Search

Background: Findings from studies assessing Long Covid in children and young people (CYP) need to be assessed in light of their methodological limitations. For example, if non-response and/or attrition over time systematically differ by sub-groups of CYP, findings could be biased and any generalisation limited. The present study aimed to (i) construct survey weights for the Children and young people with Long Covid (CLoCk) study, and (ii) apply them to published CLoCk findings showing the prevalence of shortness of breath and tiredness increased over time from baseline to 12-months post-baseline in both SARS-CoV-2 Positive and Negative CYP. Methods: Logistic regression models were fitted to compute the probability of (i) Responding given envisioned to take part, (ii) Responding timely given responded, and (iii) (Re)infection given timely response. Response, timely response and (re)infection weights were generated as the reciprocal of the corresponding probability, with an overall 'envisioned population' survey weight derived as the product of these weights. Survey weights were trimmed, and an interactive tool developed to re-calibrate target population survey weights to the general population using data from the 2021 UK Census. Results: Flexible survey weights for the CLoCk study were successfully developed. In the illustrative example, re-weighted results (when accounting for selection in response, attrition, and (re)infection) were consistent with published findings. Conclusions: Flexible survey weights to address potential bias and selection issues were created for and used in the CLoCk study. Previously reported prospective findings from CLoCk are generalisable to the wider population of CYP in England. This study highlights the importance of considering selection into a sample and attrition over time when considering generalisability of findings. [ABSTRACT FROM AUTHOR]

Background: Malaria remains a significant public health threat in Sierra Leone, particularly for pregnant women and their unborn children. Infection during pregnancy can lead to severe consequences, including maternal anaemia, low birth weight, premature birth, and even death. Therefore, preventing malaria during pregnancy is crucial for improving maternal and child health outcomes. This study investigated the predictors of insecticide-treated bed net (ITN) use among pregnant women in Sierra Leone. Methods: The study analysed the 2019 Sierra Leone Demographic and Health Survey data (SLDHS). The study comprised a total of 900 pregnant women aged 15–49 years, representing the nationally representative sample. A multivariable binary regression analysis was used to explore the predictors of ITN use. The regression results were presented using an adjusted odds ratio (AOR) with 95% confidence intervals (CI). Results: The study found that the prevalence of ITN use among pregnant women was 64.2 [60.4, 67.9] in Sierra Leone. Pregnant women who were married [aOR = 2.02, 95% CI 1.32, 3.07] had higher odds of bed net use than those who were unmarried. Pregnant women with five or more children [aOR = 1.69, 95% CI 1.01, 2.84] had higher odds of mosquito bed net use than those with four and below children. Pregnant women living in the Northern, Northwestern, Southern and Western regions all had lower odds of bed net use than those in the Eastern region, with the lowest odds among those living in the western region [aOR = 0.19, 95% CI 0.09, 0.40]. Pregnant women who were Muslims [aOR = 0.63, 95% CI 0.41, 0.95] had lower odds of mosquito bed net use than Christians. Pregnant women with female household heads [aOR = 0.65, 95% CI 0.44, 0.95] had lower odds of mosquito bed net use than those with male household heads. Conclusion: ITN use among pregnant women in Sierra Leone remains suboptimal. Marital status, parity, sex of household head, region and religion were associated with bed net use. The government and policymakers in Sierra Leone should integrate ITN education and distribution into prenatal care services, emphasizing the benefits for both mother and baby—partnering with healthcare providers to raise awareness and encourage consistent use. Involve local leaders, religious figures, and mothers' groups to promote the benefits of ITN during pregnancy. Educate husbands and partners on the importance of ITN use during pregnancy and encourage their support in its consistent use. [ABSTRACT FROM AUTHOR]

In this work we propose a functional concurrent regression model to estimate labor supply elasticities over the years 1988 through 2014 using Current Population Survey data. Assuming, as is common, that individuals' wages are endogenous, we introduce instrumental variables in a two-stage least squares approach to estimate the desired labor supply elasticities. Furthermore, we tailor our estimation method to sparse functional data. Though recent work has incorporated instrumental variables into other functional regression models, to our knowledge this has not yet been done in the functional concurrent regression model, and most existing literature is not suited for sparse functional data. We show through simulations that this two-stage least squares approach greatly eliminates the bias introduced by a naive model (i.e. one that does not acknowledge endogeneity) and produces accurate coefficient estimates for moderate sample sizes. [ABSTRACT FROM AUTHOR]

Background: Cervical cancer remains the second most common cause of death in women and poses a growing public health challenge. It is urgent to increase cervical cancer screening rates in Kenya as per the 2018 Kenya National Cancer Screening Guidelines. Addressing access to care may serve as a target to achieve this goal; however, how individual dimensions of access to care are associated with the utilization of cervical cancer screening services in low- and middle-income countries, including Kenya, remains unclear. This study aimed to examine how different aspects of access to care (affordability, availability, geographical access, and social influence) were associated with cervical cancer screening among Kenyan women of reproductive age. Methods: This cross-sectional study used data from the 2014 Kenya Demographic and Health Survey and the 2010 Kenya Service Provision Assessment. The final sample included 5,563 women aged 25–49 years. Logistic regression models were used to examine the association between different aspects of access to care and the uptake of cervical cancer screening. Results: Factors such as being in the poorest wealth quintile, lacking health insurance, having difficulty obtaining funds for treatment (affordability), limited availability of screening services at nearby facilities (availability), living in rural areas (geographical access), and having healthcare decisions made solely by husbands/partners or others (social influence) were associated with a decreased likelihood of the uptake of cervical cancer screening. Conclusions: Increasing health insurance coverage, enhancing the availability of screening services at health facilities, expanding mobile screening health facilities in rural areas, and empowering women to make their own healthcare decisions are crucial steps for increasing cervical cancer screening uptake in Kenya. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study was to investigate the link between emotion dysregulation and insomnia disorder as well as the possible role of psychiatric comorbidity on the association. More specifically, the aim was to examine whether the elevations in emotion dysregulation in insomnia are dependent on co-occurring psychiatric comorbidity, in this study defined as anxiety disorders and/or major depression. Methods: Four diagnostically differing groups with 25 participants in each were recruited: normal sleep, normal sleep with psychiatric comorbidity, insomnia disorder, and insomnia disorder with psychiatric comorbidity. The 100 study participants completed self-report scales and items assessing socio-demographic parameters, symptoms of insomnia, anxiety, and depression, generic emotion regulation, and insomnia-specific emotion regulation. Results: Concerning generic emotion regulation, the results showed that psychiatric comorbidity, but not insomnia, was associated with elevations in generic emotion dysregulation. Psychiatric comorbidity was distinctly related to elevations in non-acceptance, goals, and impulse domains (d = 1.09-1.22). Regarding insomnia-specific emotion regulation, the findings demonstrated that insomnia, with or without psychiatric comorbidity, was related to heightened use of insomnia-associated emotion dysregulation strategies. Insomnia was uniquely associated with elevated unhelpful beliefs about sleep and safety behaviors (d = 1.00-1.04). Conclusion: The current findings support the notion that insomnia is associated with specific, but not generic, emotion dysregulation strategies. These results have relevance for the conceptualization of the role of emotion dysregulation in insomnia and the clinical management of insomnia. [ABSTRACT FROM AUTHOR]

Background: Health is an inseparable part of life and central to all life supporting systems. The reproductive and child health shares a major portion of public health cases that is crucial for socio-economic development. Studies on reproductive and child health have traditionally been focused on demographic aspects using socio-economic parameters. Given the emphasis of Sustainable Development Goal (SDG)-3 on health and well-being, it is imperative to understand the geo-spatial dimension with the visible transition of key health indicators of fertility, maternal and infant/child health in the high burdened districts within these high focus Empowered Action Group (EAG) states of Rajasthan, Madhya Pradesh, Uttar Pradesh and Bihar that make up nearly 40% of India's population with relatively laggard health status. Methodology: This paper aims to understand the status and trend of key reproductive and child health indicators and vital statistics based on the recent representative demographic surveys. We intend to undertake a district level spatio-temporal analysis by developing District Composite Health Profile (DCHP) using Composite Index Method on selected 13 equally weighted key reproductive and child health indicators. The study has been carried out using data from National Family Health Survey-4 (2015–16) and National Family Health Survey-5 (2019–21) survey rounds. We employed geo-spatial techniques i.e. Moran's–I, and univariate LISA to comprehend the geographical clustering of high and low health burden districts and their heterogeneities at the district level. Results/Conclusions: The study highlights emerging inter-districts, and inter-state disparities over survey periods. With consistent improvement in the selected EAG states over time, the overall reproductive and child health status through DCHP along with each indicator was relatively better in the states of Rajasthan and worse in Bihar. Districts along the Terai belt in Uttar Pradesh and Bihar consistently performed sluggish during survey rounds. The geo-spatial clustering follows the political boundary of states, albeit with intra-state variations. Monitoring of key health indicators using composite index method provides a useful leverage for identifying priority districts/regions for universal health access that should also consider geographical space as an important policy dimension. [ABSTRACT FROM AUTHOR]

Introduction: Neonatal mortality during the first week of life is a global issue that is responsible for a large portion of deaths among children under the age of five. There are, however, very few reports about the issue in sub-Saharan Africa. For the sake of developing appropriate policies and initiatives that could aid in addressing the issue, it is important to study the prevalence of mortality during the early neonatal period and associated factors. Thus, the aim of this study was to ascertain the prevalence of and pinpoint the contributing factors to early neonatal mortality in sub-Saharan Africa. Method: Data from recent demographic and health surveys in sub-Saharan African countries was used for this study. The study included 262,763 live births in total. The determinants of early newborn mortality were identified using a multilevel mixed-effects logistic regression model. To determine the strength and significance of the association between outcome and explanatory variables, the adjusted odds ratio (AOR) at a 95% confidence interval (CI) was computed. Independent variables were deemed statistically significant when the p-value was less than the significance level (0.05). Result: Early neonatal mortality in sub-Saharan Africa was 22.94 deaths per 1,000 live births. It was found to be significantly associated with maternal age over 35 years (AOR = 1.77, 95% CI: 1.34–2.33), low birth weight (AOR = 3.27, 95% CI: 2.16, 4.94), less than four ANC visits (AOR = 1.12, 95% CI: 1.01, 1.33), delivery with caesarean section (AOR = 1.81, 95% CI: 1.30–2.5), not having any complications during pregnancy (AOR = 0.76, 95% CI: 0.61, 94), and community poverty (AOR = 1.32, 95% CI: 1.05–1.65). Conclusion: This study found that about twenty-three neonates out of one thousand live births died within the first week of life in sub-Saharan Africa. The age of mothers, birth weight, antenatal care service utilization, mode of delivery, multiple pregnancy, complications during pregnancy, and community poverty should be considered while designing policies and strategies targeting early neonatal mortality in sub-Saharan Africa. [ABSTRACT FROM AUTHOR]

