Single motherhood in Ghana: analysis of trends and predictors using demographic and health survey data

The rising rate of single-mother families has gained scholarly and policy attention. Understanding the dynamics in the socio-economic and demographic transformations that have led to the relatively high single-mother families in Ghana is important to advance policy and intervention to mitigate adverse effects of single motherhood. The study sought to examine the trends and predictors of single motherhood in Ghana from 1993 to 2014. This paper was based on data from the last five waves of the Ghana Demographic and Health Survey. Descriptive statistics of proportions with Chi-square test and binary logistic regression were used to assess individual and contextual factors associated with single motherhood in Ghana. The proportion of single motherhood increased significantly over the period from 14.1% in 1993 to 19.5% in 2014. Premarital birth emerged as the major pathway to single motherhood. Among individual factors, the likelihood of single motherhood declines as age at first sex [OR = 0.58; 95% CI = 0.48,0.70] and first birth [OR = 0.43; CI = 0.32,0.59] were 25 years and above. Also, Contraceptive users were less likely to be single mothers than non-users. Contextually, women who profess Islam [OR = 0.58; 95% CI = 0.46, 0.74] were less likely to be single mothers than women who had no religious affiliation. We observed that, after accounting some important factors, women with higher economic status—richer [OR = 0.76; 95% CI = 0.59,0.96] and richest [OR = 0.57; 95% CI = 0.31,0.56] were less likely to be single mothers than poorest women. The findings give an impression of single mothers being over-represented among economically poor women. Policies and programmes meant to mitigate adverse effects of single motherhood should also focus on empowering single mothers and their children as a way of alleviating poverty and improve the well-being of children in this family type, as well as enhance Ghana’s capacity to attain the Sustainable Development Goal 1, particularly target 1.2

Trend and determinants of complete vaccination coverage among children aged 12-23 months in Ghana: analysis of data from the 1998 to 2014 Ghana Demographic and Health Surveys

Background Vaccination is proven to be one of the most cost-effective measures adopted to improve the health of children globally. Adhering to vaccines for children has the propensity to prevent about 1.5 million annual child deaths globally. This study sought to assess the trend and determinants of complete vaccination coverage among children aged 12–23 months in Ghana. Materials and methods The study was based on data from four rounds of the Ghana Demographic and Health Survey (GDHS 1998, 2003, 2008, and 2014). Information on 5,119 children aged 12–23 months were extracted from the children’s files. Both bivariate and multivariate analyses were conducted to assess the factors associated with complete vaccination and statistical significance was pegged at p<0.05. Results We found that complete vaccination coverage increased from 85.1% in 1998 to 95.2% in 2014. Children whose mothers were in rural areas [aOR = 0.45; CI = 0.33–0.60] had lower odds of getting complete vaccination, compared to those whose mothers were in urban areas. Also, children whose mothers had a secondary level of education [aOR = 1.87; CI = 1.39–2.50] had higher odds of receiving complete vaccination, compared to those whose mothers had no formal education. Children whose mothers were either Traditionalists [aOR = 0.60; CI = 0.42–0.84] or had no religion [aOR = 0.58, CI = 0.43–0.79] had lower odds of receiving complete vaccination, compared to children whose mothers were Christians. Conclusion The study revealed that there has been an increase in the coverage of complete vaccination from 1998 to 2014 in Ghana. Mother’s place of residence, education, and religious affiliation were significantly associated with full childhood vaccination. Although there was an increase in complete childhood vaccination, it is imperative to improve health education and expand maternal and child health services to rural areas and among women with no formal education to further increase complete vaccination coverage in Ghana

Skilled antenatal care services utilisation in sub-Saharan Africa: a pooled analysis of demographic and health surveys from 32 countries

