Examining ethnic differences in age at sexual debut among adolescent girls in the Gambia

Whether age at sexual debut is influenced by adolescents’ ethnicity has not been examined in the Gambia. The aim of this study was to assess ethnic differences in age at sexual debut among girls in 24 rural Gambian settlements. A cross-sectional household survey of 181 respondents aged (10-19 years) was conducted among girls belonging to the three main ethnic groups (Mandinka, Fula and Wolof). Descriptive statistics and ordinal logistic regression were used to show the onset of sexual intercourse and describe the patterns of sexual debut by ethnic group among respondents. All the analyses were conducted in Stata 12.0. The study findings showed that the lowest median age at sexual debut is among Mandinka and Wolof girls (14 years). The results of ordinal logistic regression indicate that girls in the Mandinka and Wolof ethnic groups are approximately 20% less likely to initiate sex at an early age than girls in the Fula ethnic group. On the other hand, girls with more than 1 year of education are less likely to initiate sex at an early age than those with less than 1 year of education. It was also found that girls who live with their mothers are 71% less likely to have an early sexual debut than those who do not. These findings suggest ethnic differences in age at sexual debut among girls in the Gambia. The findings also highlight the importance of female education and living with a mother in reducing the chances of early sexual debut among adolescent girls.   La question de savoir si l’âge au début des rapports sexuels est influencé par l’origine ethnique des adolescents n’a pas été examinée en Gambie. Le but de cette étude était d'évaluer les différences ethniques d'âge au début de la relation sexuelle parmi les filles de 24 établissements ruraux gambiens. Une enquête transversale auprès des ménages auprès de 181 répondants âgés de 10 à 19 ans a été menée auprès de filles appartenant aux trois principaux groupes ethniques (mandinka, peul et wolof). Des statistiques descriptives et une régression logistique ordinale ont été utilisées pour montrer le début des rapports sexuels et décrire les modèles de débuts sexuels par groupe ethnique parmi les répondants. Toutes les analyses ont été menées dans Stata 12.0. Les résultats de l'étude ont montré que l'âge médian le plus bas au début des rapports sexuels est celui des filles mandingues et wolof (14 ans). Les résultats de la régression logistique ordinale indiquent que les filles des groupes ethniques mandinka et wolof sont environ 20% moins susceptibles d'avoir des relations sexuelles à un âge précoce que les filles du groupe peul. En revanche, les filles ayant plus d'un an d'éducation sont moins susceptibles d'avoir des relations sexuelles à un âge précoce que celles ayant moins d'un an d'éducation. Il a également été constaté que les filles qui vivent avec leur mère sont 71% moins susceptibles d'avoir des débuts sexuels précoces que celles qui n'en ont pas. Ces résultats suggèrent des différences ethniques d'âge au début des rapports sexuels parmi les filles en Gambie. Les résultats soulignent également l'importance de l'éducation des femmes et de la vie avec une mère pour réduire les chances de débuts sexuels précoces chez les adolescentes &nbsp

Examining ethnic differences in age at sexual debut among adolescent girls in the Gambia

Whether age at sexual debut is influenced by adolescents’ ethnicity has not been examined in the Gambia. The aim of this study was to assess ethnic differences in age at sexual debut among girls in 24 rural Gambian settlements. A cross-sectional household survey of 181 respondents aged (10-19 years) was conducted among girls belonging to the three main ethnic groups (Mandinka, Fula and Wolof). Descriptive statistics and ordinal logistic regression were used to show the onset of sexual intercourse and describe the patterns of sexual debut by ethnic group among respondents. All the analyses were conducted in Stata 12.0. The study findings showed that the lowest median age at sexual debut is among Mandinka and Wolof girls (14 years). The results of ordinal logistic regression indicate that girls in the Mandinka and Wolof ethnic groups are approximately 20% less likely to initiate sex at an early age than girls in the Fula ethnic group. On the other hand, girls with more than 1 year of education are less likely to initiate sex at an early age than those with less than 1 year of education. It was also found that girls who live with their mothers are 71% less likely to have an early sexual debut than those who do not. These findings suggest ethnic differences in age at sexual debut among girls in the Gambia. The findings also highlight the importance of female education and living with a mother in reducing the chances of early sexual debut among adolescent girls