Background: Identification of neonatal danger signs and immediate access to health care are two global efforts aimed at enhancing newborn and child survival by preventing 75% of neonatal deaths. Despite various small-scale studies on women's awareness of neonatal danger signs in Ethiopia, little is known about the level of receiving health information on those danger signs during the immediate postpartum period at the national level. Hence, this study aimed at assessing the level, and its determinants of the service uptake in Ethiopia. Methods: The data for this study was taken from the Ethiopian Demographic and Health Survey (EDHS), which took place from January to June 2016 and covered all administrative regions of Ethiopia. A weighted sample of 7,589.8 women was analyzed using STATA version 16. To account for data clustering, a multivariable multilevel mixed-effect logistic regression analysis was employed to determine the effects of each predictor on the outcome variable. Adjusted odds ratio with its corresponding 95% confidence interval was used to declare the statistical significance of the explanatory variables. Results: The receipt of health information on neonatal danger signs during the immediate postpartum period was 10.70% [95% CI:10.01, 11.40]. Variables namely living in Metropolitans [AOR = 2.06; 95%CI: 1.48, 2.88] and Large central [AOR = 1.83; 95%CI: 1.38, 2.42] regions, being in the highest wealth quintile [AOR = 1.87; 95% CI: 1.23, 2.84], being nulliparous [AOR = 0.27; 95% CI: 0.08, 0.87] and primiparous[AOR = 0.61;95% CI: 0.46, 0.79], getting adequate antenatal visits [AOR = 2.42; 95% CI: 1.75, 3.33], institutional delivery [AOR = 5.91; 95% CI: 4.66, 7.53], and receipt of postnatal visits [AOR = 3.52; 95% CI: 2.84, 4.38] were identified as significant determinants of receiving health information on newborn danger signs. Conclusion: The findings revealed that unacceptably low uptake of health information on newborn danger signs during the immediate postpartum period in Ethiopia. A concerted effort is needed from all stakeholders in the health sector to enhance the uptake of maternal health services (antenatal care, skilled delivery service, and postnatal care). Healthcare providers should pay special attention to nulliparous and primiparous women during and after delivery, and the government should also focus on women of peripheral regions, who make up a large portion of the low coverage. [ABSTRACT FROM AUTHOR]

Introduction: HIV-related stigma and discrimination significantly affects health, and well-being, willingness to be tested for HIV, initiation and adherence to antiretroviral therapy, and quality of life. However, the findings of the prior studies revealed that the prevalence of discrimination against people living with HIV is high. Thus, we aimed to assess the magnitude of discriminatory attitudes against people living with HIV/AIDS and associated factors in three sub-Saharan African countries. Methods: The appended and most recent Demographic and Health Survey dataset of three sub-Saharan African countries from 2021 to 2022 was used for data analysis. A total of 56,690 women aged 15–49 years were included in this study as a weighted sample. The determinants of discriminatory attitudes against people living with HIV/AIDS were determined using a multilevel mixed-effects logistic regression model. Significant factors associated with discriminatory attitudes against people living with HIV/AIDS in the multilevel mixed-effect logistic regression model were declared significant at p-values < 0.05. The adjusted odds ratio (AOR) and confidence interval (CI) were used to interpret the results. Result: The overall prevalence of discriminatory attitudes against people living with HIV/AIDS was 28.19% (95% CI: 27.74%, 28.64%). In the multivariable analysis, individual level (being young, being an internet user, being tested for HIV, and having comprehensive knowledge about HIV) and community level (being a rural dweller) were factors associated with discriminatory attitudes against people living with HIV/AIDS. Conclusion: The prevalence of discriminatory attitudes against people living with HIV/AIDS in three sub-Saharan African countries was high. Individual and community-level variables were associated with discriminatory attitudes against people living with HIV/AIDS. Therefore, special consideration should be given to rural dwellers and young adults. In addition, better to strengthen the accessibility of Internet and HIV testing services, and improve HIV-related education to reduce the magnitude of discriminatory attitudes against people living with HIV/AIDS. [ABSTRACT FROM AUTHOR]

Background: The empowerment of women has implications on the health and dietary needs of children. Using the survey-based women's empowerment index (SWPER), we examined the association between women's empowerment and dietary diversity among children aged 6–23 months in sub-Saharan Africa. Methods: Data from the Demographic and Health Surveys of 21 countries were utilized. Descriptive spatial map was used to present the proportions of dietary diversity among the children. Multilevel binary logistic regression was used to examine the association between SWPER and dietary diversity. Results: Overall, 22.35% of children aged 6–23 months had adequate minimum dietary diversity (MDD) in sub-Saharan Africa. The countries with the highest proportions of adequate MDD were Angola, Benin, Madagascar, Rwanda, Sierra Leone, and South Africa. South Africa had the highest proportion of MDD (61.00%), while Liberia reported the least (9.12%). Children born to mothers who had high social independence were more likely to have adequate MDD compared to those with low social independence [aOR = 1.31, 95% CI 1.21, 1.41]. In addition, children born to women with medium [aOR = 1.12; 95% CI 1.03, 1.21] and high decision-making [aOR = 1.25, 95% CI 1.14, 1.37] were more likely to receive MDD than those with low decision-making. Conclusions: Insufficient dietary diversity is evident among children aged 6–23 months in sub-Saharan Africa. MDD in children is influenced by women's empowerment. Policies and interventions promoting women's empowerment can enhance MDD, especially for vulnerable groups in rural and poorer households. It is crucial to leverage media and poverty reduction strategies to improve MDD among children in sub-Saharan African countries. [ABSTRACT FROM AUTHOR]

Introduction: Intimate partner violence is a human rights violation that often involves violence against women, which appears to be the most prevalent type of abuse. Intimate partner violence is a major global public health issue that includes physical, emotional, and sexual violence. The prevalence of intimate partner violence in Africa is high. The burden of intimate partner violence among reproductive-age women is high in Kenya. Therefore, the main aim of this study is to determine the associated factors of intimate partner violence among reproductive-age women at the individual and community level from the recent Demographic and Health Survey (DHS) 2022 data of Kenya. Methods: The Kenya National Demographic and Health Survey data of 2022 was used for this study. The overall sample size for this study was 14,612, which focused on women aged 15 to 49 years who had ever been partnered and responded to the domestic violence module. Multilevel logistic regression models to determine the prevalence and associated factors at the individual and community level with intimate partner violence with a 95% Confidence Interval (CI) and Adjusted Odds Ratio (AOR). Result: The overall prevalence of intimate partner violence was 41.1% with a 95% CI (40.07%, 42.60. Male-headed households, poorest and middle wealth status, partner alcohol use, separated/widowed current marital status, and low education of women were statistically significantly associated with intimate partner violence at the individual level variables in this study. Conclusions: The prevalence of intimate partner violence was high. Educating women, reducing partner alcohol use, and improving the economic status of women, were crucial in mitigating the burden of intimate partner violence. The intimate partners are supposed to respect the rights of women. [ABSTRACT FROM AUTHOR]

Background: Children with inadequate iron consumption had slower growth, weaker immunity, and poor cognitive development. Although the public health importance of iron-rich consumption in Ethiopia is known, evidence for iron-rich food consumption and predictors among children aged 6–59 months old in Ethiopia is sparse. This study aimed to assess iron-rich food consumption and predictors among children aged 6–59 months old in Ethiopia. Methods: This study used Ethiopia mini demographic and health survey 2019 (EMDHS-2019) data with a total weighted sample size of 5,112 among children aged 6–59 months old. A multilevel mixed effect logistic regression analysis was used to identify predictors of good iron-rich food consumption. Results: The proportion of good consumption of iron-rich foods among children aged 6–59 months was 27.99% (24.22, 32.10%). The findings revealed that children born to mothers who completed primary education [AOR = 1.88, 95% CI: 1.11, 3.19], a higher education [AOR = 4.45, 95% CI: 1.28, 15.48], being born to the poorer family [AOR = 1.89, 95% CI: 1.04, 3.43], richer [AOR = 2.12, 95% CI: 1.03, 4.36], and richest [AOR = 3.57, 95% CI: 1.29, 9.93] were positively associated with good iron-rich food consumption among children aged 6–59 months old. Nevertheless, being 24–59 month-old children [AOR = 0.58, 95% CI: 0.44, 0.72], residents of the Afar [AOR = 0.23, 95% CI: 0.08, 0.67], Amhara region [AOR = 0.30, 95% CI: 0.14, 0.65], and Somali region [AOR = 0.01, 95% CI: 0.01, 0.07] were negatively associated with good iron-rich food consumption among children aged 6–59 months old. Conclusion: The finding revealed that there was low consumption of iron-rich foods among children aged 6–59 months in Ethiopia compared to reports from East African countries. Improving women's literacy and economic empowerment would improve iron-rich food consumption among children aged 6–59 months old. This study's findings would have implications for policymakers in Ethiopia to enhance iron-rich food consumption. [ABSTRACT FROM AUTHOR]