Background: Each day, an estimated 800 women die from preventable pregnancy and childbirth related complications, where 99% of these avoidable deaths happen in low-and middle-income countries. Skilled attendance during antenatal care (ANC) plays a role in reducing maternal and child mortality. However, the factors that predict the utilisation of skilled ANC services in sub-Saharan Africa (SSA) remains sparsely investigated. Therefore, we examined women’s utilisation of skilled ANC services in SSA. Methods: The research used pooled data from the most recent Demographic and Health Surveys conducted in 32 countries in SSA between January 1, 2010, and December 31, 2019. Binary logistic regression was used to examine the predictors of skilled ANC services utilisation. The results are presented as crude and adjusted odds ratios (aOR) with 95% confidence interval (CI). Results: The prevalence of skilled ANC services utilisation in SSA was 76.0%, with the highest and lowest prevalence in Gambia (99.2%) and Burundi (8.4%), respectively. Lower odds of ANC from skilled providers was found among women aged 45–49 compared to those aged 20–24 (aOR = 0.86, CI = 0.79–0.94); widowed women compared to married women (aOR = 0.84, CI = 0.72–0.99); women who consider getting permission to visit the health facility as a big problem compared to those who consider that as not a big problem (aOR = 0.74, CI = 0.71–0.77); women who consider getting money needed for treatment as not a big problem compared to those who consider that as a big problem (aOR = 0.84, CI = 0.72–0.99); and women who consider distance to the health facility as a big problem compared to those who consider that as not a big problem (aOR = 0.75, CI = 0.72–0.77). Conclusion: SSA has relatively high prevalence of skilled ANC services utilisation, however, there are substantial country-level disparities that need to be prioritised. Increasing maternal reproductive age being widowed and far distance to health facility were factors that predicted lower likelihood of skilled ANC services utilisation. There is, therefore, the need to intensify female formal education, invest in community-based healthcare facilities in rural areas and leverage on the media in advocating for skilled ANC services utilisation

Effects of Spatial Location and Household Wealth on the Utilisation of Skilled Birth Attendants at Delivery Among Women in Rural Ghana

Skilled attendance during delivery has been identified as a panacea to the amelioration of maternal and new-born mortality, but utilisation is lower in rural areas than in urban areas of Ghana. The study examined the role of spatial location and household wealth in the use of skilled birth attendants at delivery among rural women in Ghana. The paper made use of data from the 2014 Ghana Demographic and Health Survey. Women from rural areas who had given birth within five years prior to the survey were included in the analysis. Frequency, percentage, Chi-square tests as well as binary and multivariate logistic regression estimation techniques were used to analyse the data. The probability of utilising skilled birth attendants at delivery increased by household wealth. Rural women in coastal Ghana also had the least probability of utilising skilled assistance at delivery. There are spatial differences in the use of skilled birth attendants at delivery among women in rural Ghana with those in the coastal areas having the highest probability of non-utilisation. A perpetuation of the current spatial and wealth variations in the utilisation of skilled birth attendants at delivery among women in the rural parts of the country implies that Ghana may not be able to meet her Sustainable Development Goal target of reducing the maternal mortality ratio to less than 70 maternal deaths per 100,000 live births by the year 2030. The study, therefore, underscores the need for geographical and income vulnerability considerations in identifying rural populations for special skilled delivery care interventions in improving maternal health outcomes

Determinants of Skilled Birth Attendance in the Northern Parts of Ghana

Background. An integral part of the Sustainable Development Goal three is to ensure universal access to sexual and reproductive healthcare services which include skilled delivery by the year 2030. We examined the determinants of skilled delivery among women in the Northern part of Ghana. Methods. The paper made use of data from the Demographic and Health Survey. Women from the Northern part of Ghana were included in the analysis. Bivariate descriptive analyses coupled with binary logistic regression estimation technique were used to analyse the data. Results. Region of residence, age, household wealth, education, distance to a health facility, religion, parity, partner’s education, and getting money for treatment were identified as the determinants of skilled delivery. While the probability of having a skilled delivery was higher in the Upper East Region, it was lower in the Northern and Upper West Regions compared to the Brong Ahafo Region. Conclusion. Our findings call for more attention from the Ghana Health Service and the Ministry of Health in addressing the skilled delivery gaps among women particularly in the Northern and Upper West Regions in ensuring attainment of the Sustainable Development Goal target related to reproductive health care accessibility for all by the year 2030

Understanding tobacco use and socioeconomic inequalities among men in Ghana, and Lesotho

