Work-life balance and self-reported health among working adults in Europe: a gender and welfare state regime comparative analysis.

Mensah A, Adjei NK. Work-life balance and self-reported health among working adults in Europe: a gender and welfare state regime comparative analysis. BMC public health. 2020;20: 1052.BACKGROUND: The pressing demands of work over the years have had a significant constraint on the family and social life of working adults. Moreover, failure to achieve a 'balance' between these domains of life may have an adverse effect on their health. This study investigated the relationship between work-life conflict and self-reported health among working adults in contemporary welfare countries in Europe.; METHODS: Data from the 6th European Working Conditions Survey 2015 on 32,275 working adults from 30 countries in Europe were analysed. Multivariate logistic regression models were used to examine the associations between work-life balance and self-reported health among men and women. We further used a 2 stage multi-level logistic regression to assess variations in self-reported health among welfare state regimes by gender.; RESULTS: The results showed a strong association between work-life conflict and poor self-reported health among working adults in Europe (aOR=2.07; 95% CI: 1.93-2.23). However, the magnitude of the effect differed slightly by gender (men: aOR=1.97; 95% CI: 1.78-2.18 vs women: aOR=2.23; 95% CI: 2.01-2.47). Furthermore, we found variations in the relationship between work-life conflict and poor self-reported health between welfare states regimes. The association was found to be weaker in the Nordic and Southern welfare states than the Liberal, Conservative, and Central Eastern European welfare states. Although the associations were more consistent among men than women in the Conservative welfare states regime, we found higher associations for women than men in the Southern, Nordic, Liberal, and Central Eastern European welfare states.; CONCLUSIONS: This study provides evidence of some variations in the association between work-life conflict and poor self-reported health among men and women across welfare states regimes in Europe. The results demonstrate the need for governments, organizations and policymakers to provide conducive working conditions and social policies for working adults to deal with competing demands from work and family activities

Inequalities in Health among Older Adults in Western Industrialised Countries : Explanations from Gender, Socioeconomic and Time Use Perspectives

Gender and socioeconomic inequalities in health persist in high-income countries, even at old age; yet, there is still no consensus about the best indicators of socioeconomic status to be used in health inequalities research among older adults, especially after retirement. Complementary social indicators that have been suggested to assess gender and socioeconomic inequalities in health outcomes at old age are social roles and time use activities. This thesis explores the social and economic inequalities in self-reported health among elderly men and women, using a combined framework of time use activities, socioeconomic status (SES) and family characteristics. It further explains gender and cross-national inequalities in health in some Western industrialised countries. The thesis is centered around three empirical studies focusing on different dimensions of social inequalities in health among elderly men and women. The studies are based on data from the Multinational Time Use Study (MTUS) on older men and women aged 65 years and above. It also consists of a framework paper with an introductory chapter and a discussion of methodological as well as content issues around the topic. Study I examined how time use activities, socioeconomic status and family characteristics impact the health of older adults, and the extent to which the associations varied by gender and across countries. It further examined the extent to which various social factors explain the gender inequalities in health at old age. Significant gender differences in self-reported health were found in Germany, Italy and Spain, but not in the United Kingdom and the United States. Further decomposition analysis showed that differences in time allocated to leisure activities and level of educational attainment accounted for the largest health gap between elderly men and women. The results also showed that whereas time devoted to paid work, housework and active leisure activities were positively associated with health, time allocated to passive leisure and personal activities were negatively related to health in both men and women. The magnitude of the associations however varied by gender and country. Study II investigated the extent to which the association between housework activities and health may be moderated by sleep duration among elderly men and women. The result showed that both short ( 7 hours) and long ( 8 hours) sleep duration were negatively associated with health for both genders. However, the interactive associations between total productive housework, sleep duration and health status varied considerably between men and women. Among women, long hours of housework combined with either short or long sleep was negatively associated with health. Study III examined whether stress defined in terms of time pressure plays a mediating role in the relationship between work-related activities (paid work and unpaid work) and health among elderly men and women. The results showed that socioeconomic status, demographic factors, stress and work-related time use activities after retirement had a significant direct influence on health among the elderly. The findings further revealed that although stress has a strong direct negative effect on the health of both genders, it does not indirectly influence the positive effects of work-related time use activities on health among older adults. The overall conclusion in this thesis is that social patterning of health inequalities persist at older ages in high-income countries. However, the magnitude of these inequalities differ across countries and are shaped by unequal distribution of social and time use resources. The results of this thesis thus demonstrate the need of using an integrated framework of social factors when analysing gender and cross-national inequalities in health among the elderly population

Exposure to family planning messages on social media and its association with maternal healthcare services in Mauritania.

