Trends and determinants of underweight and overweight/obesity among urban Ethiopian women from 2000 to 2016

Background: Nutritional, epidemiological and demographic transitions have been associated with the emergence of the double burden of malnutrition globally. In Ethiopia, there has been no nationally representative investigation of trends and determinants of both underweight and overweight/obesity among urban women. This study examined the trends and determinants of underweight and overweight/obesity in urban Ethiopian women from 2000 to 2016. Methods: Trends in the prevalence of underweight and overweight/obesity were investigated based on a series of the Ethiopia Demographic and Health Survey (EDHS) data for the years 2000 (n = 2559), 2005 (n = 1112), 2011 (n = 3569), and 2016 (n = 3106). Multivariable multinomial logistic regression was used to investigate the association between socioeconomic, demographic, behavioural, and community-level factors with underweight and overweight/obesity. Results: The prevalence of underweight in urban Ethiopian women reduced significantly from 23.2% (95% confidence interval [CI]: 20.3, 26.3%) in 2000 to 14.8% (95% CI: 13.1, 16.7%) in 2016, while overweight/obesity increased significantly from 10.9% (95% CI: 9.1, 13.0%) in 2000 to 21.4% (95% CI: 18.2, 25.1%) in 2016. Urban women from rich households and those who had never married were less likely to be underweight. Urban women who were from wealthy households and those who attained at least secondary education were more likely to be overweight/obese. Women who were informally employed and listened to the radio were less likely to be overweight/obese compared to those who were unemployed and did not listen to the radio, respectively. Conclusion: The prevalence of overweight/obesity increased from 2000 to 2016, with a concurrent reduction in the prevalence of underweight. Interventions aiming to reduce overweight and obesity should target urban women with higher education, those who resided in wealthier households and those who watched the television

Level and intensity of objectively assessed physical activity among pregnant women from urban Ethiopia.

BACKGROUND: Women in low-income countries are generally considered to have a high physical workload which is sustained during pregnancy. Although most previous studies have been based on questionnaires a recent meta-analysis of doubly labeled water data has raised questions about the actual amount of physical activity performed. In this study we report objectively assessed levels of physical activity, cardiorespiratory fitness and muscular fitness among pregnant urban Ethiopian women, and their association with demographic characteristics and anthropometric measures. METHODS: Physical activity was measured for seven consecutive days in 304 women using a combined uniaxial accelerometer and heart rate sensor. Activity energy expenditure was determined using a group calibration in a branched equation model framework. Type and duration of activities were reported using a 24-hour physical activity recall and grip strength was assessed using a dynamometer. RESULTS: Median (interquartile-range, IQR) activity energy expenditure was 31.1 (23.7-42.0) kJ/kg/day corresponding to a median (IQR) physical activity level of 1.46 (1.39-1.58). Median (IQR) time in sedentary, light, and moderate-to-vigorous intensity was 1100 (999-1175), 303 (223-374) and 40 (22-69) min/day, respectively. Mean (standard deviation) sleeping heart rate was 73.6 (8.0) beats/min and grip strength was 21.6 (4.5) kg. Activity energy expenditure was 14% higher for every 10 cm(2) difference in arm muscle area and 10% lower for every 10 cm(2) difference in arm fat area and 10-week difference in gestational age. CONCLUSION: The level and intensity of physical activity among pregnant women from urban Ethiopia is low compared to non-pregnant women from other low income countries as well as pregnant European women from high-income countries.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are

Socioeconomic correlates of overweight and obesity among ever-married urban women in Bangladesh