Background: Although the dissemination of health information is one of the pillars of HIV prevention efforts in Ethiopia, a large segment of women in the country still lack adequate HIV/AIDS knowledge, attitude, and behaviours. Despite many studies being conducted in Ethiopia, they mostly focus on the level of women's knowledge about HIV/AIDS, failing to examine composite index of knowledge, attitude, and behaviour (KAB) domains comprehensively. In addition, the previous studies overlooked individual and community-level, and spatial predictors. Hence, this study aimed to estimate the prevalence, geographical variation (Hotspots), spatial predictors, and multilevel correlates of inadequate HIV/AIDS-Knowledge, Attitude, and Behaviour (HIV/AIDS-KAB) among Ethiopian women. Methods: The study conducted using the 2016 Ethiopian Demographic and Health Survey data, included 12,672 women of reproductive age group (15–49 years). A stratified, two-stage cluster sampling technique was used; a random selection of enumeration areas (clusters) followed by selecting households per cluster. Composite index of HIV/AIDS-KAB was assessed using 11 items encompassing HIV/AIDS prevention, transmission, and misconceptions. Spatial analysis was carried out using Arc-GIS version 10.7 and SaTScan version 9.6 statistical software. Spatial autocorrelation (Moran's I) was used to determine the non-randomness of the spatial variation in inadequate knowledge about HIV/AIDS. Multilevel multivariable logistic regression was performed, with the measure of association reported using adjusted odds ratio (AOR) with its corresponding 95% CI. Results: The prevalence of inadequate HIV/AIDS-KAB among Ethiopian women was 48.9% (95% CI: 48.1, 49.8), with significant spatial variations across regions (global Moran's I = 0.64, p<0.001). Ten most likely significant SaTScan clusters were identified with a high proportion of women with inadequate KAB. Somali and most parts of Afar regions were identified as hot spots for women with inadequate HIV/AIDS-KAB. Higher odds of inadequate HIV/AIDS-KAB was observed among women living in the poorest wealth quintile (AOR = 1.63; 95% CI: 1.21, 2.18), rural residents (AOR = 1.62; 95% CI: 1.18, 2.22), having no formal education (AOR = 2.66; 95% CI: 2.04, 3.48), non-autonomous (AOR = 1.71; 95% CI: (1.43, 2.28), never listen to radio (AOR = 1.56; 95% CI: (1.02, 2.39), never watched television (AOR = 1.50; 95% CI: 1.17, 1.92), not having a mobile phone (AOR = 1.45; 95% CI: 1.27, 1.88), and not visiting health facilities (AOR = 1.46; 95% CI: 1.28, 1.72). Conclusion: The level of inadequate HIV/AIDS-KAB in Ethiopia was high, with significant spatial variation across regions, and Somali, and Afar regions contributed much to this high prevalence. Thus, the government should work on integrating HIV/AIDS education and prevention efforts with existing reproductive health services, regular monitoring and evaluation, and collaboration and partnership to tackle this gap. Stakeholders in the health sector should strengthen their efforts to provide tailored health education, and information campaigns with an emphasis on women who lack formal education, live in rural areas, and poorest wealth quintile should be key measures to enhancing knowledge. enhanced effort is needed to increase women's autonomy to empower women to access HIV/AIDS information. The media agencies could prioritise the dissemination of culturally sensitive HIV/AIDS information to women of reproductive age. The identified hot spots with relatively poor knowledge of HIV/AIDS should be targeted during resource allocation and interventions. [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV) is a worldwide issue. One of the latest developments in its theoretical framework deals with the concept of polyvictimisation – the simultaneous occurrence of physical, emotional, and sexual abuse. However, the literature lacks an overall measure of violence for surveys. The aim of this research is to study IPV within the framework of the ecological model. A model-based composite indicator that takes into account the relationship between domestic abuse and individual characteristics of respondents, family dynamics, and community and societal traits is built using survey data. The data are from the Demographic and Health Survey collected in eleven African countries on women aged 15–49. The employed structural equation model shows the importance of individual characteristics while community and societal factors are less relevant. The composite indicator is also used for classification and ranking purposes, allowing areas where socio-educational interventions are more urgent to be identified. [ABSTRACT FROM AUTHOR]

Background: Inequalities in modern contraceptive use among women in low-income countries remain a major public health challenge. Eliminating or reducing the inequalities in modern contraceptive use among women could accelerate the achievement of Sustainable Development Goals, Targets 3.7 & 5.6. Thus, this study examined the inequality gaps in modern contraceptive use and associated factors among women of reproductive age in Nigeria between 2003 and 2018. Methods: This study employed the World Health Organisation's Health Equity Assessment Toolkit to analyse the 2003 and 2018 Nigeria Demographic Health Surveys. Modern contraceptive use was aggregated using five equity stratifiers: age, economic status, educational level, place, and region of residence among women of reproductive aged 15 to 49, with a sample size of 5,336 and 29,090 for 2003 and 2018, respectively. Inequality was measured in this study using difference (D), ratio (R), population-attributable risk (PAR), and a population-attributable fraction (PAF). Results: The study shows an increase in modern contraceptive use among women of reproductive age in Nigeria from 8.25% in 2003 to 12.01% in 2018, with the use being more prominent among women of reproductive age 20–49 and those in the richest economic quintile. In both surveys, women with primary education showed the most upward increase in modern contraceptive use. Women residing in the urban areas also show an upward use of modern contraceptives use. The study further highlights inequality gaps, with age being a substantial factor, while economic status and sub-national regions showed mild to marginal inequality gaps. Finally, the educational level of women of reproductive age in Nigeria significantly shows inequality in modern contraceptive use, with a PAF of 129.11 in 2003 and 65.39 in 2018. Conclusion: The inequality gap in modern contraceptive use among women of reproductive age in Nigeria between 2003 and 2018 reported in this study includes age, education, wealth quintile, residence, and region-related inequalities. The study highlights the need for policies and programmes that target the groups with low use of modern contraceptives to promote equity in family planning services. [ABSTRACT FROM AUTHOR]

Obtaining representative information on hosts and displaced populations in a single survey is not straightforward. This article demonstrates the value of combining traditional and nontraditional sampling frames, geospatial information, and listing exercises to design a representative survey of hosts and Rohingya displaced populations in Cox's Bazar, Bangladesh. The article applies innovative segmentation techniques using geospatial data to delimit enumeration areas in the absence of updated cartography. The article also highlights the importance of listing exercises to inform stratification decisions and update population counts. [ABSTRACT FROM AUTHOR]

This retrospective study aimed to assess allergic sensitisation among adult patients tested at National Health Laboratory Service (NHLS) laboratories across nine provinces in South Africa. With a primary focus on identifying prevalent allergens, the investigation extends to comparative analyses with workers tested at the National Institute for Occupational Health (NIOH) and explores trends during a ten-year period from 2012. The overarching objective was to ascertain the potential value of leveraging routine public-health data for comprehensive occupational allergy (OA) surveillance, attempting to fill a critical gap in existing South African OA data. In examining allergic sensitisation, the study spanned NHLS laboratory tests conducted from January 2012 to December 2021, encompassing adult demographic ages from 18 to 65 years, which represent the typical working age of South Africans. The results for allergens recommended by the South African Allergic Rhinitis Working Group and other allergens of relevance in occupational settings were extracted and analysed, providing a robust foundation for a nuanced exploration of sensitisation patterns. Of the 31 913 NHLS laboratory records, 48.48% of adults tested positive for ImmunoCAP Phadiatop, indicative of atopy. In addition, the percentage sensitisation to common aeroallergens of 538 workers tested at the NIOH using the skin-prick test method was compared to those of patients tested at the NHLS. Furthermore, the study uncovered a spectrum of sensitisation patterns, with house-dust mites and grass pollens emerging as predominant allergens. Occupational allergens, including latex, alpha-amylase and chlorhexidine, manifested as noteworthy contributors to sensitisation, shedding light on potential workplace hazards. Provincial variations in sensitisation patterns underscore the nuanced nature of allergic responses across different regions. Dermatophagoides pteronyssinus dominated in five provinces, signifying geographical disparities in allergen prevalence. Intriguingly, comparison with NIOH data reveals significantly higher sensitisation rates in NHLS patients for specific allergens, which suggests potential variations in testing methodologies and patient selection between the two institutions. Drawing from these insights, the study concluded that routine NHLS data are of critical importance for trend analysis and preventive strategies. The high prevalence of sensitisation to common allergens underscores the imperative for targeted preventive measures. This study, bridging the gap in OA data, lays the groundwork for future research exploring the intricate associations between routine allergen sensitisation testing and OA surveillance. [ABSTRACT FROM AUTHOR]

School funding formulas have been applied across a number of countries for at least the last 50 years. A national funding formula (NFF) was introduced in England in 2018 and aims to provide a platform for fair funding across the country. This study explores the variations in the NFF's high needs block (HNB) funding and examines links with the use of specialist provision by English local authorities (LAs) for children with special educational needs and disability. The findings demonstrate significant and continuing differences in HNB funding between demographically similar LAs, notwithstanding a £3.5 billion (75%) HNB increase in real terms in the decade since 2013, which could have supported a shift towards a more equitable position. Published HNB funding for 2023–24 now varies by up to £49m in comparator LAs. Differences are largely the result of the persistent use of a historical factor in the formula and a ceiling on levels of income growth for lower funded LAs. The research also shows a significant link between HNB funding and the use of specialist provision. The discussion investigates how far the UK government's policy commitment to a more equitable system of HNB funding is matched by the reality, and the degree to which funding is based on need rather than demand or history. [ABSTRACT FROM AUTHOR]

Aim: Malnutrition in pregnant women significantly affects both mother and child health. This research aims to identify the best machine learning (ML) techniques for predicting the nutritional status of pregnant women in Bangladesh and detect the most essential features based on the best-performed algorithm. Methods: This study used retrospective cross-sectional data from the Bangladeshi Demographic and Health Survey 2017–18. Different feature transformations and machine learning classifiers were applied to find the best transformation and classification model. Results: This investigation found that robust scaling outperformed all feature transformation methods. The result shows that the Random Forest algorithm with robust scaling outperforms all other machine learning algorithms with 74.75% accuracy, 57.91% kappa statistics, 73.36% precision, 73.08% recall, and 73.09% f1 score. In addition, the Random Forest algorithm had the highest precision (76.76%) and f1 score (71.71%) for predicting the underweight class, as well as an expected precision of 82.01% and f1 score of 83.78% for the overweight/obese class when compared to other algorithms with a robust scaling method. The respondent's age, wealth index, region, husband's education level, husband's age, and occupation were crucial features for predicting the nutritional status of pregnant women in Bangladesh. Conclusion: The proposed classifier could help predict the expected outcome and reduce the burden of malnutrition among pregnant women in Bangladesh. [ABSTRACT FROM AUTHOR]

