health concern around the world, because it has the potential to deprive adolescent girls of their sexual reproductive health rights and limits their ability to reach their full potential in life. The prevalence of child marriage has been consistently higher in sub-Saharan Africa than elsewhere. However, fewer studies have explored the influence of both individual and community-level influences on early marriage in sub-Saharan Africa. This study, therefore, examined individual and community-level factors associated with child marriages in Zambia. Data came from the Zambia Demographic and Health Surveys (ZDHS) conducted in 2007, 2013–14 and 2018. A pooled weighted sample of 9990 women aged 20–29 years was used in the analysis. Stata software version 17 was used to perform statistical analysis, taking into account complex survey design. The association between individual- and community- level factors and early marital behavior was assessed using multilevel logistic regression models. The prevalence of child marriage among women aged 20–29 was 44.4 percent (95% CI: 42.1, 46.7) in 2018, declining from 51.5 percent (95% CI: 48.9, 54.0) in 2007. Women with secondary or higher level of education [aOR = 0.36, 95% CI = 0.26–0.49] and [aOR = 0.07, 95% CI = 0.03–0.18] and those whose age at first birth was (15–19 year) or (20–29 years) were associated with less likelihood of experiencing child marriage. Communities with a high percentage of women who gave birth at a young age [aOR = 1.36, 95% CI = 1.15–1.62] were more likely to experience child marriage. Individual and community-level characteristics accounted for 35% of the overall variations in communities' likelihood of experiencing early marriage. Even after controlling for both individual and community-level influences, the intra-class correlation revealed that around 4.5 percent of the overall variations remained unexplained. Prevalence of child marriage has reduced over the years but is still high in Zambia. Both individual and community- level factors influenced child marriage in Zambia. There is a need to strengthen strategies that keep girls in school to delay their exposure to early sexual debut and child marriage. Designing of reproductive health interventions in the country should consider integration of community factors such as economic insecurity and access to reproductive health information.

Zambia , Zambian , Research-center , Health-survey , Research-ethics-review-board-of-the-center , Zambia-demographic , Proportional-change , Information-criteria , Aikake-information-criteria , Tropical-disease , Research-ethics-review-board

Optimal antenatal care utilization in East Africa.

This study assesses if educational attainment is associated with optimal antenatal care utilization in East Africa.

Madagascar , United-states , Djibouti , Seychelles , Eritrea , Comoros , Rwanda , Burundi , Tanzania , Mauritius , Mozambique , Zambia

Frontiers | Systematic Assessment of COVID-19 Pandemic in Bangladesh: Effectiveness of Preparedness in the First Wave

Background: To develop an effective countermeasure and determine our susceptibilities to the outbreak of COVID-19 is challenging for a densely populated developing country like Bangladesh and a systematic review of the disease on a continuous basis is necessary. Methods: Publicly available and globally acclaimed datasets (4 March 2020 – 30 September 2020) from IEDCR, Bangladesh, JHU and ECDC database are used for this study. Visual exploratory data analysis is used and we fitted a polynomial model for the number of deaths. A comparison of Bangladesh scenario over different time points as well as with global perspectives is made. Results: In Bangladesh, the number of active cases had decreased, after reaching a peak, with a constant pattern of death rate at from July to the end of September, 2020. 71% of the cases and 77% of the deceased were males. People aged between 21 to 40 years were most vulnerable to the coronavirus and most of the fatalities (51.49%) were in the 60+ population. A strong positive correlation (0.93) between the number of tests and confirmed cases and a constant incidence rate (around 21%) from June 1 to August 31, 2020. The case fatality ratio was between 1 and 2. The number of cases and the number of deaths in Bangladesh were much lower compared to other countries. Conclusions: This study will help to understand the patterns of spread and transition in Bangladesh, possible measures, effectiveness of the preparedness, implementation gaps, and their consequences to gather vital information and prevent future pandemics.

Bangladesh , China , Taiwan , Afghanistan , United-states , Mymensingh , Bangladesh-general- , United-kingdom , Brazil , California , Russia , Mexico

Health insurance coverage in reproductive-age women - CEOR


1
1Department of Epidemiology and Biostatistics, College of Health and Medical Sciences, Haramaya University, Haramaya, Ethiopia;
2Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia;
3Department of Public Health and Health Policy, College of Health and Medical Sciences, School of Public Health, Haramaya University, Harar, Ethiopia
Correspondence: Biruk Shalmeno Tusa Email [email protected]
Background: Despite improvement in access to modern healthcare services in East African countries, health-service delivery and health status of the population remained poor mainly due to the weak health-sector financing system. Therefore, the current study aimed to assess the health insurance coverage and its associated factors among reproductive-age group (RAG) women in East Africa.