Sampled-data implementation of derivative-dependent control using artificial delays

We study a sampled-data implementation of linear controllers that depend on the output and its derivatives. First, we consider an LTI system of relative degree $r\ge 2$ that can be stabilized using $r-1$ output derivatives. Then, we consider PID control of a second order system. In both cases, the Euler approximation is used for the derivatives giving rise to a delayed sampled-data controller. Given a derivative-dependent controller that stabilizes the system, we show how to choose the parameters of the delayed sampled-data controller that preserves the stability under fast enough sampling. The maximum sampling period is obtained from LMIs that are derived using the Taylor's expansion of the delayed terms with the remainders compensated by appropriate Lyapunov-Krasovskii functionals. Finally, we introduce the event-triggering mechanism that may reduce the amount of sampled control signals used for stabilization

Determinants and materno-fetal outcomes related to cesarean section delivery in private and public hospitals in low- and middle-income countries: a systematic review and meta-analysis protocol

Abstract Background Despite the well-established morbidity, mortality, long-term effects, and unnecessary extra-cost burden associated with cesarean section delivery (CSD) worldwide, its rate has grown exponentially. This has become a great topical challenge for the international healthcare community and individual countries. Estimated at three times the acceptable rate as defined by the World Health Organization in 1985, the continued upward trend has been fuelled by higher income countries. Some low- and middle-income countries (LMICs) have now taken the lead, and the factors contributing to this situation are poorly understood. The expansion of the private healthcare sector may be playing a significant role. Distinguishing between the public and private hospitals\u2019 role is critical in this investigation as it has not yet been approached. This review aims to systematically synthesize knowledge on the determinants of the CSD rate rise in private and public hospitals in LMICs and to investigate materno-fetal and materno-infant outcomes of CSD in perinatal period, between private and public hospitals. Methods/design We will include studies published in English, French, Spanish, and Portuguese since 2000, using any experimental design, including randomized controlled trials (RCTs), non-RCTs, quasi-experimental, before and after studies, and interrupted time series. Outcomes of interest are the determinants of CSD and materno-fetal and materno-infant outcomes. We will only include studies carried out in private and public hospitals in LMICs. The literature searches will be conducted in the following databases: MEDLINE, Embase, CINAHL, Cochrane database, LILACS, and HINARI. We will also include unpublished studies in the gray literature (theses and technical reports). Using the two-person approach, two independent review authors will screen eligible articles, extract data, and assess risk of bias. Disagreements will be resolved through discussion with a third author. Results will be presented as structured summaries of the included studies. If possible, a meta-analysis will be conducted and, subsequently, an analysis for heterogeneity will be implemented. Discussion The proposed systematic review of the CSD rate rise will provide up-to-date evidence in regard to differences in proportions, determinants, and materno-fetal and materno-infant outcomes in perinatal period, between private and public hospitals in LMICs. We believe that this knowledge synthesis will help to shed light on the evidence and support evidence-informed decision-making with a view to addressing the issue in LMICs. ..