Introduction: Family planning (FP) is crucial for improving maternal and newborn health outcomes, promoting gender equality, and reducing poverty. Unmet FP needs persist globally, especially in South Asia and Sub-Saharan Africa leading to unintended pregnancies, unsafe abortions, and maternal fatalities. This study aims to identify the determinants of unmet needs for FP from a nationally representative survey. Methods: We analyzed the data of 11,180 currently married women from nationally representative Nepal Health Demographic Survey 2022. We conducted weighted analysis in R statistical software to account complex survey design and non-response rate. We conducted univariate and multivariable binary and multinomial logistic regression to assess association of unmet need for FP with independent variables including place of residence, province, ecological belt, ethnicity, religion, current age, participant's and husband's education, occupation, wealth quintile, parity, desire for child, and media exposure. Results: The total unmet FP need was 20.8% (95%CI: 19.7, 21.9) accounting 13.4% (95%CI: 12.5, 14.4) for unmet need for limiting and 7.4% (95%CI: 6.8, 8.0) for unmet for spacing. Lower odds of total unmet need for FP were present in 20–34 years and 35–49 years compared to <20 years, women belonging to Madhesi ethnic group (AOR: 0.78; 95%CI: 0.64, 0.95) compared to Brahmin/Chhetri, women from richest (AOR: 0.69; 95%CI: 0.56, 0.84), richer (AOR: 0.82; 95%CI: 0.68, 0.97) and middle wealth quintile (AOR: 0.82; 95%CI:0.70, 0.98) groups compared poorest wealth quintile group and women belonging to rural area (AOR: 0.89; 95%CI: 0.80, 0.99) compared to urban area. Higher odds of unmet need for FP were present among women with basic (AOR: 1.34; 95%CI: 1.17, 1.54), and secondary level (AOR: 1.32; 95%CI: 1.12, 1.56) education compared to women without education, among women from Madhesh (AOR: 1.56; 95%CI: 1.22, 1.98), Gandaki (AOR: 2.11; 95%CI: 1.66, 2.68), Lumbini (AOR: 1.97; 95%CI: 1.61, 2.42) and Sudurpashchim province (AOR: 1.64; 95%CI: 1.27, 2.10) compared to Koshi province and among women whose husband education was basic level (AOR:1.37; 95%CI: 1.15, 1.63), or secondary level (AOR: 1.32; 95%CI: 1.09, 1.60) education. Conclusion: Nepal faces relatively high unmet FP needs across various socio-demographic strata. Addressing these needs requires targeted interventions focusing on age, ethnicity, religion, education, and socio-economic factors to ensure universal access to FP services. [ABSTRACT FROM AUTHOR]

Introduction: Sexual behaviour needs to take a central position in the heart of public health policy makers and researchers. This is important in view of its association with Sexually Transmitted Infections (STIs), including HIV. Though the prevalence of HIV/AIDS is declining in Ethiopia, the country is still one of the hardest hit in the continent of Africa. Hence, this study was aimed at identifying hot spot areas and associated factors of risky sexual behavior (RSB). This would be vital for more targeted interventions which can produce a sexually healthy community in Ethiopia. Methods: In this study, a cross-sectional survey study design was employed. A further analysis of the 2016 Ethiopia Demographic and Health Survey data was done on a total weighted sample of 10,518 women and men age 15–49 years. ArcGIS version 10.7 and Kuldorff's SaTScan version 9.6 software were used for spatial analysis. Global Moran's I statistic was employed to test the spatial autocorrelation, and Getis-Ord Gi* as well as Bernoulli-based purely spatial scan statistics were used to detect significant spatial clusters of RSB. Mixed effect multivariable logistic regression model was fitted to identify predictors and variables with a p-value ≤0.05 were considered as statistically significant. Result: The study subjects who had RSB were found to account about 10.2% (95% CI: 9.64%, 10.81%) of the population, and spatial clustering of RSB was observed (Moran's I = 0.82, p-value = 0.001). Significant hot spot areas of RSB were observed in Gambela, Addis Ababa and Dire Dawa. The primary and secondary SaTScan clusters were detected in Addis Ababa (RR = 3.26, LLR = 111.59, P<0.01), and almost the entire Gambela (RR = 2.95, LLR = 56.45, P<0.01) respectively. Age, literacy level, smoking status, ever heard of HIV/AIDS, residence and region were found to be significant predictors of RSB. Conclusion: In this study, spatial clustering of risky sexual behaviour was observed in Ethiopia, and hot spot clusters were detected in Addis Ababa, Dire Dawa and Gambela regions. Therefore, interventions which can mitigate RSB should be designed and implemented in the identified hot spot areas of Ethiopia. Interventions targeting the identified factors could be helpful in controlling the problem. [ABSTRACT FROM AUTHOR]

Background: Violence against women, particularly intimate partner violence, is a significant Concern for public health as well as a violation of the human rights of women especially in low and middle-income countries. However, there was limited evidence how soon an ever-married women experience intimate partner violence in Africa. Therefore, this study aimed to investigate the timing of first intimate partner violence (FIPV) among ever-married women in 30 SSA countries and to identify the risk factors of the timing. Methods: The present study has utilized 125,731 weighted samples, who participated in the domestic violence module of the survey from Demographic and Health Surveys of 30 SSA countries. The Gompertz gamma shared frailty model was fitted to determine the predictors. For model evaluation, the theta value, Akaike Information Criteria (AIC), Bayesian Information Criteria (BIC), and deviance were used. The Adjusted Hazard Ratio (AHR) with a 95% Confidence Interval (CI) was reported in the multivariable Gompertz gamma shared frailty model to highlight the strength and statistical significance of the associations. Result: One-third (31.02%) of ever-married women had reported experiencing IPV. The overall incidence rate of FIPV was 57.68 persons per 1000 person-years (95% CI = 50.61–65.76). Age at marriage, age difference, educational status, employment, residence, women's decision-making autonomy, husband who drink alcohol and wealth status were significantly associated with the timing of FIPV. Conclusion: The findings show that ever-married women are at high and increasing risk of violence. Thus, we recommend establishing effective health and legal response services for IPV, strengthening laws governing the sale and purchase of alcohol, empowering women, raising the educational attainment of women, and putting policies in place to combat the culture of societal tolerance for IPV all contribute to the empowerment of women. [ABSTRACT FROM AUTHOR]

Introduction: Polio eradication is a current and common strategy throughout the globe. The study of the newly introduced inactivated poliovirus vaccine provides a grasp on the current status of immunization and identifies any disparities in the implementation of the vaccine throughout Ethiopia. Thus, this study aimed to demonstrate the spatial distribution, coverage, and determinants of inactivated poliovirus vaccine immunization in Ethiopia. Method: Spatial distribution and determinants of inactivated poliovirus vaccine immunization in Ethiopia were conducted using Ethiopian mini-demographic and health survey 2019 data. A total of 2,056 weighted children aged 12 to 35 months were included in the analysis. The association between the outcome and explanatory variables was determined by commuting the adjusted odds ratio at a 95% confidence interval. The p-value of less than 0.05 was used to declare factors as significantly associated with the inactivated poliovirus vaccine immunization. Result: The weighted national coverage of inactivated poliovirus vaccine immunization in Ethiopia was 51.58% at a 95% confidence interval (49.42, 53.74). While the rates of inactivated poliovirus vaccine immunization were observed to be greater in Addis Ababa, Tigiray, Amahara, and Benishangul Gumuz provinces and lower in the Somali, Afar, and SNNPR provinces of Ethiopia, Antenatal care follow-up, place of delivery, place of residence, and region were significantly associated with inactivated poliovirus immunization in Ethiopia. Conclusion: The distribution of inactivated poliovirus immunization was spatially variable across Ethiopia. Only about half of the children aged twelve to thirty-five months received the inactivated poliovirus vaccine in the country. The factors, both at the individual and community level, were significantly associated with inactivated poliovirus immunization. Therefore, policies and strategies could benefit from considering antenatal care follow-up, place of delivery, place of residence, and region while implementing inactivated poliovirus vaccine immunization. [ABSTRACT FROM AUTHOR]

Background: Chewing fresh leaves of Catha edulis (khat) is a popular pastime activity among Ethiopians where 12% women chew it. Reports show that khat use has been associated with poor nutritional status. This study aimed to determine whether khat chewing is linked to underweight and anemia. Method: We analyzed data from the 2016 Ethiopian Demographic and Health Survey (EDHS). The EDHS used two stage stratified cluster sampling to collected data from 16,650 households. We used data from a total of 15,683 respondents and 1904 respondents who chewed ever chewed khat in their lives. We used Pearson's chi-square, and logistic regression while stratifying by residence (urban vs rural) to control for confounders. Result: Our results indicated 10.7% (95%CI: 10.92,11.26) of women chewed khat for an average of 16.5 days in the previous month. A woman's current khat chewing status was significantly associated with age, educational level, region, religion, wealth group, and marital status. Women aged 40–44 were significantly more likely to chew (AOR = 2.89,) compared to those aged 15–19. Compared with Protestant women, Muslim women were 210 times more likely (AOR = 210, 95% CI 102,435.7) to chew and women in the poorest wealth quintile had 73% higher odds (AOR = 1.73, 95% CI 1.22,2.44) of chewing khat when compared with the richest. Anemia was not associated with a woman's chewing status, whereas rural women who chewed khat for more than 26 days in a month had a 78% increased risk (OR = 1.78) of being underweight when compared to non-chewers. Conclusion: Khat chewing is associated with sociodemographic factors and current khat use is associated with a higher risk of underweight among women living in rural areas. Implementing targeted awareness campaigns for women about the risks of khat chewing is recommended. [ABSTRACT FROM AUTHOR]