Abstract Background Tobacco use is one of the leading causes of preventable deaths and has become a significant public health issue. Previous studies have paid less attention to tobacco use and socio-economic equalities among men in developing countries. This study examines the relationship between tobacco use and socio-economic inequalities among men in Ghana and Lesotho. Methods The study made use of data from the 2014 Demographic and Health Survey (DHS) from Ghana, and Lesotho. Binary logistic regression was employed to examine the associations between socio-economic inequality characteristics of respondents and tobacco use. Results The results showed that the prevalence of tobacco use was high in Lesotho (47.9%) as compared to that of Ghana (6.3%). Tobacco use was generally high across all age groups in Lesotho and in contrast, it was relatively low across all ages in Ghana. A statistically significant association was found between all the socio-economic variables and tobacco use in both countries. The prevalence of tobacco use was smaller in age group 15–24 years compared to the age groups 25–34 years and 35–59 years in both Ghana and Lesotho, although the association is stronger in Ghana. The AOR’s in Ghana are respectively 5.3 (95% CI: 3.29–8.59) and 9.7 (95% CI: 6.20–15.06), compared to respectively 1.7 (95% CI: 1.32–2.11) and 1.7 (95% CI: 1.36–2.12). Smoking prevalence was smaller in men with higher level of education compared to men with no education in both Ghana and Lesotho, although the association was weaker in Ghana. The AOR in Ghana is 0.1 (95% CI: (0.02–0.11), compared to 0.2 (95% Cl: (0.17–0.30). The prevalence of tobacco use was smaller among men in urban areas compared to rural areas in both Ghana and Lesotho, although the association is stronger in Ghana. The AOR in Ghana is 2.1 (95% CI: 1.67–2.73), compared to 1.6 (95% CI: (1.31–1.95). In both countries, prevalence of tobacco use was higher in men who are traditionalist/spiritualists or who had no religion compared to Christians, although the association was stronger in Ghana. The AOR in Ghana is 6.2 (95% CI: (4.42–4.09) compared to 1.7 (95% CI: (1.21–2.47). The prevalence of tobacco use was low among men with richest wealth status compared to men with poorest wealth status in both Ghana and Lesotho, although the association is weaker in Ghana. The AOR in Ghana is 0.1 (95% Cl: (0.06–0.17) compared to 0.4 (95% CI: (0.51–1.12). In relation to occupation, prevalence of tobacco use was smaller among professional workers compared to men in the Agricultural sector in both Ghana and Lesotho, although the association is stronger in Ghana. The AOR in Ghana is 9.3 (95% Cl: (4.54–18.99), compared to 3.5 (95% CI: (2.27–5.52). Formerly married men in both countries were more likely to use tobacco compared to currently not married men, although the prevalence was higher in Ghana. The AOR in Ghana is 1.6 (95% CI: (0.99–2.28)], compared to 1.4 (95% CI: (0.89–2.28) in Lesotho. Conclusion Although similar socio-economic inequality factors provided an understanding of tobacco use among men in Ghana and Lesotho, there were variations in relation to how each factor influences tobacco use

Non-use of diabetes medication and its associated factors: a comparative analysis of female and male patients in four Sub-Saharan African countries

Abstract Background Globally, the burden of disease is shifting towards non-communicable diseases (NCDs), including diabetes. Sub-Saharan Africa (SSA) faces an increasing prevalence of diabetes, hindering the achievement of global health goals. This study investigates the determinants of non-use of diabetes medication, specifically exploring potential sex differences in four SSA countries. Methods This cross-sectional study analyzed recent Demographic and Health Survey (DHS) data (2017–2021) from four SSA countries (Benin, Cameroon, Madagascar, and Mauritania). Samples included 23,695 women and 25,339 men, focusing on individuals with diabetes not using medication (248 women, 162 men). Descriptive and inferential analyses, including chi-square tests and binary logistic regression models, were conducted using Stata version 14. Odds ratios were calculated with a 95% confidence interval to determine the associations. Results This study found that a larger proportion of female patients with diabetes (64.1%) were not using diabetes medication compared to their male counterparts (59.4%). Age influenced medication non-use in males, with older individuals exhibiting lower odds of non-usage. Higher wealth status was associated with lower odds of non-use of diabetes medications. The presence of heart disease was associated with a lower likelihood of medication non-use among females. Conclusions This study demonstrates sex disparities, age differences, wealth status, heart disease, and country-specific variations in medication non-use. Tailored interventions for different age groups, as well as socioeconomic support, are critical, as is integrated cardiovascular and diabetes care. These actions can improve medication use and adherence, quality of life, and long-term diabetes management outcomes

What Influences Where They Give Birth? Determinants of Place of Delivery among Women in Rural Ghana

Background. There is a paucity of empirical literature in Ghana on rural areas and their utilisation of health facilities. The study examined the effects of the sociodemographics of rural women on place of delivery in the country. Methods. The paper made use of data from the 2014 Ghana Demographic and Health Survey. Women from rural areas who had given birth within five years prior to the survey were included in the analysis. Descriptive analyses and binary logistic regression were used to analyse the data. Results. Wealth, maternal education, ecological zone, getting money for treatment, ethnicity, partner’s education, parity, and distance to a health facility were found as the determinants of place of delivery among women in rural Ghana. Women in the richest wealth quintile were three times (OR = 3.04, 95% CI = 0.35–26.4) more likely to deliver at a health facility than the poorest women. Conclusions. It behoves the relevant stakeholders including the Ghana Health Service and the Ministry of Health to pay attention to the wealth status, maternal education, ecological zone, ethnicity, partner’s education, parity, and distance in their planning regarding delivery care in rural Ghana

Prevalence and determinants of the place of delivery among reproductive age women in sub-Saharan Africa.