Critical assessment of refugees’ needs in post-emergency context: the case of Malian war refugees settled in Northern Burkina Faso

Abstract Background Empirically assessing the needs of refugees in camps is critical to the improvement of existing policies and programs that aim at enhancing their well-being. By neglecting the needs of refugees, interventions may fail to capture the complex patterns of refugees’ daily lives within camps. This paper provides a comprehensive assessment of the needs of encamped Malian refugees in Northern Burkina Faso following the 2012-armed conflict. In addition to assessing the needs of Malian refugees, the study aimed to critically assess from an upstream perspective the degree of their involvement in policies and practices that are targeted towards improving their livelihood. Methods We took an “upstream” view on the lives of Malian refugees to identify their unmet needs. A purposive sampling strategy was employed to collect data from various media sources, including data aggregated from the website of the United Nations High Commissioner for Refugees (UNHCR). The most populous refugee camp (Mentao) was visited in September 2012 and in-depth group discussion and interviews were conducted with key informants, including nine camp representatives and four officials from the central and decentralized administrations. Results Media canvass combined with the UNHCR level 2 census revealed a flawed headcount of refugees, which was 205.4% higher than the real number in Burkina Faso. Although refugees live harmoniously with the natives and their security has been assured, they strongly complained about the number of unused food items distributed. Camps were distributed among humanitarian organizations leading to differential advantage and resources from one camp to another. Additionally, idleness, lack of classrooms facilities for pre-school children and lack of continuous healthcare services were major concerns raised. Further, refugees expressed limited involvement in the planning and implementation of programs that are related to their welfare. Conclusion This study revealed that refugees’ voices were not taken into consideration in making tailor-made programs. This calls for more comprehensive surge capacity to deal with refugees’ basic needs. Further, a strong leadership from hoststate should be encouraged to offer equal opportunities to refugees regardless of their camps. Finally, an innovative strategy is needed to build a reliable database that could enhance the design, implementation, monitoring and evaluation of policies and programs

Socioeconomic differential in self-assessment of health and happiness in 5 African countries: Finding from World Value Survey.

Factors that contribute to wealth related inequalities in self-rated health (SRH) and happiness remains unclear most especially in sub-Saharan countries (SSA). This study aims to explore and compare socioeconomic differentials in SRH and happiness in five SSA countries.Using the 2010/2014 World Values Survey (WVS), we obtained a sample of 9,869 participants of age 16 and above from five SSA countries (Nigeria, Ghana, South Africa, Rwanda and Zimbabwe). Socioeconomic inequalities were quantified using the concentration index. The contribution of each predictor to concentration index's magnitude was obtained by means of regression based decomposition analysis.Poor SRH ranges from approximately 9% in Nigeria to 20% in Zimbabwe, whereas unhappiness was lower in Rwanda (9.5%) and higher in South Africa (23.3%). Concentration index was negative for both outcomes in all countries, which implies that poor SRH and unhappiness are excessively concentrated among the poorest socioeconomic strata. Although magnitudes differ across countries, however, the major contributor to wealth-related inequality in poor SRH is satisfaction with financial situation whereas for unhappiness the major contributors are level of income and satisfaction with financial situation.This study underscores an association between wealth related inequalities and poor SRH and unhappiness in the context of SSA. Improving equity in health, as suggested by the commission of social determinants of health may be useful in fighting against the unfair distribution of resources. Thus, knowledge about the self-rating of health and happiness can serve as proxy estimates for understanding the distribution of health care access and economic resources needed for well-being in resident countries

Psychometric evaluation of the French version of the Clinical Nursing Competence Questionnaire (CNCQ-22): A cross-sectional study in nursing education in Burkina Faso

