Not just numbers: beyond counting caesarean deliveries to understanding their determinants in Ghana using a population based cross-sectional study.

BACKGROUND:The increasing rate of caesarean deliveries (CD) has become a serious concern for public health experts globally. Despite this health concern, research on factors associated CD in many low- and -middle countries like Ghana is sparse. This study, therefore, assessed the prevalence and determinants of CD among child-bearing women aged 15-49  in Ghana. METHODS:The study used data from the 2014 Ghana Demographic and Health Survey. The analysis was limited to mothers (n = 2742) aged 15-49 , who had given birth in health facilities 5 years preceding the survey. Association between CD and its determinants was assessed by calculating adjusted odds ratios (AOR) with their respective 95% confidence intervals using a binary logistic regression. RESULTS:The percentage of mothers who delivered their babies through caesarean section (CS) was 18.5%. Using multivariable logistic regression, the results showed that women aged 45-49 (AOR = 10.5; 95% CI: 3.0-37.4), and women from a household that are headed by a female (AOR = 1.3; 95% CI = 1.1-1.7) had higher odds to deliver through CS. Women from the Upper East (AOR =0.4; 95% CI = 0.2-0.7) and Upper West (AOR = 0.4; 95% CI = 0.2-0.8) regions had lower odds to deliver their children through CS. Women with parity 4 or more (AOR = 0.3; 95% CI = 0.2-0.5) had lower odds of CD compared to those with parity 1. Women with female babies had lower odds (AOR = 0.8; CI = 0.7-0.9) of delivering them through CS compared to those with male children. CONCLUSION:The percentage of women delivering babies through the CS in Ghana is high. The high rates of CD noted do not essentially indicate good quality care or services. Hence, health facilities offering this medical protocol need to adopt comprehensive and strict measures to ensure detailed medical justifications by doctors for performing these caesarean surgeries

Household food security determinants and nutritional status of inhabitants of a peri-urban community: a case study in the Volta region of Ghana

Food shortages and malnutrition widely persist and continue to be rural peculiarities across the sub-region. A cross-sectional study was conducted in a peri-urban community of Dzodze in the Volta region to ascertain the level of food security as well as the nutritional status of the inhabitants using a random sampling technique. This community-based comparative cross-sectional study conducted from May to July 2018 adopted a multistage random sampling and selected 105 households. Sociodemographic data were collected using a structured questionnaire. Chi-square, Cramer’s-V, and Pearson’s correlations models were used to assess the association of socio-demographic, anthropometric and food frequency data while the Logit model, FSI, HCR were used to measure food security. Over half of the sample (59.6%) were in the normal range of BMI which implied good nutritional status. Remarkably, a majority of those in this normal BMI range 81 (77%) were female. Women aged 41years and above constituted a large portion of study participants (54.3%) of which many 43 (41%) were married. Just 4.8% of this group said they were both separated and cohabited with their partners non-customarily. Data on the frequency of food intake by the community revealed that, a majority of 63.4% of the respondents ate three times a day. Most of the people (77.2%, 68.7%, and 86.9%) ate breakfast, lunch, and supper, respectively, daily over a week. The fallouts from the work showed majority (71.5%) of the respondents were food secure and the remaining (about 28.5%) were food insecure. Factors such as age, gender, educational level, household size, and age were found to be significant predictors that influenced food security of the peri-urban community according to the logit model used. The smallholder households according to the computed food security index of 1.13 and normal range of BMI were identified to be indices of food security.&nbsp

Risky sexual behaviours among school-aged adolescents in Namibia: secondary data analyses of the 2013 Global school-based health survey

Aim: Risky sexual behaviours (RSB) among adolescents is one of the major public health concerns globally. These behaviours–RSB have adverse effects on their future health and well-being. Therefore, in this paper, our aim was to assess the determinants of RSB among in-school Namibian adolescents using the 2013 Global School-based Health Survey. Methods: The data was extracted and analysed with STATA version 14.2. Both bivariate and multivariable analyses were done to generate results that infomed the discussion. The results were presented as odds ratios and adjusted odds ratios (AOR) with their respective 95% confidence intervals (CI). Level of statistical significance was declared at a p-value of < 0.05. Results: Our results showed that of the 2846 adolescents surveyed, 51.8% reported they have ever had sexual intercourse. Fifty-eight percent reported having multiple sexual partners and 23.2% reported not using a condom during their last sexual intercourse. The multivariable analysis showed that age [AOR = 2.50; CI = 1.99–3.14], sex [AOR = 0.40; CI = 0.34–0.47], grade [AOR = 1.80; CI =1.38–2.36], suicidal ideation [AOR = 1.44; CI =1.16–1.79], bullying [AOR = 1.36; CI = 1.15–1.62], hunger [AOR = 1.39; CI = 1.17–1.64], alcohol use [AOR = 1.57; CI = 1.31–1.89], marijuana use [AOR = 1.98; CI = 1.14–3.45] and parental knowledge of activity [AOR = 0.82; CI = 0.68–0.99] showed statistically significant influence on sexual experience. Sex [AOR = 0.43; CI = 0.33–0.55], grade [AOR = 1.58; CI = 1.15–2.18], alcohol use [AOR = 1.37; CI =1.07–1.75], marijuana use [AOR = 2.23; CI = 1.11–4.46] and parental supervision [AOR = 0.76; CI = 0.59–0.98] were associated with multiple sexual partners. There was also statistically significant association between age [AOR = 0.32; CI = 0.21–0.48], loneliness [AOR = 1.49; CI = 1.04–2.14], number of close friends [AOR = 0.60; CI = 0.37–0.96] and parental supervision [AOR = 0.43; CI = 0.32–0.60] on non-condom use. Conclusion: These findings underscore the need for a pragmatic approach in addressing RSB among adolescents by adopting substance use prevention and mental health promotion programmes and by encouraging more parental involvement in activities of their adolescents

Household food security determinants and nutritional status of inhabitants of a peri-urban community: A case study in the Volta region of Ghana

Food shortages and malnutrition widely persist and continue to be rural peculiarities across the sub-region. A cross-sectional study was conducted in a peri-urban community of Dzodze in the Volta region to ascertain the level of food security as well as the nutritional status of the inhabitants using a random sampling technique. This community-based comparative cross-sectional study conducted from May to July 2018 adopted a multistage random sampling and selected 105 households. Socio-demographic data were collected using a structured questionnaire. Chi-square, Cramer’s-V, and Pearson’s correlations models were used to assess the association of socio-demographic, anthropometric and food frequency data while the Logit model, FSI, HCR were used to measure food security. Over half of the sample (59.6%) were in the normal range of BMI which implied good nutritional status. Remarkably, a majority of those in this normal BMI range 81 (77%) were female. Women aged 41years and above constituted a large portion of study participants (54.3%) of which many 43 (41%) were married. Just 4.8% of this group said they were both separated and cohabited with their partners non-customarily. Data on the frequency of food intake by the community revealed that, a majority of 63.4% of the respondents ate three times a day. Most of the people (77.2%, 68.7%, and 86.9%) ate breakfast, lunch, and supper, respectively, daily over a week. The fallouts from the work showed majority (71.5%) of the respondents were food secure and the remaining (about 28.5%) were food insecure. Factors such as age, gender, educational level, household size, and age were found to be significant predictors that influenced food security of the peri-urban community according to the logit model used. The smallholder households according to the computed food security index of 1.13 and normal range of BMI were identified to be indices of food security