IntroductionMaternal mortality is an issue of global public health concern with over 300,000 women dying globally each year. In sub-Saharan Africa (SSA), these deaths mainly occur around childbirth and the first 24hours after delivery. The place of delivery is, therefore, important in reducing maternal deaths and accelerating progress towards attaining the 2030 sustainable development goals (SDGs) related to maternal health. In this study, we examined the prevalence and determinants of the place of delivery among reproductive age women in SSA.Materials and methodsThis was a cross-sectional study among women in their reproductive age using data from the most recent demographic and health surveys of 28 SSA countries. Frequency, percentage, chi-square, and logistic regression were used in analysing the data. All analyses were done using STATA.ResultsThe overall prevalence of health facility delivery was 66%. This ranged from 23% in Chad to 94% in Gabon. More than half of the countries recorded a less than 70% prevalence of health facility delivery. The adjusted odds of health facility delivery were lowest in Chad. The probability of giving birth at a health facility also declined with increasing age but increased with the level of education and wealth status. Women from rural areas had a lower likelihood (AOR = 0.59, 95%CI = 0.57-0.61) of delivering at a health facility compared with urban women.ConclusionsOur findings point to the inability of many SSA countries to meet the SDG targets concerning reductions in maternal mortality and improving the health of reproductive age women. The findings thus justify the need for peer learning among SSA countries for the adaption and integration into local contexts, of interventions that have proven to be successful in improving health facility delivery among reproductive age women

Women decision-making capacity and intimate partner violence among women in sub-Saharan Africa

Abstract Background Violence against women is a common form of human rights violation, and intimate partner violence (IPV) appears to be the most significant component of violence. The aim of this study was to examine the association between women decision-making capacity and IPV among Women in Sub-Saharan Africa. The study also looked at how socio-demographic factors also influence IPV among Women in Sub-Saharan Africa. Methods The study made use of pooled data from most recent Demographic and Health Survey (DHS) conducted from January 1, 2010, and December 3, 2016, in 18 countries in Sub-Saharan Africa. For the purpose of the study, only women aged 15–49 were used (N = 84,486). Univariate and multivariate logistic regression models were used to investigate the relationship between the explanatory variables and the outcome variable. Results The odds of reporting ever experienced IPV was higher among women with decision-making capacity [AOR = 1.35; CI = 1.35–1.48]. The likelihood of experiencing IPV was low among young women. Women who belong to other religious groups and Christians were more likely to experience IPV compared to those who were Muslims [AOR = 1.73; CI = 1.65–1.82] and [AOR = 1.87; CI = 1.72–2.02] respectively. Women who have partners with no education [AOR = 1.11; CI = 1.03–1.20], those whose partners had primary education [AOR = 1.34; CI = 1.25–1.44] and those whose partners had secondary education [AOR = 1.22; CI = 1.15–1.30] were more likely to IPV compared to those whose partners had higher education. The odds of experiencing IPV were high among women who were employed compared to those who were unemployed [AOR = 1.33; CI = 1.28–1.37]. The likelihood of the occurrence of IPV was also high among women who were cohabiting compared to those who were married [AOR = 1.16; CI = 1.10–1.21]. Women with no education [AOR = 1.37; CI = 1.24–1.51], those with primary education [AOR = 1.65; CI = 1.50–1.82] and those with secondary education [AOR = 1.50; CI = 1.37–1.64] were more likely to experience IPV compared to those with higher education. Finally, women with poorest wealth status [AOR = 1.28; CI = 1.20–1.37], those with poorer wealth status [AOR = 1.24; CI = 1.17–1.32], those with middle wealth status [AOR = 1.27; CI = 1.20–1.34] and those with richer wealth status [AOR = 1.11; CI = 1.06–1.17] were more likely to IPV compared to women with richest wealth status. Conclusion Though related socio-demographic characteristics and women decision-making capacity provided an explanation of IPV among women in sub-Saharan Africa, there were differences in relation to how each socio-demographic variable predisposed women to IPV in Sub-Saharan Africa