Background The escalating prevalence of overweight and obesity globally is reflected amongst urban women in many low-to-middle income countries. Evidence also shows that overweight and obesity is an increasing trend in Bangladesh. The present study assessed the prevalence and socioeconomic determinants of overweight and obesity among urban women in Bangladesh. Methods Data were extracted from Bangladesh Demographic and Health Survey (BDHS) 2014. A two-stage stratified sampling technique has been used for data collection in this cross-sectional survey. A sample of 1701 ever-married non-pregnant urban women aged 15–49 years was selected for statistical analysis. Descriptive analysis, multiple binomial logistic regression analysis were executed in this study. Results The prevalence of overweight and obesity was 34% (95% CI, 0.30–0.38) among urban Bangladeshi women. The probability of being overweight and obese increased with increasing age and wealth index. The likelihood of being overweight and obese among the oldest women surveyed (40–49 years) was 4.3 times (OR = 4.3, 95% CI: 2.1–8.8) higher relative to the youngest women (15–19 years). The wealthiest women had 4.1 times (OR = 4.1, 95% CI: 2.5–6.7) higher likelihood of being overweight and obese compared to the reference group of poorest women. Women having higher education (OR = 1.7, 95% CI: 1.0–2.6) were more likely to be overweight and obese. However, women who were no longer living with their husband or separated from their husband were (OR = 0.4, 95% CI: 0.2–0.8) less likely to be overweight and obese. Conclusion This study provides evidence that a large number of urban women were overweight and obese in Bangladesh. Women having higher levels of education, being older and belonging in both poorer and richest wealth quintile were at risk of being overweight and obese. Appropriate health promoting interventions based on these factors should be envisaged to reduce this problem

Rural-urban disparities in maternal immunization knowledge and childhood health-seeking behavior in Nigeria: A mixed method study

Background: Immunization and appropriate health-seeking behavior are effective strategies to reduce child deaths.Objectives: To compare maternal knowledge about immunization, use of growth chart and childhood health-seeking behavior in rural and urban areas.Methods: A cross-sectional comparative study done in Lagos, Nigeria. Questionnaire survey and focus group discussions were done. 300 respondents were selected by multi-stage sampling while discussants were purposively selected.Results:Awareness of immunization was high but knowledge of vaccine preventable diseases (VPDs) was poor in both areas. Urban women utilized preventive services more; growth monitoring (p<0.001) and immunization (p<0.001) while higher proportions of rural women utilized nutritional counseling (p=0.005) and treatment of illness (p<0.001). Growth chart utilization was better in the urban areas (p<0.001). Increasing maternal education increased use of growth chart in both areas. Both groups of women use multiple treatment sources for children (more in urban), determined by cost, time, perceived severity of illness and type of ailment (urban) and peculiarity of illness (rural). There is a preference for orthodox care in the rural area.Conclusions:Knowledge of VPDs was poor and multiple treatment sources were common among rural and urban women. Education is vital to improve immunization knowledge and health-seeking behavior in both areas.Key Words: Immunization; growth chart; health-seeking behavior; child health; Nigeri

Overweight and obesity among women of reproductive age in Mali: what are the determinants?

Background Existing evidence suggests that there has been a surge of overweight and obesity in low- and middle-income countries around the world. In this study we investigated the prevalence and factors associated with overweight and obesity among women in Mali. Methods We conducted the study among 5198 women using the 2018 Mali Demographic and Health Survey data. We used binary logistic regression for the analysis and pegged statistical significance at p<0.05. Results The prevalence of overweight and obesity was 26.9%. The likelihood of overweight and obesity was high among women 40–44 y of age (adjusted odds ratio [AOR] 5.94 [confidence interval {CI} 4.10 to 8.60]), those who were widowed/divorced/separated (AOR 1.59 [CI 1.04 to 2.43]), those with secondary education (AOR 1.41 [CI 1.13 to 1.75]), richest women (AOR 3.61 [CI 2.63 to 4.95]), those who watched television at least once a week (AOR 1.28 [CI 1.07 to 1.52]) and those who lived in the Kidal region (AOR 10.71 [CI 7.05 to 16.25]). Conversely, the likelihood of overweight and obesity was low among women who belonged to other religions compared with Muslims (AOR 0.63 [CI 0.43 to 0.92]). Conclusions This study found a predominance of overweight and obesity among women in Mali. The study showed that age, marital status, education, religion, region of residence, wealth status and frequency of watching television are associated with overweight and obesity among women in Mali. It is therefore critical for public health promotion programs in Mali to sensitize people to the negative effects associated with overweight and obesity. This implies that policies aimed at controlling overweight and obesity in Mali must take these factors into consideration