BackgroundMauritania, a lower-middle-income country in Northwest Africa, has one of the highest maternal and infant mortality rates worldwide and struggles to ensure optimal use of maternal healthcare services. Raising health awareness through family planning messages can promote maternal healthcare use, potentially reducing preventable maternal and child mortalities. The objective of the study was to assess the potential impact of exposure to family planning messages through social media on the utilization of maternal healthcare services among Mauritanian women.MethodsData from the 2019-20 Mauritania Demographic and Health Survey (MDHS) on 7,640 women were analyzed. Multiple logistic regression models were applied to examine the associations between exposure to family planning messages through social media and maternal healthcare services, specifically the timing and adequacy of ANC visits, and facility-based childbirth. Adjusted odds ratios with 95% confidence intervals (CI) were estimated.ResultsThe percentage of timely initiation and adequate use of ANC among the participants were 65.6% and 45.1%, respectively. Approximately 75.0% of the women reported giving birth to their last child at a healthcare facility. Exposure to family planning messages on social media was significantly associated with increased odds of receiving adequate antenatal care visits (OR = 1.38, 95% CI = 1.12,1.71) and giving birth in a health facility (OR = 1.83, 95% CI = 1.09,3.08), Other factors such as age, health insurance, wealth, and desired timing of the last child were also found to be important predictors of maternal healthcare.ConclusionThe findings suggest that exposure to family planning messages on social media is strongly associated with adequate antenatal care and health facility-based childbirth, but not with early timing of antenatal care. Comprehensive maternal healthcare policies should consider the role of social media in promoting family planning messages

Social Capital, Deprivation and Psychological Well-Being among Young Adolescents: A Multilevel Study from England and Wales.

Examining the mechanisms influencing mental health and life satisfaction simultaneously allows for a better understanding of adolescents psychological well-being. Six indicators of neighbourhood social capital (NSC), neighbourhood socioeconomic deprivation (SecD) and their association with psychological well-being among young adolescents aged 10-15 from England and Wales were investigated. Using a random sample of 5201 adolescents (7253 observations) from the UK Household Longitudinal Study merged to aggregated local area census measures, we fitted a series of multilevel models. The findings showed that not being worried about crime and friendship networks mitigated the negative effects of deprivation on adolescent's psychological well-being. These findings suggest that some forms of NSC may have a buffering and protective function, with the strongest effects in deprived neighbourhoods. We further found that psychological well-being of adolescents is dependent on both individual vulnerabilities and neighbourhood context. However caution is required if, and when public health policies are formulated to address this issue, given significant variations (27-36%) in the inter- and intra-individual psychological well-being were found among this group over time. Thus, policies designed to improve psychological well-being among adolescents should take into account the role of social processes in transmitting deprivation's effects, as well as the various forms of social capital

Individual and community-level determinants of knowledge of ovulatory cycle among women of reproductive age in 29 African countries: a multilevel analysis

BackgroundKnowledge of the ovulatory cycle (KOC) can help reduce the chances of unwanted pregnancies and may improve a woman's reproductive health. However, little is known about the factors associated with knowledge of the ovulatory cycle across Africa. Therefore, we aimed to investigate the individual/household and community level determinants of KOC among women of childbearing age in 29 African countries.MethodsWe used data from the Demographic and Health Surveys of 29 African countries conducted between 2010 and 2020. Bivariate and multivariate multilevel logistic regressions were used to examine the association between women's correct knowledge of the ovulatory cycle and individual/household and community-level factors. The results were reported using adjusted odds ratios (AOR) with a 95% confidence interval (CI).ResultsThe pooled results showed that correct KOC among women was 15.5% (95% CI 14.2-17.0%), varying from 11.5% in Liberia to 57.1% in the Democratic Republic of Congo. Regarding regional distribution, the highest prevalence of KOC was observed in West Africa (38.8%) followed by East Africa (21.3%) and was lowest in Southern Africa (15.6%) and Central Africa (15.5%). After adjusting for potential confounders, at the individual level, we found the odds of KOC to be higher among older women (40-44 years-aOR 3.57, 95% CI 1.90-6.67, 45-49 years-aOR 2.49, 95% CI 1.29-4.82), and women with higher educational level (aOR 2.58, 95% CI 1.40-4.75); at the community level, higher KOC was among women exposed to media (aOR 2.24, 95% CI 1.32-3.81).ConclusionsKnowledge of ovulatory cycle among women of reproductive age was found to be low in the region and varied by country. Women's age and educational level were the individual-level factors associated with increased knowledge of ovulatory cycle while community-level media exposure was found to be associated with increased knowledge of ovulatory cycle in this study. This finding highlights the need for appropriate strategies (possibly use of mass media) to increase knowledge of ovulatory cycle among women of reproductive age, especially among adolescents in Africa

Impact of poverty and adversity on perceived family support in adolescence:findings from the UK Millennium Cohort Study