Background: Malaria poses a substantial public health threat in Myanmar, indicating the need for rigorous efforts to achieve elimination of the disease nationwide by 2030. The use of insecticide-treated nets (ITNs) forms part of a pivotal strategy for preventing transmission. This study explored the ownership and use of ITNs in Myanmar and identified factors associated with non-use of ITNs. Methods: Household datasets from the 2015–2016 Myanmar Demographic and Health Survey were utilised, which encompassed all household members except children under the age of five. Descriptive statistics and inferential tests, including simple and multiple logistics regression models and Pearson correlations, were employed for analysis. All analyses, taking the two-stage stratified cluster sampling design into account, used weighting factors and the "svyset" command in STATA. The ownership and use of bed nets were also visualised in QGIS maps. Results: Among the 46,507 participants, 22.3% (95% CI 20.0%, 24.5%) had access to ITNs, with only 15.3% (95% CI 13.7, 17.1%) sleeping under an ITN the night before the survey. Factors associated with the non-use of ITNs included age category (15–34 years—aOR: 1.17, 95% CI 1.01, 1.30; 50+ years—aOR: 1.19, 95% CI 1.06, 1.33), location (delta or lowland—aOR: 5.39, 95% CI 3.94, 7.38; hills—aOR: 1.80, 95% CI 1.20, 2.71; plains—aOR: 3.89, 95% CI 2.51, 6.03), urban residency (aOR: 1.63, 95% CI 1.22, 2.17), and wealth quintile (third—aOR: 1.38, 95% CI 1.08, 1.75; fourth—aOR: 1.65, 95% CI 1.23, 2.23; fifth—aOR: 1.47, 95% CI 1.02, 2.13). A coherent distribution of the ownership and use of ITNs was seen across all states/regions, and a strong correlation existed between the ownership and use of ITNs (r: 0.9795, 95% CI 0.9377, 0.9933, alpha < 0.001). Conclusions: This study identified relatively low percentages of ITN ownership and use, indicating the need to increase the distribution of ITNs to achieve the target of at least one ITN per every two people. Strengthening the use of ITNs requires targeted health promotion interventions, especially among relatively affluent individuals residing in delta or lowland areas, hills, and plains. [ABSTRACT FROM AUTHOR]

Introduction: Maternal and neonatal health are among the top prioritised agendas of global health care with due emphasis given to developing countries, where the burden is profound. Antenatal care accompanied by its recommended components is highly beneficial for both maternal health and birth outcome. Objective: The objective of this study was to identify the proportion of pregnant women who received adequate Antenatal care components and associated factors among Ethiopian women. Methods and materials: We used a nation-wide data from Mini Ethiopian Demographic and Health Survey (MEDHS) of 2019. All women of age 15–49 and who had at least one ANC visit, who were either permanent residents of the selected households or visitors who slept in the household the night before the survey, were eligible to be interviewed. Since we utilised multilevel logistic regression model, the STATA output had two components, the fixed effect and the random effect. In our model, the fixed effect part was displayed by odds ratio while the random effect was addressed by variance and intra-cluster correlation (ICC). Results: From the total women with at least one antenatal care (ANC) visit 55.41% (95% CI 53.60%, 57.20%) of them received adequate components of the care. In the final model after adjusting for the cluster and individual level variables, attending primary (AOR = 1.45; 95% CI: 1.15 to 1.84), secondary (AOR = 2.21; 95% CI: 1.51 to 3.24) and higher education (AOR = 2.42; 95% CI: 1.38 to 4.26) were significantly associated with higher odds of receiving adequate components of ANC. Similarly, wealth index of middle (AOR = 1.51; 95% CI: 1.06, 2.14), richer (AOR = 1.92; 95% CI: 1.32, 2.80), and richest (AOR = 3.86; 95% CI: 2.35, 6.33) compared to poorest index and having two or more ANC visits were significantly associated with receiving adequate components of ANC. On the other hand, being from Oromia region, from female headed household and protestant religion were negatively associated with receiving adequate components of ANC. Conclusion: The proportion of women who received adequate ANC component was much lower compared to the universal recommendation for every woman on ANC visit. Educational status, wealth index, number of ANC visit, region of residence and type of health facility were significantly associated with the odds of receiving adequate components of ANC. The government should pay attention to those without any formal education, encouraging pregnant women to receive the optimum number of ANC visits, and devising techniques to address those in poorest wealth index so that the proportion of adequate components of ANC will be increased. [ABSTRACT FROM AUTHOR]

Introduction: Utilization of modern contraceptives increases over time but it was still low and varies across ages among married youth woman. This study revealed the prevalence of modern contraceptives and its associated factors among younger and older married youth women. Methods: A cross-sectional study design was applied to the sample of EMDHS 2019. Multilevel logistic regressions were carried out using STATA version 16 to identify the individual and community-level factors of modern contraceptive utilization. Adjusted odds ratios with a 95% confidence interval and variables with a p-value < 0.05 were considered to be significant determinants of modern contraceptive utilization. Result: In the EMDHS 2019, a total of 3290 married women between ages 15 and 34 were included. Among these 1210 (36.7%) and 2080 (63%) women, they were age groups of 15–24 and 25–34 years, respectively. Modern contraceptive utilization among women aged 15–24 and 25–34 years was 54.23% and 52.6%, respectively. Injection is a commonly used modern contraceptive method. In this study, factors associated with modern contraceptive utilization among women aged 15–24 years include women who had primary education [AOR = 2.22; 95% CI: 1.02–4.83], who had three or more children in the household [AOR = 14.29; 95% CI: 1.61–126.25], Protestants [AOR = 0.29; 95% CI: 0.14–0.61], five to seven households [AOR = 0.34; 95% CI: 0.17–0.69], and region [AOR = 6.98; 95%:2.30–21.16]. On other hand, factors associated with modern contraceptive utilization among women aged 25–34 were women who had one or two under-five children in the household [AOR = 1.66; 95% CI: 1.03–2.68] and region [AOR = 3.54; 95%CI: 1.79–6.97]. Conclusions: More than 50% of participants used modern contraceptives in both age groups and, the associated factor of modern contraceptive utilization varied among this age group. Health managers and policymakers need to consider age group, region, educational status, religion, and fertility level in planning of family planning program. [ABSTRACT FROM AUTHOR]

Introduction: Existing research has shown that intimate partner violence (IPV) may hinder maternal access to healthcare services, thereby affecting maternal and child health. However, current studies have ignored whether emotional intimate partner violence (EV) could negatively affect maternal healthcare use. This study aims to evaluate the impact of invisible IPV on maternal healthcare utilization in Pakistan. Methods: We analyzed nationally representative data from the Pakistan Demographic and Health Survey database from 2012–2013 and 2017–2018. Exposure to physical intimate partner violence (PV) and EV was the primary predictor. Based on women's last birth records, outcomes included three binary variables indicating whether women had inadequate antenatal care (ANC) visits, non-institutional delivery, and lack of postnatal health check-ups. A logistic regression model was established on weighted samples. Results: Exposure to EV during pregnancy was significantly associated with having inadequate ANC visits (aOR = 2.16, 95% CI: 1.06 to 4.38, p = 0.033) and non-institutional delivery (aOR = 2.24, 95% CI: 1.41 to 3.57, p = 0.001). Lifetime exposure to EV was associated with increased risks of inadequate ANC visits (aOR = 1.48, 95% CI: 1.00 to 2.19, p = 0.049). Lifetime exposure to low-scale physical intimate partner violence (LSPV) (adjusted OR (aOR) = 1.73, 95% CI: 1.29 to 2.31, p < 0.001) was associated with increased risks of having no postnatal health check-ups. Conclusions: Pregnant women who experienced EV and LSPV are at greater risk of missing maternal healthcare, even if the violence occurred before pregnancy. Therefore, in countries with high levels of IPV, early screening for invisible violence needs to be integrated into policy development, and healthcare providers need to be trained to identify EV and LSPV. [ABSTRACT FROM AUTHOR]

Background: Intimate partner violence (IPV) is recognized as a main public health challenge, with serious consequences for women's physical, mental, sexual, and reproductive health. Despite its public health importance, most studies of IPV in Ethiopia mainly focused on individual characteristics and didn't identify how factors operating at different levels affect IPV. Thus, there is limited evidence regarding the hierarchical-level factors of IPV and the effect of individual and community-level determinants of IPV. The aim of this study is to assess the individual and community-level factors associated with violence against women among ever-married reproductive-age women in Ethiopia. Methods: A retrospective analysis of secondary data retrieved from the Ethiopia Demographic and Health Survey was conducted among reproductive age group women (15–49 years of age) who reported ever being married within the available data set for the domestic violence module. STATA 14 was used to conduct the analysis. A two-level mixed-effects logistic regression analysis was used to determine associations between IPV and individual- and community-level factors. IPV variability across the community was assessed using ICC and PCV. The model's fitness was assessed using the Akaike information criterion (AIC), the Bayesian information criterion (BIC), and the likelihood ratio test. Result: The life time prevalence of IPV in this study was 33% [95% CI: 30.74, 34.25]. Women's age 20–24 (AOR = 5.85, 95% CI: 201 3.10, 11.04), 25–29 age group (AOR = 6.41, 95% CI; 3.34, 12.32), 30–34 age group (AOR = 9.48, 95% CI: 4.71, 19.06), 35–39 age group (AOR = 9.88, 95% CI: 4.79, 20.39), 40–44 age group (AOR = 11.10, 95% CI: 5.16, 23.89), and 45–49, (AOR = 14.15, 95% CI: 6.01, 32.80), early marriage (AOR = 1.21, 95% CI: 1.08, 1.47), witnessing inter-parental violence during childhood (AOR = 2.80, 95% CI: 2.16, 3.96), having a lot of living children (AOR = 0.45, 95% CI: 0.26, 0.74), having a partner who drank alcohol (AOR = 3.00, 95% CI: 2.42–3.67), decision-making autonomy of the women (AOR = 0.77, 95% CI: 0.62, 0.97), Poor wealth index (AOR = 1.64, 95% CI: 1.23, 2.18), middle wealth index (AOR = 1.86, 95% CI: 1.36, 2.54) and exposure to media (AOR = 1.47, 95% CI: 1.06, 2.00) were all significantly associated with IPV. Conclusion and recommendation: This study showed that one-third of the women experienced IPV in their lifetime. The finding suggested that community based interventions and multi-sectorial collaborations are needed to reduce the IPV and its adverse consequences. [ABSTRACT FROM AUTHOR]

