Gender-based Household Compositional Changes and Implications for Poverty in South Africa

Poverty is one of the most challenging socio-economic problems in South Africa. Though poverty rates have been substantially reduced in the post-apartheid period, many South Africans remain poor. Available evidence also indicates a substantial gender gradient to the prevalence of poverty in the country. A standard indicator of gendered power structures is the gender of the household head. We examine the effect of transitioning from a male- to a female-headed household over time (relative to remaining in a male-headed household) on changes in the probability of transitioning into poverty from a non-poor state over a two- to six-year period. This type of longitudinal analysis is largely lacking in South Africa, where most previous studies have largely focused on cross-sectional and repeated cross-sectional analyses. The results indicate that transitioning from a male- to female-headed household is associated with an increase in the probability of falling into poverty from a previous non-poor state. The results hold true across all poverty lines and also indicate that the effect of gender-based transitions is not significant in the short term (i.e. for the one-period transitions), but over more persistent transitions

Overview Of Losses And Solutions In Power Transmission Lines

Growing popupulations and industrilization creat huge need for electrical energy. Unfortunately, electricity is not always used in large demand in the same location it is been generated. So, long cables or wires are used to transmit the generated electricity either through Underground or Overhead system method, which is reffereed to as Transmission of Electrical Energy. This transmission those not take place without encoutering loses, which is the soul aim of this report. Studying the various types of loses encouted during electrical transmission. The losses are either Technical losses or Non-technical Losses. The technical losses, which includes the; Corona loss, Juole effect, Magnetic Losses, and skin effect. While the Non-technical (commercial ) losses include, theift of electricity, vandalism to electrical substatio ns, poor meter reading, poor accounting and record keeping, etc. There could be no best way, by explaining the various methods of Analysing calculations on how to solve this technical losses, and also explaining measures to be taken to makesure that transmission losses can be reduced to bearess minimum. KEYWORDS----- Transmission Line, Losses, Energy, Electricity, Distribution Line, Voltage, Power Station, Corona Effect, Resistive Effect,  Technical Losses, and Electrical Power

Decomposition of socioeconomic inequalities in cigarette smoking: the case of Namibia

Background Namibia has one of the highest levels of income inequality in the world. Increased smoking prevalence, especially among the youth, may leave the country facing the spectre of higher smoking-related disease prevalence in the years to come. This study examines socioeconomic inequalities in smoking in Namibia and explores the drivers of this inequality. Methods Data are obtained from the Namibia 2013 Demographic and Health Survey, a nationally representative survey. Concentration curves and indices are calculated for cigarette smoking prevalence and intensity to assess the respective inequalities. Smoking intensity is defined as the number of cigarette sticks smoked within the last 24 h before the survey. We use a decomposition technique to identify the contribution of various covariates to socioeconomic inequalities in smoking prevalence and intensity. Results The concentration indices for socioeconomic inequality in cigarette smoking prevalence and smoking intensity are estimated at 0.021 and 0.135, respectively. This suggests that cigarette smoking is more prevalent among the wealthy and that they smoke more frequently compared to less wealthy Namibians. For smoking intensity, the biggest statistically significant contributors to inequality are marital status, wealth and region dummy variables while for smoking prevalence, education and place of dwelling (urban vs rural) are the main contributors. Conclusion While overall inequality in smoking prevalence and intensity is focused among the wealthy, the contribution of region of residence and education warrant some attention from policy makers. Based on our results, we suggest an assessment of compliance and enforcement of the Tobacco Products Control Act, that initially focuses on regions with reportedly low education statistics followed by an appropriate implementation strategy to address the challenges identified in implementing effective tobacco control interventions

Association between ART adherence and mental health : results from a national HIV sero-behavioural survey in South Africa