Emotional support from family members may have an important effect on adolescent health outcomes, and has been identified as a target for policy to protect against the impacts of poverty and other early life adversities. However, few studies have assessed the extent to which poverty and adversity themselves influence the nature of emotional support that parents can provide to adolescents. We, therefore, aimed to investigate the impact of trajectories of income poverty and family adversities, including parental mental ill health, alcohol misuse and domestic violence across childhood developmental stages on young people’s relationships with their families and perceived emotional support received. We analysed longitudinal data on 10,976 children from the nationally representative UK Millennium Cohort study. Exposure trajectories of poverty and family adversities were characterised using group-based multi-trajectory models (age 9 months–14 years). The outcomes were perceived emotional support and quality of family relationships, measured by the three-item Short Social Provisions Scale (SPS-3) and levels of parent–adolescent closeness and conflict, measured at age 14. ORs and 95% CIs were estimated using multivariable logistic regression models, adjusting for potential confounding factors. At age 14, the overall prevalence of low perceived emotional support was 13% (95% CI: 12, 14). Children of mothers with lower socioeconomic status (SES) were more likely to report low emotional support, with a clear social gradient (education—degree plus: 10.3% vs. no qualifications: 15.4%). Compared with children exposed to low levels of poverty and adversity, children in the persistent adversity trajectory groups experienced higher odds of low emotional support and low-quality parent–adolescent relationship; those exposed to both persistent poverty and poor parental mental health were particularly at increased risk of experiencing poor family relationships and low perceived emotional support (adjusted odds ratio 2·2; 95% CI 1·7–2·9). Low perceived emotional support and poor family relationships in adolescence are more prevalent among socially disadvantaged children and adolescents and those experiencing social adversity. Policies to improve levels of family support for UK adolescents should focus on improving modifiable determinants such as child poverty and family mental health.</p

Ectopic pregnancies in low resource setting: a retrospective review of cases in Kumasi, Ghana

Background: Ectopic pregnancy remains a public health threat for women in reproductive age, and a major cause of maternal mortalities in the first trimester of pregnancy. Past studies in Ghana on the burden of Ectopic Pregnancy (EP) have focused on major referral health facilities with little consideration of primary health facilities. This study was set out to determine the prevalence of Ectopic Pregnancy, demographic characteristics involved and the various types of Ectopic Pregnancy seen in primary health settings in Kumasi, Ghana.Methods: A retrospective descriptive cross-sectional study was conducted at the Suntreso Government and Tafo Government Hospitals in the Kumasi metropolitan area from 2007 to 2017. A review of 28,600 obstetric cases recorded in registers of the two facilities was done using electronic data extraction form. The data were exported into STATA/IC 14.0 for statistical analysis.Results: A prevalence of 0.76% EP was recorded over the study period of 10 years. 61.75% of the women diagnosed with EP were between the ages of 21-30 years with a mean age and standard deviation of 27.61 and 5.91 respectively. Tubal (fallopian tubes) EP was seen in 76.96% of the women diagnosed with EP. 10.18% and 7.19% of the tubal EP occurred in the cornual and fimbriae respectively. Ruptured EP was seen in 58.99% of the cases.Conclusions: The study reported EP in about one in a hundred cases. The commonest EP that emerged from this study was tubal (fallopian tube) EP. Among the tubal EP, cornual and fimbria were the commonest EP that occurred in the fallopian tube. Although cases of tubo-ovarian and ovarian EP are rare, a significant percentage were observed in this study. Early reporting and diagnosis of EP should be of great importance to prevent ruptured EP and any associated complications

Pregnant women's decision-making capacity and adherence to iron supplementation in sub-Saharan Africa: a multi-country analysis of 25 countries

Background: Anaemia and related complications during pregnancy is a global problem but more prevalent in sub-Sahara Africa (SSA). Women’s decision-making power has significantly been linked with maternal health service utilization but there is inadequate evidence about adherence to iron supplementation. This study therefore assessed the association between household decision-making power and iron supplementation adherence among pregnant married women in 25 sub-Saharan African countries. Methods: We used data from the Demographic and Health Surveys (DHS) of 25 sub-Saharan African countries conducted between 2010 and 2019. Women's decision-making power was measured by three parameters; own health care, making large household purchases and visits to her family or relatives. The association between women’s decision-making power and iron supplementation adherence was assessed using logistic regressions, adjusting for confounders. The results were presented as adjusted odds ratio (AOR) with 95% confidence intervals (CIs). Results: Approximately 65.4% of pregnant married women had made decisions either alone or with husband in all three decisions making parameters (i.e., own health care, making large household purchases, visits to her family or relatives). The rate of adherence to iron medication during pregnancy was 51.7% (95% CI; 48.5–54.9%). Adherence to iron supplementation was found to be higher among pregnant married women who had decision-making power (AOR = 1.46, 95% CI; 1.16–1.83), secondary education (AOR = 1.45, 95% CI; 1.05–2.00) and antenatal care visit (AOR = 2.77, 95% CI; 2.19–3.51). Wealth quintiles and religion were significantly associated with adherence to iron supplementation. Conclusions: Adherence to iron supplementation is high among pregnant women in SSA. Decision making power, educational status and antenatal care visit were found to be significantly associated with adherence to these supplements. These findings highlight that there is a need to design interventions that enhance women’s decision-making capacities, and empowering them through education to improve the coverage of antenatal iron supplementation