Objectives: Controlling population expansion and reducing unintended pregnancies through the use of modern contraceptives is a cost-effective strategy. In recent years, the rate of modern contraceptive use in Bangladesh has been declining. So, this study aimed to investigate the associated factors of the deterioration in modern contraceptive usage. Methods: This study used data from two successive Bangladesh Demographic and Health Surveys (2014 and 2017–18) and applied the Blinder-Oaxaca decomposition analysis to understand the drivers. A popular binary logistic regression model is fitted to determine the factors that influence the use of modern contraceptive methods over the years. Results: This study revealed that highly educated women were more likely to use modern contraception methods, and their use increased by 3 percent over the years. Factors such as women's working status, husband's education, number of living children, and fertility preference were found significantly associated with decreased usage of modern contraception methods over years. The result of the Blinder-Oaxaca (BO) decomposition analysis found a significant decrease between 2014 and 2018. Respondent's age, working status, husband's age, opinion on decision making, region, and media exposure were the most significant contributors to explaining the shift between 2014 and 2018. The two factors that contributed most to narrowing the difference between the two surveys were women's decision on own health (26%), and employment status (35%). Conclusions: The factors that influence modern contraceptive prevalence are important to know for policy implication purposes in Bangladesh. The findings indicate the need for further improvement of factors for balancing the usage of modern contraception methods. [ABSTRACT FROM AUTHOR]

We assess progress towards improved case management of childhood diarrhea in Nigeria over a period of targeted health systems reform from 2013 to 2018. Individual and community data from three Demographic and Health Survey rounds are leveraged in a geospatial model designed for stratified estimation by venue of treatment seeking and State. Our analysis reveals a highly regionalised health system undergoing rapid change. Nationally, there have been substantial increases in the proportion of children under 5 years old with diarrhea receiving the recommended oral rehydration therapy after seeking treatment at either a health clinic (0.57 [0.44–0.69; 95% CI] in 2008; 0.70 [0.54–0.83] in 2018) or chemist/pharmacy (0.28 [0.17–0.42] in 2008; 0.48 [0.31–0.64] in 2018). Yet State-level variations in venue attendance and performance by venue have conspired to hold the overall proportion receiving this potentially life-saving therapy (0.45 [0.35–0.55] in 2018) to well-below ideal coverage levels. High performing states that have demonstrated significant improvements include Kano, Jigawa and Borno, while under-performing states that have suffered declines in coverage include Kaduna and Taraba. The use of antibiotics is not recommended for mild cases of childhood diarrhea yet remains concerningly high nationally (0.27 [0.19–0.36] in 2018) with negligible variation between venues. Antibiotic use rates are particularly high in Enugu, Kaduna, Taraba, Kano, Niger and Kebbi, yet welcome reductions were identified in Jigawa, Adamawa and Osun. These results support the conclusions of previous studies and build the strength of evidence that urgent action is needed throughout the multi-tiered health system to improve the quality and equity of care for common childhood illnesses in Nigeria. [ABSTRACT FROM AUTHOR]

The World Health Organization as part of the goal of universal vaccination coverage by 2030 for all individuals. The global under-five mortality rate declined from 59% in 1990 to 38% in 2019, due to high immunization coverage. Despite the significant improvements in immunization coverage, about 20 million children were either unvaccinated or had incomplete immunization, making them more susceptible to mortality and morbidity. This study aimed to identify predictors of incomplete vaccination among children under-5 years in East Africa. An analysis of secondary data from six east African countries using Demographic and Health Survey dataset from 2016 to the recent 2021 was performed. A total weighted sample of 27,806 children aged (12–35) months was included in this study. Data were extracted using STATA version 17 statistical software and imported to a Jupyter notebook for further analysis. A supervised machine learning algorithm was implemented using different classification models. All analysis and calculations were performed using Python 3 programming language in Jupyter Notebook using imblearn, sklearn, XGBoost, and shap packages. XGBoost classifier demonstrated the best performance with accuracy (79.01%), recall (89.88%), F1-score (81.10%), precision (73.89%), and AUC 86%. Predictors of incomplete immunization are identified using XGBoost models with help of Shapely additive eXplanation. This study revealed that the number of living children during birth, antenatal care follow-up, maternal age, place of delivery, birth order, preceding birth interval and mothers' occupation were the top predicting factors of incomplete immunization. Thus, family planning programs should prioritize the number of living children during birth and the preceding birth interval by enhancing maternal education. In conclusion promoting institutional delivery and increasing the number of antenatal care follow-ups by more than fourfold is encouraged. [ABSTRACT FROM AUTHOR]

Background: Overweight and obesity are increasing at epidemic levels in all ages globally, but there is little nationally representative data on female adolescents in Nigeria. The focus on female adolescents is important because of the negative implications of overweight and obesity on their health and survival, and that of their unborn children. Aim: To estimate the prevalence and identify the determinants of overweight and obesity among female adolescents in Nigeria. Methods: Cross-sectional study using data from the Nigeria demographic and health survey, 2018. A total of 2,721 female adolescents aged 15–19 years were selected using cluster sampling technique. Overweight and obesity were determined using BMI-for-age reference values of World Health Organization and different explanatory variables at the individual, household and community levels were included. Binary logistic regression analysis was used to identify the determinants of overweight/obesity using five models. Results: The mean age of the respondents was 16.8 ± 1.4 years. The prevalence rate of overweight/obesity was 10.2%, but with a large variation in the geographical and socio-economic distribution. At the crude/unadjusted rate, nearly all the explanatory variables showed a statistically significant association with overweight and obesity, but at the full model which controlled for all the explanatory variables, only the household wealth index retained its statistically significant association, such that female adolescents who were from richer and richest households had about 3 times higher odds of being obese compared to those from the poorest households. (OR: 2.7; p = 0.018; CI: 1.18–6.18), (OR: 2.8; p = 0.027; CI: 1.13–7.06) respectively. Conclusion: The prevalence of overweight/obesity among female adolescents in Nigeria was 10.2%. The household wealth index remained the only factor with a statistically significant association with overweight and obesity after controlling for confounders. Efforts at addressing overweight and obesity among female adolescents in Nigeria should target those from the richer/richest households. [ABSTRACT FROM AUTHOR]

Background: The practice of female genital mutilation is associated with harmful social norms promoting violence against girls and women. Various studies have been conducted to examine the prevalence of female genital mutilation and its associated factors. However, there has been limited studies conducted to assess the association between female genital mutilation and markers of women's autonomy, such as their ability to negotiate for safer sex. In this study, we examined the association between female genital mutilation and women's ability to negotiate for safer sex in sub-Saharan Africa (SSA). Methods: We pooled data from the most recent Demographic and Health Surveys (DHS) conducted from 2010 to 2020. Data from a sample of 50,337 currently married and cohabiting women from eleven sub-Saharan African countries were included in the study. A multilevel binary logistic regression analysis was used to examine the association between female genital mutilation and women's ability to refuse sex and ask their partners to use condom. Adjusted odds ratios (aORs) with a 95% confidence interval (CI) were used to present the findings of the logistic regression analysis. Statistical significance was set at p<0.05. Results: Female genital mutilation was performed on 56.1% of women included in our study. The highest and lowest prevalence of female genital mutilation were found among women from Guinea (96.3%) and Togo (6.9%), respectively. We found that women who had undergone female genital mutilation were less likely to refuse sex from their partners (aOR = 0.91, 95% CI = 0.86, 0.96) and ask their partners to use condoms (aOR = 0.82, 95% CI = 0.78, 0.86) compared to those who had not undergone female genital mutilation. Conclusion: Female genital mutilation hinders women's ability to negotiate for safer sex. It is necessary to implement health education and promotion interventions (e.g., decision making skills) that assist women who have experienced female genital mutilation to negotiate for safer sex. These interventions are crucial to enhance sexual health outcomes for these women. Further, strict enforcement of policies and laws aimed at eradicating the practice of female genital mutilation are encouraged to help contribute to the improvement of women's reproductive health. [ABSTRACT FROM AUTHOR]

Background: Antenatal care (ANC) is essential health care and medical support provided to pregnant women, with the aim of promoting optimal health for both the mother and the developing baby. Pregnant women should initiate ANC within the first trimester of pregnancy to access a wide range of crucial services. Early initiation of ANC significantly reduces adverse pregnancy outcomes, yet many women in Sub-Saharan Africa delay its initiation. The aim of this study was to assess prevalence and determinants of delayed ANC initiation in Ethiopia. Methods: We conducted a secondary data analysis of the 2019 Ethiopian Mini Demographic and Health Survey (EMDHS). The study involved women of reproductive age who had given birth within the five years prior to the survey and had attended ANC for their most recent child. A total weighted sample of 2,895 pregnant women were included in the analysis. Due to the hierarchical nature of the data, we employed a multi-level logistic regression model to examine both individual and community level factors associated with delayed ANC initiation. The findings of the regressions were presented with odds ratios (OR), 95% confidence intervals (CI), and p-values. All the statistical analysis were performed using STATA—14 software. Results: This study showed that 62.3% (95% CI: 60.5, 64.1) of pregnant women in Ethiopia delayed ANC initiation. Participants, on average, began their ANC at 4 months gestational age. Women with no education (AOR = 2.1; 95% CI: 1.4, 3.0), poorest wealth status (AOR = 1.9; 95% CI: 1.3, 2.8), from the Southern Nations, Nationalities, and Peoples (SNNP) region (AOR = 2.1; 95% CI: 1.3, 3.3), and those who gave birth at home (AOR = 1.4; 95% CI: 1.1, 1.7) were more likely to delay ANC initiation. Conclusions: The prevalence of delayed ANC initiation in Ethiopia was high. Enhancing mothers' education, empowering them through economic initiatives, improving their health-seeking behavior towards facility delivery, and universally reinforcing standardized ANC, along with collaborating with the existing local community structure to disseminate health information, are recommended measures to reduce delayed ANC initiation. [ABSTRACT FROM AUTHOR]