Determinants of quality contraceptive counselling information among young women in Sierra Leone: insights from the 2019 Sierra Leone demographic health survey

Background The quality of contraceptive counseling information received by prospective clients of family planning services can greatly influence both the uptake and continued use of contraceptives. Therefore, an understanding of the level and determinants of quality contraception information among young women in Sierra Leon could inform family programs, with the aim of reducing the high unmet need in the country. Methods We analyzed secondary data from the 2019 Sierra Leone Demographic Health Survey (SLDHS). Participants were young women aged 15–24 years, who were using a family planning method (n = 1,506). Good quality family planning counselling was defined a composite variable that included; a woman being told about side effects, how to deal with side effects, and the availability of other family planning methods/options. Logistic regression was performed using SPSS software version 25. Results Out of 1,506 young women, 955 (63.4%, 95% CI: 60.5–65.3) received good quality family planning counselling services. Of the 36.6% that received inadequate counselling, 17.1% received no counselling at all. Good quality family planning counselling services was positively associated with receiving family planning services from government health facilities (aOR: 2.50, 95% CI: 1.83–3.41), having no major challenges with distance to access healthcare (aOR: 1.45, 95% CI: 1.10–1.90), having visited a health facility (AOR: 1.93, 95% CI: 1.45–2.58), and having been visited by a health field worker within the last 12 months (aOR: 1.67, 95% CI: 1.24–2.26) while residing in the southern region ( aOR: 0.39, 95% CI: 0.22–0.69) and belonging to the richest wealth quintile (aOR: 0.49, 95% CI: 0.24–0.98) were associated with less odds of receiving good quality family planning counselling services. Conclusion About 37% of the young women in Sierra Leone do not receive good quality family planning counselling services of which 17.1% received none. Based on the study’s findings, it is important to emphasize the need to ensure that all young women have access to proper counselling services especially for those receiving these services from private health units, from the southern region and richest wealth quintile. Ensuring easier acces

Association between exposure to family planning messages on different mass media channels and the utilization of modern contraceptives among young women in Sierra Leone: Insights from the 2019 Sierra Leone Demographic Health Survey

Background Access to sexual and reproductive health information enables young women to make appropriate decisions. We examined the association between exposure to family planning messages on different mass media and the use of modern contraceptives among young women in Sierra Leone. Methods This was a secondary analysis of the 2019 Sierra Leone Demographic and Health Survey data of young women aged 15–24 years. Multistage stratified sampling was used to select study participants in the survey. We used multivariable logistic regression to determine the association between exposure to family panning messages on different types mass media channels and utilization of modern contraceptives. All our analyses were done using SPSS version 25. Results Out of 6055 young women, 1506 (24.9%, 95% CI 24.0–26.2) were utilizing a modern contraceptive method with the prevalence higher among urban women (26.5%) compared to rural women (23.1%). Less than half (45.6%) had been exposed to family planning messages on mass media (radio 28.6%, television 10.6%, mobile phones 4.2% and newspapers or magazines 2.2%). Young women who had exposure to family planning messages on radio (AOR: 1.26, 95% CI 1.06–1.50) and mobile phones (AOR: 1.84, 95% CI 1.25–2.69) had higher odds of using modern contraceptives compared to their counterparts without the same exposure. Furthermore, having access to internet (AOR: 1.45, 95% CI 1.19–1.78), working (AOR: 1.49, 95% CI 1.27–1.74), being older (20–24 years) (AOR: 1.75, 95% CI 1.46–2.10), being married (AOR: 0.33, 95% CI 0.26–0.42), having visited a health facility within the last 12 months (AOR: 1.34, 95% CI 1.10–1.63), having secondary (AOR: 2.83, 95% CI 2.20–3.64) and tertiary levels of education (AOR: 3.35, 95% CI 1.83–6.13), higher parity (having above one child) AOR: 1.57, 95% CI 1.19–2.08) and residing in the southern (AOR: 2.11, 95% CI 1.61–2.79), northwestern (AOR: 1.87, 95% CI 1.39–2.52), northern (AOR: 2.11, 95% CI 1.59–2.82) and eastern (AOR: 1.68, 95% CI 1.27–2.22) regions of residence were associated with higher odds of modern contraceptives utilization. Conclusion In Sierra Leon, only one in four young women were using modern contraception and more than half of them had not had any exposure to family planning messages on the different types of mass media channels. Behavior change communicators can prioritize family planning messages using radio, mobile phones and the internet. In order to publicize and encourage young women to adopt healthy behaviours and increase uptake of modern contraceptive