[[abstract]]Background: Clinical nursing competence (CNC) is the essence of the nursing profession. It has received attention as a central component of nursing education; however, most instruments of measure were developed in high income countries and essentially in English. To gauge the CNC of nursing students attending Bachelor of Science in Nursing programs, a specialized scale is needed. This study aimed to validate a French version of the 22-item Clinical Nursing Competence Questionnaire (CNCQ-22), designed and implemented in Taiwan. Methods: A cross-sectional descriptive survey was carried out to assess the psychometric properties of the CNCQ-22. A total of 255 pre-graduate nursing students of three nursing campuses of Burkina Faso (École Nationale de Santé Publique) participated in the study from June to October 2009. In addition to descriptive analysis, the reliability of the instrument, test-retest, and convergent and discriminant validity were examined. Results: Most participants were pre-registered nursing students (66.3%), predominantly male (68.2%), and their mean age was 30.54 (±5.66) (range 21-48). The original English version of the CNCQ-22 was translated into French and yielded an internal consistency coefficient of 0.89. The instrument revealed solid stability through a test-retest that yielded a Spearman's rho of 0.61 and supported good convergent and discriminant validity. Exploratory and confirmatory factor analyses resulted in a three-factor solution. Conclusion: The French version of the CNCQ-22 demonstrates promising psychometric integrity and can be considered as a reliable and valid instrument to evaluate CNC in a French nursing education context. An accurate assessment of CNC provided by an adapted, easy-to-use CNCQ-22 may help nursing educators and academics improve the quality of training

Factors contributing to regional inequalities in acute respiratory infections symptoms among under-five children in Nigeria: a decomposition analysis

Abstract Background Acute respiratory infections (ARI) are major causes of morbidity and mortality in many low-income countries. Although factors associated with ARI symptoms in children under 5 years of age have been identified; however, variation in their prevalence resulting from regional-specific proximate determinants has received little attention. Therefore, we aim to investigate the specific regional determinants of overall and wealth-related inequality in children having ARI in Nigeria over a decade. Methods We analyzed trends in development of ARI symptoms among children under 5 years of age in Nigeria using nationally representative cross sectional surveys carried out in 2003, 2008 and 2013. Overall- and household wealth index based- inequality in the distribution of prevalence of ARI symptoms were estimated by region using Gini index and Concentration Index, respectively. Multivariate logistic regressions for complex survey and decomposition analysis for both indexes were used to calculate percentual contribution. Results We found a decreasing trend in development of ARI symptoms over the decade between regions. Children in South Western region had reduced likelihood of developing the symptoms. Concentration index (CI) for the prevalence of ARI symptoms over the years and across regions had negative values (all p < 0.05). Gini index (GI) varies from 0.21 in North East to 0.62 in South Western region. Furthermore, the mapping showed that the extent at which both inequalities contribute to ARI symptoms prevalence in each region is different. The four major sources of wealth-related inequalities were poor households, no maternal education, biomass cooking, and rural area. The major contributors to overall inequalities were having a child aged 6 to 23 months, having no maternal education, having no vaccination card, and having a high birth order/short birth interval. Conclusions Although ARI prevalence decreased over the decade, it has remained unequally distributed between regions and over the time. The sources of those inequalities are context sensitive. Thus, in future health promotion initiatives, it is imperative to account for regional variations in the distribution of ARI

Community social capital on the timing of sexual debut and teen birth in Nicaragua: a multilevel approach

Abstract Background Community attributes have been gradually recognized as critical determinants shaping sexual behaviors in young population; nevertheless, most of the published studies were conducted in high income countries. The study aims to examine the association between community social capital with the time to sexual onset and to first birth in Central America. Methods Building upon the 2011/12 Demographic and Health Survey conducted in Nicaragua, we identified a sample of 2766 community-dwelling female adolescents aged 15 to 19 years. Multilevel survival analyses were performed to estimate the risks linked with three domains of community social capital (i.e., norms, resource and social network). Results Higher prevalence of female sexual debut (norms) and higher proportion of secondary school or higher education (resource) in the community are associated with an earlier age of sexual debut by 47 % (p < 0.05) and 16 %, respectively (p < 0.001). Living in a community with a high proportion of females having a child increases the hazard of teen birth (p < 0.001) and resource is negatively associated with teen childbearing (p < 0.05). Residential stability and community religious composition (social network) were not linked with teen-onset sex and birth. Conclusions The norm and resource aspects of social capital appeared differentially associated with adolescent sexual and reproductive behaviors. Interventions aiming to tackle unfavorable sexual and reproductive outcomes in young people should be devised and implemented with integration of social process