Introduction: Emergency caesarean delivery is a surgical procedure that is decided after the labour pain has started. According to the global report of the World Health Organization, the rate of caesarean sections has risen over time. In Ethiopia, the overall caesarean delivery was 18%, which varied between 46% in the private sector and 15% in the public sector. But specifically, the magnitude of emergency caesarean delivery and its predictors are not well addressed in Ethiopia. Therefore, this study was aimed at assessing the prevalence and predictors of emergency caesarean delivery in Ethiopia using EDHS 2016. Method: A cross-sectional study was used, and a total of 11,022 samples were included in this study. The Ethiopian Demographic Health Survey 2016 data set was used as a data source. The STATA version 17 software was used for descriptive, bi-variable, and multivariable analysis. Multilevel binary logistic regression was used to identify the significant factors at a p-value of <0.05 and a 95% confidence level. Model comparison and goodness of fit was assessed by AIC. Results: The prevalence of emergency caesarean deliveries in Ethiopia was 1.2% (95% CI: 0.58, 1.78). History of fistula (AOR = 7.82, 95% CI: 1.59–38.4), age ≥ 35 years (AOR = 6.98, 95% CI: 3.33–14.63), and rural residence (AOR = 2.23, 95% CI: 1.25–3.21) were the predictors of emergency caesarean delivery. Conclusion: As compared to the previous study, the prevalence of emergency caesarean delivery was low. Women with a history of fistula, from rural residence, and age≥ 35 years were at risk for emergency caesarean delivery. Therefore, interventions need to be encouraged to give attention to rural women whose age is ≥ 35 years and fistula reduction activities, such as avoiding early marriage, to reverse the problem. Early and accurate screening of women for emergency cesarean delivery by encouraging co-services like ANC is also recommended. [ABSTRACT FROM AUTHOR]

The northern giant hornet Vespa mandarinia (NGH) is a voracious predator of other insect species, including honey bees. NGH's native range spans subtropical and temperate regions across much of east and southeast Asia and, in 2019, exotic populations of the species were discovered in North America. Despite this broad range and invasive potential, investigation of the population genomic structure of NGH across its native and introduced ranges has thus far been limited to a small number of mitochondrial samples. Here, we present analyses of genomic data from NGH individuals collected across the species' native range and from exotic individuals collected in North America. We provide the first survey of whole-genome population variation for any hornet species, covering this species' native and invasive ranges, and in doing so confirm likely origins in Japan and South Korea for the two introductions. We additionally show that, while this introduced population exhibited strongly elevated levels of inbreeding, these signatures of inbreeding are also present in some long-standing native populations, which may indicate that inbreeding depression alone is insufficient to prevent the persistence of NGH populations. As well as highlighting the importance of ongoing monitoring and eradication efforts to limit the spread of this species outside of its natural range, our data will serve as a foundational database for future genomic studies into introduced hornet populations. [ABSTRACT FROM AUTHOR]

Background: Diarrhea poses a significant threat to the lives of children in The Gambia, accounting for approximately 9% of all deaths among children under the age of five. Addressing and reducing child mortality from diarrhea diseases is crucial for achieving the Sustainable Development Goal (SDG) 3, specifically target 3.2, which aims to eliminate preventable deaths in newborns and children under the age of five by 2030. Thus, this research aims to assess the prevalence and contextual factors associated with diarrhea among under-five children in The Gambia. Methods: This research employed secondary data from the 2019/20 Gambia Demographic Health Survey (GDHS). The study initially involved 8,362 women aged between 15 and 49 years. Of these, 6,929 women with children under five were included in this analysis. Data were analyzed using STATA with cross-tabulation and model fitting. Multilevel logistic regression was applied to accommodate the hierarchical structure of the demographic health survey data. The model comparison parameters were BIC, AIC, deviance, and LLR. Variables with a p-value less than 0.05 were selected for multivariable analysis. The statistical significance of the factors was determined using an adjusted odds ratio with a 95% confidence interval (CI) and a p-value of less than 0.05. Results: The prevalence of diarrhea in under-five children was 53.2% in males and 46.8% in females. In the final model, Kerewan (aOR = 0.58; 95% CI = 0.33–0.98) and Basse (aOR = 0.59; 95% CI = 0.35–0.98) have significantly lower odds of childhood diarrhea compared to Banjul, female children show slightly lower, yet significant, odds of diarrhea compared to males (aOR = 0.96; 95% CI = 0.86–0.98), deliveries at government health centers are associated with higher odds of childhood diarrhea compared to home births (aOR = 1.24; 95% CI = 1.01–1.52). Mothers with post-secondary education had significantly lower odds of having children with diarrhea than those without any education (aOR = 0.50; 95% CI = 0.26–0.99) after controlling for confounders. Conclusion: The study findings indicate that several factors significantly impact the risk of childhood diarrhea in The Gambia. These factors include region of residence, sex of the child, place of delivery, and education level of the mother. The study suggests that existing interventions aimed at improving child health outcomes in the country should take into consideration these influential factors. Addressing these modifiable factors can enhance the effectiveness of interventions and promote better health outcomes for children in Gambia. [ABSTRACT FROM AUTHOR]

Background: Stunting poses a significant health risk to adolescent girls aged 15–19 in low- and middle-income countries, leading to lower education levels, reduced productivity, increased disease vulnerability, and intergenerational malnutrition. Despite the inclusion of adolescent nutrition services in the Sustainable Development Goals, little progress has been made in addressing malnutrition among adolescent girls in several African nations. Limited evidence exists in East Africa due to small sample sizes and methodological limitations. To overcome these constraints, this study utilizes the latest Demographic and Health Survey data to estimate the prevalence and factors influencing stunting among late adolescent girls in ten East African countries. Methods: This study utilized the most recent Demographic and Health Survey (DHS) data from 10 East African countries, including a total sample weight of 22,504 late-adolescent girls. A multilevel mixed-effect binary logistic regression model with cluster-level random effects was employed to identify factors associated with stunting among these girls. The odds ratio, along with the 95% confidence interval, was calculated to determine individual and community-level factors related to stunting. A p-value less than 0.05 was considered statistically significant in determining the factors influencing stunting among late-adolescent girls. Results: The prevalence of stunting among late adolescent girls in East Africa was found to be 13.90% (95% CI: 0.13–0.14). Religion, relationship to the head, presence of under-five children in the household, lactating adolescent, marital status, Time to get water source, and country of residence were significantly associated with Stunting. Conclusion: This study highlights the complexity of stunting in East Africa and identifies key factors that need attention to reduce its prevalence. Interventions should focus on improving water access, supporting lactating girls, addressing socioeconomic disparities, promoting optimal care practices, and implementing country-specific interventions to combat stunting and improve adolescent girls' nutrition. [ABSTRACT FROM AUTHOR]

Background: The maternal continuum of care (CoC) is a cost-effective approach to mitigate preventable maternal and neonatal deaths. Women in developing countries, including Tanzania, face an increased vulnerability to significant dropout rates from maternal CoC, and addressing dropout from the continuum remains a persistent public health challenge. Method: This study used the 2022 Tanzania Demographic and Health Survey (TDHS). A total weighted sample of 5,172 women who gave birth in the past 5 years and had first antenatal care (ANC) were included in this study. Multilevel binary logistic regression analyses were used to examine factors associated with dropout from the 3 components of maternal CoC (i.e., ANC, institutional delivery, and postnatal care (PNC)). Results: The vast majority, 83.86% (95% confidence interval (CI): 82.83%, 84.83%), of women reported dropout from the maternal CoC. The odds of dropout from the CoC was 36% (AOR = 0.64, (95% CI: 0.41, 0.98)) lower among married women compared to their divorced counterparts. Women who belonged to the richer wealth index reported a 39% (AOR = 0.61, (95% CI: 0.39, 0.95)) reduction in the odds of dropout, while those belonged to the richest wealth index demonstrated a 49% (AOR = 0.51, (95% CI: 0.31, 0.82)) reduction. The odds of dropout from CoC was 37% (AOR = 0.63, (95% CI: 0.45,0.87)) lower among women who reported the use of internet in the past 12 months compared to those who had no prior exposure to the internet. Geographical location emerged as a significant factor, with women residing in the Northern region and Southern Highland Zone, respectively, experiencing a 44% (AOR = 0.56, 95% CI: 0.35–0.89) and 58% (AOR = 0.42, 95% CI: 0.26–0.68) lower odds of dropout compared to their counterparts in the central zone. Conclusion: The dropout rate from the maternity CoC in Tanzania was high. The findings contribute to our understanding of the complex dynamics surrounding maternity care continuity and underscore the need for targeted interventions, considering factors such as marital status, socioeconomic status, internet usage, and geographical location. [ABSTRACT FROM AUTHOR]

Background: Diarrhea is the second leading cause of under-five deaths claiming half a million children every year. Most of these deaths occurred in sub-Saharan Africa and South Asia. Oral rehydration solution (ORS) has been described as the most effective treatment of diarrhea. However, only 36% of children with diarrhea received ORS in sub-Saharan Africa. This study examined the factors associated with ORS use for children with diarrhea in the sub-region. Methods: Demographic and Health Surveys (DHS) data sets of 31 countries in sub-Saharan Africa were used in this study. The data involved 30,102 under-five children with diarrhea. The multivariable analysis involved binary logistic regression. Results: Prevalence of ORS use was 38% in sub-Saharan Africa with countries such as Namibia (71.8%), Zambia (66.4%) and Malawi (63.8%) having the highest rates. Use of ORS was most common among children whose mothers had secondary or higher education (45%), were exposed to media (41%) and attended antenatal care (41%). ORS use was significantly associated with secondary or higher education (OR = 1.63; 95%CI: [1.47–1.81]; p<0.001), exposure to media (OR = 1.17; 95%CI: [1.07–1.27]; p<0.001), antenatal care attendance (OR = 2.33; 95%CI: [1.08–1.27]; p<0.001), child's age (OR = 1.46; 95%CI: [1.35–1.59]; p<0.001), child's size at birth (OR = 1.08; 95%CI: [1.00–1.17]; p<0.05), household size (OR = 1.28; 95%CI:[1.06–1.54]; p<0.05) and source of drinking water (OR = 1.18; 95%CI: [1.09–1.29]; p<0.001). Conclusion: This study revealed a 38% prevalence of ORS use during diarrhea episodes in sub-Saharan Africa. This is low as it is less than the 44% recorded for developing countries as a whole. While this study emphasises the need for a further study on effects of severity of diarrhea on ORS use and factors determining differences in ORS use among countries, it also calls for interventions that will increase use of ORS is sub-Saharan Africa. Such interventions should include increase in literacy rate among girls and women, increase in the proportion of women with access to media, involvement of health workers in programmes that would promote antenatal care utilization among women at community level and provision of social amenities like pipe-borne water. [ABSTRACT FROM AUTHOR]