Kenya , Malawi , Zimbabwe , Ghana , Comoros , Burundi , Tanzania , Mozambique , Zambia , Uganda , Ethiopia ,

Spatial distribution and determinant factors of anemia among adults aged 15–59 in Ethiopia; using mixed-effects ordinal logistic regression model


Background
Anemia is a global public health problem, particularly in developing countries. Assessing the geographic distributions and determinant factors is a key and crucial step in designing targeted prevention and intervention programmes to address anemia. Thus, the current study is aimed to assess the spatial distribution and determinant factors of anemia in Ethiopia among adults aged 15–59.
Methods
A secondary data analysis was done based on 2016 Ethiopian Demographic and Health Surveys (EDHS). Total weighted samples of 29,140 adults were included. Data processing and analysis were performed using STATA 14; ArcGIS 10.1 and SaTScan 9.6 software. Spatial autocorrelation was checked using Global Moran’s index (Moran’s I). Hotspot analysis was made using Gettis-OrdGi*statistics. Additionally, spatial scan statistics were applied to identify significant primary and secondary cluster of anemia. Mixed effect ordinal logistics were fitted to determine factors associated with the level of anemia.

Amhara , Amara , Ethiopia , Gambella , Gambela-hizboch , Tigray , Addis-ababa , T10 , Dire-dawa , Somalia , Somali , Ethiopian

Frontiers | mHealth: Potentials and Risks for Addressing Mental Health and Well-Being Issues Among Nepali Adolescents


Department of Economics, University of New Mexico, Albuquerque, NM, United States
Adolescents are slowly being recognized as a generation, worldwide, that may require different policy approaches to improve staggering statistics on their failing well-being, including mental health. By providing the support to allow the next generation to achieve better mental health outcomes, they are going to be more economically successful and the future economic growth of nations can be better assured. Adoption of mobile-based health interventions (e.g., mHealth) has garnered a lot of attention toward this end. While mHealth interventions are growing in popularity, many researchers/policy-makers appear to have neglected assessing potential (indirect) costs/negative consequences from their use. Evidence from the developed world shows strong associations between extensive cell phone use and negative mental health outcomes, but similar research is minimal in developing world contexts. Additionally, the bulk of work on the outcomes of mobile phone use is studied using a unidirectional approach with blinders to front-end motivations. Using primary data from a large-scale, school-based survey of older adolescents in southwestern Nepal (

United-states , United-kingdom , Siddhartha-nagar , Nepal-general , Nepal , New-delhi , Delhi , India , China , Tanzania , Chiang-mai , Thailand

[Full text] Time to Long-Acting Reversible Contraceptive Uptake Over Twelve Months


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1Institut de Recherche en Sciences de la Santé (IRSS), Département Biomédical et Santé Publique, Ouagadougou, Burkina Faso;
2Institut Africain de Santé Publique, Ouagadougou, Burkina Faso;
3University of Technology, Faculty of Health, Australian Centre for Public and Population Health Research, Sydney, Australia;
4Université Joseph KI-ZERBO, Unité de Formation et de Recherche en Sciences de la Santé, Ouagadougou, Burkina Faso;
5World Health Organization, Department of Reproductive Health Research, Geneva, Switzerland;
6Université de Kinshasa, Ecole de Santé Publique, Kinshasa, République Démocratique du Congo
Correspondence: Abou Coulibaly
Tel +226 71 40 77 89
Purpose: An earlier adoption of contraceptive methods during the postpartum period could help women to extend the inter-pregnancy interval. This article aimed to determine and compare the timing of long-acting reversible contraceptives (LARC) use (ie, intrauterine device and implant) in Burkina Faso (BF) and DR Congo (DRC) between the intervention and control groups.

Burkina-faso , Geneva , Gene , Switzerland , Helsinki , Eteläuomen-läi , Finland , Congo , Burkina , Health-surveys , Research-ethics-review-committee