This paper assesses the levels of antiretroviral treatment (ART) adherence and mental health distress among study participants in a national behavioural HIV-sero prevalence study South Africa. The study was a cross-sectional population-based multi-stage stratified cluster random survey, (SABSSM V, 2017). Structured questionnaires were used to collect information on socio-demographics, HIV knowledge, perceptions, HIV testing and HIV treatment history. Study participants were tested for HIV infection, antiretroviral use, viral suppression, and ART drug resistance. A total of 2155 PLHIV aged 15 years or older who were on ART were included in the study. Incidence of either moderate or severe mental health distress was 19.7%. Self-reported ART adherence among study participants with no, mild, moderate, or severe mental distress was 82%, 83%, 86% and 78%, respectively. The adjusted odds ratio for ART non-adherence was 0.58 (95% CI 0.24; 1.40) for mild mental distress, 0.82 (95% CI 0.35; 1.91) for moderate mental distress and 2.19 (95% CI 1.14; 4.19) for severe mental distress groups compared to the no mental health distress group. The other factors that were associated with ART non-adherence in adjusted models included education level, alcohol use and province/region of residence. The study revealed that mental health remains a challenge to ART adherence in South Africa. To improve ART adherence, HIV continuum of care programs should include screening for mental health among people living with HIV.The President’s Emergency Plan for AIDS Relief through the Centers for Disease Control and Prevention under the terms of Cooperative Agreement Number NU2GGH001629. Additional funding was also received from the South African Department of Science and Technology (now known as the Department of Science and Innovation), South African National AIDS Council, The Global Fund to Fight AIDS, Tuberculosis and Malaria, Right to Care, United Nations Children’s Fund (UNICEF), the Centre for Communication Impact, Soul City, and love Life.http://link.springer.com/journal/10461hj2023Psycholog

Socioeconomic inequalities in maternal health service utilisation: a case of antenatal care in Nigeria using a decomposition approach

Abstract Background Antenatal care (ANC) services are critical for maternal health but Nigeria performs poorly in ANC utilisation compared to other countries in sub-Saharan Africa. This study aimed to assess socioeconomic inequalities in ANC utilisation and the determinants of these inequalities in Nigeria. Methods The 2013 Nigeria Demographic and Health Survey data with 18,559 women was used for analysis. The paper used concentration curves and indices for different measures of ANC utilisation (no ANC visit, 1–3 ANC visits, at least four ANC visits, and the number of ANC visits). A positive (or negative) concentration index means that the measure of ANC utilisation was concentrated on the richer (poorer) population compared to their poorer (richer) counterparts. The concentration indices were also decomposed using standard methodologies to examine the significant determinants of the socioeconomic inequalities in no ANC visit, at least four ANC visits, and the number of ANC visits. Results No ANC visit was disproportionately concentrated among the poor (concentration index (CI) = − 0.573), whereas at least four ANC visits (CI = 0.582) and a higher number of ANC visits (CI = 0.357) were disproportionately concentrated among the rich. While these results were consistent across all the geopolitical zones and rural and urban areas, the inequalities were more prevalent in the northern zones (which also have the highest incidence of poverty in the country) and the rural areas. The significant contributors to inequalities in ANC utilisation were the zone of residence, wealth, women’s education (especially secondary) and employment, urban-rural residence, ethnicity, spousal education, and problems with obtaining permission to seek health care and distance to the clinic. Conclusions Addressing wealth inequalities, enhancing literacy, employment and mitigating spatial impediments to health care use will reduce socioeconomic inequalities in ANC utilisation in Nigeria. These factors are the social determinants of health inequalities. Thus, a social determinants of health approach is needed to address socioeconomic inequalities in ANC coverage in Nigeria

Explaining changes in wealth inequalities in child health: The case of stunting and wasting in Nigeria.

BackgroundMalnutrition is a major cause of child death, and many children suffer from acute and chronic malnutrition. Nigeria has the second-highest burden of stunting globally and a higher-than-average child wasting prevalence. Moreover, there is substantial spatial variation in the prevalence of stunting and wasting in Nigeria. This paper assessed the socioeconomic inequalities and determinants of the change in socioeconomic inequalities in child stunting and wasting in Nigeria between 2013 and 2018.MethodsData came from the 2013 and 2018 Nigeria Demographic and Health Survey. Socioeconomic inequalities in stunting and wasting were measured using the concentration curve and Erreygers' corrected concentration index. A pro-poor concentration index is negative, meaning that the poor bear a disproportionately higher burden of stunting or wasting than the wealthy. A positive or pro-rich index is the opposite. Standard methodologies were applied to decompose the concentration index (C) while the Oaxaca-Blinder approach was used to decompose changes in the concentration indices (ΔC).FindingsThe socioeconomic inequalities in child stunting and wasting were pro-poor in 2013 and 2018. The concentration indices for stunting reduced from -0.298 (2013) to -0.330 (2018) (ΔC = -0.032). However, the concentration indices for wasting increased from -0.066 to -0.048 (ΔC = 0.018). The changes in the socioeconomic inequalities in stunting and wasting varied by geopolitical zones. Significant determinants of these changes for both stunting and wasting were changes in inequalities in wealth, maternal education and religion. Under-five dependency, access to improved toilet facilities and geopolitical zone significantly explained changes in only stunting inequality, while access to improved water facilities only significantly determined the change in inequality in wasting.ConclusionAddressing the socio-economic, spatial and demographic determinants of the changes in the socioeconomic inequalities in child stunting and wasting, especially wealth, maternal education and access to sanitation is critical for improving child stunting and wasting in Nigeria