Objective. To estimate the prevalence and factors related to heavy drinking in men and women from Honduras. Materials and methods. Data from the 2019 National Demographic and Health Survey were used, and multiple regression models were applied to determine associated factors. Results. 2.8% of men and 0.7% of women incurred in heavy drinking. In men, factors such as age, urban living, having children but not living with them, being people who smoke, and physical assault experiences were associated with a higher likelihood of heavy drinking. For women, higher education levels, urban living, previous marriage or cohabitation, wealth quintile, being people who smoke, and physical assault experiences were linked to a higher prevalence of heavy drinking. Conclusions. The findings provide insight into the issue of excessive alcohol consumption in Honduras and how various experiential, demographic, and health factors may influence its occurrence. [ABSTRACT FROM AUTHOR]

Background and purpose: Knee joint disorders are divided into two general categories of traumatic and non-traumatic injuries, including skeletal deformities such as genu valgum (knocked knee) and genu varum (bowed legs). Genu valgum and genu varum are two of the most common deformities of the knee joint. These deformities can directly affect the quality of people's social lives. Considering the importance of determining its rate in the youth community, this study aims to determine the relationship between genu valgum and genu varum with anthropometric indices in elementary school students of Dezful City in 2022. Materials and methods: The current research was cross-sectional-analytical, which was conducted in 2022 at the level of elementary schools in Dezful City on 400 students of girls' and boys' schools between 7 and 11 years old. Patient demographic information, including age, gender, height, weight, family history, and hip joint width, was gathered using a questionnaire. To evaluate the deformation of the lower limb, the participants must stand in a way that the knee is in full extension and the ankles of both legs should be close together so that the patella bones on both sides are facing forward. In this position, deformation of the knee joint (genu valgum and genu varum) was determined by measuring the distances between the medial condyles of the femur and the medial malleolus of the ankle, and its relationship with demographic information was evaluated. Results: The frequency distribution showed that 2.5% of the studied subjects had genu valgum, and 11.5% of them did not have genu varum. These results showed the existence of skeletal disorders in knee joints at the rate of 14% in the studied population. Also, the results of this study showed that only 2.2% of the studied population had a family history of musculoskeletal disorders such as genu valgum and genu varum, and 97.5% of them had no family history, which indicated the absence of a significant relationship between the occurrence of disorders and family history (P=0.187). Results showed that there was a significant relationship between the average age and the observation of genu varum and genu valgum disorder (P<0.001). Also, a significant relationship was observed between height and weight and genu varum and genu valgum (P=0.001). It is noteworthy that a significant relationship was observed between the width of the hip joint with these abnormalities (P<0.05). Conclusion: Although the rate of disorders in the sample population was not very impressive, investigations in this study have confirmed a significant relationship between demographic indicators and knee joint disorders. The existence of a relationship between height, weight, age, and other important anatomical indicators, such as the distance between the hip joint and genu varum and genu valgum, probably indicates the increasing trend of observing these disorders in society with growth and changes in the skeletal framework, which requires further evaluation. The findings of this research can be utilized by health policy institutions to mitigate the prevalence of this condition, particularly among the younger population, through implementing suitable plans and strategies. [ABSTRACT FROM AUTHOR]

Background and purpose: An unintended pregnancy denotes a conception that occurs without prior planning or intention by the couple involved. The repercussions of such pregnancies can be substantial for both the mother and the child, potentially resulting in inadvertent neglect of fetal health and influencing the quality of caregiving behaviors. These factors may contribute to adverse outcomes, such as low birth weight. This research aims to assess the impact of unintended pregnancy on newborn anthropometric parameters within the marginal neighborhoods of Bandar Abbas. Materials and methods: This study is a component of a prospective cohort project involving pregnant women residing in marginalized areas of Bandar Abbas City in 2015. A total of 1351 participants were enrolled in the cohort project, with 825 individuals included in this investigation. Among these, 132 were categorized into the exposure group representing unintended pregnancies, while 693 comprised the non-exposure (control) group, based on the proportion of unintended pregnancies in the original dataset. Our study delineates the associations between birth weight, height, head circumference, and the primary exposure variable of maternal unintended pregnancy. Data collection on unintended pregnancy and potential confounding factors was conducted through questionnaires and face-to-face interviews during the initial cohort visit, coinciding with the women's pregnancies. Confounding variables pertinent to each outcome were rigorously evaluated utilizing a causal analysis approach, facilitated by the dagitty software, with data management performed using SPSS version 24. Univariate analysis involved the utilization of Pearson's correlation coefficient, independent t-tests, and one-way analysis of variance to explore the relationships between anthropometric indices and individual characteristics. Meanwhile, multivariate analysis entailed the application of multiple linear regression techniques. Results: Among the total of 1351 pregnancies investigated, 219 (16.2%) were identified as unintended. The mean age of mothers experiencing unintended pregnancies was 29.23±6.49 years, compared to 26.98±5.31 years for those with intended pregnancies. For unintended pregnancies, the mean and standard deviation of birth weight, height, and head circumference were calculated as 3059.24±501.11 grams, 48.52±3.11 cm, and 33.80±2.22 cm, respectively. Conversely, for intended pregnancies, these measures were 3080±17.17 grams, 48.63±2.65 cm, and 33.82±1.92 cm, respectively. Statistically significant positive correlations were observed between birth weight and maternal age (P=0.041, r=0.056), paternal age (P=0.008, r=0.073), and maternal BMI (P<0.001, r=0.159). Additionally, Statistically significant positive correlations were noted between maternal BMI and infant height (P=0.022, r=0.062), as well as birth head circumference (P<0.001, r=0.102). Multiple linear regression analysis revealed no evidence of an association between unintended pregnancy and birth weight (95% CI: -91.3 to 58.3, b= -16.5), height (95% CI: - 0.47 to 47.0, b= 0.01), or head circumference (95% CI: -0.32 to 0.34, b= 0.01). Conclusion: Our findings suggest a lack of substantial evidence supporting a correlation between unintended pregnancy and covariates including low birth weight, short height, and low head circumference. The outcomes of research in this domain exhibit inconsistencies, potentially attributed to variations in study design, methodologies for confounding variable management, demographic disparities among study populations, and other pertinent factors. [ABSTRACT FROM AUTHOR]

Purpose: The study's objective is to measure the gender gap in quit behavior, consider whether it has changed over time and determine whether parenthood affects the gender gap in quit decisions. Design/methodology/approach: The quantitative study design leverages two separate USA data sources to analyze the gender gap in quits over time. Two separate cohorts confirm the study's results in Logit, ordinary least squares (OLS) and fixed effects estimations, using the Current Population Survey (CPS) and the National Longitudinal Survey of Youth (NLSY). Findings: After controlling for demographic and job characteristics, individual and geographic fixed effects and local unemployment rates, the study finds that the gender gap in voluntary turnover has declined over time and that parenthood's effect on quit behavior has converged between genders. Originality/value: Women earn less than men. One common explanation is women's propensity to interrupt their careers, often voluntarily, more so than men. Yet, the determinants and trends of this gender gap in quit behavior has not been given much attention in the literature, including the role of parenthood. [ABSTRACT FROM AUTHOR]

Discrimination is associated with numerous psychological health outcomes over the life course. The nine-item Everyday Discrimination Scale (EDS) is one of the most widely used measures of discrimination; however, this nine-item measure may not be feasible in large-scale population health surveys where a shortened discrimination measure would be advantageous. The current study examined the construct validity of a combined two-item discrimination measure adapted from the EDS by Add Health (N = 14,839) as compared to the full nine-item EDS and a two-item EDS scale (parallel to the adapted combined measure) used in the National Survey of American Life (NSAL; N = 1,111) and National Latino and Asian American Study (NLAAS) studies (N = 1,055). Results identified convergence among the EDS scales, with high item-total correlations, convergent validity, and criterion validity for psychological outcomes, thus providing evidence for the construct validity of the two-item combined scale. Taken together, the findings provide support for using this reduced scale in studies where the full EDS scale is not available. [ABSTRACT FROM AUTHOR]

Demographic changes continue to challenge educators across the United States. Currently, five million English language learners (ELL) attend the country's public schools, and immigrant populations are expected to increase by 85% by 2060. Despite teacher education programmes offering English for Speakers of Other Languages (ESOL) courses to prepare pre-service teachers to attend to the high demand of immigrant children, these courses often do not prepare them to be culturally competent. A longitudinal qualitative case study was applied to investigate pre-service teachers' perceptions of teaching immigrant children during one academic semester through cultural competence lenses. The case was an upper-level undergraduate Foundations of ESOL course in a Southwest Florida public university. After the aggregated data was organised and coded, three themes emerged, indicating that the participants developed three competencies during the academic semester: (1) Self-awareness allowed them to see themselves through the experiences of immigrant students; (2) Compassionate competence emerged from the significant impact that understanding immigrants' lives and struggles had on the participants' perceptions of teaching immigrants; and (3) Culturally responsive awareness revealed the participants' understanding of the importance of becoming culturally responsive in their future classrooms. Implications are discussed, and recommendations are offered based on the study's findings. [ABSTRACT FROM AUTHOR]

Objective: This study seeks to examine the impact of war on maternal mortality following an exacerbation in the dynamics of inequality in maternal health caused by the continuing conflict. Design: Community‐based cross‐sectional study. Setting: Tigray region of Northern Ethiopia, between November 2020 and May 2022. Population: This study surveyed a total of 189 087 households from six of the seven zones of Tigray in 121 tabiyas from 31 districts selected. A multistage cluster sampling technique was used to select the districts and tabiyas. Methods: The study was conducted in two phases. In the first phase, reproductive‐age deaths that occurred during the study period were screened. In the second phase, verbal autopsies were conducted at the screened households. Main Outcome Measures: Maternal mortality ratio level and cause‐specific mortality. Results: The results of the study showed that the maternal mortality ratio was 840 (95% CI 739–914) per 100 000 live births. Haemorrhage, 107 (42.8%), pregnancy‐induced hypertension, 21 (8.4%), and accidents, 14 (5.6%), were the main causes of mortality. Additionally, 203 (81.2%) of the mothers died outside of a health facility. Conclusions: This study has shown a higher maternal mortality ratio following the dynamics of the Tigray war, as compared with the pre‐war level of 186/100 000. Furthermore, potentially many of the pregnancy‐related deaths could have been prevented with access to preventive and emergency services. Given the destruction and looting of many facilities, the restoration and improvement of the Tigray health system must take precedence. [ABSTRACT FROM AUTHOR]