Identifying Indicators of the Construct for Motivation for Weight Loss: Designing a Questionnaire

The prevalence of overweight and obesity is rising rapidly throughout both the developed and the developing world, and it is creating social, economic and health burden on society particularly in urban areas (Popkin, 2006 in Tesfalem, 2013). As a part of designing a questionnaire, the current research aims to identify the indicators of the latent construct motivation for weight loss. To achieve this, the paper raised the following two specific research questions: What are the indicators of the motivation for participation for weight loss program? And where do the indicators fit in the factors of social determination theory (SDT)?  To gain a rich understanding of the motivation for the participation in weight loss program, semi-structured focus group discussions (FGD) were conducted with purposely recruited samples of two groups: overweight people and their interventionists. Based on the themes identified from the FGD the indicators were identified. Besides, from the consultations gained from the review of related literature the indicators were placed in SDT. Keywords: Overweight, Weight loss, Motivation, Self-Determination Theory (SDT) DOI: 10.7176/JEP/12-28-03 Publication date:October 31st 202

Factors associated with utilization of quality antenatal care: Asecondary data analysis of Rwandan Demographic Health Survey 2020

Background Over the last decade, progress in reducing maternal mortality in Rwanda has been slow, from 210 deaths per 100,000 live births in 2015 to 203 deaths per 100,000 live births in 2020. Access to quality antenatal care (ANC) can substantially reduce maternal and newborn mortality. Several studies have investigated factors that influence the use of ANC, but information on its quality is limited. Therefore, this study aimed to identify the determinants of quality antenatal care among pregnant women in Rwanda using a nationally representative sample. Methods We analyzed secondary data of 6,302 women aged 15–49 years who had given birth five years prior the survey from the Rwanda Demographic and Health Survey (RDHS) of 2020 data. Multistage sampling was used to select RDHS participants. Good quality was considered as having utilized all the ANC components. Multivariable logistic regression was conducted to explore the associated factors using SPSS version 25. Results Out of the 6,302 women, 825 (13.1%, 95% CI: 12.4–14.1) utilized all the ANC indicators of good quality ANC); 3,696 (60%, 95% CI: 58.6–61.1) initiated ANC within the first trimester, 2,975 (47.2%, 95% CI: 46.1–48.6) had 4 or more ANC contacts, 16 (0.3%, 95% CI: 0.1–0.4) had 8 or more ANC contacts. Exposure to newspapers/magazines at least once a week (aOR 1.48, 95% CI: 1.09–2.02), lower parity (para1: aOR 6.04, 95% CI: 3.82–9.57) and having been visited by a field worker (aOR 1.47, 95% CI: 1.23–1.76) were associated with more odds of receiving all ANC components. In addition, belonging to smaller households (aOR 1.34, 95% CI: 1.10–1.63), initiating ANC in the first trimester (aOR 1.45, 95% CI: 1.18–1.79) and having had 4 or more ANC contacts (aOR 1.52, 95% CI: 1.25–1.85) were associated with more odds of receiving all ANC components. Working women had lower odds of receiving all ANC components (aOR 0.79, 95% CI: 0.66–0.95). Conclusion The utilization of ANC components (13.1%) is low with components such as having at least two tetanus injections (33.6%) and receiving drugs for intestinal parasites (43%) being highly underutilized. Therefore, programs aimed at increasing utilization of ANC components need to prioritize high parity and working women residing in larger households. Promoting the use of field health workers, timely initiation and increased frequency of ANC might enhance the quality of care