Is socioeconomic inequality in antenatal care coverage widening or reducing between- and within-socioeconomic groups? A case of 19 countries in sub-Saharan Africa

Maternal health statistics have improved in many countries in sub-Saharan Africa (SSA). Still, progress remains slow in meeting the Sustainable Development Goals (SDG) targets. Accelerating antenatal care (ANC) coverage is critical to improving maternal health outcomes. To progress, countries should understand whether to target reducing health disparities between- or within-socioeconomic groups, as policies for achieving these may differ. This paper develops a framework for decomposing changes in socioeconomic inequalities in health into changes in between- and within-socioeconomic groups using the concentration index, a popular measure for assessing socioeconomic inequalities in health. It begins by noting the challenge in decomposing the concentration index into only between- and within-group components due to the possibility of an overlap created by overlapping distributions of socioeconomic status between groups. Using quantiles of socioeconomic status provides a convenient way to decompose the concentration index so that the overlap component disappears. In characterising the decomposition, a pro-poor shift occurs when socioeconomic inequality is reduced over time, including between- and within-socioeconomic groups, while a pro-rich shift or change occurs conversely. The framework is applied to data from two rounds of the Demographic and Health Survey of 19 countries in SSA conducted about ten years apart in each country. It assessed changes in socioeconomic inequalities in an indicator of at least four antenatal care visits (ANC4+) and the count of ANC visits (ANC intensity). The results show that many countries in SSA witnessed significant pro-poor shifts or reductions in socioeconomic inequalities in ANC coverage because pro-rich inequalities in ANC4+ and ANC intensity become less pro-rich. Changes in between-socioeconomic group inequalities drive the changes in ANC service coverage inequalities in all countries. Thus, policies addressing inequalities between-socioeconomic groups are vital to reducing overall disparities and closing the gap between the rich and the poor, a crucial objective for the SDGs

Validation of antihypertensive drug requirement to measure the severity of hypertension and the efficacy of lifestyle intervention

Background/objective: The ongoing pandemic of non-communicable diseases, with systemic arterial hypertension at the forefront, mandates urgent attention to the aetiopathogenic mechanism rather than continuing to rely on suppressive drug therapies. Lifestyle interventions (such as diet, sleep and exercise) may have substantial impact on blood pressure control in hypertension. However this may not be evident in clinical trials of lifestyle intervention if the blood pressure was previously controlled by drugs. We therefore sought to develop an alternative method of measuring the impact of lifestyle intervention, rather than rely on blood pressure measurement alone. Methods: The open trial of a personalized food avoidance dietary approach to stop hypertension was approved by the UNTH ethics committee. The Antihypertensive Drug Treatment Requirement (ADTR) score was calculated as the total number of defined unitary dosages of antihypertensive drugs times adherence +/- 0.1 accordingly for each mm Hg that average systolic pressure either exceeds 120 mm Hg (AOBP or home BP, whichever higher) or goes below 100 mm Hg Hg (AOBP or home BP, whichever lower). The dietary compliance score was based on the frequency of major/ minor dietary indiscretion (as per the PFADASH guidelines) i.e. less than (= GOOD) or more than (= POOR) once a month/ once a fortnight, respectively. Normality of data distribution was assessed by computing Shapiro-Wilk statistics. Cronbach's alpha reliability coefficient was used to assess internal consistency of ADTR measurements. Results: Bi-quarterly Shapiro – Wilk statistics for AdhRx scores and ADTR scores showed more than 80% likelihood of being normally distributed at 5% significance level (i.e. 13 out of 16 data sets tested). Cronbach's alpha reliability coefficient was 0.980. This confirmed consistency of the ADTR measurement scale. For three study participants who improved to Good compliance (after dietary counseling) and four participants who failed to improve, Good compliance was associated with lower ADTR scores, but the differences between Good (mean ADTR of 1.07+0.82) and Poor (3.81+3.15) were not statistically significant (p = 0.210). For the three study participants who transited from Poor to Good compliance (in response to counseling), there was a high degree of negative correlation (i.e. decline of drug requirement) which was statistically significant in two of them (p<0.05). However, in the study participants who failed to improve their dietary compliance, there was a relative lack of correlation (with higher p values). The overall pattern is consistent with a negative association between dietary compliance and ADTR score. Conclusion: We conclude that ADTR scores are useful and valid tools to assess the impact of dietary interventions which address the aetiopathogenic mechanism in essential hypertension. This enables differentiation between blood pressure lowering by drugs and that due to dietary intervention